INVELTYS (loteprednol etabonate)

INVELTYS (loteprednol etabonate) 

SELF ADMINISTRATION - Ophthalmic

Indications for Prior Authorization:

• Indicated for the treatment of post-operative inflammation and pain following ocular surgery

Patients must meet the following criteria for the indication(s) above:

• Diagnosis of post-operative inflammatory pain confirmed by chart note documentation, AND
• Must try and fail 2 generic alternatives such as dexamethasone sodium phosphate ophthalmic solution 0.1%, fluorometholone ophthalmic suspension 0.1%, prednisolone acetate ophthalmic suspension 1%, Lotemax® ophthalmic suspension 0.5%, Lotemax® ophthalmic ointment 0.5%, Lotemax® ophthalmic gel 0.5%

Dosing:

• Instill one to two drops of Inveltys™ into the affected eye twice daily beginning the day after surgery and continuing throughout the first two weeks of the post-operative period

Approval: 

• 14 days
• Max 1 fill, 2 bottles