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Rhopressa netarsudil .2 mg/mL Solution/ Drops, 1 bottle — NDC 70727-0497-25 package photo
Label image from the product's FDA listing (DailyMed) — may show a different pack size or an older label revision.

Rhopressa netarsudil .2 mg/mL Solution/ Drops, 1 bottle — NDC 70727-497-25 (Billing 70727-0497-25)

by Alcon Laboratories, Inc. · 1 BOTTLE in 1 CARTON / 2.5 mL in 1 BOTTLE

This is a package of 1 bottle of Rhopressa netarsudil .2 mg/mL Solution/ Drops from Alcon Laboratories, Inc., marketed since Dec 2017 and currently FDA-listed; retail pharmacies pay about $131.68 per mL (NADAC). It is the main listing for this product, which comes in 2 package sizes.

NDC 70727-0497-25
🏷️ FDA NDC (as labeled) 70727-497-25 billing pads the product segment with a zero
This package
Contains1 bottle Cost per mL$131.68 NADAC Per package$329.19 / 2.5 ml Pack sizes2 compare ↓
Also priced by: Medicaid pays $131.96/unit · Part D plans $132.31/unit — full pricing hub ↓
Main listing for product 70727-497 · Also comes in: 2.5 mL 70727-497-99
Rx only Brand On market Non-controlled ⇄ Compare with another NDC
🗂️ FDA directory synced Oct 1, 2026 · this listing last changed Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

Identity & classification

Regulatory identifiers FDA, NLM and CMS codes for this package

FDA NDC (as labeled) 70727-497-25
Product NDC 70727-497
11-digit billing NDC 70727049725
NCPDP billing unit ML — per mL (volume)
RxCUI 1992868, 1992873
UNII VL756B1K0U
UPC 0370727497255
Application # NDA208254
SPL Set ID 7d4f0e3a-5b86-4c43-982a-813b22ae7e22
Established class (EPC) Rho Kinase Inhibitor
Mechanism of action Rho Kinase Inhibitors
DEA schedule Non-controlled
Marketing category NDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2017-12-18
Route OPHTHALMIC, TOPICAL
Dosage form SOLUTION/ DROPS
Substance NETARSUDIL MESYLATE

Drug-database identifiers Medi-Span GPI and First Databank GCN / HICL / AHFS classification

GPI-14 86527040202020
GPI class Rhopressa
GCN Seq No 078066
GCN 44308
HICL code 044724
Ingredient (HICL) Netarsudil Mesylate
HIC1 code Q
Therapeutic class — broad (HIC1) Ear/Eye/Nose/Rectum/Topical/Vagina/Other
HIC2 code Q6
Therapeutic class — intermediate (HIC2) Ophthalmic Preparations
HIC3 code Q6G
Therapeutic class — specific (HIC3) Miotics And Other Intraocular Pressure Reducers
AHFS code 52:40.32.00
AHFS class Rho Kinase Inhibitors
FDB label name RHOPRESSA 0.02% OPHTH SOLUTION
FDB brand name Rhopressa
Legend status F — Federal legend — prescription drug or device
Quick answers
  • GSN (GCN sequence number): 078066
  • GCN: 44308
  • GPI-14 (Medi-Span): 86527040202020
  • HICL (First Databank): 044724
  • AHFS class code: 52:40.32.00
  • RxCUI (RxNorm): 1992868
Why two NDCs? The FDA registers this code as 70727-497-25 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 70727-0497-25. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

RxNorm drug class

This medicine belongs to the Rho Kinase Inhibitor class.

Pharmacologic class Rho Kinase Inhibitor
Drug family (ATC) Other antiglaucoma preparations, Prostaglandin analogues
How it works Rho Kinase Inhibitors
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

Clinical

Label name RHOPRESSA 0.02% OPHTH SOLUTION Ingredient Netarsudil Mesylate
📖 What it is MedlinePlus · NLM

Netarsudil ophthalmic is used to treat glaucoma (a condition in which increased pressure in the eye can lead to gradual loss of vision) and ocular hypertension (a condition which causes increased pressure in the eye). Netarsudil is in a class of medications called rho kinase inhibitors. It works by lowering the pressure in the eye by increasing the flow of natural eye fluids out of the eye.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • Rhopressa lowers high pressure inside your eye. It is used for open-angle glaucoma and ocular hypertension. Keeping eye pressure down is the goal of treatment.
  • Put one drop in the affected eye or eyes once a day in the evening. Don't use it twice a day, since that isn't well tolerated. If you miss a dose, just use the next evening dose.
  • Quite possibly. Redness was the most common side effect, in about half of patients, and about 6% stopped because of it. Other common effects include eye pain when the drop goes in,...
  • Take your contact lenses out before using the drops. You can put them back in 15 minutes later.
📖 Read our full Netarsudil Ophthalmic guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly $131.676 $329.19 / 2.5 ml
Medicaid paysCMS SDUD · 12 mo $131.96 $329.90 / 2.5 ml
Medicare drug plans payPart D · Q2 2026 $132.31 $330.76 / 2.5 ml
NADAC price history (per mL) — tap or hover for the price & month
Oct 2021 Jan 2024 Jun 2026 Sep 2026 $131.920 $108.652
▲ Up 21% over the last 9 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startMarketing endStatus
70727-0497-25 You're viewing this Main listing 1 BOTTLE in 1 CARTON / 2.5 mL in 1 BOTTLE $131.68 / mL $329.19 2017-12-18 — Active
70727-0497-99 70727-497-99 1 BOTTLE in 1 CARTON / 2.5 mL in 1 BOTTLE Sample — — 2017-12-18 — Active

In Medicaid, this is the most-dispensed pack of this product — about 100% of fills over the last four reported quarters. See all packs ↓

Pack size FAQ

What quantity is in this package?
This package contains 1 bottle — 1 bottle in 1 carton / 2.5 ml in 1 bottle.
How does this package differ from NDC 70727-0497-99?
Both are Rhopressa netarsudil .2 mg/mL Solution/ Drops — the drug itself is identical. This page's package is the 1 bottle one, while NDC 70727-0497-99 is the 1 bottle package.
What NDC number is used to bill for this package of Rhopressa netarsudil .2 mg/mL Solution/ Drops?
Use the 11-digit billing form listed in the identifiers section of this page. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Rhopressa .2 mg/mLthis 70727-0497-25 Alcon 1 bottle $131.676 — Availability likely —
About this product: this is the brand-name version. We did not find an FDA-approved generic match for this exact strength, form and route.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2017
First FDA approval
Dec 2017
📍
2026
Currently FDA-listed
9 years listed
🛡️
2034
Latest patent/protection listed
not a guaranteed launch date
🔒No FDA-approved generic found

We did not find an FDA-approved generic match for this exact strength, form and route. Patent/protection dates below may affect future generic timing.

🛡️ Latest patent/protection date listed: FDA patent/protection data lists protections through Mar 2034. This may affect when a full generic version becomes widely available, but it is not a guaranteed launch date.
📅 FDA approved Dec 18, 2017 RLD RS ⏳ ~7.4 yr to latest listed protection

Why the date isn’t exact: Generic timing can change because patents may be challenged, settled, licensed, added, removed, or worked around with a narrower label — and FDA approval does not always mean a pharmacy can get the generic today.

Patents & exclusivity — FDA Orange Book
US 8450344 — drug substance (U-1524)
US 9096569 — drug substance (U-1524)
US 10174017 — drug substance (U-1524)
US 10882840 — method of use (U-1524)
US 8394826 — drug substance (U-1524)
US 11618748 — method of use (U-1524)
US 9931336 — drug substance (U-1524)
US 11020385 — method of use (U-1524)
US 10532993 — method of use (U-1524)
US 10654844 — drug substance (U-1524)
US 10588901 — drug substance (U-1524)
US 11021456 — method of use (U-1524)
US 11028081 — method of use (U-1524)
US 9415043 — drug substance
US 11185538 — drug product
2017 2019 2021 2023 2025 2027 2029 2031 2033
Today
LOE
Substance patent Formulation patent Method-of-use patent Exclusivity Pediatric +6mo
🏛️FDA exclusivity
FDA-granted marketing protection. It’s separate from patents and may be shorter than patent protection.
🧪Product / substance patents
Patents covering the active ingredient, product, formulation, or related drug features.
🎯Method-of-use patents
Patents covering specific approved uses. These can sometimes be carved out with a “skinny label,” but not always.
🛈 What do these terms mean?
Patent
Legal protection listed in the Orange Book that may delay generic approval or launch. Issued by the U.S. Patent & Trademark Office.
Substance patent
Covers the active drug molecule itself — the hardest to design around. A generic generally can’t launch until it expires.
Formulation (product) patent
Covers a specific formulation or dosage form. A generic can sometimes work around it with a different formulation.
Method-of-use patent
A patent covering one specific approved use of the drug — not necessarily the whole molecule. A generic can sometimes launch with a “skinny label” that carves out the protected use and keeps the others.
Skinny label
A generic label that omits a still-patented use when the FDA allows it — letting a generic reach the market for the unprotected uses.
Exclusivity
FDA-granted marketing protection, separate from patents — e.g. 5-yr new chemical entity, 7-yr orphan drug, or a +6-month pediatric extension.
Paragraph IV
A generic applicant’s formal challenge to a listed patent. It can potentially lead to earlier generic entry, but often involves litigation or a settlement.
RLD / RS
Reference Listed Drug — the brand product the FDA uses as the reference for generic applications. Reference Standard — the product the FDA expects generics to compare against in bioequivalence testing.
TE / AB rating
FDA therapeutic-equivalence rating. An AB rating generally means the FDA considers a generic therapeutically equivalent to — and substitutable for — the brand.
LOE (loss of exclusivity)
The latest patent or exclusivity currently listed — the loss-of-exclusivity / latest-listed-protection date shown on this page. Paragraph-IV challenges and settlements can move the real date earlier; FDA approval and a manufacturer’s decision to market can move it later.

Built from the FDA Orange Book. The bars above are scaled to each protection’s expiry; the red LOE marker is the last one to lapse.

Listed patents (15)
PatentTypeUse codeExpires
US 8450344 ↗ Drug substance U-1524 Jul 11, 2026
US 9096569 ↗ Drug substance U-1524 Jul 11, 2026
US 10174017 ↗ Drug substance U-1524 Jan 27, 2030
US 10882840 ↗ Method of use U-1524 Jul 11, 2026
US 8394826 ↗ Drug substance U-1524 Nov 10, 2030
US 11618748 ↗ Method of use U-1524 Jan 27, 2030
US 9931336 ↗ Drug substance U-1524 Mar 14, 2034
US 11020385 ↗ Method of use U-1524 Mar 14, 2034
US 10532993 ↗ Method of use U-1524 Jul 11, 2026
US 10654844 ↗ Drug substance U-1524 Jan 27, 2030
US 10588901 ↗ Drug substance U-1524 Mar 14, 2034
US 11021456 ↗ Method of use U-1524 Jul 11, 2026
US 11028081 ↗ Method of use U-1524 Jan 27, 2030
US 9415043 ↗ Drug substance — Mar 14, 2034
US 11185538 ↗ Drug product — Mar 14, 2034
Common questions
Is there a generic version of RHOPRESSA 0.02% OPHTH SOLUTION?
No FDA-approved generic equivalent is currently listed in the FDA Orange Book for RHOPRESSA 0.02% OPHTH SOLUTION. Based on the patents and exclusivity currently listed, the Orange Book estimate is that full-label generic entry may be delayed until Mar 2034 — an estimate, not a guaranteed launch date.
The FDA approved a generic — why can’t I get it at my pharmacy yet?
FDA approval and pharmacy availability are two different things. The FDA can approve a generic years before it actually reaches pharmacies, because the brand company may still hold patents or have a settlement that delays the launch. A manufacturer also has to choose to make and sell it, and have supply ready. So a drug can be “FDA-approved generic exists” and still be brand-only at the counter today.
Why do different websites show different generic release dates?
Generic availability is not based on one single date. Some sources use the first exclusivity expiration, some use the last product patent, and others use the latest method-of-use patent. Patent challenges, settlements, licenses, and label carve-outs can also change the real-world launch date. This page shows the underlying Orange Book dates so you can see why estimates may differ.
What does “FDA listed” mean?
It means the product appears in the FDA’s official NDC directory. That’s a good sign a product exists and is intended for the U.S. market, but on its own it does not confirm a pharmacy can fill it today. Where we have recent retail pricing data (NADAC) for a product, we label it “Availability likely” instead.
What does a patent or protection date mean here?
It’s the latest date currently listed in the FDA Orange Book for a patent or exclusivity on the brand product. It can affect when a full generic version becomes widely available — but it is not a guaranteed generic launch date. Generics sometimes arrive earlier (through a settlement or patent challenge) or later (a manufacturer still has to make and sell one).
What does “current Orange Book estimate” mean?
It means we are using the latest patent and exclusivity dates currently listed in the FDA Orange Book. It is not a guaranteed launch date.
Can a generic come out before the last patent expires?
Sometimes. A generic company may challenge a patent, settle with the brand manufacturer, receive a license, or obtain approval with a narrower label that avoids a patented use. In other cases, the last listed protection may delay full-label generic competition.
Can a generic come out after the listed dates?
Yes. Even after patents or exclusivity expire, a generic still needs FDA approval and a manufacturer must choose to market it. Supply, litigation, business decisions, or regulatory issues can delay actual availability.
What is the difference between patents and exclusivity?
Patents are legal protections usually issued by the U.S. Patent and Trademark Office. FDA exclusivity is marketing protection granted by the FDA. They are separate, and either one can affect generic timing.
Why are there multiple patent dates?
One drug can have several patents covering different things: the active ingredient, a formulation, a manufacturing process, or a specific approved use. That is why a page may show several expiration dates instead of one simple generic date.
Built from FDA Orange Book patent and exclusivity data. Dates are refreshed from public FDA data when available; the marker is max(latest patent expiry, latest exclusivity expiry). Paragraph-IV settlements and first-filer 180-day exclusivity can shift the real date; a method-of-use patent may allow an earlier skinny-label generic for non-protected indications. Generic launch timing is an estimate, not a guarantee.
Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII F5UM2KM3W7
    Benzalkonium chloride is a chemical compound that works as a preservative and antimicrobial agent in medications. It prevents bacterial and fungal growth in liquid formulations to keep the product safe during storage and use.
  • UNII R57ZHV85D4
    Boric acid is a weak acid derived from boron. In medicines, it typically serves as a buffer to help maintain the product's pH level and may act as a preservative in certain formulations.
  • UNII 3OWL53L36A
    A natural sugar alcohol derived from seaweed or synthesized in the lab. It's used as a filler to add bulk, a sweetener in sugar-free formulas, and a disintegrant to help tablets break apart in the stomach.
  • UNII 55X04QC32I
    A strong alkaline chemical used to adjust and maintain the pH balance of liquid medicines. It helps keep the medicine stable and ensures it stays effective during storage.
  • UNII 059QF0KO0R
    Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.

5 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMed — ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

Manufacturer & labeler

LabelerAlcon Laboratories, Inc.
Application holderALCON LABORATORIES INC
FDA applicationNDA208254 (NDA)
Labeler code70727
First marketedDec 2017
Product typeHuman Prescription Drug
Portfolio55 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Very long sections are excerpted here and marked; the full text is on DailyMed (linked in the sources below). Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage 49 words ▾

1 INDICATIONS AND USAGE RHOPRESSA is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. RHOPRESSA ® is a Rho kinase inhibitor indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension. ( 1 )

⏱️ Dosage and Administration 92 words ▾

2 DOSAGE AND ADMINISTRATION The recommended dosage is one drop in the affected eye(s) once daily in the evening. If one dose is missed, treatment should continue with the next dose in the evening. Twice a day dosing is not well tolerated and is not recommended.

If RHOPRESSA is to be used concomitantly with other topical ophthalmic drug products to lower IOP, administer each drug product at least 5 minutes apart [see Patient Counseling Information ( 17 )]. One drop into the affected eye(s) once daily in the evening. ( 2 )

💊 Dosage Forms and Strengths 20 words ▾

3 DOSAGE FORMS AND STRENGTHS Ophthalmic solution containing netarsudil 0.02% (0.2 mg/mL). Ophthalmic solution containing netarsudil 0.02%. ( 3 )

⛔ Contraindications 7 words ▾

4 CONTRAINDICATIONS None. None. ( 4 )

⚠️ Warnings and Cautions 154 words ▾

5 WARNINGS AND PRECAUTIONS

5.1Epithelial Corneal Edema Epithelial corneal edema, described as honeycomb or bullous, has been reported in some patients with pre-existing corneal stromal edema or following ocular procedures that could affect corneal endothelial function. Epithelial corneal edema typically resolves upon discontinuation of RHOPRESSA. Advise patients to notify their physician if they experience eye pain or decreased vision while using RHOPRESSA [see Adverse Reactions ( 6.2 ) and Patient Counselling Information ( 17 )] .

5.2Bacterial Keratitis There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface [see Patient Counseling Information ( 17 )].

5.3Use with Contact Lenses Contact lenses should be removed prior to instillation of RHOPRESSA and may be reinserted 15 minutes following its administration.

🤒 Adverse Reactions ~1 min read ▾

6 ADVERSE REACTIONS The most common adverse reaction is conjunctival hyperemia (53%). Other common adverse reactions, approximately 20% include: corneal verticillata, instillation site pain, and conjunctival hemorrhage. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Alcon Laboratories, Inc. at 1‑800-757-9195, or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch .

6.1Clinical Trials Experience Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice. The most common ocular adverse reaction observed in controlled clinical studies with RHOPRESSA dosed once daily was conjunctival hyperemia which was reported in 53% of patients. Six percent of patients discontinued therapy due to conjunctival hyperemia.

Other common (approximately 20%) ocular adverse reactions reported were: corneal verticillata, instillation site pain, and conjunctival hemorrhage. Instillation site erythema, corneal staining, blurred vision, increased lacrimation, erythema of eyelid, and reduced visual acuity were reported in 5-10% of patients. Corneal Verticillata Corneal verticillata occurred in approximately 20% of the patients in controlled clinical studies.

The corneal verticillata seen in RHOPRESSA-treated patients were first noted at 4 weeks of daily dosing. This reaction did not result in any apparent visual functional changes in patients. Most corneal verticillata resolved upon discontinuation of treatment.

6.2Postmarketing Experience The following adverse reactions have been identified during postmarketing use of RHOPRESSA. 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. Eye disorders : Epithelial corneal edema has been reported in some patients with pre-existing corneal stromal edema or following ocular procedures (that could affect corneal endothelial function) [see Warnings and Precautions ( 5.1 )] .

👥 Use in Specific Populations ~2 min read ▾

8 USE IN SPECIFIC POPULATIONS

8.1Pregnancy Risk Summary There are no available data on RHOPRESSA use in pregnant women to inform any drug associated risk; however, systemic exposure to netarsudil from ocular administration is low [see Clinical Pharmacology ( 12.3 ) ] . Intravenous administration of netarsudil to pregnant rats and rabbits during organogenesis did not produce adverse embryofetal effects at clinically relevant systemic exposures [see Data] . Data Animal Data Netarsudil administered daily by intravenous injection to rats during organogenesis caused abortions and embryofetal lethality at doses ≥0.3 mg/kg/day (126-fold the plasma exposure at the recommended human ophthalmic dose [RHOD], based on C max ).

The no-observed-adverse-effect-level (NOAEL) for embryofetal development toxicity was 0.1 mg/kg/day (40-fold the plasma exposure at the RHOD, based on C max ). Netarsudil administered daily by intravenous injection to rabbits during organogenesis caused embryofetal lethality and decreased fetal weight at 5 mg/kg/day (1480-fold the plasma exposure at the RHOD, based on C max ). Malformations were observed at ≥3 mg/kg/day (1330-fold the plasma exposure at the RHOD, based on C max ), including thoracogastroschisis, umbilical hernia and absent intermediate lung lobe.

The NOAEL for embryofetal development toxicity was 0.5 mg/kg/day (214-fold the plasma exposure at the RHOD, based on C max ).

8.2Lactation Risk Summary There are no data on the presence of RHOPRESSA in human milk, the effects on the breastfed infant, or the effects on milk production. However, systemic exposure to netarsudil following topical ocular administration is low [see Clinical Pharmacology ( 12.3 )] , and it is not known whether measurable levels of netarsudil would be present in maternal milk following topical ocular administration. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for RHOPRESSA and any potential adverse effects on the breast-fed child from RHOPRESSA.

8.4Pediatric Use Safety and effectiveness in pediatric patients below the age of 18 years have not been established.

8.5Geriatric Use No overall differences in safety or effectiveness have been observed between elderly and other adult patients.

🤰 Pregnancy 204 words ▾

8.1Pregnancy Risk Summary There are no available data on RHOPRESSA use in pregnant women to inform any drug associated risk; however, systemic exposure to netarsudil from ocular administration is low [see Clinical Pharmacology ( 12.3 ) ] . Intravenous administration of netarsudil to pregnant rats and rabbits during organogenesis did not produce adverse embryofetal effects at clinically relevant systemic exposures [see Data] . Data Animal Data Netarsudil administered daily by intravenous injection to rats during organogenesis caused abortions and embryofetal lethality at doses ≥0.3 mg/kg/day (126-fold the plasma exposure at the recommended human ophthalmic dose [RHOD], based on C max ).

The no-observed-adverse-effect-level (NOAEL) for embryofetal development toxicity was 0.1 mg/kg/day (40-fold the plasma exposure at the RHOD, based on C max ). Netarsudil administered daily by intravenous injection to rabbits during organogenesis caused embryofetal lethality and decreased fetal weight at 5 mg/kg/day (1480-fold the plasma exposure at the RHOD, based on C max ). Malformations were observed at ≥3 mg/kg/day (1330-fold the plasma exposure at the RHOD, based on C max ), including thoracogastroschisis, umbilical hernia and absent intermediate lung lobe.

The NOAEL for embryofetal development toxicity was 0.5 mg/kg/day (214-fold the plasma exposure at the RHOD, based on C max ).

🧒 Pediatric Use 19 words ▾

8.4Pediatric Use Safety and effectiveness in pediatric patients below the age of 18 years have not been established.

🧓 Geriatric Use 19 words ▾

8.5Geriatric Use No overall differences in safety or effectiveness have been observed between elderly and other adult patients.

🧬 Clinical Pharmacology 131 words ▾

12 CLINICAL PHARMACOLOGY

12.1Mechanism of Action Netarsudil is a rho kinase inhibitor, which is believed to reduce IOP by increasing the outflow of aqueous humor through the trabecular meshwork. The exact mechanism is unknown.

12.3Pharmacokinetics Absorption The systemic exposures of netarsudil and its active metabolite, AR-13503, were evaluated in 18 healthy subjects after topical ocular administration of RHOPRESSA 0.02% once daily (one drop bilaterally in the morning) for 8 days. There were no quantifiable plasma concentrations of netarsudil (lower limit of quantitation (LLOQ) 0.100 ng/mL) post dose on Day 1 and Day 8. Only one plasma concentration at 0.11 ng/mL for the active metabolite was observed for one subject on Day 8 at 8 hours post-dose.

Metabolism After topical ocular dosing, netarsudil is metabolized by esterases in the eye.

🧬 Mechanism of Action 32 words ▾

12.1Mechanism of Action Netarsudil is a rho kinase inhibitor, which is believed to reduce IOP by increasing the outflow of aqueous humor through the trabecular meshwork. The exact mechanism is unknown.

📦 How Supplied / Storage and Handling 121 words ▾

16 HOW SUPPLIED/STORAGE AND HANDLING RHOPRESSA ® (netarsudil ophthalmic solution) 0.02% (0.2 mg per mL) is supplied sterile in opaque white low density polyethylene bottles and tips with white polypropylene caps. 2.5 mL fill in a 4 mL container NDC # 70727-497-25 Storage: Store at 2°C to 8°C (36°F to 46°F) until opened. After opening, the product may be kept at 2°C to 25°C (36°F to 77°F) for up to 6 weeks.

If after opening the product is kept refrigerated at 2°C to 8°C (36°F to 46°F), then the product can be used until the expiration date stamped on the bottle. During shipment, the bottle may be maintained at temperatures up to 40°C (104°F) for a period not exceeding 14 days.

📋 Description 183 words ▾

11 DESCRIPTION Netarsudil is a Rho kinase inhibitor. Its chemical name is (S)-4-(3-amino-1-(isoquinolin-6-yl-amino)-1-oxopropan-2-yl) benzyl 2,4-dimethylbenzoate dimesylate. The molecular formula of the free base is C 28 H 27 N 3 O 3 and the molecular formula of the dimesylate is C 30 H 35 N 3 O 9 S 2 .

The molecular weight of the free base is 453.54 and the molecular weight of the dimesylate is 645.74. The chemical structure is: Netarsudil dimesylate is a light yellow-to-white powder that is freely soluble in water, soluble in methanol, sparingly soluble in dimethyl formamide, and practically insoluble in dichloromethane and heptane. RHOPRESSA (netarsudil ophthalmic solution) 0.02% is supplied as a sterile, isotonic, buffered aqueous solution of netarsudil dimesylate with a pH of approximately 5 and an osmolality of approximately 295 mOsmol/kg.

It is intended for topical application in the eye. Each mL of RHOPRESSA contains 0.2 mg of netarsudil (equivalent to 0.28 mg of netarsudil dimesylate). Benzalkonium chloride, 0.015%, is added as a preservative.

The inactive ingredients are: boric acid, mannitol, sodium hydroxide to adjust pH, and water for injection. Netarsudil structural formula

💬 Information for Patients 219 words ▾

17 PATIENT COUNSELING INFORMATION Handling the Container Instruct patients to avoid allowing the tip of the dispensing container to contact the eye, surrounding structures, fingers, or any other surface in order to minimize contamination of the solution. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions [see Warnings and Precautions ( 5.2 )]. When to Seek Physician Advice Advise patients that if they develop an intercurrent ocular condition (e.g., trauma, infection, or decreased vision with or without eye pain), have ocular surgery, or develop any ocular reactions, particularly conjunctivitis and eyelid reactions, they should immediately seek their physician’s advice concerning the continued use of RHOPRESSA.

Use with Contact Lenses Advise patients that RHOPRESSA contains benzalkonium chloride, which may be absorbed by soft contact lenses. Contact lenses should be removed prior to instillation of RHOPRESSA and may be reinserted 15 minutes following its administration. Use with Other Ophthalmic Drugs Advise patients that if more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes between applications.

Missed Dose Advise patients that if one dose is missed, treatment should continue with the next dose in the evening. © 2024 Alcon Inc. U.S. Pat.: www.alconpatents.com ALCON LABORATORIES, INC.

6201 South Freeway Fort Worth, Texas 76134 USA 1-800-757-9195 [email protected]

🧬 Pharmacokinetics 96 words ▾

12.3Pharmacokinetics Absorption The systemic exposures of netarsudil and its active metabolite, AR-13503, were evaluated in 18 healthy subjects after topical ocular administration of RHOPRESSA 0.02% once daily (one drop bilaterally in the morning) for 8 days. There were no quantifiable plasma concentrations of netarsudil (lower limit of quantitation (LLOQ) 0.100 ng/mL) post dose on Day 1 and Day 8. Only one plasma concentration at 0.11 ng/mL for the active metabolite was observed for one subject on Day 8 at 8 hours post-dose.

Metabolism After topical ocular dosing, netarsudil is metabolized by esterases in the eye.

🔬 Clinical Studies ~1 min read ▾

14 CLINICAL STUDIES RHOPRESSA 0.02% was evaluated in three randomized and controlled clinical trials, namely AR-13324-CS301 (NCT 02207491, referred to as Study 301), AR-13324-CS302 (NCT 02207621, referred to as Study 302), and AR-13324-CS304 (NCT 02558374, referred to as Study 304), in patients with open-angle glaucoma or ocular hypertension. Studies 301 and 302 enrolled subjects with baseline IOP lower than 27 mmHg and Study 304 enrolled subjects with baseline IOP lower than 30 mmHg. The treatment duration was 3 months in Study 301, 12 months in Study 302, and 6 months in Study 304.

The three studies demonstrated up to 5 mmHg reductions in IOP for subjects treated with RHOPRESSA 0.02% once daily in the evening. For patients with baseline IOP < 25 mmHg, the IOP reductions with RHOPRESSA 0.02% dosed once daily were similar to those with timolol 0.5% dosed twice daily (see Table 1). For patients with baseline IOP equal to or above 25 mmHg, however, RHOPRESSA 0.02% resulted in smaller mean IOP reductions at the morning time points than timolol 0.5% for study visits on Days 43 and 90; the difference in mean IOP reduction between the two treatment groups was as high as 3 mmHg, favoring timolol.

Table 1: Mean IOP Change from Baseline of Study Eye (mmHg) by Visit and Time This table was produced based on the observed data from all randomized subjects who did not have major protocol violations. The treatment differences and two-sided CIs for comparing Rhopressa QD vs Timolol BID 0.5% were based on Analysis of Covariance (ANCOVA) adjusted for baseline IOP. Study 301: Subjects with Baseline IOP < 25 mmHg Study 301: Subjects with Baseline IOP >= 25 and < 27 mmHg Study 302: Subjects with Baseline IOP < 25 mmHg Study 302: Subjects with Baseline IOP >= 25 and < 27 mmHg Study 304: Subjects with Baseline IOP < 25 mmHg Study 304: Subjects with Baseline IOP >= 25 and < 30 mmHg

🧪 Nonclinical Toxicology 63 words ▾

13 NONCLINICAL TOXICOLOGY

13.1Carcinogenesis, Mutagenesis, Impairment of Fertility Long-term studies in animals have not been performed to evaluate the carcinogenic potential of netarsudil. Netarsudil was not mutagenic in the Ames test, in the mouse lymphoma test, or in the in vivo rat micronucleus test. Studies to evaluate the effects of netarsudil on male or female fertility in animals have not been performed.

📄 Carcinogenesis, Mutagenesis, Impairment of Fertility 60 words ▾

13.1Carcinogenesis, Mutagenesis, Impairment of Fertility Long-term studies in animals have not been performed to evaluate the carcinogenic potential of netarsudil. Netarsudil was not mutagenic in the Ames test, in the mouse lymphoma test, or in the in vivo rat micronucleus test. Studies to evaluate the effects of netarsudil on male or female fertility in animals have not been performed.

📄 Recent Major Changes 10 words ▾

Warnings and Precautions, Epithelial Corneal Edema ( 5.1 ) 9/2024

📄 Package Label / Principal Display Panel ~3 min read ▾

PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 70727-497-25 rhopressa ® (netarsudil ophthalmic solution) 0.02% For topical application in the eye Sterile Rx only 2.5 mL Alcon Usual dosage: One drop in the affected eye(s) once daily in the evening. Each mL Rhopressa ® ophthalmic solution contains: Active: netarsudil mesylate 0.285 mg Preservative: benzalkonium chloride 0.15 mg Inactives: mannitol, boric acid, sodium hydroxide to adjust pH and water for injection. Manufactured for: ALCON LABORATORIES, INC.

Fort Worth, TX 76134 USA U.S. Pat: www.alconpatents.com Store at 2°C - 8°C (36°F - 46°F) until opened. After opening, the product may be kept at 2°C - 25°C (36°F - 77°F) for up to 6 weeks.

If after opening the product is kept refrigerated at 2°C - 8°C (36°F - 46°F), then the product can be used until the expiration date stamped on the bottle. During shipment, the bottle may be maintained at temperatures up to 40°C (104°F) for a period not exceeding 14 days. 41079 NDC 70727-497-25 For topical application in the eye. rhopressa ® (netarsudil ophthalmic solution) 0.02% Rx only Sterile 2.5 mL Alcon 41077 See carton for storage conditions.

Manufactured for: Alcon Laboratories, Inc. Fort Worth, TX 76134 LOT: EXP: NDC 70727-497-99 SAMPLE - Not for Resale rhopressa ® (netarsudil ophthalmic solution) 0.02% For topical application in the eye Sterile Rx only 2.5 mL Alcon Usual dosage: One drop in the affected eye(s) once daily in the evening. Each mL Rhopressa ® ophthalmic solution contains: Active: netarsudil mesylate 0.285 mg Preservative: benzalkonium chloride 0.15 mg Inactives: mannitol, boric acid, sodium hydroxide to adjust pH and water for injection.

Manufactured for: ALCON LABORATORIES, INC. Fort Worth, TX 76134 USA U.S. Pat: www.alconpatents.com Store at 2°C - 8°C (36°F - 46°F) until opened.

After opening, the product may be kept at 2°C - 25°C (36°F - 77°F) for up to 6 weeks. If after opening the product is kept refrigerated at 2°C - 8°C (36°F - 46°F), then the product can be used until the expiration date stamped on the bottle. During shipment, the bottle may be maintained at temperatures up to 40°C (104°F) for a period not exceeding 14 days.

41080 NDC 70727-497-99 SAMPLE - Not for Resale For topical application in the eye. rhopressa ® (netarsudil ophthalmic solution) 0.02% Rx only Sterile 2.5 mL Alcon 41078 See carton for storage conditions. Manufactured for: Alcon Laboratories, Inc. Fort Worth, TX 76134 LOT: EXP: NDC 70727-497-25 rhopressa ® (netarsudil ophthalmic solution) 0.02% For topical application in the eye Sterile Rx only 2.5 mL Alcon Usual dosage: One drop in the affected eye(s) once daily in the evening.

Each mL Rhopressa ® ophthalmic solution contains: Active: netarsudil mesylate 0.285 mg Preservative: benzalkonium chloride 0.15 mg Inactives: mannitol, boric acid, sodium hydroxide toadjust pH and water for injection. ALCON LABORATORIES, INC. Fort Worth, TX 76134 USA U.S.

Pat: www.alconpatents.com Store at 2°C - 8°C (36°F - 46°F) until opened. After opening, the product may be kept at 2°C - 25°C (36°F - 77°F) for up to 6 weeks. If after opening the product is kept refrigerated at 2°C - 8°C (36°F - 46°F), then the product can be used until the expiration date stamped on the bottle.

During shipment, the bottle may be maintained at temperatures up to 40°C (104°F) for a period not exceeding 14 days. 300069021-1224 NDC 70727-497-25 For topical application in the eye. rhopressa ® (netarsudil ophthalmic solution) 0.02% Rx only Sterile 2.5 mL Alcon See carton for storage conditions. Alcon Laboratories, Inc.

Fort Worth, TX 76134 LOT: EXP.: 300069075 1224 Carton Label

PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 70727-497-99 SAMPLE - Not for Resale rhopressa ® (netarsudil ophthalmic solution) 0.02% For topical application in the eye Sterile Rx only 2.5 mL Alcon Usual dosage: One drop in the affected eye(s) once daily in the evening. Each mL Rhopressa ® ophthalmic solution contains: Active: netarsudil mesylate 0.285 mg Preservative: b… [Excerpted — this section continues on DailyMed.]

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗

Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for this package alone, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q1 2026 · 5 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
24.1K
Units reimbursed last 4 qtrs
69K
Gross reimbursed last 4 qtrs
$9.1M
Avg / prescription
$377.29
Avg / unit
$131.96
Latest quarter Q1 2026
5.6KRx
Medicaid pays / mL
$131.96
gross reimbursed
vs
NADAC / mL
$131.68
acquisition cost
=
Spread
+$0.2829
+0% vs cost
What Medicaid paid per mL (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care ⓘ
63% FFS 37% MCO
Fee-for-service · 15,247 Rx Managed care · 8,880 Rx
State Medicaid map
Alaska: 30 units · 4.1 per 100k residents AK Maine: 178 units · 12.8 per 100k residents ME Washington: 593 units · 7.6 per 100k residents WA Idaho: 30 units · 1.5 per 100k residents ID Montana: 30 units · 2.7 per 100k residents MT North Dakota: no data reported ND Minnesota: 588 units · 10.2 per 100k residents MN Wisconsin: 1,260 units · 21.3 per 100k residents WI Michigan: 1,115 units · 11.1 per 100k residents MI New York: 17,170 units · 87.7 per 100k residents NY Vermont: no data reported VT New Hampshire: no data reported NH Oregon: 295 units · 7.0 per 100k residents OR Nevada: 455 units · 14.2 per 100k residents NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: 173 units · 5.4 per 100k residents IA Illinois: 1,915 units · 15.3 per 100k residents IL Indiana: 798 units · 11.6 per 100k residents IN Ohio: 2,563 units · 21.7 per 100k residents OH Pennsylvania: 1,753 units · 13.5 per 100k residents PA New Jersey: 1,075 units · 11.6 per 100k residents NJ Massachusetts: 1,668 units · 23.8 per 100k residents MA California: 18,443 units · 47.3 per 100k residents CA Utah: no data reported UT Colorado: 383 units · 6.5 per 100k residents CO Nebraska: 93 units · 4.7 per 100k residents NE Missouri: 255 units · 4.1 per 100k residents MO Kentucky: 456 units · 10.1 per 100k residents KY West Virginia: 243 units · 13.7 per 100k residents WV Virginia: 1,535 units · 17.6 per 100k residents VA Maryland: 1,163 units · 18.8 per 100k residents MD Connecticut: 1,483 units · 41.0 per 100k residents CT Rhode Island: 148 units · 13.5 per 100k residents RI Arizona: 415 units · 5.6 per 100k residents AZ New Mexico: 245 units · 11.6 per 100k residents NM Kansas: no data reported KS Arkansas: 180 units · 5.9 per 100k residents AR Tennessee: 633 units · 8.9 per 100k residents TN North Carolina: 1,240 units · 11.4 per 100k residents NC South Carolina: 285 units · 5.3 per 100k residents SC Delaware: no data reported DE Oklahoma: 485 units · 12.0 per 100k residents OK Louisiana: 1,628 units · 35.6 per 100k residents LA Mississippi: 200 units · 6.8 per 100k residents MS Alabama: 190 units · 3.7 per 100k residents AL Georgia: 803 units · 7.3 per 100k residents GA D.C.: 675 units · 99.4 per 100k residents DC Hawaii: 169 units · 11.8 per 100k residents HI Texas: 3,243 units · 10.6 per 100k residents TX Florida: 2,678 units · 11.8 per 100k residents FL
Units reimbursed · per 100k residents
1.599.4
gray = no data reported ⓘ
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 D.C. 99.4 /100k
2 New York 87.7 /100k
3 California 47.3 /100k
4 Connecticut 41.0 /100k
5 Louisiana 35.6 /100k
6 Massachusetts 23.8 /100k
7 Ohio 21.7 /100k
8 Wisconsin 21.3 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
1 bottle this page70727-0497-25 24,127 Rx · $9,102,856
1 bottle70727-0497-99 No Medicaid data
Drug total (last 4 qtrs): 24,127 Rx · 68,983 units · $9,102,856 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

Medicare Part D spend CMS · PART D · 2026 (Q1)

Medicare Part D (outpatient prescription) spending for Rhopressa — the program that covers self-administered drugs. 1 manufacturer.
⚠️ Drug-level data: CMS publishes Part D spending by drug, not by NDC — these figures combine every manufacturer, strength and package size sold under the name Rhopressa. That’s a different level of aggregation than the Medicaid card above, which is specific to this exact 11-digit NDC (pack size included), so the two aren’t directly comparable.
Period
Total Part D spend
$37.76M
Claims incl. refills
76.5K
Beneficiaries
49K
Spend / beneficiary
$770.53
Spend / claim
$493.45
Trend by period
💵 About the dollar figures: spending is what Part D plans paid before confidential manufacturer rebates, so the program’s real net cost is lower. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part D Spending by Drug (data.cms.gov), updated quarterly.
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.