Lotilaner ophthalmic solution
Anti-infective · Rx
Trade namesXdemvy
Drug classEctoparasiticide (isoxazoline), targets Demodex mites
Strength0.25% (2.5 mg/mL)
AvailabilityRx
Mechanism of actionIsoxazoline; blocks GABA- and glutamate-gated chloride channels in the mite nervous system, causing paralysis and death of Demodex folliculorum/brevis on the lash line.
Indication / reason for useDemodex blepharitis, confirmed by collarettes (cylindrical dandruff) on lash epilation. First and only FDA-approved drug that targets the mite directly rather than just the resulting inflammation.
Usual adult dosing1 drop in each eye twice daily (~12 h apart) for 6 weeks.
PreservativePreservative-free, single-patient multidose bottle , a preservative-free option exists
Contact lensesRemove contact lenses before instilling, contains potassium sorbate which may discolor soft lenses. Reinsert 15 min after.
Common / important adverse effectsStinging / burning on instillation (~10%, most common); less often blurred vision, eye irritation, or punctate keratitis.
Contraindications & cautionsNone significant.
Pregnancy / lactationNo human data; use only if clearly needed.
Practice notesApproved on SATURN-1/2 trial data (833 patients). Look for collarettes at the lash base to confirm Demodex before prescribing; lid hygiene (tea tree oil-based wipes/cleansers) is an off-label adjunct or alternative.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.