Important Safety Information Prescribing Information
For US Healthcare Professionals Dompé Site Patient Site
OXERVATE® (cenegermin-bkbj)
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Important Safety Information Prescribing Information Dompé Site Patient Site
Contact a Rep

STARTING OXERVATE®

Access Support Every Step of the Way

You can prescribe OXERVATE through Dompé CONNECT to Care
or directly to Accredo Specialty Pharmacy.

~82% of all enrollments are approved1

Download enrollment form

Dompé CONNECT to Care provides support with benefits verification and prior authorizations and provides answers to general questions.

E-PRESCRIBE

FAX

Enroll patient in Dompé
CONNECT to Care

Log into your EMR/EHR and E‑prescribe OXERVATE to CoAssist Pharmacy:

NCPDP: 5733604

Phone: 1-855-382-2533 Mon-Fri 9 AM-5 PM ET

Location: Orlando, FL

After your E‑prescription is received, patients will be sent a text message with a link to provide consent.

OR

Download and fax the
Enrollment Form

Download the Enrollment Form, which acts as both the prescription for OXERVATE and the patient’s authorization to enroll in Dompé CONNECT to Care.

Once the form is filled out, please ensure that the patient signs the authorization section.

The completed form can be faxed to Dompé CONNECT to Care at 1-855-263-1775.

When you E-prescribe OXERVATE, input the below required information:

DOSING DIRECTIONS

1 DROP IN [the right eye, the left eye, or both eyes]

6 TIMES DAILY

AT 2-HOUR INTERVALS

FOR 8 WEEKS

QUANTITY

Quantity
Day Supply
UNILATERAL TREATMENT
56 mL
56 days
BILATERAL TREATMENT
112 mL
56 days

1 carton of OXERVATE = 7 mL (1 mL/vial)
Full 8 weeks of therapy (8 cartons) = 56 mL per eye

APPLICABLE
ICD-10 CODE(S)2

Right Eye
Left Eye
Bilateral
NEUROTROPHIC
KERATOCONJUNCTIVITIS
H16.231
H16.232
H16.233

Input the following required information in “Note to Pharmacy”
or in the free text field: treated eye, applicable ICD-10 code(s),
and office contact name and email address

All details are required to process the E‑prescription.

Accredo provides financial assistance support, shipment coordination, medication fulfillment, and pharmacist counseling.

E-PRESCRIBE

FAX

E-prescribing to Accredo
requires 2 steps

Step 1:

Download the Patient Authorization Form and have the patient sign it, then fax it to 1-888-454-8488.

Step 2:

Use your practice’s EHR system to E‑prescribe OXERVATE to:

Accredo Specialty Pharmacy

NCPDP: 4436920

Phone: 1-877-831-8112 Mon-Fri 8 AM-8 PM ET

Location: Memphis, TN

OR

Download and fax the
Enrollment Form

Download the Enrollment Form. The completed enrollment form serves as the prescription for OXERVATE. Have the patient sign the form for authorization, then fax the completed form to Accredo at 1-888-454-8488.

When you E-prescribe OXERVATE, input the below required information:

DOSING DIRECTIONS

1 DROP IN [the right eye, the left eye, or both eyes]

6 TIMES DAILY

AT 2-HOUR INTERVALS

FOR 8 WEEKS

QUANTITY

Quantity
Day Supply
UNILATERAL TREATMENT
56 mL
56 days
BILATERAL TREATMENT
112 mL
56 days

1 carton of OXERVATE = 7 mL (1 mL/vial)
Full 8 weeks of therapy (8 cartons) = 56 mL per eye

APPLICABLE
ICD-10 CODE(S)2

Right Eye
Left Eye
Bilateral
NEUROTROPHIC
KERATOCONJUNCTIVITIS
H16.231
H16.232
H16.233

Input the following required information in “Note to Pharmacy”
or in the free text field: treated eyes, applicable ICD-10 code(s),
and your office contact name and email address

All details are required to process the E-prescription.

Coverage details and prior authorization requirements are typically
faxed to your office within 1 business day of submission.

Meet your OXERVATE support teams

Resources are available to support you and your patient along the access journey. Your Dompé Key Account Manager (KAM) is your primary point of contact for any OXERVATE access questions and can connect you with Field Access Managers (FAMs) and Patient Access Managers (PAMs) when additional support is needed.

From enrollment through delivery, support is
available to help you navigate access to OXERVATE

BENEFITS VERIFICATION

PLAN AND COVERAGE DETAILS

PRIOR AUTHORIZATIONS AND APPEALS

FINANCIAL ASSISTANCE SUPPORT

MEDICATION FULFILLMENT

ANSWERS TO GENERAL QUESTIONS

Majority of patients receive their medication shipment within 4 weeks of approval1

Explore affordability options for patients,
regardless of insurance type

Patient coverage

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For US healthcare professionals only.

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FUTURE COMMUNICATION
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By checking this box and submitting this form, I consent to Dompé collecting, using, and processing the personal information I provide, including information that may relate to my health condition or treatment, to send me educational materials, product information, support resources, market research communications, and other marketing information about OXERVATE® or related services.

I understand that Dompé may share my information with service providers, contractors, business partners, or vendors acting on its behalf to deliver these communications and services. My information will not be sold.

I understand that providing this consent is voluntary, there is no cost to me, and my decision will not affect my ability to receive OXERVATE or any other medical care or medications.

I may withdraw my consent at any time by following the instructions in the Privacy Policy.

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Indication and Important Safety Information

WARNINGS AND PRECAUTIONS

Use with Contact Lens
Contact lenses should be removed before applying OXERVATE because the presence of a contact lens (either therapeutic or corrective) could theoretically limit the distribution of cenegermin-bkbj onto the area of the corneal lesion. Lenses may be reinserted 15 minutes after administration.

Eye Discomfort
OXERVATE may cause mild to moderate eye discomfort such as eye pain during treatment. The patient should be advised to contact their doctor if a more serious eye reaction occurs.

ADVERSE REACTIONS
In clinical trials, the most common adverse reaction was eye pain following instillation which was reported in approximately 16% of patients. Eye pain may arise as corneal healing occurs. Other adverse reactions occurring in 1% to 10% of OXERVATE patients included corneal deposits, foreign body sensation, ocular hyperemia, ocular inflammation, photophobia, tearing, and headache.

USE IN SPECIFIC POPULATIONS

Pregnancy
There are no data from the use of OXERVATE in pregnant women to inform any drug associated risks.

Lactation
The developmental and health benefits of breastfeeding should be considered, along with the mother’s clinical need for OXERVATE, and any potential adverse effects on the breastfed infant from OXERVATE.

Pediatric Use
The safety and effectiveness of OXERVATE have been established in the pediatric population. Use of OXERVATE in pediatric patients 2 years of age and older is supported by evidence from adequate and well-controlled trials of OXERVATE in adults with additional safety data in children.

INDICATION
OXERVATE® (cenegermin-bkbj) ophthalmic solution 0.002% (20 mcg/mL) is indicated for the treatment of neurotrophic keratitis.

DOSAGE AND ADMINISTRATION
Instill one drop of OXERVATE in the affected eye(s), 6 times a day at 2-hour intervals for eight weeks.

To report ADVERSE REACTIONS, contact Dompé U.S. Inc. at 1‌-‌8‌3‌3‌-‌3‌6‌6‌-‌7‌3‌8‌7 or FDA at 1‌-‌8‌0‌0‌-‌F‌D‌A‌-‌1‌0‌8‌8 or www.fda.gov/medwatch.

Please see full Prescribing Information for OXERVATE.

References: 1. Data on file. San Mateo, CA: Dompé U.S. Inc. 2. Centers for Medicare & Medicaid Services, National Center for Health Statistics. ICD-10-CM Tabular List of Diseases and Injuries. Updated June 5, 2026. Accessed June 29, 2026. https://www.cms.gov/medicare/coding-billing/icd-10-codes

Indication and Important Safety Information

OXERVATE® (cenegermin-bkbj) ophthalmic solution 0.002% (20 mcg/mL) is indicated for the treatment of neurotrophic keratitis.

WARNINGS AND PRECAUTIONS

Use with Contact Lens
Contact lenses should be removed before applying OXERVATE because the presence of a contact lens (either therapeutic or corrective) could theoretically limit the distribution of cenegermin-bkbj onto the area of the corneal lesion. Lenses may be reinserted 15 minutes after administration.

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