1. Healthcare

Moorfields Eye Hospital
Ophthalmic Formulary
February 2015 (Version 1.11)
Medicines Information Publication
Current editor – Edward Hindle (Formulary Pharmacist)
Supporting Authors – Emilia Lamberti (Formulary Pharmacist), Jill Bloom (Medicines Information Principal Pharmacist)
Created by – Michael Man
( C l i c k
t o )
BEGIN
Ophthalmic Formulary
NICE
As part of the good practice guidance released by NICE (December 2012), every NHS organisation was expected to develop and update a local
formulary, which would be made available on the internet from the 1st April.
The aim of the formulary was to:
 Reflect local needs
 Reduce variation in prescribing
 Allow rapid uptake of innovative medicines and treatments (i.e. NICE recommendations)
Features:
1. Accessibility - Everything should be easily accessible from this document. You'll find relevant web links and internal documents (available only to
Moorfields Eye Hospital)
2. Contents page - Simply by clicking the drug category, you'll be taken directly to the relevant section. Above and below each page are links, which
direct you to the contents page.
3. If a Summary of Product Characteristic or Patient Information Leaflet is available, a link can be found besides each drug/class. We've now
also incorporated fact sheets for some of PMU unlicensed products.
4. Relevant resources – e.g. MEH anti-infective guidelines can be found at the end of each drug category.
Quick Links (Click on tab)
Contents Page
Instructions
↖To MAIN Page
Contents
(Click on drug category to continue)
Infection
Anti-inflammatory & Adjuncts
Antiamoebic
Antibacterial
Antifungal
Antiviral
Tapeworm
Corticosteroids
NSAIDs
Immunosuppresants
Miscellaneous
Antihistamines
Cytotoxic
Ocular Lubricants & Other Eye
Drop Preparations
Glaucoma
Mydriatic
Vasoconstrictor
Neovascularisation
Ocular Lubricants
Other (eye drop) preparations
Diagnostic &
Surgical
Dye
Antiseptic
Irrigation
General Anaesthesia &
Gases
Local Anaesthetic
Viscosurgical
Surgical (other)
Other (Systemic)
Mydriatic &
Vasoconstrictor
Neurological
Botulinum
Systemic
Appendix 1. Fact
Sheets
Bisphosphonates
Gastro-intestinal
Analgesics
Nutrition
To Instruction Page ↘
↖To MAIN Content Page
Instructions
Press for
Contents
Page
Under each sub-heading you’ll
find a list of relevant sources
▼This medicine
is monitored
intensively by the
UK safety
regulators – the
MHRA and CHM.
Trust Formulary Approval
Relevant
Sources
Follow the link
for SPC & PIL
P/L – Product License
█ Unlicensed
█ Product License
↖To MAIN Content Page
N – National Guideline
L – Local (MEH)
Guideline
✔ Local or National
Guidelines Exists
4
↖To MAIN Content Page
- Blank Page -
↖To MAIN Content Page
5
↖To MAIN Content Page
Infection
Antiamoebic
Antibacterial
Antifungal
Antiviral
Tapeworm
Primary Source
MEH Anti-infective Guidelines
Secondary Source
Adnexal Service Manual
Toxoplasmosis – Out of Hour Policy
Paediatric Orbital Cellulitis Guidelines
Antiamoebic Infection
Drug Name
Access
P/L†
Drug Class
Formulary Indication
Acanthamoeba keratitis; antiseptic in patients with povidone iodine
allergy
chlorHEXidine digluconate 0.02% eye
drops
█
Antiamoebic
dibromopropamidine 0.15% eye ointment
█
Antiamoebic
hexamidine 0.1% eye drops
█
Antiamoebic
polihexanide 0.02% eye drops
█
Antiamoebic
█
█
FACT
SHEET
polihexanide 0.06% eye drops
proPAMidine 0.1% eye drops
↖To MAIN Content Page
SPC PIL
N*
L*
✔
✔
Comments
Source
MEH Anti-infective Guidelines;
Cornea and External Disease
Induction Manual page 51
MEH Anti-infective Guidelines
✔
MEH Anti-infective Guidelines;
Cornea and External Disease
Induction Manual page 51
Antiamoebic
✔
MEH Anti-infective Guidelines
Antiamoebic
✔
MEH Anti-infective Guidelines; BNF
64 11.3.1
Acanthamoeba keratitis
6
↖To MAIN Content Page
Antibacterial Infection
Bacterial Endophthalmitis (Novermber 2005)
Cornea and External Disease Induction Manual - Bacterial keratitis page 45
Glaucoma service handbook
Medical Retina Service Guidelines - Bacterial endophthalmitis
Drug Name
Access
P/L†
Drug Class
Formulary Indication
L*
Comments
█
Antibacterial
Bacterial & Mycobacteria keratitis
July 2012 DTC
Neisseria conjunctivitis; ophthalmia neonatorum; bacterial keratitis
✔
✔
✔
█
Antibacterial
Ocular Chlamydia infections; blepharitis
cefTAZidime 5% eye drops
█
Antibacterial
cefUROxime 5% eye drops
█
Antibacterial
Neisseria conjunctivitis; ophthalmia neonatorum; bacterial keratitis;
blebitis; bleb-related endophthalmitis
✔
█
Antibacterial
✔
Antibacterial
bacterial conjunctivitis; ophthalmia neonatorum; bacterial
endophthalmitis; post-op prophylaxis; post intravitreal prophylaxis;
corneal abrasion; dacryocystitis; canaliculitis; suture removal
█
█
Antibacterial
Bacterial Conjunctivitis
✔
chlorAMPhenicol 1% eye ointment
█
Antibacterial
Bacterial Blepharitis
✔
CLArithromycin 1% eye drops
█
Antibacterial
Mycobacterial keratitis
CLArithromycin 2% eye drops
█
Antibacterial
dexamethasone 0.05% with framycetin
0.5% with gramicidin 0.005% eye/ear
drops
█
Antibacterial
Uninfected inflammatory conditions of the anterior segment where
development of bacterial infection is possible
erythromycin 0.5% eye ointment
█
Antibacterial
Chlamydial conjunctivits & trachomatis
█
Antibacterial
Infections due to Staphylococcus (usually in pregnant women)
gentamicin 0.3% eye drops
█
Antibacterial
gentamicin 0.3% eye drops (preservativefree)
█
Antibacterial
gentamicin 1.5% FORTE eye drops
█
Antibacterial
gentamicin 1.5% FORTE eye drops
(preservative-free)
█
Antibacterial
levoFLOXacin 0.5% eye drops
█
Antibacterial
Bacterial conjunctivitis; bacterial, sterile & mycobacterial keratitis;
bleb-related endophthalmitis; blebitis; intraocular & periocular
surgery; suture removal; post intravitreal injections; corneal
abrasions
✔
DTC Oct 2007
levoFLOXacin 0.5% single use eye drops
█
Antibacterial
No longer stocked at MEH
✔
June 2008 DTC
█
Antibacterial
Bacterial conjunctivitis; bacterial, sterile & mycobacterial keratitis;
bleb-related endophthalmitis; blebitis; intraocular & periocular
✔
July 2012 DTC
amikacin 2.5% eye drops
azithroMYCin 1.5% single use eye drops
▼
SPC PIL
chlorAMPhenicol 0.5% eye drops
chlorAMPhenicol 0.5% eye drops
(preservative-free bottle)
chlorAMPhenicol 0.5% single use eye
drops
fusidic acid 1% eye drops
moxifloxacin 0.5% eye drops
↖To MAIN Content Page
SPC PIL
&
FACT
SHEET
SPC PIL
SPC PIL
N*
x
Source
✔
BNF 11.3.1; MEH Anti-infective
Guidelines
✔
✔
✔
Bacterial keratitis
BNF 11.3.1; MEH Anti-infective
Guidelines
7
↖To MAIN Content Page
Drug Name
Access
P/L†
Drug Class
Formulary Indication
N*
L*
Comments
Source
surgery; suture removal; post intravitreal injections; corneal
abrasions
penicillin 0.3% eye drops
█
Antibacterial
Bacterial keratitis
vancomycin 1.4% eye drops
█
Antibacterial
Boston K-pro antibiotic prophylaxis
vancomycin 5% eye drops
█
Antibacterial
Bacterial keratitis
spECTinomycin 2g injection
█
Antibacterial
Neisseria conjuctivitis
✔
✔
✔
✔
cefUROxime 1mg in 0.1mL intracameral
prefilled syringe
amikacin 0.4mg in 0.1mL intravitreal
injection pre-pack
vancomycin 2mg in 0.1mL intravitreal
injection pre-pack
█
Antibacterial
Prophylaxis during intraocular and periocular surgery
✔
█
Antibacterial
amikacin 500mg in 2mL injection
SPC PIL
amoxicillin 250mg injection
SPC PIL
amoxicillin 500mg injection
benzylpenicillin 600mg injection
SPC PIL
cefTAZidime 1g injection
SPC PIL
cefTAZidime 2g injection
cefTRIaxone 1g injection
SPC PIL
cefTRIaxone 2g injection
cefUROxime 250mg injection
SPC PIL
cefUROxime 750mg injection
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
Bacterial endophthalmitis
Necrotising fasciitis
Bacterial endophthalmitis
Neisseria conjunctivitis; ophthalmia neonatorum; orbital cellulitis
█
Antibacterial
█
Antibacterial
█
Antibacterial
Prophylaxis prior to complex adnexal procedures
ciprofloxacin 100mg in 50mL infusion
SPC PIL
█
Antibacterial
CLArithromycin 500mg injection
SPC PIL
█
Antibacterial
CLINdamycin 300mg in 2mL injection
SPC PIL
█
Antibacterial
erythromycin lactobionate 1g injection
SPC PIL
█
Antibacterial
█
Antibacterial
█
Antibacterial
Bacterial endophthalmitis; orbital cellulitis; necrotising fasciitis
Orbital cellulitis (with ciprofloxacin), necrotizing fasciitis (with
ciprofloxacin & benzylpenicillin)
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
gentamicin 80mg in 2mL injection
SPC PIL
█
Antibacterial
teicoplanin 200mg injection
SPC PIL
█
Antibacterial
Patients positive or at high risk of MRSA - prophylaxis in surgery
metroniDAZole 500mg in 100mL infusion
SPC PIL
█
Antibacterial
orbital cellulitis (with ceftriaxone & flucloxacillin)
✔
chlorhexidine 0.1% with neomycin
sulphate 0.5% nasal cream
SPC PIL
█
Antibacterial
MRSA eradication if allergy to mupirocin
✔
SPC PIL
flucLOXacillin 500mg injection
Orbital cellulitis
BNF 5.1; MEH Anti-infective
Guidelines
BNF 5.1; MEH Anti-infective
Guidelines; Paediatric Orbital
Cellulitis
BNF 5.1; MEH Anti-infective
Guidelines
✔
✔
✔
✔
✔
✔
flucLOXacillin 250mg injection
DTC Oct 2011
✔
Bacterial endophthalmitis
█
May 2012
BNF 5.1; MEH Anti-infective
Guidelines; Paediatric Orbital
Cellulitis
BNF 5.1; MEH Anti-infective
Guidelines
BNF 5.1; MEH Anti-infective
↖To MAIN Content Page
Guidelines; Paediatric Orbital
Cellulitis
BNF 5.1; MEH Anti-infective
Guidelines
8
↖To MAIN Content Page
Drug Name
Access
amoxicillin 125mg in 5mL sugar free
suspension
P/L†
Drug Class
Formulary Indication
N*
L*
█
Antibacterial
✔
█
Antibacterial
✔
█
Antibacterial
✔
amoxicillin 3g sugar free sachet
█
Antibacterial
azithroMYCin 200mg in 5mL suspension
█
Antibacterial
█
Antibacterial
azithroMYCin 250mg tablets
█
Antibacterial
azithroMYCin 500mg tablets
█
Antibacterial
█
Antibacterial
cefALExin 125mg in 5mL suspension
█
Antibacterial
cefALExin 250mg capsules
█
Antibacterial
cefALExin 250mg in 5mL suspension
█
Antibacterial
cefALExin 250mg tablets
█
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
ciprofloxacin 500mg tablets
█
Antibacterial
ciprofloxacin 750mg tablets
█
Antibacterial
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
amoxicillin 250mg capsules
amoxicillin 250mg in 5mL sugar free
suspension
SPC PIL
azithroMYCin 250mg capsules
SPC PIL
cefACLor 250mg in 5mL suspension
cefUROxime 125mg tablets
SPC PIL
SPC PIL
ciprofloxacin 250mg in 5mL suspension
ciprofloxacin 250mg tablets
SPC PIL
Blebitis & bleb-related endophthalmitis (with moxifloxacin),
toxoplasmosis
Post-operative complex procedures; pre-septal cellulitis; lid
lacerations
Bacterial endophthalmitis (with clarithromycin)
CLArithromycin 250mg tablets
SPC PIL
█
Antibacterial
Bacterial endophthalmitis (with ciprofloxacin), soft tissue infection,
preseptal cellulitis, lid lacerations, orbital blow out fractures,
periocular abcesses (with metronidazole)
✔
CLINdamycin 150mg capsules
SPC PIL
█
Antibacterial
Toxoplasmosis
✔
█
Antibacterial
█
Antibacterial
co-amOXIclav 375mg tablets
█
Antibacterial
co-amOXIclav 625mg tablets
█
Antibacterial
co-amOXIclav 125/31 sugar free
suspension
co-amOXIclav 250/62 sugar free
suspension
SPC PIL
Blebits (& moxifloxacin); preseptal cellulitis; lid lacerations; orbital
blow out fractures; periocular abcesses (with metronidazole),
dacrycystitis (with chloramphenicol); sinusitis
SPC PIL
█
Antibacterial
co-trimoxazole 480mg tablets
SPC PIL
█
Antibacterial
Prophylaxis of toxoplasmosis
█
Antibacterial
█
Antibacterial
Treatment of ocular cicatricial pemphigoid and cicatrizing
conjunctivitis in linear IgA disease
SPC PIL
dapsone 50mg tablets
↖To MAIN Content Page
Source
✔
cofluampicil 250/250 capsules
dapsone 100mg tablets
Comments
✔
✔
✔
✔
✔
✔
✔
BNF 5.1; MEH Anti-infective
Guidelines
BNF 5.1; MEH Anti-infective
Guidelines; Cornea and External
Disease Induction Manual page 175
9
↖To MAIN Content Page
Drug Name
Access
P/L†
doxycycline 50mg capsules
SPC PIL
Drug Class
Formulary Indication
█
Antibacterial
Chlamydial conjunctivitis, blepharitis, chalazia
█
Antibacterial
✔
✔
█
Antibacterial
Blepharitis, soft tissue infection, preseptal cellulitis, lid lacerations,
orbital blow out fractures, periocular abcesses (with metronidazole)
✔
erythromycin 250mg tablets
█
Antibacterial
ethambutol 100mg tablets
█
Antibacterial
flucLOXacillin 125mg in 5mL syrup
█
Antibacterial
█
Antibacterial
flucLOXacillin 250mg in 5mL syrup
█
Antibacterial
flucLOXacillin 500mg capsules
█
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
erythromycin 125mg in 5mL suspension
erythromycin 250mg in 5mL sugar free
suspension
SPC PIL
flucLOXacillin 250mg capsules
SPC PIL
isoniazid 100mg tablets
SPC PIL
isoniazid 50mg tablets
metroniDAZole 200mg in 5mL suspension
SPC PIL
metroniDAZole 200mg tablets
Soft tissue infection
Preseptal cellulitis (with co-amoxiclav or cefalexin)
Bacterial endophthalmitis, mycobacterial keratitis (with
clarithromycin), blebitis. (All unlicensed indications)
N*
L*
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
moxifloxacin 400mg tablets
SPC PIL
█
Antibacterial
ofloxacin 400mg tablets
SPC PIL
█
Antibacterial
✔
█
Antibacterial
✔
█
Antibacterial
✔
█
Antibacterial
█
Antibacterial
█
Antibacterial
✔
█
Antibacterial
✔
█
Antibacterial
✔
✔
✔
✔
✔
✔
✔
✔
phenOXYmethylpenicillin 125mg in 5mL
solution
phenOXYmethylpenicillin 250mg in 5mL
solution
SPC PIL
phenOXYmethylpenicillin 250mg tablets
pyriMEThamine 25mg tablets
SPC PIL
rifampicin 150mg with isoniazid 100mg
tablets
rifampicin 300mg with isoniazid 150mg
tablets
SPC PIL
spirAMYcin 1g tablets
Toxoplasmosis (with sulfadiazine and folinic acid)
sulfaDIAzine 500mg tablets
SPC PIL
█
Antibacterial
Toxoplasmosis (with pyrimethamine and folinic acid)
tetraCYCline 250mg tablets
SPC PIL
█
Antibacterial
Blepharitis (long term treatment)
triMEThoprim 200mg tablets
SPC PIL
█
Antibacterial
mupirocin 2% nasal ointment
SPC PIL
█
Antibacterial
█
Antibacterial
█
Antibacterial
█
Antibacterial
fusidic acid 2% cream
fusidic acid 2% ointment
hydrocortisone acetate 1% with fusidic
↖To MAIN Content Page
SPC PIL
MRSA
Comments
Source
BNF 5.1; MEH Anti-infective
Guidelines
July 2009
✔
✔
BNF 5.1; MEH Anti-infective
Guidelines
10
↖To MAIN Content Page
Drug Name
Access
P/L†
Drug Class
Formulary Indication
N*
L*
Comments
Source
Comments
Source
Aug 2011 DTC –
approved; review
due Aug 2012
MEH Anti-infective Guidelines
acid 2% ointment
OCTENISAN ANTIMICROBIAL WASH
LOTION
vancomycin 500mg injection
SPC PIL
█
Antibacterial
█
Antibacterial
✔
✔
Bacterial endophthalmitis
Antifungal Infection
Fungal Endophthalmitis September 2003
Cornea and External Disease Induction Manual - Fungal keratitis
Medical Retina Service Guidelines – Metastatic Fungal Endophthalmitis
P/L†
Drug Class
Formulary Indication
amphotericin 0.15% eye drops
█
Antifungal
Candida fungal infections; keratitis
✔
chlorHEXidine digluconate 0.2% eye drops
█
Antifungal
Fungal keratitis
✔
cloTRImazole 1% eye drops
█
Antifungal
Anti-fungal eye drop
econazole 1% eye drops
█
Antifungal
Discontinued product
miCONazole 1% eye drops
█
Antifungal
Candida fungal infections; keratitis
✔
✔
✔
natamycin 5% eye drops
█
Antifungal
Fungal Keratitis
✔
voriconazole 1% eye drops
█
Antifungal
Fungal infection
✔
amphotericin 5 micrograms in 0.1mL
intravitreal injection pre-pack
█
Antifungal
Fungal endophthalmitis
✔
█
Antifungal
Fungal infection
█
Antifungal
Fungal infection
✔
✔
✔
✔
✔
✔
✔
✔
✔
Drug Name
Access
amphotericin 50mg deoxycholate injection
amphotericin 50mg liposomal injection
SPC PIL
flucONAzole 200mg in 100mL infusion
SPC PIL
█
Antifungal
Fungal infection
voriconazole 200mg infusion
SPC PIL
█
Antifungal
Fungal endophthalmitis; keratitis
█
Antifungal
█
Antifungal
█
Antifungal
flucONAzole 200mg capsules
flucONAzole 50mg capsules
SPC PIL
flucONAzole 50mg in 5mL suspension
flucYTOsine 500mg tablets
SPC PIL
█
Antifungal
itraconazole 100mg capsules
SPC PIL
█
Antifungal
↖To MAIN Content Page
Fungal endophthalmitis, keratitis (Candida)
Fungal keratitis (Aspergillus)
N*
L*
JFC Approval May
2013
DTC Approved
August 2011
MEH Anti-infective Guidelines
11
↖To MAIN Content Page
Drug Name
Access
P/L†
Drug Class
Formulary Indication
ketoCONazole 200mg tablets
SPC PIL
█
Antifungal
Fungal infection (Discontinued based on MHRA alert)
nystatin 100,000 units in 1mL suspension
SPC PIL
█
Antifungal
Oral fungal infection
terBINafine 250mg tablets
SPC PIL
█
Antifungal
Fungal infection
█
Antifungal
voriconazole 200mg tablets
SPC PIL
voriconazole 50mg tablets
miconazole 2% with hydrocortisone 1%
cream
SPC PIL
N*
✔
✔
✔
✔
Fungal Endophthalmitis, keratitis
█
Antifungal
█
Antifungal
Fungal skin infection
Drug Class
Formulary Indication
L*
✔
Comments
Source
Sep 2003
Consultant only
(Medical Retina or
Vitreo-Retinal)
✔
MEH Anti-infective Guidelines
Antiviral Infection
Drug Name
Access
P/L†
aciclovir 3% eye ointment
SPC PIL
█
Antiviral
Herpes simplex keratitis & conjunctivitis
ganciclovir 0.15% eye gel
SPC PIL
█
Antiviral
Herpes simplex keratitis
✔
✔
triFLUorothymidine 1% eye drops
█
Antiviral
Herpes simplex keratitis & conjunctivitis and stromal Herpes simplex
keratitis
✔
triFLUorothymidine 1% eye drops
█
Antiviral
Herpes simplex keratitis and stromal Herpes simplex keratitis
█
Antiviral
Cytomegalovirus retinitis
✔
✔
ganciclovir 4.5mg intravitreal implant
█
Antiviral
CMV retinitis in patients with AIDS and those who have undergone
organ transplants or using immunosuppressive agents for collagen
diseases.
✔
aciclovir 250mg injection
█
Antiviral
Acute retinal necrosis
foscarnet 24mg in 1ml injection
SPC PIL
N*
L*
█
Antiviral
✔
✔
█
Antiviral
✔
aciclovir 200mg tablets
█
Antiviral
Herpes simplex conjunctivitis, keratitis
aciclovir 400mg tablets
█
Antiviral
Herpes simplex conjunctivitis, keratitis; Bell’s Palsy
aciclovir 800mg dispersible tablets
█
Antiviral
Acute Retinal Necrosis
aciclovir 500mg injection
aciclovir 200mg in 5mL sugar free
suspension
SPC PIL
famciclovir 250mg tablets
SPC PIL
█
Antiviral
oseltamivir 12mg in 1mL oral suspension
SPC PIL
█
Antiviral
↖To MAIN Content Page
Comments
Source
MEH Anti-infective Guidelines
April 2008
MEH Anti-infective Guidelines; A&E
Guidelines
✔
✔
✔
✔
✔
12
↖To MAIN Content Page
Drug Name
Access
P/L†
Drug Class
oseltamivir 30mg capsules
█
Antiviral
oseltamivir 45mg capsules
█
Antiviral
oseltamivir 75mg capsules
█
Antiviral
Formulary Indication
N*
L*
Comments
Source
MEH Anti-infective Guidelines; A&E
Guidelines
✔
✔
✔
valACIclovir 500mg tablets
SPC PIL
█
Antiviral
Varicella Zoster Virus, Herpes Retinitis, Acute Retinal Necrosis; Bell’s
Palsy
✔
December 2006
valGANciclovir 450mg tablets
SPC PIL
█
Antiviral
CMV retinitis induction and maintenance treatment.
✔
April 2008
Drug Class
Formulary Indication
L*
Comments
Anthelmintics
Microsporium (Used with Fumadil-B)
Tapeworm Infections
Drug Name
alBENdazole 400mg tablets
↖To MAIN Content Page
Access
P/L†
█
N*
✔
Source
MEH Anti-infective Guidelines
13
↖To MAIN Content Page
Anti-inflammatory & Adjuncts
Corticosteroids
NSAIDs
Immunosuppressant
Immunomodulating
Antihistamines
Corticosteroids
Cornea and External Disease Induction Manual
Adnexal Service Handbook
Drug Name
Access
P/L†
Drug Class
Formulary Indication
N*
L*
Uninfected inflammatory conditions of the anterior segment where
development of bacterial infection is possible
x
✔
✔
✔
✔
betamethasone 0.1% / neomycin 0.5%
eye/ear/nose drops
█
Steroid
betamethasone 0.1% eye ointment
█
Steroid
x
█
Steroid
x
betamethasone 0.1% eye/ear/nose drops
dexamethasone 0.1% eye drops
SPC PIL
█
Steroid
dexamethasone 0.1% eye drops
(preservative-free bottles)
FACT
SHEET
█
Steroid
█
dexamethasone 0.1% single use eye drops
dexamethasone 0.1% with neomycin
0.35% with polymyxin B sulphate 6,000
units in 1g eye ointment
dexamethasone 0.1% with neomycin
0.35% with polymyxin B sulphate 6,000
units in 1mL eye drops
fluoROMetholone 0.1% eye drops
loTEPrednol etabonate 0.5% eye drops
prednisolone 0.001% eye drops
Inflammation in anterior segment; post-operatively to reduce
inflammation
Steroid
x
x
✔
x
✔
x
SPC PIL
SPC PIL
SPC PIL
█
Steroid
Uninfected inflammatory conditions of the anterior segment where
development of bacterial infection is possible
█
Steroid
█
Steroid
Inflammation of the palpebral and bulbar conjunctiva, cornea and
anterior segment of the globe
Lotaprednol second line (apart from postoperative situation) for
steroid responder patients requiring topical steroids.
x
✔
✔
✔
✔
✔
█
Steroid
x
prednisolone 0.003% eye drops
█
Steroid
x
prednisolone 0.01% eye drops
█
Steroid
x
prednisolone 0.01% eye drops
(preservative-free bottles)
█
Steroid
prednisolone 0.03% eye drops
prednisolone 0.03% eye
drops(preservative-free bottles)
↖To MAIN Content Page
█
█
Steroid
Steroid
Inflammation in anterior segment
Moorfields Pharmacists Handbook;
Cornea and External Disease
Induction Manual; Adnexal Service
Handbook
✔
x
Steroid
Source
✔
x
█
Comments
x
✔
x
✔
x
✔
DTMMC January
2010
14
↖To MAIN Content Page
Drug Name
Access
prednisolone 0.1% eye drops
(preservative-free bottles)
prednisolone 0.3% eye drops
(preservative-free bottles)
FACT
SHEET
FACT
SHEET
x
✔
x
✔
x
✔
x
✔
Steroid
x
█
Steroid
x
█
Steroid
x
█
Steroid
✔
✔
✔
✔
✔
█
█
█
SPC PIL
prednisolone 1% eye drops
RIMexolone 1% eye drops
L*
█
prednisolone 0.5% eye/ear drops
prednisolone 0.5% single use eye drops
N*
█
prednisolone 0.1% eye drops
prednisolone 0.3% eye drops
P/L†
SPC PIL
Drug Class
Steroid
Steroid
Steroid
Steroid
dexamethasone 2mg tablets
SPC PIL
█
Steroid
methylPREDnisolone 100mg tablets
SPC PIL
█
Steroid
█
prednisolone 1mg tablets
Formulary Indication
Hypertensive uveitis
x
x
Multiple sclerosis associated optic neuritis, non-MS associated optic
neuritis, chronic relapsing inflammatory optic neuropathy and
chronic relapsing inflammatory optic neuropathy in neuromyelitis
optica
✔
✔
Steroid
x
✔
✔
✔
✔
✔
✔
prednisolone 2.5mg enteric-coated tablets
█
Steroid
x
prednisolone 25mg tablets
█
Steroid
x
prednisolone 5mg enteric-coated tablets
█
Steroid
x
prednisolone 5mg soluble tablets
█
Steroid
x
prednisolone 5mg tablets
█
Steroid
x
█
Steroid
SPC PIL
beclometasone 50 microgram aqueous
nasal spray
betamethasone sodium phosphate 4mg in
1mL injection
dexamethasone 0.7mg intravitreal
implant▼
SPC PIL
█
SPC
PIL;
MEHPIL
Systemic anti-inflammatory
Steroid
█
Steroid
dexamethasone 3.3mg in 1mL injection
HOSPIRA
dexamethasone base 3.3mg in 1mL
injection
█
Steroid
█
Steroid
dexamethasone base 4mg in 1mL injection
█
Steroid
dexamethasone phosphate 8mg in 2mL
injection
↖To MAIN Content Page
█
Steroid
Treatment of macular oedema following central retinal vein
occlusion.
Treatment of macular oedema following branch retinal vein
occlusion when: treatment with laser photocoagulation has not been
beneficial or treatment with laser photocoagulation is not considered
suitable because of extent of macular haemorrhage.
Treatment of adult patients with inflammation of the posterior
segment of the eye presenting as non-infectious uveitis.
x
✔
x
✔
Comments
Source
Nov 2008
May 2012
Formulary
NICE Multiple sclerosis
July 2011; NCL JFC
Jan 13
NICE Dexamethasone Intravitreal
Implant Technology Appraisal; MEH
Ozurdex (dexamethasone implant);
NCL JFC Jan 13 Minutes
✔
✔
x
✔
x
✔
x
✔
x
✔
15
↖To MAIN Content Page
Drug Name
Access
P/L†
fluocinolone acetonide 190 mcg
intravitreal implant
SPC PIL
SPC PIL
hydrocortisone sodium succinate 100mg
injection
methylPREDnisolone acetate 40mg in 1mL
injection
methylPREDnisolone sodium succinate
40mg injection
methylPREDnisolone sodium succinate
500mg injection
methylPREDnisolone sodium succinate 1g
injection
triAMCinolone acetonide 40mg in 1mL
injection
Drug Class
Formulary Indication
N*
L*
█
Steroid
Chronic diabetic macular oedema after an inadequate response to
prior therapy. As per NICE TA 301
✔
✔
█
Steroid
x
✔
x
✔
x
✔
Multiple sclerosis associated optic neuritis, non-MS associated optic
neuritis, chronic relapsing inflammatory optic neuropathy and
chronic relapsing inflammatory optic neuropathy in neuromyelitis
optica
Uveitic macular oedema refractory to other treatment modalities
and diabetic macular oedema refractory to other treatment
modalities.
Progressive visual loss from macular oedema secondary to AMD,
vascular occlusions and pseduophakic macula oedema’ hypotony
maculopathy’
✔
✔
✔
✔
x
Drug Class
Formulary Indication
N*
x
x
█
█
Steroid
Steroid
SPC PIL
█
Steroid
█
Steroid
SPC PIL
█
Steroid
Access
P/L†
Comments
Source
NICE TA Nov 2013
NICE Technology appraisal
May 2012
Formulary
NICE Multiple sclerosis
✔
DTC October 2007
Consultant Only
Kenolog in Medical Retina Service
L*
Comments
Source
NSAIDS
Drug Name
diclofenac sodium 0.1% single use eye
drops
SPC PIL
█
NSAIDs
(i) inhibition of perperative miosis during cataract surgery (ii)
Treatment of post-operative inflammation, pain and discomfort (iii)
relief of ocular signs and symptoms of seasonal allergic conjunctivitis
ketoROLac 0.5% eye drops
SPC PIL
█
NSAIDs
Inflammation in the anterior segment
diclofenac sodium 75mg in 3mL injection
diclofenac sodium 100mg modified release
tablets
diclofenac sodium 25mg enteric coated
tablets
diclofenac sodium 50mg dispersible
tablets
diclofenac sodium 50mg enteric coated
tablets
diclofenac sodium 75mg modified release
tablets
flurBIProfen 50mg tablets
ibuprofen 100mg in 5mL sugar free
suspension
ibuprofen 200mg tablets
↖To MAIN Content Page
SPC PIL
SPC PIL
█
NSAIDs
█
NSAIDs
█
NSAIDs
█
NSAIDs
█
NSAIDs
█
NSAIDs
█
NSAIDs
█
NSAIDs
█
NSAIDs
SPC PIL
✔
x
✔
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
Pain and inflammation
BNF 11.8; Moorfields Pharmacists
Handbook
BNF 10.1.1; Moorfields Pharmacists
Handbook
16
↖To MAIN Content Page
ibuprofen 400mg tablets
meFENamic acid 250mg capsules
SPC PIL
meLOXicam 15mg tablets
█
NSAIDs
x
█
NSAIDs
x
█
NSAIDs
x
naPROxen 250mg tablets
SPC PIL
█
NSAIDs
x
piroxicam 20mg tablets
SPC PIL
█
NSAIDs
x
diclofenac sodium 100mg suppositories
█
NSAIDs
x
diclofenac sodium 12.5mg suppositories
█
NSAIDs
x
█
NSAIDs
x
█
NSAIDs
x
diclofenac sodium 25mg suppositories
SPC PIL
diclofenac sodium 50mg suppositories
✔
✔
✔
✔
✔
✔
✔
✔
✔
Immunosuppressant
Cornea and External Disease Induction Manual
Adnexal Service Handbook
Drug Name
Access
P/L†
methoTREXate 2.5mg tablets
SPC PIL
sirolimus 1mg tablets
Drug Class
Formulary Indication
█
Immunosuppre
sive
Uveitis
SPC PIL
█
Immunosuppre
sive
Corneal allograft recipients at high risk of rejection, in whom
calcineurin antagonists are not tolerated or ineffective in prevention
of rejection.
methoTREXate 15mg in 0.3mL syringe
SPC PIL
█
ciclosporin 0.2% eye ointment
FACT
SHEET
█
█
ciclosporin 0.06% eye drops
ciclosporin 2% eye drops
FACT
SHEET
█
█
azathioPRIne 25mg tablets
SPC PIL
azathioPRIne 50mg tablets
█
ciclosporin 100mg capsules
█
SPC PIL
ciclosporin 100mg in 1mL solution
↖To MAIN Content Page
█
Immunosuppre
sive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
N*
x
Primary intraocular lymphoma
Management of severe allergic eye disease. Severe dry eye
syndromes. Prevention of corneal graft rejection. Autoimmune
keratoconjunctivitis e.g. vernal, atopic, staphylococcal
hypersensitivity. Thygeson’s keratitis. Ligneous conjunctivitis. Non
healing corneal erosions.
Non-infectious intermediate, posterior or pan-uveitis and retinal
vasculitis. Necrotising scleritis (initially often cyclophosphamide
needed to establish control). Non-necrotising scleritis.
Steroid sparing agent. Uveitis, scleritis: Intermediate, posterior or
pan-uveitis and retinal vascualitis of non-infectious origin, refractory
non-infectious childhood uveitis. Non-necrotising s scleritis,
necrotizing, keratolysis, ulcerative keratitis.
L*
Comments
Source
✔
Jan 2011
Medical Retina Service Guidelines
page 64; Policy for Oral
Methotrexate
✔
Dec 2004
Cornea and External Disease
Induction Manual page 194
x
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
BNOS Guideline PCNSL
July 2012 – DTC
approved
Moorfields Pharmacists Handbook
Cornea and External Disease
Induction Manual page 123
Cornea and External Disease
Induction Manual page 135
17
↖To MAIN Content Page
█
ciclosporin 25mg capsules
█
ciclosporin 50mg capsules
cycloPHOsphamide 50mg tablets
SPC PIL
█
mycophenolate mofetil 250mg capsules
█
mycophenolate mofetil 250mg capsules
█
mycophenolate mofetil 500mg tablets
█
SPC PIL
mycophenolate mofetil 500mg tablets
█
mycophenoLIC acid 360mg tablets
█
mycophenolate mofetil 1g in 5mL
suspension
█
tacrolimus 1mg capsules
█
tacrolimus 500 microgram capsules
tacrolimus 5mg capsules
↖To MAIN Content Page
SPC PIL
█
█
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
Immunosuppre
ssive
x
Atopic keratoconjuctivitis, atopic sclerokeratitis, vernal
keratoconjuctivitis, ligneous keratoconjectivitis, Thygesons superficial
punctuate keratitis. Rheumatoid corneal melt and corneal melt
associated with other causes of systemic vasculitis. Mooren’s ulcer.
Acathamoeba sclerokeratitis. High risk PK.
Thyroid eye disease and Idiopathic orbital inflammation.
Necrotising scleritis, rarely for the management of uveitis in younger
patients; destructive corneal disease, ocular cicatricial pemphigoid,
idiopathic orbital inflammation, Wegener’s granulomatosis and
Thyroid eye disease: probably not favourable.
Steroid sparing agent. Uveitis, Scleritis: Limited experience,
mycophenolate has been used for JIA associated uveitis, noninfectious intermediate-, posterior- or panuveitis and retinal
vasculitis as well as for different types of scleritis.
Steroid sparing agent and uveitis, scleritis (sight-threatening uveitis
of non-infectious origin – including non respondersto cyclosporine or
cannot tolerate side effects.
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
Cornea and External Disease
Induction Manual 164
Cornea and External Disease
Induction Manual page 151
Cornea and External Disease
Induction Manual page 181
18
↖To MAIN Content Page
Miscellaneous
Drug Name
Access
interferon alfa-2a 1 million units in 1mL
eye drops
adalimumab 40mg solution for injection
P/L†
█
SPC PIL
█
Drug Class
Immunomodula
ting
Cytokine
modulator
Formulary Indication
Corneal and conjunctival intraepithelial neoplasias
N*
L*
Comments
x
✔
May 2012 DTC
✔
Sep 2013 JFC
Posterior uveitis
Infliximab solution for infusion
SPC PIL
█
Cytokine
modulator
Acute or chronic refractory ocular inflammation in patients nonresponsive to systemic immunosuppressive treatment (unlicensed
indication). Orbital inflammation and severe corneal and conjunctival
inflammatory disease (unlicensed indication).
Rituximab
SPC PIL
█
Cytokine
modulator
Mucus membrane pemphigoid
Source
April 2008 DTC &
Nov 2009 DTC
✔
✔
DTC Jan 2015
Comments
Not to be
administered at
MEH
Antihistamines
Cornea and External Disease Induction Manual
Drug Name
Access
P/L†
emedastine 0.05% eye drops
SPC PIL
█
Drug Class
Formulary Indication
N*
L*
Antihistamine
Seasonal allergic conjunctivitis
x
✔
✔
✔
loDOXamide 0.1% eye drops
SPC PIL
█
Antihistamine
Allergic conjunctivitis
x
nedocromil sodium 2% eye drops
SPC PIL
█
Antihistamine
Allergic conjunctivitis; vernal keratoconjunctivitis
x
olopatadine 1mg in 1mL eye drops
SPC PIL
█
Antihistamine
Seasonal allergic conjunctivitis
sodium CROmoglycate 2% eye drops
SPC PIL
█
Antihistamine
sodium CROmoglycate 2% eye drops
(preservative-free bottle)
sodium CROmoglycate 2% single use eye
drops
chlorPHEnamine 10mg in 1mL injection
FACT
SHEET
█
Antihistamine
SPC PIL
█
Antihistamine
SPC PIL
█
Antihistamine
Emergency treatment of anaphylactic reactions
█
Antihistamine
cetirizine 10mg tablets
cetirizine 5mg in 5mL solution
chlorPHEnamine 2mg in 5mL syrup
↖To MAIN Content Page
SPC PIL
SPC PIL
x
✔
x
✔
x
✔
x
✔
✔
✔
x
✔
✔
✔
Allergic conjunctivitis; vernal keratoconjunctivitis
█
Antihistamine
Symptomatic relief of allergy such as hay fever, chronic idiopathic
urticaria
█
Antihistamine
Symptomatic relief of allergy such as hay fever, urticaria
x
x
Source
BNF 11.4.2; Moorfields Pharmacists
Handbook page 132
Approved June
2003
DTC July 2010
BNF 11.4.2; Moorfields Pharmacists
Handbook page 132
BNF 3.4.1 & 3.4.3, Emergency
treatment of anaphylactic
reactions; NICE CG134
BNF 3.4
19
↖To MAIN Content Page
█
Antihistamine
█
Antihistamine
proMEThazine 10mg tablets
█
Antihistamine
proMEThazine 25mg tablets
█
Antihistamine
proMEThazine 5mg in 5mL elixir
█
Antihistamine
proMEThazine 25mg in 1mL injection
█
Antihistamine
chlorPHEnamine 4mg tablets
loraTIDine 10mg tablets
SPC PIL
SPC PIL
↖To MAIN Content Page
Symptomatic relief of allergy such as hay fever, chronic idiopathic
urticaria
Symptomatic relief of allergy such as hay fever, urticaria; emergency
treatment of anaphylactic reactions; sedation; nausea and vomiting
x
✔
x
✔
✔
✔
✔
✔
✔
✔
✔
✔
BNF 3.4.1, 4.1.1 & 4.6; Emergency
treatment of anaphylactic
reactions; NICE CG134
20
↖To MAIN Content Page
Glaucoma
NICE Gluacoma Guidelines
Glaucoma Service Handbook
Drug Name
Access
P/L†
█
apraclonidine 0.5% eye drops
Drug Class
Glaucoma
SPC PIL
Formulary Indication
N*
Short-term reduction of elevated intraocular pressure in chronic
open angle glaucoma. Used in maximum tolerated therapy to delay
surgery or laser therapy. Horner’s Syndrome test
To lower intraocular pressure in patient: Uncontrolled intraocular
pressure (IOP) on maximum medical treatment; Allergy to
preservatives in eye drops; Visual acuity less than 6/60 in fellow eye;
Ocular surface disease or previous corneal surgery; High risk of
surgical morbidity; Patient unwilling to undergo glaucoma surgery
x
L*
Comments
✔
x
January 2012
DTMMC Consultant
Only
apraclonidine 1% eye drops single use eye
drops
█
Glaucoma
betAXOlol 0.25% eye drops
█
Glaucoma
✔
✔
betAXOlol 0.25% single use eye drops
█
Glaucoma
✔
✔
bimatoprost 0.03% with timolol 0.5% eye
drops
█
Glaucoma
✔
✔
DTC Sep 2007
█
Glaucoma
Glaucoma
✔
✔
July 2010 DTC
█
✔
✔
█
Glaucoma
✔
✔
█
Glaucoma
✔
✔
█
Glaucoma
✔
✔
Sep 2005 DTC
█
Glaucoma
✔
✔
July 2009 DTC
briNZOlamide 10mg in 1mL eye drops
█
Glaucoma
carTEOlol 1% eye drops
█
Glaucoma
carTEOlol 2% eye drops
█
Glaucoma
dorzolamide 2% eye drops
█
Glaucoma
█
Glaucoma
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
Feb 2005 DTC
█
Glaucoma
✔
✔
Feb 2005 DTC
█
Glaucoma
✔
✔
█
Glaucoma
✔
✔
SPC PIL
bimatoprost 0.1mg in 1mL eye drops
bimatoprost 0.3mg in 1mL eye drops
SPC PIL
bimatoprost 0.3mg in 1mL single use eye
drops
briMONidine 0.2% eye drops
brimonidine 0.2% with timolol 0.5% eye
drops
brinzolamide 1% with timolol 0.5% eye
drops
SPC PIL
SPC PIL
SPC PIL
dorzolamide 2% single use eye drops
dorzolamide 2% with timolol 0.5% eye
drops
dorzolamide 2% with timolol 0.5% single
use eye drops
SPC PIL
latanoprost 0.005% eye drops
SPC PIL
↖To MAIN Content Page
Open angle glaucoma & ocular hypertension
Source
✔
Glaucoma Service Handbook; A&E
Guidelines
NICE Gluacoma Guidelines;
Glaucoma Service Handbook
Joint Formulary
Committee Apr
2013
December 2006
Prescriptions signed
21
↖To MAIN Content Page
Drug Name
Access
P/L†
Drug Class
Formulary Indication
N*
L*
latanoprost 0.005% single use eye drops
█
Glaucoma
✔
✔
latanoprost 0.005% with timolol 0.5% eye
drops
█
Glaucoma
✔
✔
█
Glaucoma
levoBUNolol 0.5% single use eye drops
█
Glaucoma
✔
✔
pilocarpine 0.25% eye drops
█
Glaucoma
Open angle and other forms of chronic glaucoma
x
pilocarpine 0.5% eye drops
█
Glaucoma
No longer on formulary
x
✔
✔
✔
✔
No longer on formulary
levoBUNolol 0.5% eye drops
SPC PIL
pilocarpine 0.5% eye drops (preservativefree bottle)
FACT
SHEET
█
Glaucoma
x
✔
pilocarpine 1% eye drops
SPC PIL
█
Glaucoma
✔
✔
█
Glaucoma
x
✔
█
Glaucoma
✔
✔
█
Glaucoma
x
✔
█
Glaucoma
✔
█
Glaucoma
█
Glaucoma
✔
✔
✔
pilocarpine 4% eye drops (preservativefree bottle)
█
Glaucoma
pilocarpine 6% eye drops
█
pilocarpine 1% eye drops (preservativefree bottle)
pilocarpine 2% eye drops
SPC PIL
pilocarpine 2% eye drops (preservativefree bottle)
pilocarpine 2% single use eye drops
SPC PIL
pilocarpine 3% eye drops
pilocarpine 4% eye drops
SPC PIL
Open angle and other forms of chronic glaucoma
x
No longer on formulary
✔
Open angle and other forms of chronic glaucoma
Glaucoma
x
✔
x
✔
x
✔
pilocarpine 6% eye drops (preservativefree bottle)
█
Glaucoma
pilocarpine 8% eye drops
█
Glaucoma
No longer on formulary
x
✔
█
Glaucoma
No longer on formulary
✔
✔
█
Glaucoma
Open angle glaucoma & ocular hypertension
█
Glaucoma
✔
✔
✔
✔
█
Glaucoma
Open angle glaucoma & ocular hypertension
x
✔
█
Glaucoma
✔
✔
tafluprost 15 microgram in 1mL single use
eye drops
SPC PIL
timolol 0.1% eye drops single use eye gel
timolol 0.25% eye drops
SPC PIL
timolol 0.25% eye drops (preservativefree bottle)
timolol 0.25% eye gel (LA)
↖To MAIN Content Page
SPC PIL
Comments
Source
by Consultant staff
within the
Glaucoma Service
only
Joint Formulary
Committee Apr
2013
December 2006
(Consultant’s
signature only)
DTC November
2010
22
↖To MAIN Content Page
P/L†
Drug Class
timolol 0.25% single use eye drops
█
Glaucoma
timolol 0.5% eye gel (LA)
█
Glaucoma
timolol 0.5% single use eye drops
█
Glaucoma
travoprost 0.04% with timolol 0.5% eye
drops
█
Glaucoma
travoprost 40 microgram in 1mL eye drops
█
Glaucoma
acetazolamide 500mg injection
█
Glaucoma
Primary acute angle closure. Open and narrow angle glaucoma
█
Glaucoma
mannitol 20% infusion
█
Glaucoma
Rapid reduction of elevated intraocular pressure especially during
acute angle closure
acetazolamide 250mg in 5mL suspension
█
Glaucoma
█
Glaucoma
█
Glaucoma
Drug Name
Access
Open angle glaucoma & ocular hypertension
SPC PIL
SPC PIL
mannitol 10% infusion
SPC PIL
acetazolamide 250mg modified release
capsules
acetazolamide 250mg tablets
glycerol 50% oral solution
↖To MAIN Content Page
Formulary Indication
SPC PIL
█
Glaucoma
N*
L*
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
x
x
x
x
Open and narrow angle glaucoma
Short-term reduction of elevated intraocular pressure in angleclosure glaucoma
x
✔
x
✔
x
✔
Comments
Source
DTC Sep 2007
23
↖To MAIN Content Page
Mydriatic & Vasoconstrictor
Mydriatic
Vasoconstrictor
Mydriatic
Drug Name
Access
P/L†
Drug Class
atropine 1% eye drops
SPC PIL
█
Mydriatic
atropine 1% eye drops (preservative-free
bottle)
FACT
SHEET
█
Mydriatic
atropine 1% single use eye drops
SPC PIL
█
Formulary Indication
N*
L*
x
✔
x
✔
Mydriatic
x
✔
✔
✔
✔
✔
Mydriasis and cycloplegia; Refraction in children; Occlusion.
atropine 1/8% eye drops
█
Mydriatic
x
cyclopentolate 0.5% eye drops
█
Mydriatic
x
█
Mydriatic
x
█
Mydriatic
x
cyclopentolate 0.5% single use eye drops
SPC PIL
cyclopentolate 1% eye drops
cyclopentolate 1% eye drops
(preservative-free bottle)
FACT
SHEET
█
Mydriatic
x
✔
cyclopentolate 1% single use eye drops
SPC PIL
█
Mydriatic
x
x
✔
✔
homatropine 1% eye drops
█
Mydriatic
homatropine 1% eye drops (preservativefree bottle)
█
Mydriatic
homatropine 2% eye drops
█
Mydriatic
Mydriasis and cycloplegia
x
✔
x
✔
x
✔
✔
✔
✔
✔
✔
✔
homatropine 2% eye drops (preseravtivefree bottle)
█
Mydriatic
hyoscine 1/2% eye drops
█
Mydriatic
x
█
Mydriatic
x
█
Mydriatic
x
█
Mydriatic
hyoscine 1/8% eye drops
phenyLEPhrine 10% single use eye drops
SPC PIL
phenyLEPhrine 2.5% eye drops
x
Mydriasis for diagnostic or surgical procedures
phenyLEPhrine 2.5% single use eye drops
█
Mydriatic
x
phenyLEPhrine 5% eye drops
█
Mydriatic
x
█
Mydriatic
tropicamide 0.5% eye drops single use eye
drops
↖To MAIN Content Page
SPC PIL
Mydriasis and cycloplegia
x
Comments
Source
Moorfields Pharmacists Handbook
Moorfields Pharmacists Handbook
✔
24
↖To MAIN Content Page
Drug Name
Access
tropicamide 1% eye drops
tropicamide 1% eye drops single use eye
drops
P/L†
Drug Class
█
Mydriatic
█
█
phenyLEPhrine 0.6% intracameral injection
atropine 0.5mg with adrenaline 1 in 1,000
0.06mL with procaine 3mg in 0.3mL
injection
atropine 1mg with adrenaline 1 in 1,000
0.12mL with procaine 6mg in 0.3mL
injection
SPC PIL
Mydriasert ophthalmic insert
SPC PIL
Formulary Indication
Mydriatic
Mydriatic
N*
L*
x
✔
x
✔
x
✔
x
█
Mydriatic
Rapid dilatation of the pupil
█
Mydriatic
█
Mydriatic
Maximal pupil dilation pre surgery
P/L†
Drug Class
Formulary Indication
x
Comments
Source
November 2010
✔
✔
✔
Vasoconstrictor
Drug Name
Access
█
adrenaline 0.01% eye drops
adrenaline 0.1% eye drops
xylometazoline 0.05% nose drops
SPC PIL
xylometazoline 0.1% nasal spray
↖To MAIN Content Page
Vasoconstrictor
Vasoconstrictor. To prevent rapid loss of sub-conjunctival injections
into the systemic circulation. To control bleeding during surgery
N*
L*
x
✔
✔
✔
✔
x
█
Vasoconstrictor
█
Vasoconstrictor
x
█
Vasoconstrictor
x
Comments
Source
25
↖To MAIN Content Page
Cytotoxic
Moorfields Pharmacist Handbook
Cornea and External Disease Induction Manual
Glaucoma Service Handbook
P/L†
Drug Class
Formulary Indication
N*
L*
mitoMYCin 0.02% eye drops
█
Cytotoxic
Laser surgery. Minimises/eradicates post-op haze and scar
formation
x
✔
mitoMYCin 0.04% eye drops
█
Cytotoxic
Conjunctival or corneal squamous cell carcinoma
x
✔
x
✔
x
✔
Intravitreal Injection of Therapeutic
Agents
x
✔
✔
✔
✔
Moorfields Pharmacists Handbook
Drug Name
tretinoin 0.05% eye drops
Access
FACT
SHEET
█
Cytotoxic
methoTREXate 800 microgram in 0.2mL
intravitreal injection
█
Cytotoxic
fluoroURAcil 10mg in 0.2ml syringe
█
Cytotoxic
fluoroURAcil 250mg in 10mL injection
SPC PIL
fluoroURAcil 500mg in 10mL injection
mitoMYCin 2mg injection
↖To MAIN Content Page
SPC PIL
█
Cytotoxic
█
Cytotoxic
█
Cytotoxic
Squamous metaplasia and keratinisation of the conjunctiva
Primary intraocular lymphoma
Post trabeculectomy, when indicated (inhibit cellular proliferation
and reduce scarring post-op)
x
x
Intro-operative use, for long-term pressure control. Restricted use.
x
Comments
Source
26
↖To MAIN Content Page
Ocular Lubricants & Other Eye Drop
Preparations
Ocular Lubricant
Others
Ocular Lubricants
MEH Guideline for Ocular Lubricants
Drug Name
Access
P/L†
acetylCYSteine 10% eye drops
█
acetylCYSteine 10% eye drops
(preservative-free bottle)
█
acetylCYSteine 20% eye drops
█
acetylCYSteine 5% eye drops
SPC PIL
acetylCYSteine 5% eye drops
(preservative-free bottle)
carbomer 0.2% eye gel
█
█
SPC PIL
█
carMELLose 0.5% eye drops
█
carMELLose 1% eye drops
█
carMELLose sodium 0.5% with glycerine
0.9% eye drops (Optive)
SPC PIL
█
hydroxypropyl guar eye drops (Systane)
█
hydroxypropyl guar single use eye drops
(Systane)
█
hypromellose 0.3% eye drops
hypromellose 0.3% eye drops
(preservative-free bottle)
↖To MAIN Content Page
SPC PIL
FACT
SHEET
█
█
Drug Class
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Formulary Indication
No longer on formulary
Tear deficiency, impaired or abnormal mucus production
No longer on formulary
Tear deficiency, impaired or abnormal mucus production
No longer on formulary
Dry eyes including keratoconjuctivitis sicca, unstable tear film
N*
L*
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
For artificial eyes
No longer on formulary
Tear deficiency
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
Source
BNF 11.8.1; MEH Guideline for
Ocular Lubricants; Moorfields
Pharmacist Handbook page 35
✔
Dry eye conditions
Dry eye conditions
Comments
Jan 2012 DTMMC
July 2010 DTMMC
27
↖To MAIN Content Page
Drug Name
Access
█
hypromellose 0.3% single use eye drops
hypromellose 0.3% with dextran '70' 0.1%
eye drops
P/L†
SPC PIL
█
hypromellose 1% eye drops
█
light liquid paraffin eye drops
█
paraffin eye ointment with vitamin A (VitAPos)
█
paraffin eye ointment lanolin free
█
polyvinyl alcohol 1.4% eye drops
SPC PIL
█
polyvinyl alcohol 1.4% eye drops
(preservative-free bottle)
FACT
SHEET
█
█
polyvinyl alcohol 1.4% single use eye drops
simple eye ointment
FACT
SHEET
█
sodium chloride 0.9% eye drops
FACT
SHEET
█
SPC PIL
█
sodium chloride 0.9% single use eye drops
sodium hyaluronate 0.1% eye drops
sodium hyaluronate 0.15% single use eye
drops
sodium hyaluronate 0.15% with XANthan
gum 1% single use eye GEL
sodium hyaluronate 0.2% eye drops
↖To MAIN Content Page
█
█
█
█
Drug Class
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Tear Film
Substitute
Formulary Indication
No longer on formulary
Dry eye conditions
Lubricate the eye surface, especially in cases of recurrent corneal
epithelial erosion
Ocular Lubricant & protection of the ocular surface (lanolin allergy)
No longer on formulary
Tear deficiency
Tear deficiency
Lubricate the eye surface, especially in cases of recurrent corneal
epithelial erosion
Irritation, including first-aid removal of harmful substances
Dry eye conditions
N*
L*
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
x
✔
DTC July 2012
✔
DTC July 2013
✔
DTC July 2011
Dry eye conditions (Restricted: for scleral lens wearers only)
x
Comments
Source
28
↖To MAIN Content Page
Others
Cornea and External Disease Induction Manual
Drug Name
Access
P/L†
█
cyanoacrylate glue
Drug Class
Formulary Indication
N*
L*
Other
Plugs corneal perforations, whilst awaiting donor material
x
✔
x
✔
x
✔
x
✔
x
✔
disodium edetate 0.37% eye drops
█
Other
Collagenase inhibitor
glycerol 50% eye drops
█
Other
Clearing corneal oedema
hyaluronidase 1,500 units injection
█
Other
pilocarpine 0.1% eye drops
█
Other
Diagnostic test for Holmes Adie or tonic pupil
potassium ascorbate 10% eye drops
█
Other
Acid & alkali burns to the cornea
█
Other
Reduce corneal oedema
x
sodium chloride 5% eye drops
sodium chloride 5% eye ointment
FACT
SHEET
█
Other
Recurrent corneal erosions
x
x
x
Moorfields Pharmacist Handbook
page 95
Moorfields Pharmacist Handbook
page 52; Cornea and External
Disease Induction Manual
Moorfields Pharmacist Handbook
page 135
✔
Other
x
Other
x
✔
✔
BNF 12.3.5
Other
Acid & alkali burns to the cornea
disodium edetate 0.37% solution
█
Other
Chelating agent as an aid to calcified corneal plaque removal
ethanol 20% sterile solution
█
↖To MAIN Content Page
✔
Moorfields Pharmacist Handbook
page 146
Moorfields Pharmacist Handbook
page 135
x
█
█
✔
Source
Moorfields Pharmacist Handbook
page 52; Cornea and External
Disease Induction Manual
Moorfields Pharmacist Handbook
page 146
sodium citrate 10.11% eye drops
pilocarpine 5mg tablets
✔
Comments
Dry eyes
✔
29
↖To MAIN Content Page
Neovascularisation
Drug Name
Access
bevacizumab 1.25mg in 0.05mL syringe
raniBIZumab 10mg in 1mL injection
▼
bevacizumab 5mg in 0.2mL syringe
MEHPIL;
MEHPIL (2)
P/L†
█
Drug Class
AntiVEGF
Formulary Indication
Avastin for neovascular glaucoma (approved in DTC June 2008)
Bevacizumab for AMD related CNV (prior funding required (DTC
September 2009) funding via IFR
Avastin for non-AMD CNV (DTC Sep 2009) funding via IFR
Trabeculectomy surgery (Jan 2015)
SPC PIL
MEHPIL
█
AntiVEGF
wet AMD
DMO
RVO
CNV (Pathological myopia )
MEHPIL
█
AntiVEGF
Bevacizumab sub-conjunctival injection
N*
x
L*
Comments
✔
November 2009
DTC – it should be
noted on Formulary
that a licensed drug
exists (Lucentis)
Oct 2012
✔
✔
x
✔
Source
NICE Macular oedema (diabetic)
Technology Appraisal; NICE AMD
Technology Appraisal; Medical
Retina AMD Guidelines; Medical
Retina Service Guidelines; NICE
Macular oedema (retinal vein
occlusion Technology Appraisal
NICE CNV (pathological myopia)
Technology Appraisal
DTC Oct 2011
Joint Formulary
Committee Feb
2013
NICE TA Feb 2014
NICE AMD Technology Appraisal
(AMD)
NICE AMD Technology Appraisal
(MO CRVO)
SPC PIL
█
AntiVEGF
wet AMD
Macular oedema secondary by CRVO
Drug Name
Access
P/L†
Drug Class
Formulary Indication
N*
L*
Comments
Source
verTEPorfin 15mg infusion
SPC PIL
█
Dye
Wet AMD; chronic serous retinopathy; choroidal haemangioma
✔
✔
December 2007
NICE TA Macular degeneration
(age-related)
aflibercept 40mg in 1mL injection
▼
↖To MAIN Content Page
✔
30
↖To MAIN Content Page
Neurological
Botulinum
Systemic
Botulinum
Drug Name
Access
botulinum A toxin 100 units injection
(BOTOX)
P/L†
█
Drug Class
Neuro
Formulary Indication
blepharospasm; hemifacial spasm
N*
L*
x
Comments
✔
BNF 4.9.3;Botulinum Toxin Policy
✔
BNF 4.9.3;Botulinum Toxin by
Adnexal Nurse Specialist; Corneal
and External Disease Induction
Manual; Adnexal Service Handbook;
Botulinum Toxin Policy
x
botulinum A toxin 500 units injection
(DYSPORT)
botulinum A toxin 50 units injection
(XEOMIN)
SPC
PIL;
MEHPIL
█
Neuro
Protective ptosis & squint; blepharospasm; hemifacial spasm
█
Neuro
First line (Adnexal) blepharospasm; hemifacial spasm
█
Neuro
Non-responders to Type A toxin (Adnexal)
P/L†
Drug Class
Formulary Indication
█
Antidepressants
Antidepressants
Antidepressants
x
x
botulinum B toxin (NEUROBLOC)
✔
✔
DTC Oct 2003
Strabismus service
July 2012
blepharospasm and
hemifacial spasm
July 2012
blepharospasm and
hemifacial spasm
Source
BNF 4.9.3
BNF 4.9.3
Systemic
Drug Name
Access
amitriptyline 10mg tablets
amitriptyline 25mg tablets
SPC PIL
█
█
amitriptyline 50mg tablets
█
gabapentin 100mg capsules
Anticonvulsant
SPC PIL
gabapentin 300mg capsules
Neuropathic pain; post-herpetic neuralgia
Neuropathic pain; post-herpetic neuralgia
█
Anticonvulsant
N*
L*
x
✔
x
✔
x
✔
x
✔
✔
✔
✔
x
preGABalin 25mg capsules
SPC PIL
█
Anticonvulsant
Neuropathic pain; post-herpetic neuralgia
x
meLATonin 2mg tablets
SPC PIL
█
Hypnoptic
Circadian sleep disorders in the blind
x
pyridostigmine 60mg tablets
SPC PIL
█
Anticholinesterase
↖To MAIN Content Page
x
Comments
Source
BNF 4.3.1
BNF 4.8.1
BNF 4.8.1
✔
31
↖To MAIN Content Page
Diagnostic & Surgical
Dye
Antiseptic
General Anaesthesia & Gases
Irrigation
Local Anaesthetic
Viscosurgical
Surgical (Other)
Dye
Drug Name
fluoREScein sodium 2% single use eye
drops
Access
P/L†
Drug Class
█
Dye
brilliant blue G 0.125mg in 0.5mL syringe
█
Dye
trypan blue 0.15% with brilliant blue G
0.025% injection
█
Dye
fluoREScein 10% injection
█
Dye
fluoREScein sodium 20% injection
indocyanine green 25mg injection
trypan blue 0.06% injection
↖To MAIN Content Page
SPC PIL
SPC
PIL;
MEHPIL
MEHPIL
Formulary Indication
Diagnostic examinations
█
Dye
Ophthalmic angiography including examination of the fundus and iris
vasculature, sclera and episclera
█
Dye
Ophthalmic angiography of choroidal vasculature
█
Dye
Diagnostic examinations
N*
L*
x
✔
x
✔
x
✔
x
✔
Comments
Moorfields Pharmacist Handbook
page 45
Moorfields Pharmacist Handbook
page 4; Medical Retina Service
Guidelines page 54; Adult IV
Fluorescein Angiography Policy;
Paediatric IV Fluorescein
Angiography Policy
Medical Retina Service Guidelines
page 59; Adult IV ICG Angiography
Policy
x
✔
x
x
✔
✔
Source
August 2003
32
↖To MAIN Content Page
Antiseptic
Drug Name
Access
povidone iodine 5% eye drops
P/L†
Drug Class
█
Antiseptic
Formulary Indication
Antiseptic prior to surgical procedures
N*
L*
x
✔
Moorfields Pharmacists Handbook
page 71
x
✔
BNF 13.11.4
x
✔
BNF 13.11.2
x
✔
BNF 13.11.4
BNF 13.11.6
povidone iodine 10% antiseptic solution
SPC
█
Antiseptic
chlorHEXidine 0.015% cetrimide 0.15%
sachets
SPC
█
Antiseptic
iodine tincture
SPC
█
Antiseptic
hydROGen peroxide 6% solution
SPC PIL
█
Antiseptic
For skin disinfection, particularly cleansing and deodorising wounds
and ulcers
x
✔
Access
P/L†
Drug Class
Formulary Indication
N*
L*
Irrigation
x
✔
✔
✔
✔
✔
Skin disinfection
Comments
Source
Irrigation
Drug Name
sodium chloride 0.9% irrigation sachets
█
sodium chloride 0.9% sterile eye irrigation
█
Irrigation
x
balanced salt solution 19mL
█
Irrigation
x
balanced salt solution 500mL
█
Irrigation
sodium chloride 0.9% irrigation
█
Irrigation
compound sodium lactate 1000mL
infusion
█
Irrigation
compound sodium lactate 500mL infusion
█
Irrigation
STERIMAR
█
Irrigation
↖To MAIN Content Page
Surgical Procedures
x
x
As a nasal douche following dacryocystorhinostomy (DCN)
x
✔
x
✔
✔
Comments
Source
DTMMC Jan 2013
33
↖To MAIN Content Page
General Anaesthesia & Gases
Drug Name
isoflurane volatile liquid
Access
SPC PIL
P/L†
█
sevoflurane volatile liquid
SPC PIL
█
alFENtanyl 1mg in 2mL injection
SPC PIL
█
atracurium 25mg in 2.5mL injection
█
atracurium 50mg in 5mL injection
█
glycopyrronium 200 microgram in 1mL
injection
glycopyrronium 500 micrograms with
neostigmine 2.5mg in 1mL injection
glycopyrronium 600 microgram in 3mL
injection
█
█
█
█
proPOFol 1% injection
SPC PIL
█
proPOFol 2% injection
proPRANolol 1mg in 1mL injection
SPC PIL
█
remifentanyl 1mg injection
SPC PIL
█
rocuronium 50mg in 5mL injection
SPC PIL
█
█
suxamethonium 100mg in 2mL injection
SPC PIL
suxamethonium 100mg in 2mL syringe
█
thiopental 500mg injection
█
vecuronium 10mg injection
SPC PIL
█
ketamine 10mg in 1mL injection
SPC PIL
█
neostigmine 2.5mg in 1mL injection
SPC PIL
█
sugammadex 100mg in 1mL injection
nitrous oxide SIZE E
SPC
█
█
nitrous oxide SIZE G
█
oxygen SIZE C
█
↖To MAIN Content Page
Drug Class
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
Formulary Indication
N*
L*
Comments
Source
✔
Induction of anaethesia
✔
✔
Analgesic supplement for use before and during anaesthesia
✔
✔
✔
✔
✔
✔
Induction of anaethesia
✔
✔
Analgesic agent for use during induction and/or maintenance of
general anaethesia
✔
BNF 15.1
✔
✔
Neuromuscular blockade
✔
Induction of anaethesia
✔
Neuromuscular blockade
✔
Induction of anaethesia
✔
✔
Neuromuscular blockade
Antiseptic prior to surgical procedures
x
✔
DTMMC Apr 2013
✔
Maintenance of anaesthesia and analgesia
✔
✔
34
↖To MAIN Content Page
P/L†
Drug Class
oxygen SIZE CD
█
oxygen SIZE D
█
oxygen SIZE E
█
oxygen SIZE F
█
oxygen SIZE G
█
oxygen SIZE HX
█
oxygen SIZE J
█
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
General
anaesthesia
Drug Name
Access
Formulary Indication
N*
L*
Comments
Source
Comments
Source
✔
✔
✔
✔
✔
✔
✔
Local Anaesthetic
Drug Name
Access
P/L†
cocaine 4% eye drops
█
Lidocaine 3.5% eye gel
█
oxybuprocaine 0.4% single use eye drops
SPC PIL
█
proxymetacaine 0.5% single use eye drops
proxymetacaine 0.5% with fluorescein
0.25% single use eye drops
tetracaine 1% single use eye drops
↖To MAIN Content Page
█
SPC PIL
█
SPC PIL
█
Drug Class
Formulary Indication
N*
L*
Local
Anaesthetic
Local
Anaesthetic
Local
Anaesthetic
Local
anaesthetic
Local
anaesthetic
Local
Anaesthetic
Surface anaesthesia when conditions also require pupil dilation or
vasoconstriction. Diagnosis of Horner's syndrome.
x
✔
✔
Strabismus surgery only
Surface anaesthesia
Surface anaesthesia and staining
Surface anaesthesia
x
✔
x
✔
x
✔
x
✔
Moorfields Pharmacist Handbook
page 48, BNF 15.2
DTMMC Oct 2014
Moorfields Pharmacist Handbook
page 48, BNF 15.2
35
↖To MAIN Content Page
Viscosurgical
Drug Name
Access
HPMC 2% in balanced salt solution
injection
sodium hyaluronate 10mg in 1mL
intraocular injection
sodium hyaluronate 14mg in 1mL
intraocular injection
sodium hyaluronate 23mg in 1mL
intraocular injection
silicone oil 1,300 cps injection
P/L†
Drug Class
Formulary Indication
N*
L*
█
Viscosurgical
Protection of ocular structures and maintenance of anterior chamber
depth during surgical procedures
x
✔
█
Viscosurgical
x
✔
x
✔
x
✔
x
✔
Surgical procedures on the eye including cataract extraction.
Protection of ocular structure within the anterior or posterior
chamber.
Comments
Source
Moorfields Pharmacists Handbook
page 140
█
Viscosurgical
█
Viscosurgical
█
Viscosurgical
Intraocular tamponade
Drug Class
Formulary Indication
N*
L*
✔
✔
NICE Technology Appraisal
Moorfields Pharmacists Handbook
page 110
Alcon Product Information
Moorfields Pharmacists Handbook
page 140
Surgical other
Access
P/L†
SPC PIL
█
Miscellaneous
Vitreomacular traction. As per NICE TA 297
Tissue plasminogen activator (TPA) / rTPA
/alteplase
█
Miscellaneous
Ophthalmic fibrinolysis
✔
Juvederm Ultra 3 / Juvederm Ultra 4
█
Dermal filler
Reconstructive surgery / socket volume augmentation
✔
Drug Name
ocriplasmin
▼
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Comments
Source
NICE TA Oct 2013
DTMMC Oct 2014
36
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Other (Systemic)
Bisphosphonates
Gastrointestinal
Analgesics
Nutrition
Bisphosphonates
Drug Name
Access
P/L†
█
alendronic acid 70mg tablets
Drug Class
Formulary Indication
N*
L*
Bisphosphonates
Steroid-induced osteoporosis
✔
✔
Drug Class
Formulary Indication
N*
L*
x
✔
✔
Comments
Source
NICE Technology Appraisal; Clinical
Knowledge Summaries; National
Osteoporosis Society
Gastro-intestinal
Drug Name
omeprazole 20mg capsules
Access
P/L†
█
SPC PIL
omeprazole 20mg dispersible tablets
ranitidine 150mg tablets
Prophylaxis of NSAID-associated gastic or duodenal ulcer
█
PPI
█
Histamine
Antagonist
Histamine
antagonist
Prophylaxis of NSAID-associated gastic or duodenal ulcer
P/L†
Drug Class
█
Analgesic
SPC PIL
█
ranitidine 75mg in 5mL sugar free syrup
PPI
x
x
✔
x
✔
Formulary Indication
N*
L*
Pain and inflammation; antiplatelet
x
Antiplatelet
x
✔
✔
✔
✔
✔
Comments
Source
BNF 1.3.5
BNF 1.3.1
Analgesics
Drug Name
Access
aspirin 300mg dispersible tablets
aspirin 75mg dispersible tablets
SPC PIL
aspirin 75mg enteric-coated tablets
co-CODamol 30/500 capsules
co-CODamol 8/500 effervescent tablets
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█
Analgesic
█
Analgesic
█
Analgesic
█
Analgesic
SPC PIL
x
Pain relief
x
x
Comments
Source
BNF 2.9
BNF 4.7
37
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Drug Name
Access
co-CODamol 8/500 tablets
P/L†
Drug Class
█
Formulary Indication
N*
L*
Analgesic
x
✔
✔
✔
✔
✔
✔
✔
codeine 15mg in 5mL linctus
█
Analgesic
x
codeine phosphate 15mg tablets
█
Analgesic
x
codeine phosphate 30mg tablets
█
Analgesic
x
█
Analgesic
x
█
Analgesic
x
█
Analgesic
x
█
Analgesic
coDYDramol 10/500 tablets
SPC PIL
dihydrocodeine 30mg tablets
morphine sulphate 10mg in 5mL solution
paracetamol 120mg in 5mL sugar free
suspension
paracetamol 250mg in 5mL sugar free
suspension
SPC PIL
SPC PIL
█
Analgesic
x
✔
x
✔
✔
✔
✔
✔
✔
✔
paracetamol 500mg soluble tablets
█
Analgesic
x
paracetamol 500mg tablets
█
Analgesic
x
█
Analgesic
x
█
Analgesic
x
█
Analgesic
x
█
Analgesic
x
P/L†
Drug Class
tramadol 50mg capsules
SPC PIL
paracetamol 120mg suppositories
paracetamol 240mg suppositories
SPC PIL
paracetamol 500mg suppositories
Comments
Source
Comments
Source
Nutrition
Drug Name
Access
calcium carbonate 1.25g chewable tablets
calcium carbonate D3 chewable tablets
SPC PIL
calcium carbonate D3 FORTE chewable
tablets
█
Calcium
█
Calcium
█
Calcium
Formulary Indication
N*
L*
Primary prevention of osteoporosis
✔
✔
✔
✔
✔
✔
calcium folinate 15mg tablets
SPC PIL
█
Calcium
Counteract the folate-antagonist action of pyrimethamine and
sulfdiazine
folic acid 5mg tablets
SPC PIL
█
Anaemia
Prevention of methotrexate-induced side-effects
█
Vitamin
ascorbic acid 500mg tablets
ascorbic acid 50mg tablets
pyridoXINe 10mg tablets
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█
Vitamin
Oral supplement (with topical drops) for acid or alkaline burns to
the cornea
█
Vitamin
Deficiency states, isoniazid- or pencillamine-induced neuropathy,
SPC PIL
SPC PIL
x
✔
x
x
x
x
✔
✔
✔
✔
BNF 9.5.1; NICE Technology
Appraisal; SIGN Osteoporosis
BNF 8.1; MEH Anti-infective
Guidelines; Moorfields Pharmacists
Handbook page 114
BNF 9.1.2; NeLM
BNF 9.6.3; Moorfields Pharmacists
Handbook page 52
BNF 9.6.2
38
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Drug Name
Access
█
pyridoXINe 50mg tablets
thiamine 100mg tablets
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P/L†
SPC PIL
█
Drug Class
Formulary Indication
N*
L*
Vitamin
idiopathic sideroblastic anaemia, premenstrual syndrome.
x
Vitamin B1 deficiency
x
✔
✔
Vitamin
Comments
Source
39
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Appendix 1 – Fact Sheets (Unlicenced
Medication)
General Recommendations
The use of Preservative Free Products over Preserved Ones may be recommended even when there is no allergy to preservatives.
This often applies to:
 Patients who are on many different preserved drops at the same time
 Patients who need drops with high frequency
 Patients on long term therapy
 Patients with compromised cornea e.g. corneal dystrophies, grafts, burns




The rationale behind this is that preservatives can be toxic to the eye so the use of too much of it or for long term should be avoided when possible
Unpredictable sensitivity to any component of a topical eye formulation should always be borne in mind. Sometimes patients may experience stinging, discomfort or
blurred vision. This may lead to complaints and compliance issues
The choice of artificial tear solution is partly subjective as to which one best controls the symptoms. Often patients try many lubricants until they find the one which works
for them.
If any product change is considered then patient approval should always be requested
These Fact Sheets are to be considered as information on what is current practice at Moorfields Eye Hospital. They are not to be intended as guidelines
Developed by:
Medicines Information Team / Formulary Team 02075662369
Moorfields Eye Hospital NHS Foundation Trust
City Road, London, EC1V 2PD
Pharmacist Lead:
Emilia Perla Lamberti
Antibiotic & Formulary Pharmacist
Pharmacy Department
Moorfields Eye Hospital NHS Foundation Trust
For more detailed information please refer to:
Moorfields Eye Hospital NHS Foundation Trust Pharmacists Handbook 2006
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Contents
40
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Contents
Atropine 1% (Preservative Free) eye
drops
Chloramphenicol 0.5%
(Preservative Free) eye drops
Cyclopentolate 1% (Preservative
Free) eye drops
Ciclosporin A 0.06% (Preservative
Free) eye drops
Ciclosporin A 0.2% (Preservative
Free) eye ointment (Optimmune)
Ciclosporin A 2% (Preservative
Free) eye drops
Dexamethasone 0.1%
(Preservative Free) eye drops
Hypromellose (HPRM) 0.3%
(Preservative Free) eye drops
Pilocarpine 2% (Preservative Free)
eye drops
Polihexanide 0.02% and 0.06%
(Preservative Free) PHMB eye
drops
Polyvinyl Alcohol 1.4%
(Preservative Free) eye drops
Prednisolone 0.3% (With
Preservatives) eye drops
Prednisolone 0.3% (Preservative
Free) eye drops
Sodium Chloride 0.9%
(Preservative Free) eye drops
Sodium Chloride 5% eye
ointment
Sodium Chloride 5% (Preservative
Free) eye drops
Sodium Cromoglicate 2%
(Preservative Free) eye drops
Tretinoin 0.05% (Preservative
Free) eye drops (All trans
retinoic acid)
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41
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Atropine 1% (Preservative Free) eye drops
Presentation: Multidose 10 ml bottle
Uses: To induce mydriasis and cycloplegia. It also acts on the blood vessels of the iris and ciliary body to restore natural
permeability.
Conditions which cause inflammation of the anterior segment e.g. iridocyclitis and anterior uveitis. Refraction in children.
Occlusion (suppression amblyopia). Thrombotic glaucoma
Rationale for use: Formulation may be preferred because of presentation e.g.. patient acceptability.
The use of bottles over Minims may be favoured when the patient is physically or otherwise impaired to use unit
doses e.g. manual dexterity problems
Licensed alternative: Atropine 1% Minims
Dose: Usually 1 drop once or twice a day, but can be used up to 4 times a day.
Refraction: 1 drop twice a day for 3 days prior to refraction
Occlusion: 1 drop once a day
Expected length of treatment: Various, it depends on the patient diagnosis
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Same as licensed product
Storage: Once opened, keep refrigerated and discard after one week.
Other information: Atropine is very potent, with effects that can last for up to two weeks
The Moorfields Pharmaceuticals formulation contains boric acid whilst
Minims formulation contains hydrochloric acid for PH adjustment.
Very rarely patients may develop sensitivity to boric acid
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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42
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Chloramphenicol 0.5% (Preservative Free) eye drops
Presentation: Multidose 10ml bottle
Uses: Topical broad spectrum antibiotic
Rationale for use: Formulation may be preferred because of presentation e.g. patient acceptability. The use of bottles over
Minims may be favoured when the patient is physically or otherwise impaired to use unit doses e.g. manual dexterity
problems
Licensed Alternative: Chloramphenicol 0.5% Minims
Dose: Depends on severity of condition.
Severe infections: 1 drop 0.5 to 2 hourly
Pre and post-operatively: 1 drop 4 times a day
Minor infections: 1 drop 4 times a day
Expected length of treatment: Usually 1 to 2 weeks
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side Effects ( as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Same as licensed product
Storage: Drops need to be stored in refrigerator and to be discarded one week after opening
Other information: Pseudomonas resistant
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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Cyclopentolate 1% (Preservative Free) eye drops
Presentation: Multidose 10ml bottle
Uses: To induce mydriasis and cycloplegia. Conditions which cause inflammation of the anterior segment e.g. iridocyclitis and anterior
uveitis
Rationale for use: Formulation may be preferred because of presentation e.g. patient acceptability.
The use of bottles over Minims may be favoured when the patient is physically or otherwise impaired to use unit
doses e.g. manual dexterity problems
Licensed alternative: Cyclopentolate hydrochloride 1% Minims
Dose: 1 drop 1 to 4 times a day
Expected length of treatment: Various it depends on the patient diagnosis
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side Effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Same as licensed product
Storage: Once opened, keep refrigerated and discard after one week
Other information: Synthetically derived and structurally dissimilar to atropine, and may possibly be used in atropine allergy
Moorfields formulation contains boric acid and potassium chloride (buffer)
Very rarely patients may develop sensitivity to boric acid
Minims contain hydrochloric acid for pH adjustment
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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44
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Ciclosporin A 0.06% (Preservative Free) eye drops
Presentation: 10ml multidose bottle
Uses: Management of severe allergic eye disease. Severe dry eye syndromes. Prevention of corneal graft rejection
autoimmune keratoconjunctivitis e.g. vernal, atopic, staphylococcal hypersensitivity
Thygeson’s keratitis, ligneous conjunctivitis. Non healing corneal erosions, fungal keratitis
Rationale for use: No licensed alternative available
Dose: Place ONE drop into eye(s) one to four times daily (depending on diagnosis/severity)
Expected length of treatment: Various, it depends on the patient diagnosis, often long term
Cautions: Wash hands after use
Safety in pregnancy and lactation not established
Contact lens wear to be avoided except after specialist recommendation
Side effects: Mild irritation in the first few days of therapy may occur
Monitoring: The drug does not require any special monitoring as systemic adsorption is minimal
Storage: Store below 25°C until opened. Once opened store in a refrigerator and discard 1 week after opening
Other information: Useful when patients cannot tolerate eye ointment or higher strength drops
Contains glycerol, carbomer, miglyol, laureth 4, poloxamer, sodium hydroxide and Water for Injections.
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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45
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Ciclosporin A 0.2% (Preservative Free) eye ointment (Optimmune)
Presentation: 3.5 g tube (Optimmune)
Uses: Management of severe allergic eye disease. Severe dry eye syndromes. Prevention of corneal graft rejection
Autoimmune keratoconjunctivitis e.g. vernal, atopic, staphylococcal hypersensitivity
Thygeson’s keratitis, Ligneous conjunctivitis. Non healing corneal erosions
Rationale for use: No licensed alternative available
Dose: Apply 2 to 4 times a day
Expected length of treatment: Various, it depends on the patient diagnosis, often long term
Cautions: Wash hands after use
Do not use in pregnancy
Do not use when there is fungal disease of the eye
Contact lens wear to be avoided except after specialist recommendation
Side effects: Mild irritation in the first few days of therapy may occur
Monitoring: The drug does not require any special monitoring as systemic adsorption is minimal
Storage: Store below 25C. Discard one month after opening
Other information: Licensed as an animal medicine but has been manufactured to exactly the same standards as required for
licensed human medicines
Useful when patients cannot tolerate eye drops
Contains paraffin base, maize oil and lanolin alcohol
Ordered from: Moorfields Eye Hospital Pharmacy orders this product (Optimmune) directly from Moorfields Pharmaceuticals
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46
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Ciclosporin A 2% (Preservative Free) eye drops
Presentation: 10ml multidose bottle
Uses: Management of severe dry eye syndromes, severe allergic eye diseases. Prevention of corneal graft rejection.
Autoimmune keratoconjunctivitis e.g. vernal, atopic, staphylococcal hypersensitivity. Thygeson’s keratitis, Ligneous
conjunctivitis. Non healing corneal erosions
Rationale for use: No licensed alternative available
Dose: Depends on severity of condition
Usually 1 drop 4 times a day but can be used more frequently if needed
Expected length of treatment: Various, it depends on the patient diagnosis
Cautions: Wash hands after use
Do not use in pregnancy
Do not use when there is fungal disease of the eye (except after specialist recommendation)
Contact lens wear to be avoided except after specialist recommendation
Side effects: May cause severe stinging on instillation. This may limit the dose tolerated
Monitoring: The drug does not require any special monitoring as systemic adsorption is minimal
Storage: Store at room temperature at all times, as drug precipitates out of solution in cold temperatures
Other information: Ciclosporin 2% in alcohol and maize oil
Ciclosporin 2% eye drops Preservative Free is often chosen when other drugs have already proved to be
unsuccessful
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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Dexamethasone 0.1% (Preservative Free) eye drops
Presentation: Multidose 10ml bottle
Uses: Corticosteroids have many uses and numerous adverse effects. The anti-inflammatory glucocorticoid action determines
their usefulness as ocular drugs.
Rationale for use: Formulation may be preferred because of presentation e.g. patient acceptability.
The use of bottles over Minims may be favoured when the patient is physically or otherwise impaired to use
unit doses e.g. manual dexterity problems. This is a phosphate free formulation. Phosphate free formulations are preferable in
certain patients such as those with band keratopathy or any patient where calcium phosphate deposition is of concern.
Licensed alternative: Dexamethasone 0.1% Minims
Dose: Depends on the patient diagnosis, from 1 drop every half an hour to 1 drop on alternate days. Usually dose is reduced
by tapering over a period of time
Expected length of treatment: Various, it depends on the patient diagnosis
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: The drug does not require any special monitoring apart from standard ocular steroid monitoring i.e. intraocular
pressure, cataract formation, delayed healing rate and corneal ulceration
Storage: Once opened, keep refrigerated and discard after one week
Other information: Penetration of steroids is significantly increased if the cornea is abraded
Minims contain disodium edetate, very rarely patients may develop sensitivity to this compound
Minims also contain a phosphate buffer, and have the sodium phosphate salt of dexamethasone, as opposed
to sodium metasulphobenzoate salt in Moorfields Pharmaceuticals preparation. Drugs like fluorometholone and rimexolone,
both with preservative, are less likely to cause raised intraocular pressure than other topical steroids, but may not penetrate
the cornea as well as drugs such as dexamethasone.
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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Hypromellose (HPRM) 0.3% (Preservative Free) eye drops
Presentation: Multidose 8ml bottle
Uses: Ocular lubrication for the relief of mild to moderate dry eye syndromes associates with deficient tear secretion or
lubrication with hard or gas permeable contact lenses
Rationale for use: Formulation may be preferred because of presentation e.g.. patient acceptability.
The use of bottles over single doses may be favoured when the patient is physically or otherwise impaired to
use unit doses e.g. manual dexterity problems.
Licensed alternative: Hydromoor preservative free single doses units
Hydromoor, is a Moorfields Pharmaceutical formulation, is CE marked and has same
formulation as the unlicensed bottle product except for disodium edetate
Dose: 1 drop as required
Expected length of treatment: Various, it depends on the patient diagnosis/response
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Same as licensed product
Storage: Once opened, keep refrigerated and discard after one week
Other information: Moorfields unlicensed formulation contains disodium edetate
Patients may very rarely develop sensitivity to it
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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49
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Pilocarpine 2% (Preservative Free) eye drops
Presentation: 10ml multidose bottle
Uses: To reduce intraocular pressure in open angle glaucoma and other forms of chronic glaucoma
Other uses: Constricts the pupil after cataract surgery
Rationale for use: Formulation may be preferred because of presentation e.g. patient acceptability.
The use of bottles over Minims may be favoured when the patient is physically or otherwise impaired to use
unit doses e.g. manual dexterity problems
Licensed alternative: Pilocarpine 2% Minims
Dose: Usually 1 drop 4 times a day, but dose ranges from once a day in some patients with ocular
hypertension to 6 times a day, when the intraocular pressure cannot be controlled with lower doses
Expected length of treatment: Various, it depends on the patient diagnosis
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Systemic side effects to be monitored
Storage: Once opened, keep refrigerated and discard one week after opening
Other information: Minims contain nitrate as the salt whilst Moorfields Pharmaceuticals preparation contains HCL salt.
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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50
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Polihexanide 0.02% and 0.06% (Preservative Free) eye drops (Polyhexamethylene
biguanide) PHMB
Presentation: 10ml multidose bottle
Uses: Acanthamoeba Keratitis infections usually in contact lenses users
Rationale for use: No licensed alternative available
Dose: Depends on severity of condition:
1 drop every hour day and night for 2 days, then every hour day only for 3 days.
Intensive treatment is used at an early stage, while organisms are susceptible and before cysts have fully matured.
Reduce to 3 hourly, then tailor thereafter according to the course of the disease
Expected length of treatment Treatment must be prolonged in order to eradicate cysts
Cautions: None listed
Side effects: Toxicity with PHMB is rare
Monitoring: The drug does not require any special monitoring
Storage: Store below 25°C. Discard four weeks after opening
Other information: Used in combination with propamidine 0.1% or hexamidine 0.1% eye drops
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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Polyvinyl Alcohol 1.4% (Preservative Free) eye drops
Presentation: Multidose 10 ml bottle
Uses: Ocular lubrication for the relief of dry eye syndromes associated with deficient tear secretion
Ocular lubrication when wearing hard or gas permeable contact lenses
Rationale for use: Formulation may be preferred because of presentation e.g.. patient acceptability.
The use of bottles over single doses may be favoured when the patient is physically or otherwise impaired to
use unit doses e.g. manual dexterity problems
Licensed alternative: Refresh ophthalmic eye drops single dose units
Dose: 1 drop as required
Expected length of treatment: Various, it depends on the patient diagnosis/response
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Same as licensed product
Storage: Once opened keep refrigerated and discard after one week
Other information: The Moorfields formulation contains mannitol, sodium citrate and citric acid
Refresh contains povidone, sodium chloride, sodium hydroxide or hydrochloric acid (to adjust PH)
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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Prednisolone 0.3 % (With Preservatives) eye drops
Presentation: 10ml multidose bottle
Uses: Inflammatory conditions of the anterior segment. To reduce host response
Tapering dose of higher strength preparation. Inflammatory keratitis due to Herpes Zoster and Herpes Simplex virus
Rationale for use: No licensed alternative available
Dose: Depends on severity of condition
Expected length of treatment: Various, usually short term, it depends on the patient diagnosis /response
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Side effects to be monitored
Storage: Once open, discard after four weeks
Other information: Moorfields formulation contains:
sodium chloride, sodium dihydrogen phosphate dihydrate, disodium edetate and sodium hydroxide.
Preservative: 0.01% benzalkonium chloride
There is no evidence of different clinical effectiveness between 0.3% and 0.5% Prednisolone.
Instead of lower strength Prednisolone, it maybe suitable to use licensed Prednisolone 0.5% (Predsol) less
frequently
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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53
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Prednisolone 0.3 % (Preservative Free) eye drops
Presentation: 10ml multidose bottle
Uses: Inflammatory conditions of the anterior segment. To reduce host response
Tapering dose of higher strength preparation. Inflammatory keratitis due to Herpes Zoster and Herpes Simplex virus
Rationale for use: No licensed alternative available
Dose: Depends on severity of condition
Expected length of treatment: Various, usually short term, it depends on the patient diagnosis /response
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Side effects to be monitored
Storage: Once open, keep refrigerated and discard after one week
Other information: Moorfields formulation contains:
sodium chloride, sodium dihydrogen phosphate dihydrate, disodium edetate and sodium hydroxide.
There is no evidence of different clinical effectiveness between 0.3% and 0.5% Prednisolone.
Instead of lower strength Prednisolone, it maybe suitable to use licensed Prednisolone Minims 0.5% less
frequently
Minims contain disodium edetate, disodium dihydrogen phosphate, sodium chloride and sodium hydroxide
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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54
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Sodium Chloride 0.9% (Preservative Free) eye drops
Presentation: Multidose 10ml bottle
Uses: Relief of dry eye syndromes, for moistening of contact lenses
Rationale for use: Formulation may be preferred because of presentation e.g.. patient acceptability.
The use of bottles over single doses may be favoured when the patient is physically or otherwise impaired to
use unit doses e.g. manual dexterity problems.
Licensed alternative: Minims Saline
Dose: 1 drop as required
Expected length of treatment: Various, it depends on the patient diagnosis/response
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Same as licensed product
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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55
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Sodium Chloride 5% eye ointment
Presentation: 5 g tube
Uses: Hypertonic agent used for recurrent corneal erosions
Reduces the corneal edema, which may be due to a variety of factors (bullous Keratitis, post-operative of cataract
extraction
and hereditary corneal dystrophia or Fuch’s dystrophia)
Preservative: 0.0016% methylparahydroxybenzoate and
0.001% propyl parahydroxybenzoate in ointment
Rationale for use: No licensed alternative available
Dose: Usually to be applied once at night
Can be used twice daily or otherwise according to physician’s criterion
Expected length of treatment: Various, it depends on the patient diagnosis/response
Cautions: Application should be carried out under hygienic conditions, avoiding contact with the nozzle of the tube
Side effects: Stings on instillation, some patients may experience a normally transitory slight itching
Monitoring: The drug does not require any special monitoring
Storage: Store below 25°C. Discard one month after opening
Other information: Eye ointment contains lanolin, liquid paraffin and white soft paraffin
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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56
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Sodium Chloride 5% (Preservative Free) eye drops
Presentation: 10ml multidose bottle
Uses: Hypertonic agent, draws water out from the corneal epithelium and stroma to clear or reduce corneal oedema
Can be used for diagnostic purpose
Rationale for use: No licensed alternative available
Dose: Usually 1 drop 3 times a day
Expected length of treatment: It depends on the patient diagnosis, usually long term
(endothelial dystrophies may require lifelong management)
Cautions: None listed
Side effects: Stings on instillation
Monitoring: The drug does not require any special monitoring
Storage: Once opened, keep refrigerated and discard after one week
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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57
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Sodium Cromoglicate 2% (Preservative Free) eye drops
Presentation: Multidose 10ml bottle
Uses: Topical treatment of allergic conjunctivitis and vernal keratoconjunctivitis
Rationale for use: Formulation may be preferred because of presentation e.g.. patient acceptability.
The use of bottles over single doses may be favoured when the patient is physically or otherwise impaired to
use unit doses e.g. manual dexterity problems.
Licensed alternative: Catacrom 2% eye drops single unit doses
Dose: 1 drop 4 times a day.
Expected length of treatment: Various, from seasonal to long term
Cautions (as per active ingredient): Same as listed in BNF for licensed product
Side effects (as per active ingredient): Same as listed in BNF for licensed product
Monitoring: Same as licensed product
Storage: Once opened keep refrigerated and discard after one week
Other information: Acting as mast cells stabiliser, its full effect can take several days to occur
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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Tretinoin 0.05% (Preservative Free) eye drops (All trans retinoic acid)
Presentation: 10ml multidose bottle
Uses: Squamous metaplasia and keratinisation of the conjunctiva
Rationale for use: No licensed alternative available
Doses: 1 drop daily. When benefit is noted, reduce to 1 drop on alternate days or twice a week
Expected length of treatment: Various it depends on the patient diagnosis, but may be long term
Cautions: It contains Arachis (peanut) oil and absolute alcohol. Be aware of nuts allergy
Side effects: Lid irritation. Teratogenic
Monitoring: Adverse effects to be monitored
Storage: Store in freezer
Protect from light at all times
As precautionary measure a shelf-life at -20 °C for 28 days has been given to this product, however limited stability
data show that the preparation is also stable at room temperature
Ordered from: Moorfields Eye Hospital Pharmacy orders this product directly from Moorfields Pharmaceuticals
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