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Medications listed are available on OH EPIC Formulary, unless otherwise noted.
Not all formulary medications are available at each facility. Please refer to your local pharmacy for available inventory.
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triamcinolone ophthalmic

triamcinolone ophthalmic
Drug Name Form Strength Infusion Center Available Restricted Non-formulary Ambulatory Available Interchange REMS
Triesence SUSPENSION, INTRAVITREAL 40 mg/mL            
Xipere SUSPENSION, INTRAVITREAL 40 mg/mL          
VIEW MORE Corticosteroids
CLASS
520808
Additional Information and Links

Xipere Formulary Restrictions:

  • Indication: Treatment of macular edema associated with uveitis
  • Service line: Ophthalmology
  • Formulary location: Ambulatory
  • Service location: Clinic
  • Patient population: Adults
  • Prior authorization required: Yes
  • Restriction/criteria of use (all will apply unless specified):
    • Diagnosis of macular edema associated with non-infectious uveitis
    • Intraocular pressure ≤ 22 mmHg
    • No active ocular disease or infection other than uveitis
    • No uncontrolled glaucoma
    • No topical ocular corticosteroid
    • No intraocular or periocular corticosteroid injections in the last 2 months
    • No ocular implant
      • Ozurdex implant in the last 3 months
      • Iluvien implant in the last 12 months
      • Retisert or Yutiq implant in the last 30 months
Last updated: Apr. 25, 2024

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