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Brand Status

Restrictions

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Tier Classifications

TIER 1
Usually, these are generic drugs available at the lowest co-pay.
TIER 2
Usually, these are “preferred” (or on formulary) brand name drugs.
TIER 3
Usually, these are "non-preferred" brand drugs, which require higher-level co-pay.
TIER 4-9
Usually, these are "non-preferred" brand drugs or specialty prescription products, which require higher-level co-pay.

Tier Definitions

N/C
Not Covered: This plan does not cover the drug.
N/A
Not Available: We are not able to provide formulary data for this drug/healthcare plan.

Please note: Plans and formulary information are subject to change. Please contact the prescription drug benefit provider for current formulary information.

Restrictions

PA
Prior Authorization: A drug that requires additional documentation before a prescription is approved and filled. Specific clinical criteria must be met prior to the approval.
QL
Quantity Limits: For safety and cost reasons, plans may set quantity limits on the amount of drugs they cover over a certain period of time.
ST
Step Therapy: A drug written for step therapy; restrictions for such a drug usually require that certain criteria be met before a prescription is approved.
Indications and Usage

BEPREVE® (bepotastine besilate ophthalmic solution) 1.5% is a histamine H1 receptor antagonist indicated for the treatment of itching associated with allergic conjunctivitis.

Important Safety Information
  • BEPREVE is contraindicated in patients with a history of hypersensitivity reactions to bepotastine or any of the other ingredients.
  • To minimize contaminating the dropper tip and solution, advise the patient not to touch the eyelids or surrounding areas with the dropper tip of the bottle and to keep the bottle tightly closed when not in use.
  • BEPREVE should not be used to treat contact lens-related irritation.
  • Patient should remove contact lenses prior to instillation of BEPREVE, because benzalkonium chloride may be absorbed by soft contact lenses. Lenses may be reinserted 10 minutes after BEPREVE administration.
  • The most common adverse reaction occurring in approximately 25% of patients was a mild taste following instillation. Other adverse reactions occurring in 2%-5% of patients were eye irritation, headache, and nasopharyngitis.

You are encouraged to report side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Click here for Prescribing Information for BEPREVE.

Indications and Usage

BEPREVE® (bepotastine besilate ophthalmic solution) 1.5% is a histamine H1 receptor antagonist indicated for the treatment of itching associated with allergic conjunctivitis.

Important Safety Information
  • BEPREVE is contraindicated in patients with a history of hypersensitivity reactions to bepotastine or any of the other ingredients.
  • To minimize contaminating the dropper tip and solution, advise the patient not to touch the eyelids or surrounding areas with the dropper tip of the bottle and to keep the bottle tightly closed when not in use.
  • BEPREVE should not be used to treat contact lens-related irritation.
  • Patient should remove contact lenses prior to instillation of BEPREVE, because benzalkonium chloride may be absorbed by soft contact lenses. Lenses may be reinserted 10 minutes after BEPREVE administration.
  • The most common adverse reaction occurring in approximately 25% of patients was a mild taste following instillation. Other adverse reactions occurring in 2%-5% of patients were eye irritation, headache, and nasopharyngitis.

You are encouraged to report side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Click here for Prescribing Information for BEPREVE.