Timoptic in Ocudose — Medica

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