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How to Prescribe

Listen and look to diagnose Demodex blepharitis (DB)

Don't let DB turn into a problem -- check for signs and symptoms

in EVERY patient during routine eye exams

DB can complicate eye health, and it starts in the eyelid.

The eyelids and lashes are essential components of ocular health.1,2

They provide a protected and hydrated environment for the ocular surface.1,2

Demodex mites can compromise the eyelid and have serious consequences.3,4

Any amount of collarettes indicates an infestation of Demodex mites.3,5

Here are a few steps to follow before you treat with XDEMVY

LISTEN to how patients
describe their symptoms

LOOK down during a
slit lamp exam5

DIAGNOSE DB at the
first sign of collarettes3,5

of patients with collarettes have Demodex mites6

Collarettes are cylindrical, waxy deposits of mite waste products, keratinized cells, and eggs found at the base of the eyelashes.3

Listen to how patients describe their symptoms

Here are some questions to get them talking:

  1. Are you noticeably aware of your eyes during the day?
  2. Did you spend time ahead of our exam to clean your eyelashes?
  3. What about your eyelids at night — any itching, tickling, or “something crawling” sensations?
  4. First thing in the morning, do you notice any flaking, crusts, or sleevelike buildup you need to wipe away on your lashes or lids?
  5. Have you noticed any lash loss, lash breaking, or lashes growing in odd directions?

If your patients complain about any of the following symptoms, it may be DB3:

  • Erythema (redness on the eyelid margin)
  • Missing or misdirected eyelashes
  • Itchy eyes
  • Dry eyes
  • Swollen eyelids
  • Foreign body sensation

To find collarettes, have your patients look down!5

For a clear view of lashes, make sure the patient is looking down, not forward

Real patient with DB.
IMAGE CREDIT: Cory Lappin, OD

Magnification used to

visualize collarettes fully.

Keep an eye out for collarettes
  • Collarettes are the pathognomonic sign of DB3,5
  • Have patients look down during a routine slit lamp examination5
  • If you see collarettes, then you can confidently diagnose DB6
Delivering the diagnosis

It’s important to assure patients that DB is:

  1. Easy to effectively treat7
  2. Very common and not their fault — it does not imply poor hygiene5,8,9
  3. Caused by an overgrowth of microscopic mites that can damage your eyelids3,5,6

Some patients may experience a return of DB after treatment (~50% of patients saw a recurrence over time*).10 Including a refill gives them the option to act early should signs and symptoms (ie, collarettes, redness, itchiness etc) reappear within a year.

*Based on an extrapolation of the percentages at Days 43 and 365 among patients who completed treatment in the XDEMVY group of the Extension Safety Study, approximately 50% of patients who achieved a reduction to ≤2 collarettes at Day 43 may have recurrence at Day 365.

See how physicians deliver the DB diagnosis to their patients

Mitchell Shultz, MD
Hardeep Kataria, OD, FAAO
Janelle Davison, OD
Damon Dierker, OD
Nate Lighthizer, OD
Selina McGee, OD
Pam Theriot, OD

Demodex blepharitis

Seeing the root of the problem

About XDEMVY

The first and only FDA-approved

treatment for DB

References: 1. Carter SR. Eyelid disorders: diagnosis and management. Am Fam Physician. 1998;57(11):2695-2702. 2. Aumond S, Bitton E. The eyelash follicle features and anomalies: a review. J Optom. 2018;11(4):211-222. 3. Fromstein SR, Harthan JS, Patel J, Opitz DL. Demodex blepharitis: clinical perspectives. Clin Optom (Auckl). 2018;10:57-63. 4. Rhee MK, Yeu E, Barnett M, et al. Demodex blepharitis: a comprehensive review of the disease, current management, and emerging therapies. Eye Contact Lens. 2023;49(8):311-318. 5. Trattler W, Karpecki P, Rapoport Y, et al. The prevalence of Demodex blepharitis in US eye care clinic patients as determined by collarettes: a pathognomonic sign. Clin Ophthalmol. 2022;16:1153-1164. 6. Gao YY, Di Pascuale MA, Li W, et al. High prevalence of Demodex in eyelashes with cylindrical dandruff. Invest Ophthalmol Vis Sci. 2005;46(9):3089-3094. 7. XDEMVY [prescribing information]. Tarsus Pharmaceuticals, Inc; 2023. 8. O’Dell L, Dierker DS, Devries DK, et al. Psychosocial impact of Demodex blepharitis. Clin Ophthalmol. 2022;16:2979-2987. 9. Liu J, Sheha H, Tseng SCG. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010;10(5):505-510. 10. Sadri E, Paauw JD, Ciolino JB, et al. Long-term outcomes of 6-week treatment of lotilaner ophthalmic solution, 0.25%, for Demodex blepharitis: a noninterventional extension study. Cornea. 2024;43(11):1368-1374.

INDICATIONS AND USAGE
XDEMVY (lotilaner ophthalmic solution) 0.25% is indicated for the treatment of Demodex blepharitis.

IMPORTANT SAFETY INFORMATION:

WARNINGS AND PRECAUTIONS

Risk of Contamination: Do not allow the tip of the dispensing container to contact the eye, surrounding structures, fingers, or any other surface in order to minimize contamination of the solution. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions.

Use with Contact Lenses: XDEMVY contains potassium sorbate, which may discolor soft contact lenses. Contact lenses should be removed prior to instillation of XDEMVY and may be reinserted 15 minutes following its administration.

ADVERSE REACTIONS: The most common adverse reaction with XDEMVY was instillation site stinging and burning which was reported in 10% of patients. Other ocular adverse reactions reported in less than 2% of patients were chalazion/hordeolum and punctate keratitis.

To report SUSPECTED ADVERSE REACTIONS, contact Tarsus Pharmaceuticals, Inc. at 1-888-421-4002 or the FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

Please see full Prescribing Information.

Available by prescription only.

INDICATIONS AND USAGE
XDEMVY (lotilaner ophthalmic solution) 0.25% is indicated for the treatment of Demodex blepharitis.

IMPORTANT SAFETY INFORMATION:

WARNINGS AND PRECAUTIONS

Risk of Contamination: Do not allow the tip of the dispensing container to contact the eye, surrounding structures, fingers, or any other surface in order to minimize contamination of the solution. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions.