Istalol — Medica
elevated intraocular pressure in patients with ocular hypertension
Preferred products
- generic betaxolol 0.5% ophthalmic solution
- generic carteolol 1% ophthalmic solution
- generic levobunolol 0.5% ophthalmic solution
- generic timolol maleate 0.25% ophthalmic solution
- generic timolol maleate 0.5% ophthalmic solution
Initial criteria
- Patient has tried one Step 1 Product (generic betaxolol 0.5% ophthalmic solution, generic carteolol 1% ophthalmic solution, generic levobunolol 0.5% ophthalmic solution, generic timolol maleate 0.25% ophthalmic solution, or generic timolol maleate 0.5% ophthalmic solution)
- OR patient has a known benzalkonium chloride (BAK) sensitivity (approve Timoptic in Ocudose or Timoptic XE)
Reauthorization criteria
- Same as initial criteria
Approval duration
1 year