FML Liquifilm — Medica
any ophthalmic corticosteroid use requiring Step 2 Product
Preferred products
- generic dexamethasone sodium phosphate ophthalmic solution 0.1%
- generic fluorometholone ophthalmic suspension 0.1%
- generic loteprednol etabonate ophthalmic suspension 0.5%
- generic prednisolone acetate ophthalmic suspension 1%
Initial criteria
- If the patient has tried two Step 1 Products, approve a Step 2 Product.
- If the patient is diagnosed with endogenous anterior uveitis, approve Durezol (brand or generic).
- If the patient has an allergy to benzalkonium chloride, approve Durezol (brand or generic), FML SOP ointment, or Lotemax ophthalmic ointment.
- No other exceptions are recommended.
Approval duration
1 year