NDC 0078-0911Prescription (Rx only)FDA NDA · NDA208073

Xiidra

Active substance: Lifitegrast

FDA labeler: Novartis Pharmaceuticals Corporation

2 formulations • 8 package configurations
All 10 registered NDCs — click to copy
In one line

Xiidra (Lifitegrast) NDC 0078-0911 converts to 00078-0911-12 for billing and bills under J3490 at Per Administration.

FDA Approval & Market Entry Timeline

Official openFDA & DailyMed regulatory registration sequence
Listing: 0078-0911 Verified
1. Initial Approval
2016
First U.S. FDA clearance for Lifitegrast
2. FDA Application
NDA208073
Regulatory pathway: NDA
3. Market Entry Date
Jul 11, 2016
First commercial NDC distribution & launch date
4. Regulatory Status
Active Commercial Listing
Registration valid through Dec 31, 2026
Billing & reimbursement crosswalk

NDC • HCPCS Level II • CPT administration

HCPCS Level II J-Code
J3490
Unclassified drugs (requires invoice & NDC on claim)
Billable unit: Per Administration
11-digit HIPAA NDC
00078-0911-12
Zero-padded 5-4-2 format
Standard conversion
CPT administration code
67028
Intravitreal injection of a pharmacologic agent
UB-04 revenue code
Rev 0636
0636 (Pharmacy - Extension of 0250 Drugs Requiring Detail)
Qualifier: ML

Interactive Unit Multiplier Calculator

J3490

Calculate the exact number of billable HCPCS units to report on CMS-1500 / 837P claims based on the patient dose and single-dose vial waste.

MG
Units to report on claim:
100 Units
Based on 1 mg = 1 billable unit (100.0 exact)
Box 24 / HCPCS Quantity Formatted Line:J3490 UN100 (N40078091112)
Always verify NDC package code, billable multiplier, and invoice qualifier with specific payer guidelines before claim filing.
Complete drug registry

All registered strengths & packaging

Every registered strength and package for Xiidra, with 10-digit and 11-digit NDC formats
Formulation / rolePackage NDCProduct NDC11-digit HIPAAPackaging detailCopy
50 mg/mL24208-911-1224208-91124208-0911-1212 POUCH in 1 CARTON (24208-911-12) / 5 AMPULE in 1 POUCH (24208-911-05) / .2 mL in 1 AMPULE
Inner component24208-911-0524208-91124208-0911-05Inner component of kit (24208-911-12)
50 mg/mL24208-911-9424208-91124208-0911-944 POUCH in 1 CARTON (24208-911-94) / 5 AMPULE in 1 POUCH (24208-911-95) / .2 mL in 1 AMPULESample
Inner component24208-911-9524208-91124208-0911-95Inner component of kit (24208-911-94)
50 mg/mL0078-0911-120078-091100078-0911-1212 POUCH in 1 CARTON (0078-0911-12) / 5 AMPULE in 1 POUCH (0078-0911-05) / .2 mL in 1 AMPULE
Inner component0078-0911-050078-091100078-0911-05Inner component of kit (0078-0911-12)
50 mg/mL0078-0911-940078-091100078-0911-944 POUCH in 1 CARTON (0078-0911-94) / 5 AMPULE in 1 POUCH (0078-0911-95) / .2 mL in 1 AMPULESample
Inner component0078-0911-950078-091100078-0911-95Inner component of kit (0078-0911-94)
FDA drug label

Prescribing information

Taken from the manufacturer's FDA Structured Product Labeling submission. This is the label as filed, not a summary.

9 Label Sections
1 INDICATIONS AND USAGE Xiidra ® (lifitegrast ophthalmic solution) 5% is indicated for the treatment of the signs and symptoms of dry eye disease (DED). Xiidra (lifitegrast ophthalmic solution) 5% is a lymphocyte function-associated antigen-1 (LFA-1) antagonist indicated for the treatment of the signs and symptoms of dry eye disease (DED). ( 1 )
2 DOSAGE AND ADMINISTRATION Instill one drop of Xiidra twice daily (approximately 12 hours apart) into each eye using a single-use container. Discard the single‑use container immediately after using in each eye. Contact lenses should be removed prior to the administration of Xiidra and may be reinserted 15 minutes following administration. One drop twice daily in each eye (approximately 12 hours apart). ( 2 )
3 DOSAGE FORMS AND STRENGTHS Ophthalmic solution containing lifitegrast 50 mg/mL (5%). Ophthalmic solution containing lifitegrast 50 mg/mL (5%). ( 3 )
4 CONTRAINDICATIONS Xiidra is contraindicated in patients with known hypersensitivity to lifitegrast or to any of the other ingredients in the formulation [see Adverse Reactions (6.2) ]. Hypersensitivity. ( 4 )
6 ADVERSE REACTIONS The following serious adverse reactions are described elsewhere in the labeling: Hypersensitivity [see Contraindications (4) ] The most common adverse reactions (incidence 5%-25%) following the use of Xiidra were instillation-site irritation, dysgeusia, and decreased visual acuity ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Bausch & Lomb Incorporated at 1-800-553-5340 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. In five clinical trials of DED conducted with lifitegrast ophthalmic solution, 1401 patients received at least one dose of lifitegrast (1287 of which received lifitegrast 5%). The majority of patients (84%) had less than or equal to 3 months of treatment exposure. One hundred-seventy patients were exposed to lifitegrast for approximately 12 months. The majority of the treated patients were female (77%). The most common adverse reactions reported in 5%-25% of patients were instillation-site irritation, dysgeusia, and reduced visual acuity. Other adverse reactions reported in 1%-5% of the patients were blurred vision, conjunctival hyperemia, eye irritation, headache, increased lacrimation, eye discharge, eye discomfort, eye pruritus, and sinusitis. 6.2 Postmarketing Experience The following adverse reactions have been identified during post-approval use of Xiidra. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Rare serious cases of hypersensitivity, including anaphylactic reaction, bronchospasm, respiratory distress, pharyngeal edema, swollen tongue, urticaria, allergic conjunctivitis, dyspnea, angioedema, and allergic dermatitis have been reported. Eye swelling and rash have also been reported [see Contraindications (4) ]
16 HOW SUPPLIED/STORAGE AND HANDLING Xiidra (lifitegrast ophthalmic solution) 5% (50 mg/mL) is supplied in a foil pouch containing 5 low-density polyethylene 0.2 mL single-use containers. Carton of 60 single-use containers NDC 24208-911-12 Storage: Store at 20°C to 25°C (68°F to 77°F). Store single-use containers in the original foil pouch.
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