People’s Pharmacy: Xdemvy eye drops control pesky eyelid mites
Q. My eyelid was irritated when I saw my ophthalmologist last year. He said I had eyelid mites and had me use Noveha, a tea tree oil-based eyelid cleanser. In addition, I used neo/poly B/Dexamethasone ointment for two weeks. After two weeks, he prescribed Xdemvy and recommended I continue use of the eyelid cleanser.
My eyes were constantly filmy and sensitive to light for the first two weeks. I stopped the Xdemvy after four days as my eyes began to ache and burn. Can you shed some light on this condition for me?
A. Eyelid mites are also known as Demodex. They live in the follicles of the eyelashes. Some people seem to react strongly to them by developing inflammation.
Lotilaner (Xdemvy) is a compound that paralyzes and kills the mites. A review of six randomized clinical trials concluded that this medicine “offers a novel, effective therapy for this condition, enabling earlier intervention and improved outcomes for patients” (HCA Healthcare Journal of Medicine, June 1, 2025). In clinical trials, about 10% of people experienced stinging and burning when they applied Xdemvy drops.
This drug is expensive. According to Drugs.com, Xdemvy solution could cost almost $2,000 for 10 milliliters. That’s about 2 teaspoons of medicine, which should last six weeks. Some insurance companies cover this treatment, while others may not.
Q. I have been taking the antidepressant duloxetine for a long time, starting with brand-name Cymbalta. Ten years ago, I wanted to get off it, so my psychiatrist halved my dose to 30 milligrams. I turned into a maniac. When I went to the dentist, they asked me to sign a paper I didn’t agree with. Quite unlike my usual demeanor, I screamed at them and threw the paper and other things at the hygienist, making a fool out of myself.
To get back under control, I had to restart Cymbalta at 60 milligrams. I don’t think I’ll ever try to go off it again.
A. Your doctor tapered your dose far too fast. Many other readers report that a very slow reduction in dose can be successful.
Because this antidepressant comes in a capsule containing many tiny beads of active medicine, people have resorted to removing one additional bead a week from each capsule. That could take as long as a year or more, but a slow taper seems to reduce the risk of withdrawal symptoms. This should always be supervised by a physician.
You can learn more about duloxetine and other antidepressants in our “eGuide to Dealing with Depression.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. I have been a weightlifter for 25 years and stay active physically. At 53, my blood pressure has risen, and I need to medicate. The doctor prescribed HCTZ with lisinopril.
Will this med lower my sodium and potassium levels? I understand from many nutrition sites that we need about 4.7 grams of potassium daily from food sources to stay healthy, so I am concerned about the possibility of sodium/potassium depletion. Any insights would be greatly appreciated.
A. You pose a fascinating question. Both lisinopril and hydrochlorothiazide (HCTZ) deplete the body of sodium. They have opposite effects on potassium: lisinopril raises this mineral while HCTZ lowers it. The only way to know how your body is handling these blood pressure pills is to have your doctor run a blood test.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com.