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Ophthalmology
PRESCRIBE EYE PREPARATIONS GENERICALLY
| 1 Allergic & inflammatory eye conditions | ||
| 1.1 Allergic Conjunctivitis | ||
| ANTIHISTAMINES | ||
| ANTAZOLINE & XYLOMETAZOLINE | 0.5% / 0.05% Eye Drops | |
| KETOTIFEN | 250micrograms/ml PF Eye drops | Preservative Free Dual action: MAST cell stabiliser and antihistamine Restricted to Ophthalmologist prescribing. Patients who have not been successfully treated in primary care and where reduced frequency of administration would aid compliance. |
| MAST-CELL STABILISERS | ||
| LODOXAMIDE | Eye drops 0.1% | |
| NEDOCROMIL SODIUM | Eye drops 2% | |
| SODIUM CROMOGLICATE | Eye drops 2% | |
| 1.2 Immflammatory eye conditions | ||
| CORTICOSTEROIDS | NOTES | |
| BETAMETHASONE SODIUM PHOSPHATE | Eye drops 0.1%, eye ointment 0.1% | |
| DEXAMETHASONE | Eye drops 0.1% Single-use preservative-free eye drop 0.1%
| |
Intravitreal implant, 700micrograms | Restricted to Ophthalmology only, in line with NICE and/or local pathways. Funding is only available with the use of Blueteq initiation and continuation forms. NICE TA460 Adalimumab and dexamethasone for treating non-infectious uveitis APC traffic light status: RED | |
| FLUOROMETHOLONE | Eye drops 0.1% | |
| PREDNISOLONE | Eye drop s 0.5%, 1% Single-use preservative free eye drops 0.5% | |
| CORTICOSTEROIDS WITH ANTIBACTERIALS | ||
| BETAMETHASONE with NEOMYCIN | Eye drops betamethasone 0.1%, neomycin 0.5% | |
| DEXAMETHASONE + HYPROMELLOSE + NEOMYCIN | MAXITROL Eye drops, eye ointment (0.1% / 0.5% / 0.35%) | |
| DEXAMETHASONE with TOBRAMYCIN | TOBRADEX Eye drops 0.1% / 0.3% | |
| PREDNISOLONE with NEOMYCIN | Eye drops 0.5% / 0.5% | |
| IMMUNOSUPPRESSANTS – Calcineurin inhibitors & related drugs | NOTES | |
| CICLOSPORIN | 0.1% Eye Drops | Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears [TA 369] |
| 2% Eye Drops (10ml) 0.2% Eye Ointment (3.5g) | UNLICENSED PREPARATIONS / CONSULTANT OPHTHALMOLOGIST ONLY APC traffic light status: RED | |
| ANTI-TNF ALPHA | NOTES | |
| ADALIMUMAB | RESTRICTED for OPHTHALMOLOGY only in line with NICE guidelines and shared care parthway with terriary centre. NICE TA460 Adalimumab and dexamethasone for treating non-infectious uveitis APC traffic light status: RED | |
| 1.2a Anterior Uveitis | ||
| MYDRIATICS AND CYCLOPLEGICS (ANTIMUSCARINICS) | NOTES | |
| ATROPINE SULPHATE | Eye ointment 1% Minims 1% | Uveitis / Iritis APC traffic light status: RED Painful ciliary spasm APC traffic light status: BLUE |
| CYCLOPENTOLATE | Eye drops 0.5%, 1% Minims 0.5%, 1% | Uveitis / Iritis APC traffic light status: RED Painful ciliary spasm APC traffic light status: BLUE |
| 2 Dry Eye Conditions | ||
| Surrey PCN Dry Eyes Management RCO & UK-OPG Specials_Guidance 2014 RCO & UK-OPG Ophthalmic_Special_Order_Products 2014 | ||
| OCULAR LUBRICANTS | ||
| ACETYLCYSTEINE | 5 % Eye Drops | RESTRICTED for patients with ‘filaments’ ILUBE Eye Drops Surrey PCN Dry Eyes Management |
| 10% | UNLICENSED PREPARATION / CONSULTANT OPHTHALMOLOGIST ONLY APC traffic light status: RED | |
| ACETYLCYSTEINE + HYPROMELLOSE | 5% + 0.35% Eye Drops | |
| CARBOMER 980 (polyacrylic acid) | 0.2% (eye gel = eye drops) | Surrey PCN Dry Eyes Management |
| CARMELLOSE | 0.5% Eye Drops | Surrey PCN Dry Eyes Management |
| 0.5%, 1% Preservative Free Eye Drops | Single Use Eye Drops Surrey PCN Dry Eyes Management | |
| HYPROMELLOSE | 0.3 % Eye Drops | Surrey PCN Dry Eyes Management |
| 0.3 % Preservative Free Eye Drops | [6month expiry] Surrey PCN Dry Eyes Management | |
| LIQUID PARAFFIN eye ointment | [6month expiry] Surrey PCN Dry Eyes Management | |
| SODIUM HYALURONATE | 0.1% Preservative-Free Eye Drops 0.2% Preservative-Free Eye Drops | [6month expiry] Surrey PCN Dry Eyes Management |
| 3 Eye Infections | ||
| 3.1 Bacterial Eye infections | ||
| ANTIBACTERIALS – Aminoglycosides | NOTES | |
| GENTAMICIN | Eye/ear drops 0.3% Preservative-free eye drops 1.5% (unlicensed) | PF 1.5% for bacterial keratatis only |
| ANTIBACTERIALS – Cephalosporins, second generation | NOTES | |
| CEFUROXIME | Preservative free eye drops 5% (unlicensed) Intra-ocular injection 2mg in 0.2ml (unlicensed) | RESTRICTED for OPHTHALMOLOGY Team only 5% drops for Bacterial Keratitis OnlyIntra-ocular injection for Opthalmology consultant only |
| ANTIBACTERIALS – Quinolones | NOTES | |
| CIPROFLOXACIN 0.3 % Eye Drops | Eye drops 0.3% | |
| LEVOFLOXACIN | Preservative free single use eye drops 0.5% (minims) x 30 | RESTRICTED for OPHTHALMOLOGY CONSULTANTS only |
| MOXIFLOXACIN | 0.5% Preservative free (self preserving) 5ml eye drops | RESTRICTED for OPHTHALMOLOGY use only. Bacterial conjunctivitis (2nd line or 1st line if severe) Bacterial keratitis (OFF LABEL) Post-op Endophthalmitis (OFF LABEL) APC traffic light status: RED |
| ANTIBACTERIALS – Other | NOTES | |
| CHLORAMPHENICOL | Eye drops 0.5% Eye Ointment 1% Single use preservative-free eye drops 0.5% (minims) 20 x 0.5ml | |
| FUSIDIC ACID | Eye drops 1% | |
| VANCOMYCIN | Preservative free eye drops 5%(unlicensed) | RESTRICTED for OPHTHALMOLOGY Team only Bacterial Keratitis Only Microbiology Guidance required |
| ANTIPROTAZOALS – Other | NOTES | |
| PROPAMIDINE ISETHIONATE | Eye drops 0.1% | |
| 3.2 Viral Eye Infections | ||
| 3.2a Opthalmic Herpes Simplex | ||
| ANTIVIRALS – Nucleoside Analogues | NOTES | |
| GANCICLOVIR | 0.15% eye gel | replaces aciclovir 3% eye ointment (discontinued June 2019). 1st line for herpatic conjunctivitis and keratitis |
| ANTIVIRALS – Other | NOTES | |
| TRIFLUOROTHIMIDINE | 1% eye drops | UNLICENSED PRODUCT (licensed in US) 2nd line for herpatic conjunctivitis and keratitis only when ganciclovir is unavailable. Not for sequential use. |
| 4 Eye Procedures | ||
| ANTIMUSCARINICS | NOTES | |
| TROPICAMIDE | Eye drops 1% Minims 0.5%, 1% | |
| ANTISEPTICS & DISINFECTANTS – Iodine Products | NOTES | |
| POVIDONE IODINE | 5% Eye Drops MINIMS | Prophylaxis of ocular infections pre ocular surgery/intravitreal injection |
| OCULAR DIAGNOSTIC AGENTS – Dyes | NOTES | |
| FLUORESCEIN SODIUM | 2 % Minims (Eye drops) 1 % Minims (Eye drops) | Detection of ocular lesions / foreign bodies |
| SYMPATHOMIMETICS | NOTES | |
| PHENYLEPHRINE | Minims 2.5%, 10% | |
| PHENYLEPHINE + TROPICAMIDE | MYDRIASERT 5.4mg / 0.28mg Ophthalmic Insert | Pre-Op Mydriasis : 1 insert into the lower conjunctival sac up to max. 2 hours before procedure Remove insert within 30 minutes of satisfactory mydriasis and within 2 hours of application Patients with severe dry eyes may require a drop of saline to improve tolerance |
| OCULAR PERI-OPERATIVE PREPARATIONS | NOTES | |
| SODIUM HYALURONATE | 10 mg / ml Healon Intra-ocular Injection 0.85ml 14 mg / ml Healon GV Intra-ocular Injection 0.85ml Viscoelastic PE Ha-Luron 1.4% Intra-ocular injection 1ml | RESTRICTED for OPHTHALMOLOGY only |
| ACETYLCHOLINE CHLORIDE | Intra-ocular Irrigation | |
| SODIUM CHLORIDE | 0.9% Eye Drops 0.9% (Minims) Eye Drops | |
| 5% Eye Drops (10ml) 5% Preservative Free Eye Drops (10ml) 5% Eye Ointment (4g) | RESTRICTED for OPHTHALMOLOGY only | |
| 4.1 Post-operative pain & inflammation | ||
| LOCAL ANAESTHETICS | NOTES | |
| FLUORESCEIN + LIDOCAINE | 0.25% / 4% eye drops | MINIMS |
| PROXYMETACAINE HYDROCHLORIDE | 0.5 % Minims Eye drops | MINIMS |
| TETRACAINE (Amethocaine) | 1 % Minims (Eye drops) | MINIMS |
| ANALGESICS – Non-steroidal-anti-inflammatory drugs | NOTES | |
| DICLOFENAC SODIUM | 0.1 % Unit dose (Eye Drops) | |
| KETOROLAC | 0.5% Eye Drops | RESTRICTED for OPHTHALMOLOGY only |
| 5 Glaucoma & Ocular Hypertension | ||
| NICE Quality Standards GLAUCOMA | ||
| BETA-BLOCKERS | NOTES | |
| BETAXOLOL | Eye drops 0.25%, 0.5% Preservative-free 0.25% | |
| LEVOBUNOLOL | Eye drops 0.5% | |
| TIMOLOL | Eye drops 0.25%, 0.5% Opthalmic gel-forming solution 0.25%, 0.5% Preservative-free 0.25%, 0.5% | Gel-forming solution RESTRICTED for OPHTHALMOLOGY only |
| CARBONIC ANHYDRASE INHIBITORS | NOTES | |
| ACETAZOLAMIDE | 250mg TABLETS 250mg SR 500 mg Injection | |
| BRINZOLAMIDE | 10mg/ml Eye Drops | |
| DORZOLAMIDE | 2 % Eye Drops | |
| DORZOLAMIDE + TIMOLOL | 2 % / 0.5% Eye Drops 2 % / 0.5% Preservative-free Eye Drops | Preservative free for patients who cannot tolerate preserved formulations |
| MIOTICS – parasympathomimetics | NOTES | |
| PILOCARPINE | 0.5%, 1%, 3% & 4%Eye Drops 2%, 4% Eye drop minims | |
| PROSTAGLANDIN ANALOGUES & PROSTAMIDES | NOTES | |
| BIMATOPROST | 100mcg/ml Eye Drops 300 mcg/ml Eye Drops | RESTRICTED for OPHTHALMOLOGY only |
| BIMATOPROST / TIMOLOL | 300 mcg/ml + 5mg/ml Eye Drops Preservative Free 300 mcg/ml + 5mg/ml unit dose Eye Drops | RESTRICTED for OPHTHALMOLOGY only |
| LATANOPROST | 50 mcg/ml Eye Drops | APC traffic light status: GREEN |
| Preservative-free 50mcg/ml eye drop 0.2ml minims | For use in patients with allergy to preservative only. | |
| LATANOPROST / TIMOLOL | 50 mcg/ml+ 5mg/ml Eye Drops | APC traffic light status: GREEN |
| SYMPATHOMIMETICS – Alpha2 – adrenoceptor agonists | NOTES | |
| APRACLONIDINE | 1% eye drop dose units (PF)
| RESTRICTED for OPHTHALMOLOGY only Prevention of postoperative elevation of intraocular pressure after anterior segment laser
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| 0.5% eye drops | 3rd line short term adjunctive treatment | |
| BRIMONIDINE | 0.2% Eye Drops | |
| 6 Retinal disorders | ||
| ANTINEOVASCULARISATION DRUGS – Vascular endothelial growth factor inhibitors | NOTES | |
| AFLIBERCEPT (Eylea) 40mg/ml Intravitreal Injection (0.1ml vial) | RESTRICTED for OPHTHALMOLOGY only (PbRE)Surrey PCN [Eylea for wet AMD]NICE TAG Eylea (2013) NICE TA 409 (branch retinal vein occlusion) NICE TA486:Aflibercept for treating choroidal neovascularisation PCN Policy Statement: Aflibercept for choroidal neovascularisationAPC traffic light status: RED | |
BEVACIZUMAB (Avastin) | RESTRICTED for OPHTHALMOLOGY only PbR Excluded – Requires CCG FundingPCN Policy Statement: Bevacizumab for the treatment of uveitisOff-label use Uveitis APC traffic light status: RED | |
| RANIBIZUMAB (Lucentis) | 10mg/ml Intravitreal Injection (0.23ml vial) | RESTRICTED for OPHTHALMOLOGY only (PbRE)NICE TAG for wet AMD (2008) NICE TAG DMONICE TAG RVOSurrey PCN [Ozurdex 1st line for CRVO] NICE TAG pathological myopiaSurrey PCN Lucentis Myopic Surrey PCN wet AMD Sequential Therapy REJECTEDAPC traffic light status: RED |
| 6.2 Macular Oedema | ||
| CORTICOSTEROIDS | NOTES | |
| FLUOCINOLONE ACETONIDE (Iluvien) | 190microgram Implant
| RESTRICTED for OPHTHALMOLOGY only (PbRE) NICE TA 590: Fluocinolone acetonide intravitreal implant for treating recurrent non-infectious uveitisAPC Policy statement: 2019 Fluocinolone in uveitis‘BLACK’ for intravitreal implant for treating chronic diabetic macular oedema in phakic eyes after an inadequate response to previous therapy. Fluocinolone acetonide is not on the formulary for this indication.APC Policy statement: Fluocinolone DMO phakic TA613APC traffic light status: RED |
| 6.4 Vitreomacular Traction | ||
| RECOMBINAT PROTEOLYTIC ENZYMES | NOTES | |
| OCRIPLASMIN (Jetrea) | 0.5mg/0.2ml Intravitreal Injection | RESTRICTED for OPHTHALMOLOGY only (PbRE) NICE TAG for OcriplasminAPC traffic light status: RED |
| OTHER – chalating agents | ||
| CHELATING AGENTS | NOTES | |
| DISODIUM EDETATE | 0.4% solution | RESTRICTED for OPHTHALMOLOGY surgery Band Keratopathy UNLICENSED PRODUCT
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1. Gastro-Intestinal System | 2. Cardiovascular System | 3. Respiratory System | 4. Central Nervous System | 5. Antimicrobials | 6. Endocrine System | 7. Obstetrics, Gynaecology & Urology | 8. Malignant Disease & Immunosuppression | 9. Nutrition & Blood | 10. Musculoskelatal & Joint Diseases | 11. Opthalmology | 12. Ear, Nose & Oropharynx | 13. Dermatology | 14. Immunology & Vaccines | 15. Anaesthetics | GP Centre Home