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MIEBO FAQs
Got questions? “Ohh yeah,” we've got answers! Select a topic to learn more.
Overview of MIEBO
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What is MIEBO?
- MIEBO is a prescription eye drop used to treat the signs and symptoms of dry eye disease. It’s the first and only prescription eye drop that directly targets too much tear evaporation—the #1 cause of rough, gritty, dry eye.
What is MIEBO used for?
- MIEBO is used for the treatment of the signs and symptoms of dry eye disease.
- “Signs” refer to the damage to the surface of your eye. “Symptoms” refer to the feeling of eye dryness experienced, such as dry, rough, or gritty.
Who can use MIEBO? Is MIEBO right for me?
- MIEBO is used for the treatment of the signs and symptoms of dry eye disease.
- If you’ve tried over-the-counter treatments, prescriptions, or procedures and are still looking for relief, it’s time to try something different. Consider asking your doctor about MIEBO.
- Other eye drops may add tears or increase the number of tears you make. But for about 9 out of 10 people with dry eye, a leading cause is too much tear evaporation.
- Everyone’s tears evaporate. But when you have excessive tear evaporation, your tears escape too quickly and the quality of new tears is not as good. This can lead to actual damage on the surface of the eye over time and cause symptoms to get worse.
- MIEBO is the only prescription eye drop that directly targets too much tear evaporation.
- You can also take the quiz to find out if MIEBO may be right for you.
Dry eye disease
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What is dry eye disease?
- Dry eye is more than just the symptoms that you feel. It's an underlying condition that can be caused by different things. There are 2 types of dry eye. The first type involves your eyes not producing enough tears. This is called aqueous-deficient dry eye. The second type is when your tears evaporate too quickly. This is called evaporative dry eye. Too much tear evaporation is a leading cause of dry eye in about 9 out of 10 people. In both types, these conditions can potentially result in symptoms that make your eyes feel tired, scratchy, gritty, rough, or dry. Evaporative dry eye can be driven by factors in our modern lifestyle, like screen time. Sometimes, you can have a combination of both types. MIEBO is the only prescription eye drop that directly targets too much tear evaporation to treat dry eye disease. No other water-based or water-free drops directly target tear evaporation.
Is all dry eye the same?
- No, not all dry eye is the same. There are 2 types of dry eye:
- Evaporative, or “too much tear evaporation,” which contributes to dry eye in about 9 out of 10 people.
- Aqueous deficient, or “not making enough tears,” which is a less common type of dry eye.
- Some people may have a combination of both types.
What role does evaporation play in dry eye disease?
- Everyone’s tears evaporate. But when you have evaporative dry eye, your tears escape too quickly—more than what’s considered normal. Too much tear evaporation is the #1 cause of dry eye and can leave eyes feeling symptoms such as tiredness, scratchiness, grittiness, roughness, or dryness.
What does dry eye feel like? What are the symptoms of dry eye?
- Dry eye may make your eyes feel one or more of the following: tired, scratchy, gritty, stinging, painful, heavy, sensitive to light, burning, rough, itchy, watery, or irritated. It’s also common to experience the need to clear your vision by blinking and vision that fluctuates throughout the day.
What is meibomian gland dysfunction (MGD)?
- Meibomian (my-bo-mee-an) gland dysfunction, also called MGD, is the leading cause of too much tear evaporation. Little glands called meibomian glands make an oily layer, or lipids, on the surface of the eye. The oily layer prevents the tears beneath from evaporating and helps protect the surface of the eye. In evaporative dry eye, the meibomian glands don’t work as they should, and the oily layer becomes damaged. This damage leads to too much tear evaporation.
Savings/Coverage
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What does MIEBO cost? Is MIEBO expensive?
- Our goal is to make MIEBO affordable and accessible to patients as quickly as possible. The price of MIEBO will vary from person to person based on insurance coverage.
- More information can be found on our Savings page.
What type of coverage is there?
- As of January 2025, MIEBO is covered broadly on both commercial and Medicare Part D plans, qualifying as best-in-class coverage. About 75% of commercial plans cover MIEBO, and about 65% of Medicare Part D plans cover MIEBO.
- Eligible commercially insured patients may pay as little as a $0 copay. Eligible Medicare Part D patients may be able to receive a product trial through the digital pharmacy service BlinkRx while they await coverage decisions for MIEBO.
Is there patient assistance for MIEBO? Who is eligible? How can I find out if I’m eligible?
- Yes, the Bausch + Lomb Patient Assistance Program helps patients who have limited assets, have limited or no prescription coverage, or are on government insurance. To find out if you are eligible, please fill out the patient assistance questionnaire or call 1-855-770-0424.
Can I get MIEBO at any pharmacy?
- A MIEBO prescription can be sent to traditional pharmacies or to BlinkRx, a digital pharmacy alternative.
- If you are picking up MIEBO from a traditional pharmacy, the MySavings Program may be able to help you save on your copay. With our MIEBO Copay Card, eligible commercially insured patients may pay as little as a $0 copay for new prescriptions and refills. Please visit the My Savings Program website to learn more. Terms and conditions apply.
What is BlinkRx?
- BlinkRx offers a digital alternative to traditional pharmacies. BlinkRx will work with your insurance to find out if you are eligible and apply savings to your MIEBO prescription if so. Through BlinkRx, you are able to pay for your prescription online or over the phone and receive free delivery of your MIEBO prescription. The BlinkRx team has pharmacists available to help answer your questions and help with refills and reminders. They can be reached by phone at 1-833-914-3856 or by email at support@blinkrx.com.
- BlinkRx is not a traditional pharmacy. If you would like your prescription sent to your home by BlinkRx, your eye doctor will need to search for the virtual or mail order pharmacy “BlinkRx” in Boise, Idaho.
What is a copay program?
- The MySavings Program may be able to help you save on your copay for MIEBO. With our MIEBO Copay Card, eligible commercially insured patients may pay as little as a $0 copay for new prescriptions and refills. The program/card is not valid for patients whose prescriptions are reimbursed by any federal or state healthcare program, including Medicaid, Medicare, TRICARE, or any other federal or state healthcare program. Please visit the My Savings Program website to learn more. Terms and conditions apply.
Clinical studies
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What do studies of MIEBO show?
- MIEBO is an FDA-approved prescription eye drop that's been studied in over 600 people. In clinical studies, MIEBO was shown to significantly reduce the signs—damage on the surface of the eye—and symptoms of dry eye. With continued use of MIEBO, doctors saw significant improvement in the damage on the surface of the eye. People in the studies felt their eye dryness significantly improved.
- In the studies, doctors checked the signs and symptoms of dry eye after 2 weeks, and again after 8 weeks. Patients saw significant improvement at both checkpoints, as those improvements continued and were maintained with continued use of MIEBO.
- In these studies (GOBI and MOJAVE), MIEBO was studied against saline in 2 clinical trials of more than 1200 patients. A total of 208 patients from the GOBI study went on to enroll in an open-label extension study, KALAHARI, that evaluated the long-term safety and efficacy of MIEBO for an additional 52 weeks.
How many patients were enrolled in the study?
- MIEBO was studied against saline in 2 clinical trials of more than 1200 patients.
When were the studies completed?
- The studies took place from 2019 to 2022. GOBI lasted from December 2019 until March 2021. MOJAVE lasted from November 2020 until August 2021. KALAHARI then evaluated the long-term safety and efficacy of MIEBO for an additional 52 weeks.
Did anyone in the studies stop using MIEBO?
- Yes, 1 person out of 614 people in the studies stopped using MIEBO due to side effects, specifically eye irritation.
FDA approval: Why is MIEBO a prescription and not offered over the counter?
- In the United States, the main ingredient in MIEBO had never been approved by the FDA before. So since it’s a new drug in the US, the FDA required it to be approved as a prescription first to ensure its safety and effectiveness.
How quickly can I expect to experience relief with MIEBO?
- Clinical studies showed that patients experienced relief from the signs and symptoms of dry eye disease from the first evaluation (Week 2) through the last evaluation (Week 8). 208 patients in the GOBI study continued to use MIEBO for 52 weeks in the long-term safety study, KALAHARI. It's important to note that everyone's experience is different.
How MIEBO works
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How does MIEBO work?
- MIEBO is a different type of eye drop for dry eye. It’s the first and only prescription eye drop that directly targets too much tear evaporation. When you place a drop of MIEBO in your eye, it spreads evenly and quickly to form a protective layer on the surface of your eye. This reduces evaporation so that you can keep more of your own tears. Don’t feel it? Don’t worry. Because of the unique properties of MIEBO, you may not feel the drop or it may not make you blink when applied.*
What makes MIEBO unique?
- MIEBO is the first and only prescription eye drop that directly targets tear evaporation. A bottle of MIEBO contains 100% MIEBO—1 ingredient, nothing else. It’s preservative-free, which means it’s gentle on the eyes. It also contains no additives or water, which means it’s a smaller drop. Typical drops that contain water, like some artificial tears, are 3-5x larger than a drop of MIEBO.
- MIEBO also helps form a lasting barrier that fights tear evaporation to improve the signs and symptoms of dry eye with continued use. It mimics the way the protective outer layer of your own tear film prevents evaporation. MIEBO may reduce friction to help relieve that rough, gritty, dry feeling. And it can help heal the surface of the eye with continued use as directed.*
Is MIEBO an artificial tear?
- No, MIEBO is not an artificial tear. MIEBO is a prescription treatment for the signs and symptoms of dry eye disease.
- You can only get MIEBO from your eye doctor. If you don’t have an eye doctor, you can go to the Find a Doctor tab on our website to locate one near you.
What makes MIEBO different from artificial tears?
- Prescription drugs in the US demand a significantly higher level of scrutiny and oversight than over-the-counter products, so the safety and effectiveness of MIEBO were evaluated in rigorous clinical studies. Over-the-counter eye drops, like artificial tears, may provide temporary relief by adding moisture to your eyes. But for people with dry eye disease, this may not be enough. MIEBO specifically targets too much tear evaporation.
How is MIEBO different from drops that contain water, like some artificial tears?
- A bottle of MIEBO contains only 1 ingredient: 100% MIEBO—and nothing else. It’s preservative-free, which means it’s gentle on the eyes, it contains no additives or water, and it’s a smaller drop. Typical drops that contain water, like some artificial tears, are 3-5x larger than a drop of MIEBO. This means you may not need as much as you're used to. Because of its unique properties, you may not feel the drop, or it may not make you blink.
How do you know MIEBO targets too much tear evaporation?
- MIEBO has been studied extensively in clinical trials. The results demonstrate that MIEBO effectively targets too much tear evaporation. From lab studies, we know that MIEBO mimics the way the natural lipids, or oily layer, of your own tear film prevent evaporation. The exact way MIEBO works is unknown.
Why is the exact way MIEBO works “unknown”?
- This is a common statement that the FDA includes in the package insert for many drugs. It is used when there is understanding of a drug’s therapeutic effects but the complete mechanisms by which it works are not entirely known. This statement is included in the package inserts for most dry eye medications.
Why does it say MIEBO is a product of Japan?
- The unique, single ingredient used in MIEBO, perfluorohexyloctane, is produced by a Japanese pharmaceutical company. Bausch + Lomb takes the ingredient from the Japanese manufacturer to package MIEBO in the United States, ensuring that FDA health and safety standards are met.
Does MIEBO help with inflammation?
- MIEBO targets the #1 cause of dry eye: too much tear evaporation. MIEBO is for the treatment of the signs and symptoms of dry eye disease. MIEBO may help heal the surface of the eye with continued use, which, in turn, may help interrupt the cycle of damage and inflammation that results in the signs and symptoms of dry eye.
How is Xiidra different than MIEBO?
- Xiidra works differently than MIEBO. Both are used to treat the signs and symptoms of dry eye disease but do so by targeting different characteristics of the problem. Xiidra is a prescription dry eye treatment that works by targeting a source of inflammation. MIEBO addresses too much tear evaporation. You should consult with your eye doctor to learn about the treatment approach that may be right for you.
What is the difference between MIEBO and VEVYE?
- MIEBO is the only prescription drop that directly targets the #1 cause of dry eye: too much tear evaporation. VEVYE works by increasing the amount of tears that are made—it does not address tear evaporation directly.
- Both MIEBO and VEVYE are water-free products, but MIEBO is just one ingredient while VEVYE is made of multiple ingredients. None of the ingredients in VEVYE are the same as MIEBO.
Does MIEBO treat blockage in my meibomian glands or meibomian gland dysfunction (MGD)?
- MIEBO does not treat the meibomian glands. It treats the signs and symptoms of dry eye disease. MIEBO treats dry eye disease associated with meibomian gland dysfunction (MGD). In clinical studies of MIEBO, all patients had MGD, the reason for too much tear evaporation. MGD is a cause of dry eye for about 9 out of 10 people.
Does MIEBO heal damage on the surface of the eye caused by dry eye?
- MIEBO treats the signs and symptoms of dry eye disease and can protect and help heal the surface of the eye with continued use over time.
*The exact way MIEBO works is not known.
Safety
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Is MIEBO safe?
- MIEBO is a prescription eye drop approved by the FDA. Since prescription drugs in the US demand a significantly higher level of scrutiny and oversight than over-the-counter products, the safety and effectiveness of MIEBO were evaluated in rigorous clinical studies. These included 2 clinical trials where MIEBO was studied in over 600 people for 57 days (the 2 clinical trials were named GOBI and MOJAVE). No serious side effects were seen in either study. The following data is an average of the studies:
- 0 serious side effects. No one treated with MIEBO experienced serious side effects.
- 0.2% of people studied stopped using MIEBO due to side effects. That means that of the 614 people studied, only 1 person, in the GOBI study, stopped using MIEBO because of side effects.
- 0.5% of people studied felt burning or stinging when putting in MIEBO. This was 3 people in the GOBI study.
- And 2.1% of people studied reported blurred vision, which usually resolved within minutes. This was 9 people in the GOBI study and 4 people in the MOJAVE study. 0.8% also experienced eye redness.
Is there any long-term safety data available about MIEBO?
- Yes, we have long-term data from a clinical study called KALAHARI. Because MIEBO is a prescription, it was studied in depth in patients, unlike over-the-counter artificial tears. This included the long-term safety study KALAHARI, which demonstrated no additional safety concerns, confirming the safety data from the previous studies GOBI and MOJAVE. Detailed safety data from the studies can be found on our Results with MIEBO page.
What are possible side effects of MIEBO?
- In 2 clinical trials that lasted 57 days, no one treated with MIEBO experienced serious side effects. Out of everyone MIEBO was studied in:
- 0.2% of people studied stopped using MIEBO due to side effects. That means that of the 614 people studied, only 1 person stopped using MIEBO because of side effects.
- 0.5% of people studied felt burning or stinging when putting in MIEBO.
- And 2.1% of people studied reported blurred vision, which usually resolved within minutes. 0.8% also experienced eye redness.
- The safety of MIEBO was also demonstrated in a long-term study, KALAHARI, which reinforced the safety data from the previous studies, GOBI and MOJAVE.
Does my body metabolize MIEBO?
- Data suggests that MIEBO is not metabolized in humans. That means it exits your body as waste, with the chemical structure unchanged from when it was put in.
How does my body get rid of MIEBO?
- MIEBO is excreted from the body as waste. A small amount of it also evaporates from the surface of the eye over time.
Is MIEBO or any other Bausch + Lomb product affected by recent recalls and warnings from the CDC and FDA for over-the-counter artificial tears?
- No. The recalls and warnings do not apply or relate to any Bausch + Lomb products. The health and safety of anyone who uses our products is a top priority at Bausch + Lomb. We take great pride in supporting and serving our customers, patients, and consumers every day by offering only products that meet high standards of safety and quality.
- This is why it’s important to only use products containing perfluorohexyloctane (the active ingredient in MIEBO) that are prescribed within the US and therefore manufactured by Bausch + Lomb. Bausch + Lomb cannot stand behind the quality of illegally imported products in the US manufactured by other companies.
Can I wear contact lenses while using MIEBO?
- Yes, you can continue wearing your contact lenses while using MIEBO, but you should not put the drops in while your lenses are in your eyes. Be sure to remove your contact lenses before using MIEBO, and wait at least 30 minutes after applying the drops before putting your lenses back in.
Will my dry eye symptoms or irritation come back if I stop using MIEBO?
- Dry eye disease is a chronic condition where there is damage to the surface of the eye that can result in dry eye symptoms. There is no known cure for dry eye disease. Since MIEBO can help heal the eye's surface with continued use, if you stop using it your dry eye symptoms are likely to return. There is no study data to show exactly how long that may take, but the vicious cycle of damage associated with the condition could progress.
How to use MIEBO
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How do I use MIEBO?
- To use MIEBO, it’s important to know that this different kind of drop means a different way of using the bottle too. Each bottle of MIEBO has all you need for a full month of treatment (about 270 drops). To make sure you only get 1 drop of MIEBO each time, you’ll need to prime the bottle.
- To make sure you only get 1 drop of MIEBO each time you squeeze the bottle, follow these simple steps:
- Step 1: Get ready. Unscrew and remove the cap from the bottle. If wearing contact lenses, remove them before using MIEBO and wait at least 30 minutes before putting them back in.
- Step 2: Get set. Prime the bottle before you use it: Squeeze the bottle while upright. Turn it upside down (so the tip points down) while squeezing. Release the pressure.
- Step 3: Go with MIEBO. With the bottle upside down, move it above your eye and squeeze it again to release 1 drop.
- Repeat all of Step 2 to prime the bottle and release 1 drop in your other eye.
- For step-by-step instructions and a video example, please visit our How to use MIEBO page.
Why do I have to prime the bottle?
- The first squeeze while the bottle is upright will help make sure you only use 1 drop of MIEBO each time. Each bottle of MIEBO has all you need for a month.
Are there special tips on how to use MIEBO?
- Yes. Because you may not feel the drop go in, using a mirror is a great way to make sure it did in fact go in.
Why don’t I feel it?
- MIEBO spreads quickly to form a silky-smooth feeling protective layer right on the surface of your eye. Don’t feel it? Don’t worry. MIEBO is a comfortable drop. Because of its unique properties, you may not feel the drop, or it may not make you blink when applied.
Why do I go through drops so quickly? How long should a bottle of MIEBO last?
- Each bottle of MIEBO has what you need for a full month of treatment (about 270 drops). MIEBO has no additives or water, which means it’s a smaller drop than other, water-based drops, which are 3-5x larger. To make sure you only get one drop of MIEBO each time you squeeze the bottle, check out our step-by-step video.
- MIEBO was studied in people using 4 drops per day, so make sure to use MIEBO as directed by your doctor.
Do I have to use MIEBO 4 times a day?
- Always follow the dosing instructions provided by your eye doctor. MIEBO was studied in people using a dosage of 4 drops per day.
Can I use MIEBO with artificial tears?
- MIEBO is not known to have any reactions to other eye drops. If you are using other drops in addition to MIEBO, you may want to use MIEBO last because other drops may wash it away if used after it. Always check with your doctor before starting new medications or combining medications.
Can I use MIEBO with other eye medications?
- Always check with your doctor before starting a new medication or combining medications.
How should I store MIEBO?
- You should store MIEBO at around room temperature, anywhere from 59°F-77°F (15°C-25°C). After opening, MIEBO can be used until the expiration date on the bottle.
MIEBO in depth
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Can you tell me more about the main ingredient in MIEBO?
- MIEBO is unique because it contains only 1 ingredient: 100% MIEBO—and nothing else. The ingredient, perfluorohexyloctane, helps form a lasting barrier to fight tear evaporation. It’s preservative-free, which means it’s gentle on the eyes, and it contains no additives or water, which means it’s a smaller drop. Because of its unique properties, you may not feel the drop or it may not make you blink. MIEBO directly targets too much tear evaporation, and with continued use can help heal the surface of the eye.
Is MIEBO a PFAS/“forever chemical”?
- PFAS stands for perfluoroalkyl and polyfluoroalkyl substances, and is a broad term for many different compounds. The term PFAS does not indicate whether a substance is harmful or not.
- Perfluorohexyloctane, which is the only ingredient in MIEBO, has also been safely used in ophthalmic surgery, and other PFAS have been used in contact lenses for 5 decades with no safety concerns.
- MIEBO is non-reactive with other things. It does not change, react with, or bind to other substances.
- MIEBO is NOT metabolized; it leaves the body unchanged. Studies show that MIEBO exits the body naturally by evaporating from the eye or passing through the digestive system.
- Some other PFAS can stay in the body because they dissolve easily in water and interact with proteins. However, MIEBO does not react with the body and cannot readily dissolve in water.
- Based on thorough testing in both laboratory and clinical studies, the FDA has approved MIEBO as a safe and effective treatment for the signs and symptoms of dry eye disease. It has been commercially available in the US since September 2023 with no serious side effects seen in two 57-day clinical studies.
Has perfluorohexyloctane been used for anything else?
- Yes, perfluorohexyloctane has been used in other medical applications in eye care.
Is MIEBO available outside the US?
- No, Bausch + Lomb does not sell MIEBO outside of the US. In some parts of the world, the active ingredient, perfluorohexyloctane, is sold as a medical device. This means that it must be asked for by name at the pharmacy. Perfluorohexyloctane was approved by the FDA in May 2023 as a standalone product in eye care. As it is a new drug in the US, it was approved as a prescription in order to ensure its safety and effectiveness.
- It’s important to understand that it is illegal for pharmacies to import products that are prescriptions in the US from other countries. Since perfluorohexyloctane eye drops from countries outside the US were not manufactured by Bausch +Lomb, they have not been evaluated by the FDA, so there is no assurance about their quality or the standards of their production.
Is MIEBO only available as a prescription?
- Yes, the only way to get MIEBO is with a prescription. Ask your eye doctor if MIEBO may be right for you.
Finding a doctor
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What if I don’t have an eye doctor?
- Because MIEBO is a prescription eye drop, the first step in finding relief is talking with an eye doctor. If you don’t have an eye doctor, you can use the “Find a doctor” tool on our website to search for one by name, location, and specialty. Visit our Find a doctor page to search now.
Dry eye… but why?
Learn more tear evaporation and how it may be responsible for your dry eye symptoms.
How can I save on MIEBO?
With our support services, if you are eligible, you may pay as little as $0 Copay* on your MIEBO prescription.
*Terms and Conditions apply. This offer is only valid for eligible patients with commercial insurance. This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs. Please see MIEBO.CopaySavingsProgram.com for Eligibility Criteria and full Terms and Conditions.
INDICATION
MIEBO® (perfluorohexyloctane ophthalmic solution) is used to treat the signs and symptoms of dry eye disease.
IMPORTANT SAFETY INFORMATION
- Remove contact lenses before using MIEBO and wait for at least 30 minutes before reinserting
- It is important to use MIEBO exactly as prescribed
- It is not known if MIEBO is safe and effective in children under the age of 18
- The most common eye side effect seen in studies was blurred vision (1% to 3% of patients reported blurred vision and eye redness)
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Click here for full Prescribing Information for MIEBO.
INDICATION
MIEBO® (perfluorohexyloctane ophthalmic solution) is used to treat the signs and symptoms of dry eye disease.
IMPORTANT SAFETY INFORMATION
- Remove contact lenses before using MIEBO and wait for at least 30 minutes before reinserting
- It is important to use MIEBO exactly as prescribed
- It is not known if MIEBO is safe and effective in children under the age of 18
- The most common eye side effect seen in studies was blurred vision (1% to 3% of patients reported blurred vision and eye redness)
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Click here for full Prescribing Information for MIEBO.
