Comprehensive medication guide to Xdemvy including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for most insured patients with prior authorization; Xdemvy Savings Card may cover remaining copay.
Estimated Cash Pricing
$600–$2,034 for a full 6-week course without insurance; most patients pay around $1,850 retail.
Medfinder Findability Score
55/100
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Xdemvy (Lotilaner ophthalmic solution 0.25%) is the first and only FDA-approved prescription eye drop for the treatment of Demodex blepharitis — a common but often underdiagnosed condition caused by an overpopulation of Demodex mites living on the eyelids and eyelashes. Symptoms include itching, irritation, redness, crusty or flaky eyelids, and a gritty or burning sensation in the eyes. Xdemvy is manufactured by Tarsus Pharmaceuticals, Inc. and was approved by the FDA in 2023.
Xdemvy contains Lotilaner, an isoxazoline-class parasiticide that targets and kills Demodex mites. It works by inhibiting GABA-gated chloride channels specifically in the mites' nervous system, causing uncontrolled neural activity that paralyzes and eliminates them. Importantly, Lotilaner does not affect mammalian GABA receptors at therapeutic doses, making it safe for human use. The 6-week (42-day) treatment course is designed to cover at least , ensuring thorough eradication of both adult mites and newly hatched offspring.
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Ophthalmic solution 0.25% — ophthalmic
5 mL bottle
Ophthalmic solution 0.25% — ophthalmic
10 mL bottle (typically used for the full 6-week treatment course)
Xdemvy has a findability score of 55 out of 100, meaning it can be moderately difficult to locate. There is no active FDA shortage, but Xdemvy is a limited distribution drug (LDD) — it is only available through select specialty pharmacies like CVS Specialty and Walgreens Specialty. You will not find it at your regular retail pharmacy. Patients should expect the medication to be shipped directly to their home or picked up at a specialty pharmacy location. If your prescriber is unfamiliar with the ordering process, Tarsus Field Reimbursement Managers can help facilitate access.
Xdemvy is prescribed by eye care specialists, including:
If you suspect you have Demodex blepharitis (chronic eyelid irritation, crusty lashes, redness), schedule an appointment with your eye care provider. They can examine your eyelids under magnification to check for Demodex mites and determine if Xdemvy is right for you. Telehealth prescribing is generally not available for this medication, as an in-person eye exam is typically needed for diagnosis.
No. Xdemvy is not a controlled substance and is not scheduled by the DEA. It does not have abuse potential. However, it is only available through specialty pharmacies due to its limited distribution model, so a standard pharmacy cannot dispense it.
Less common side effects (occurring in fewer than 2% of patients) include:
Most side effects are mild and temporary. If you experience severe or persistent eye pain, vision changes, or worsening symptoms, contact your eye care provider promptly.
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Tea Tree Oil lid scrubs (Terpinen-4-ol)
Over-the-counter eyelid cleansers containing tea tree oil or its active component. Requires consistent daily use and is generally less effective than prescription treatment.
Ivermectin (oral or topical)
An anti-parasitic medication used off-label for Demodex. Available as oral tablets or topical cream applied to the eyelid area. Not FDA-approved for ocular Demodex.
BlephEx (microblepharoexfoliation)
An in-office procedure that mechanically removes Demodex mites, biofilm, and debris from the eyelid margin. May need to be repeated periodically.
Intense Pulsed Light (IPL) therapy
An in-office light-based treatment that can reduce Demodex populations and improve meibomian gland function. Often combined with other therapies.
Prefer Xdemvy? We can find it.
Contact lenses
moderateRemove contact lenses before instilling Xdemvy and wait at least 15 minutes before reinserting them.
Other eye drops
moderateIf you use other ophthalmic medications, wait at least 5 minutes between each drop to prevent dilution and ensure proper absorption.
Do not allow the dropper tip to touch your eye, eyelids, fingers, or any surface to avoid contamination.
moderateXdemvy represents a breakthrough for the estimated 25 million Americans affected by Demodex blepharitis — a condition that was previously managed with inconsistent off-label treatments. As the first FDA-approved prescription specifically targeting Demodex mites, it offers a defined 6-week treatment course with a clear mechanism of action. The biggest hurdle for most patients is access and cost: Xdemvy is only available through specialty pharmacies and can cost nearly $2,000 without insurance. The good news is that insurance coverage has expanded to over 85% of insured patients, and with the manufacturer savings card, many patients pay $30 or less out of pocket. If you've been struggling with chronic eyelid irritation and haven't been evaluated for Demodex, ask your eye doctor — effective treatment is now available.
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