lu codes
Source: ODB Formulary/CDI, edition 43 (effective 2026-04-28). Checked weekly for updates. Unofficial search tool.
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showing 10 of 13 drugs (28 codes)
IPRATROPIUM BROMIDE Atrovent, PMS-Ipratropium
For the treatment of non-allergic vasomotor rhinitis
1 year
other eye, ear, nose and throat agents
DEXTRAN 70 & HYDROXYPROPYL METHYLCELLULOSE & POLYQUAD, PETROLATUM/MINERAL OIL, POLYVINYL ALCOHOL, POLYVINYL ALCOHOL & POLYVINYLPYRROLIDONE Tears Naturale II, Isopto Tears, Lacri-Lube, Soothe Night Time, Liquifilm Tears, Tears Plus
For patients with objective evidence of keratoconjunctivitis sicca as confirmed by filamentary keratopathy on slit lamp examination or biopsy.
Indefinite
other eye, ear, nose and throat agents
OFLOXACIN Ocuflox
For the treatment of conjunctivitis caused by susceptible strain(s) of Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae and Hemophilus influenzae which is/are resistant or unresponsive to listed alternative agents.
1 year
anti-infectives other anti-infectives
BIMATOPROST, BRIMONIDINE, BRINZOLAMIDE, DORZOLAMIDE HCL, LATANOPROST, LATANOPROSTENE BUNOD, TRAVOPROST Lumigan, Vistitan, Lumigan RC, Alphagan P, Brimonidine P, Alphagan +24 more
As first line treatment of elevated intraocular pressure in patients who cannot tolerate an ophthalmic beta-blocking agent or where beta-blocking agents are contraindicated.
Indefinite
As second line monotherapy or combination therapy in patients who do not have an adequate intraocular pressure lowering response to ophthalmic beta-blocking agents.
Indefinite
For use as adjunctive therapy with an ophthalmic beta-blocking agent in an urgent situation (e.g. patients with a high baseline intraocular pressure) where monotherapy is unlikely to be effective.
Indefinite
other eye, ear, nose and throat agents
BENZYDAMINE HCL Tantum, Pharixia, PMS-Benzydamine, Odan-Benzydamine
For the symptomatic relief of treatment induced mucositis in cancer patients.
1 year
local anesthetics
BRIMONIDINE TARTRATE & TIMOLOL MALEATE, BRINZOLAMIDE & TIMOLOL MALEATE, DORZOLAMIDE HCL & TIMOLOL MALEATE, LATANOPROST & TIMOLOL MALEATE, TIMOLOL MALEATE & TRAVOPROST Apo-Brimonidine-Timop, Jamp Brimonidine/Timolol, Combigan, Azarga, Cosopt, Apo-Dorzo-Timop +21 more
As second-line therapy for patients who do not have an adequate intraocular pressure lowering response to monotherapy with ophthalmic beta-blocking agents.
Indefinite
other eye, ear, nose and throat agents
BRIMONIDINE TARTRATE & TIMOLOL MALEATE, BRINZOLAMIDE & BRIMONIDINE TARTRATE, BRINZOLAMIDE & TIMOLOL MALEATE, DORZOLAMIDE HCL & TIMOLOL MALEATE, LATANOPROST & TIMOLOL MALEATE, TIMOLOL MALEATE & TRAVOPROST Apo-Brimonidine-Timop, Jamp Brimonidine/Timolol, Combigan, Simbrinza, Azarga, Cosopt +22 more
For use as initial therapy in an urgent situation (e.g. patients with a high baseline intraocular pressure) where monotherapy is unlikely to be effective.
Indefinite
other eye, ear, nose and throat agents
AFLIBERCEPT Eylea, Eylea HD, Eydenzelt, Enzeevu, Aflivu, Yesafili
For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) in a verteporfin PDT (Visudyne)-naive eye, but only for patients established on Eylea (aflibercept) therapy prior to August 29, 2025.
1 year
Initial diagnosis should be confirmed by an appropriate diagnostic procedure and administration should be done by a qualified ophthalmologist experienced in intravitreal injections.
Patients receiving concurrent administration of verteporfin PDT (Visudyne) or ranibizumab (Lucentis) are not eligible for reimbursement.
Treatment should be initiated with a monthly intravitreal injection for the first 3 consecutive doses, followed by one injection every 2 months.
The interval between two doses should not be shorter than one month.
Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy.
For clarity, coverage will be provided for patients responding to therapy with Lucentis who switch to Eylea. Coverage will NOT be provided for patients who have failed to respond to Lucentis.
For the treatment of patients with clinically significant macular edema secondary to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), but only for patients established on Eylea (aflibercept) therapy prior to August 29, 2025.
1 year
Treatment should be initiated with an intravitreal injection once every month. The interval between two doses should not be shorter than one month. The treatment interval may be extended up to 3 months based on visual and anatomic outcomes.
Prescribers are advised to periodically assess the need for continued therapy.
Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy.
For clarity, coverage will be provided for patients responding to therapy with Lucentis who switch to Eylea. Coverage will NOT be provided for patients who have failed to respond to Lucentis.
For the treatment of patients with clinically significant diabetic macular edema (DME) for whom laser photocoagulation is also indicated; and a hemoglobin A1c of less than 12 percent, but only for patients established on Eylea (aflibercept) therapy prior to August 29, 2025.
1 year
Treatment should be initiated with a monthly intravitreal injection for the first 5 consecutive doses, followed by one injection every 2 months.
The interval between two doses should not be shorter than one month.
Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy.
For clarity, coverage will be provided for patients responding to therapy with Lucentis who switch to Eylea. Coverage will NOT be provided for patients who have failed to respond to Lucentis.
For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) in a treatment-naive eye.
1 year
Initial diagnosis should be confirmed by an appropriate diagnostic procedure and administration should be done by a qualified ophthalmologist experienced in intravitreal injections.
Patients receiving concurrent administration of other anti-VEGF intravitreal injections are not eligible for reimbursement.
Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy.
Coverage will be provided for patients responding to therapy with another anti-VEGF agent who switch to Eylea HD. Coverage will not be provided for patients who have failed to respond to other anti-VEGF agents.
Recommended Dose: Treatment should be initiated with a monthly intravitreal injection for the first 3 consecutive doses, followed by one injection every 8 to 16 weeks.
For the treatment of patients with clinically significant diabetic macular edema (DME) for whom laser photocoagulation is also indicated; and a hemoglobin A1c of less than 12 percent.
1 year
Patients receiving concurrent administration of other anti-VEGF intravitreal injections are not eligible for reimbursement.
Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy.
Coverage will be provided for patients responding to therapy with another anti-VEGF agent who switch to Eylea HD. Coverage will not be provided for patients who have failed to respond to other anti-VEGF agents.
Recommended Dose: Treatment should be initiated with a monthly intravitreal injection for the first 3 consecutive doses, followed by one injection every 8 to 16 weeks.
For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) in a treatment-naive eye.
1 year
Initial diagnosis should be confirmed by an appropriate diagnostic procedure and administration should be done by a qualified ophthalmologist experienced in intravitreal injections.
Patients receiving concurrent administration of other anti-VEGF intravitreal injections are not eligible for reimbursement.
Treatment should be initiated with a monthly intravitreal injection for the first 3 consecutive doses, followed by one injection every 2 months.
The interval between two doses should not be shorter than one month.
Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy.
Coverage will be provided for patients responding to therapy with another anti-VEGF agent who switch to this product. Coverage will NOT be provided for patients who have failed to respond to other anti-VEGF agents.
For the treatment of patients with clinically significant macular edema secondary to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO).
1 year
Patients receiving concurrent administration of other anti-VEGF intravitreal injections are not eligible for reimbursement.
Treatment should be initiated with an intravitreal injection once every month. The interval between two doses should not be shorter than one month. The treatment interval may be extended up to 3 months based on visual and anatomic outcomes.
Prescribers are advised to periodically assess the need for continued therapy.
Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy.
Coverage will be provided for patients responding to therapy with another anti-VEGF agent who switch to this product. Coverage will NOT be provided for patients who have failed to respond to other anti-VEGF agents.
For the treatment of patients with clinically significant diabetic macular edema (DME) for whom laser photocoagulation is also indicated; and a hemoglobin A1c of less than 12 percent.
1 year
Patients receiving concurrent administration of other anti-VEGF intravitreal injections are not eligible for reimbursement.
Treatment should be initiated with a monthly intravitreal injection for the first 5 consecutive doses, followed by one injection every 2 months.
The interval between two doses should not be shorter than one month.
Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy.
Coverage will be provided for patients responding to therapy with another anti-VEGF agent who switch to this product. Coverage will NOT be provided for patients who have failed to respond to other anti-VEGF agents.
other eye, ear, nose and throat agents
BRINZOLAMIDE & BRIMONIDINE TARTRATE Simbrinza
As second-line therapy for patients who do not have an adequate intraocular pressure lowering response to monotherapy with brinzolamide or brimonidine.
Indefinite
other eye, ear, nose and throat agents
CIPROFLOXACIN AND DEXAMETHASONE Ciprodex, Taro-Ciprofloxacin/Dexamethasone, Sandoz Ciprofloxacin/Dexamethasone
The treatment of otitis externa in patients:
1 year
- With known perforated tympanic membrane or ventilation tubes;
OR
- Requiring chronic therapy (i.e., more than 14 days);
OR
- Who have been receiving more than 7 days of topical aminoglycoside therapy without improvement, where there is concern of a resistant pathogen;
OR
- With documented pre-existing hearing impairment.
anti-infectives antibiotics
No matching LU codes found.