Is Xdemvy (lotilaner) a steroid?

No, Xdemvy (lotilaner) isn't a steroid medication, it's an antiparasitic. Unlike steroids, which reduce inflammation by calming the immune system, Xdemvy (lotilaner) works by targeting and killing Demodex mites, which cause blepharitis (eyelid inflammation).

Does Xdemvy (lotilaner) cure blepharitis?

While it might cure blepharitis for good, Xdemvy (lotilaner) can help treat and greatly reduce the symptoms of Demodex blepharitis. In [studies](https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trials-snapshots-xdemvy), many people had less redness and crusting after using it twice a day for 6 weeks. But because blepharitis can come back, symptoms might return, and you might need another round of treatment. Always follow your prescriber's advice for the best long-term care.

How long does Xdemvy (lotilaner) take to work?

Xdemvy (lotilaner) usually starts working within a few weeks, but the full effect is usually seen by [6 weeks](https://pmc.ncbi.nlm.nih.gov/articles/PMC11825414/). Some people might notice improvement earlier, but it’s important to finish the full treatment for the best results. If you don't see an improvement by the end of treatment, speak with your prescriber.

When was Xdemvy (lotilaner) FDA approved?

Xdemvy (lotilaner) was approved in [July 2023](https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trials-snapshots-xdemvy) for the treatment of Demodex blepharitis.

Xdemvy

lotilaner

Used for Eye Inflammation

Xdemvy (lotilaner) is an eye drop used to treat adults with Demodex blepharitis, an eye condition caused by tiny mites that live on the eyelids that lead to redness, irritation, and crusty buildup. It's an antiparasitic that works by paralyzing and killing the mites. You use one drop in each eye twice a day, about 12 hours apart, for 6 weeks. A common side effect is a stinging or burning feeling right after use. There is no generic version available at this time.

Reviewed by:

Allison Gourley, PharmD

Daisy Chau, PharmD

Last reviewed on August 5, 2025

What is Xdemvy (lotilaner)?

What is Xdemvy (lotilaner) used for?

Treatment of Demodex blepharitis in adults

How Xdemvy (lotilaner) works

Xdemvy (lotilaner) is an antiparasitic. It works by acting on the nervous system of Demodex mites, paralyzing and killing them to help relieve symptoms.

When does Xdemvy (lotilaner) start working?Time passed since treatment started:

HOURS

DAYS

WEEKS

Full effect

MONTHS

Drug facts

Common Brands	Xdemvy
Drug Class	Antiparasitic
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Xdemvy

Drug Class

Antiparasitic

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Xdemvy (lotilaner)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Burning sensation in the eyes (10%)
Stinging sensation in the eyes (10%)

Less Common Side Effects

Small bump on the eyelid
Swelling of the cornea

When do Xdemvy (lotilaner) possible side effects begin and end?

Time passed since treatment started:

MMINUTES

HHOURS

DDAYS

WWEEKS

MMONTHS

Burning sensation

Stinging sensation

Source: DailyMed

The following Xdemvy (lotilaner) side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
New or worsening eye pain, redness, irritation, or discharge

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

Burning or stinging of the eyes after use

Pros and cons of Xdemvy (lotilaner)

Pros

The only FDA-approved treatment for Demodex blepharitis
Not many serious side effects
Can be stored at room temperature

Cons

Need to use for the full 6 week course
Must apply to both eyes twice a day
Only available through certain specialty pharmacies

Pharmacist tips for Xdemvy (lotilaner)

Be careful not to let the tip of the Xdemvy (lotilaner) bottle touch your eye, eyelid, fingers, or anything else. This helps keep the drops clean and free of germs. Using contaminated eye drops could seriously harm your eye or even affect your vision.
If you miss a dose of Xdemvy (lotilaner), skip it and use your next dose at the regular time. Don’t use extra drops to make up for the one you missed.
If you get an eye injury, infection, have eye surgery, or notice redness, swelling, or other unusual changes while using Xdemvy (lotilaner), contact your care team right away. Your prescriber will let you know if you should keep using the drops.
Take your contacts out before using Xdemvy (lotilaner). The preservative in the drops can stain soft contact lenses. You can put them back in after 15 minutes after using the drops.
You can use Xdemvy (lotilaner) with other eye drops, but wait at least 5 minutes between each one. This helps each medication get fully absorbed.
Store Xdemvy (lotilaner) at room temperature. Don't store it in the refrigerator since it might damage it.

Common questions about Xdemvy

Yes, Xdemvy is generally safe for most people when used as directed. It doesn't cause many serious side effects. In studies, about 10% of people felt burning or stinging in the eye right after using the drops. If you have any concerns or your symptoms get worse, talk to your prescriber.

No, Xdemvy isn't a steroid medication, it's an antiparasitic. Unlike steroids, which reduce inflammation by calming the immune system, Xdemvy works by targeting and killing Demodex mites, which cause blepharitis (eyelid inflammation).

While it might cure blepharitis for good, Xdemvy can help treat and greatly reduce the symptoms of Demodex blepharitis. In studies, many people had less redness and crusting after using it twice a day for 6 weeks. But because blepharitis can come back, symptoms might return, and you might need another round of treatment. Always follow your prescriber's advice for the best long-term care.

Xdemvy usually starts working within a few weeks, but the full effect is usually seen by 6 weeks. Some people might notice improvement earlier, but it’s important to finish the full treatment for the best results. If you don't see an improvement by the end of treatment, speak with your prescriber.

Xdemvy was approved in July 2023 for the treatment of Demodex blepharitis.

Xdemvy is very effective at treating Demodex blepharitis. In studies, 50% of people had less crusty buildup on their eyelashes. And about 60% of people had all of their Demodex mites completely gone after using it. While results can vary, most people see clear improvement when using it twice a day for 6 weeks as directed.

No, Xdemvy is only available with a prescription from a healthcare professional. You can't get it over the counter, especially since it's only available through certain specialty pharmacies.

Use only one drop of Xdemvy in each eye twice a day, about 12 hours apart, for 6 weeks. It's not known if using it longer than that is safe. Follow your prescriber’s instructions and don’t use more than directed.

Risks and warnings for Xdemvy (lotilaner)

Xdemvy (lotilaner) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Risk of contamination

Don't let the tip of the Xdemvy (lotilaner) bottle touch your eye, eyelid, fingers, or any surface. This helps keep the drops clean and prevents germs from getting into the bottle. Using contaminated drops could seriously harm your eye or even affect your vision.

Color change in contact lenses

Risk factors: Wearing soft contact lenses

The preservative in Xdemvy (lotilaner) can change the color of your soft contact lenses. To avoid this, take your lenses out before using the drops. Wait 15 minutes before putting your lenses back in.

Xdemvy (lotilaner) dosage

The average cost for 1 eye dropper of 10ml of 0.25% of Xdemvy (lotilaner) is $30.00 with a free GoodRx coupon.

Eye dropper

Dosage	Quantity	Price as low as	Price per unit
10ml of 0.25%	1 eye dropper	$30.00	$30.00

Typical dosage for Xdemvy (lotilaner)

The typical dose is one drop in each eye twice daily (12 hours apart) for 6 weeks.

How much does Xdemvy (lotilaner) cost?

To access savings, use a GoodRx coupon and pay just a fraction of the retail price.

Xdemvy (brand)

GoodRx lowest price

$30.00

View prices and coupons

What are alternatives to Xdemvy (lotilaner)?

There are a number of medications that your doctor can prescribe in place of Xdemvy (lotilaner). Compare a few possible alternatives below.

Xdemvy (lotilaner)

Used for:

Treatment of Demodex blepharitis in adults

$30.00Lowest GoodRx priceView prices

Hypochlorous acid

Used for:

Certain eye conditions that cause red, itchy, crusty eyes. Such as:

Blepharitis (inflamed eyelids)
Meibomian gland dysfunction (MGD; a common eye condition that causes dry eyes)
Dry eyes
Demodex eye infection - Acuicyn only
Contact lens intolerance - Avenova only

$309.38Lowest GoodRx priceView prices

Xdemvy (lotilaner) images

This medicine is Yellow Eye Dropper.yellow - Xdemvy 0.25% Ophthalmic Solution

References

Burkat, C. N., et al. (2025). Demodex Infestation. American Academy of Ophthalmology.

Food and Drug Administration. (2024). Drug Trials Snapshots: XDEMVY.

Tarsus Pharmaceuticals, Inc. (n.d.). Discover the XDEMVY® Effect.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

What is Xdemvy (lotilaner)?

What is Xdemvy (lotilaner) used for?

How Xdemvy (lotilaner) works

Drug facts

Side effects of Xdemvy (lotilaner)

Common Side Effects

Less Common Side Effects

The following Xdemvy (lotilaner) side effects have also been reported

Pros and cons of Xdemvy (lotilaner)

Pros

Cons

Pharmacist tips for Xdemvy (lotilaner)

Common questions about Xdemvy

Is Xdemvy safe?

Is Xdemvy a steroid?

Does Xdemvy cure blepharitis?

How long does Xdemvy take to work?

When was Xdemvy FDA approved?

How effective is Xdemvy?

Can I get Xdemvy over the counter (OTC)?

How often can Xdemvy be used?

Risks and warnings for Xdemvy (lotilaner)

Risk of contamination

Color change in contact lenses

Xdemvy (lotilaner) dosage

Typical dosage for Xdemvy (lotilaner)

How much does Xdemvy (lotilaner) cost?

$30.00

What are alternatives to Xdemvy (lotilaner)?

Xdemvy (lotilaner) images

References

View All References (5)

Common questions about Xdemvy

Is Xdemvy safe?

Is Xdemvy a steroid?

Does Xdemvy cure blepharitis?

How long does Xdemvy take to work?

When was Xdemvy FDA approved?

How effective is Xdemvy?

Can I get Xdemvy over the counter (OTC)?

How often can Xdemvy be used?