KETOROLAC/ PHENYLEPHRINE OPH IRR Generic Name KETOROLAC/ PHENYLEPHRINE OPH IRR Brand Names OMIDRIA Drug Class OPHTHALMICS,OTHER Formulary Status Prior Auth Required Formulary with prior authorization Copay Tier 3 Last Updated June 1, 2023 Clinical Criteria Summary Inclusion CriteriaUse limited to high risk patients Source Documents Download CFU PDF: Ketorolac phenylephrine OMIDRIA Criteria June 2023