Miebo™ Eye Drops – What is the Days’ Supply?

Miebo™ is the first and only prescription eye drop used to treat dry eye syndrome by directly targeting tear evaporation. PAAS National® has fielded several calls regarding Miebo™ asking how to calculate the days’ supply. Per DailyMed, Miebo™ comes in a package size of 3 mL. Section 16 of the package insert states it is supplied in a multi-dose 5 mL bottle. Which measurement, 3 mL, or 5 mL, should you use to calculate the days’ supply? Miebo™ is billed as 3 mL; there are 3 mL of active ingredient in a 5 mL multi-dose bottle, presumptively to make administration easier. However, based on information from the Bausch + Lomb website, the days’ supply calculation remains complicated. Miebo™ contains only one ingredient (perfluorohexyloctane), unlike other eye drops that contain water, preservatives, and steroids. Eye drop formulations with water have a typical drop size of 30 to 50 microliters. The Miebo™ drop size is much smaller at 11 microliters, causing problems with the traditional 15 to 20 drops per mL estimate.

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Per the manufacturer, the preservative free multi-dose 3 mL bottle should give the patient a one-month supply with the normal dosing of 1 drop , in both eyes, four times a day. Approximating based on a drop size that is 1/3 -1/5 smaller, the patient should get 3 to 5 times more drops. That would be anywhere from 135 – 300 total drops, with 240 drops being required for a 30-days’ supply.

PAAS Tips:

Jennifer Ottman, CPhT