Xalatan — Medica
reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension
Preferred products
- generic latanoprost ophthalmic solution
- generic bimatoprost 0.03% ophthalmic solution
- generic travoprost 0.004% ophthalmic solution
Initial criteria
- Patient has tried one Step 1 Product (generic latanoprost ophthalmic solution, generic bimatoprost 0.03% ophthalmic solution, or generic travoprost 0.004% ophthalmic solution)
- OR patient has a known benzalkonium chloride (BAK) sensitivity AND a known sensitivity to other ophthalmic preservatives (for Xelpros or Zioptan only)
Reauthorization criteria
- Same criteria as initial approval
Approval duration
1 year