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Kings College Hospital NHS Foundation Trust
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 Formulary Chapter 11: Eye - Full Chapter
Notes:

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

 Details...
11.01  Administration of drugs to the eye
11.02  Control of microbial contamination
11.03  Anti-infective eye preparations
Malathion Liquid 0.5%  (aqueous)
View adult BNF View SPC online
Formulary

Approved off-label indication:

Treating lice infested eyelashes and eyebrows (the alcoholic solution is not suitable)

  • Apply to eyelashes & brows using a cotton bud
  • Allow to dry naturally
  • Wash face thoroughly after 12 hours
  • Repeat after 7 days if necessary.
 
   
Chlorhexidine digluconate 0.02% eye drops
Unlicensed Drug Unlicensed
Red
Acanthamoeba  
   
Polyhexamethylene biguanide 0.02% (PHMB) eye drops
Unlicensed Drug Unlicensed
Red
Acanthamoeba  
   
11.03.01  Antibacterials
Cefuroxime 1mg intracameral injeciton
Formulary
Red

Antimicrobial prophylaxis of postoperative endophthalmitis after cataract surgery

 
   
Chloramphenicol eye drops 0.5%, eye ointment 1%
View adult BNF View SPC online
Formulary Preservative-free eye drops available on request 
   
Ciprofloxacin eye drops 0.3%
View adult BNF View SPC online
Formulary  
   
Fusidic acid eye drops 1%
View adult BNF View SPC online
Formulary  
   
Gentamicin drops 0.3% (eye)
View adult BNF View SPC online
Formulary Preservative-free eye drops available on request (1.5% - see below) 
   
Levofloxacin eye drops 0.5%
View adult BNF View SPC online
Formulary Preservative-free eye drops available on request for patients with preservative allergies, ocular surface disease and atopy 
   
Moxifloxacin 0.5% eye drops (bacterial keratitis - off-label)
View adult BNF View SPC online
Formulary
Red

Approved indication (off-label):

  • First line antibiotic in bacterial keratitis where a preservative free formulation is required
  • Hourly dosing may be required on initation (off-label)
 
Link  SE London APC recommendation: Moxifloxcacin eye drops for bacterial keratitis
   
Ofloxacin opthalmic solution 0.3%
View adult BNF View SPC online
Formulary  
   
Propamidine isetionate eye drops 0.1%
View adult BNF View SPC online
Formulary  
   
Tobramycin eye drops 0.3%
View adult BNF View SPC online
Restricted Drug Restricted
Red
Reserved for severe corneal infections with sensitivity to aminoglycosides where an alternative less toxic agent than gentamicin is required 
   
Amikacin 0.4 mg intravitreal injection
Unlicensed Drug Unlicensed
Red
Endophthalmitis in beta-lactam allergic patients 
   
Ceftazidime eye drops 5%
Unlicensed Drug Unlicensed  
   
Ceftazidime 2mg intravitreal injeciton
Unlicensed Drug Unlicensed
Red
Endophthalmitis 
   
Cefuroxime eye drops 5%
Unlicensed Drug Unlicensed  
   
Gentamicin Forte PF eye drops 1.5%
Unlicensed Drug Unlicensed
Red
 
   
Penicillin eye drops 0.3%
Unlicensed Drug Unlicensed  
   
Vancomycin 2mg intravitreal injection
Unlicensed Drug Unlicensed
Red
Endophthalmitis 
   
11.03.02  Antifungals to top
Natamycin 5% eye drops
First Choice
Red

First line empiric management of fungal keratitis

Unlicensed preparation

Usual dosing schedule = one drop hourly day and night for 48 hours, then one drop hourly during the day time, gradually reduced to four times a day.

Usual course length 1 month.

 
Chlorhexidine 0.2% eye drops
Unlicensed Drug Unlicensed
Red

Additional topical treatment for fungal keratitis where there has been insufficient response to natamycin eye drops

Usual dosing schedule = one drop hourly day and night for 48 hours, then one drop hourly during the day time, gradually reduced to four times a day.

Usual course length 1 month.

 
   
Amphotericin 0.15% eye drops
Unlicensed Drug Unlicensed
Red
For fungal keratitis with confirm/suspected candida infection  
   
Amphotericin 5 micrograms intravitreal injection
Unlicensed Drug Unlicensed
Red

Acute treatment of fungal endogenous endophthalmitis

 
   
11.03.03  Antivirals
Aciclovir eye ointment 3%
View adult BNF View SPC online
Formulary  
   
Foscarnet intravitreal injection
Unlicensed Drug Unlicensed
Red
Viral retinitis  
   
11.04  Corticosteroids and other anti-inflammatory preparations
11.04.01  Corticosteroids
Betamethasone 0.1% & neomycin 0.5% eye drops & ointment
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Formulary  
   
Betamethasone 0.1% eye drops & ointment
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Formulary  
   
Dexamethasone eye drops 0.1%
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Formulary Preservative-free eye drops available on request 
   
Dexamethasone injection (intracameral use - off-label)
View adult BNF View SPC online
Formulary
Red

Approved off-label indication:

Intracameral use in Endoscopic Cyclophotocoagulation (ECP) and cataract surgery where there is increased inflammation

Dose: 0.4mg peri-operatively

Only the Hospira AMPOULE (preservative free) formulation is approved for use in this indication

 
   
Fluorometholone eye drops 0.1% (FML®)
View adult BNF View SPC online
Formulary  
   
Loteprednol eye drops 0.5%
View adult BNF View SPC online
Formulary

Treatment of post-operative inflammation following ocular surgery

Approved off-label indication:

Control of intraocular inflammation in patients with uveitis where the patient is known to be or becomes a steroid responder

 
   
Maxitrol® eye drops
View adult BNF View SPC online
Formulary Contains:
  • Dexamethasone 0.1%
  • Hypromellose 0.5%
  • Neomycin 0.35%
  • Polymyxin B sulphate 6000 units/ml 
  •    
    Maxitrol® eye ointment
    View adult BNF View SPC online
    Formulary Contains:
  • Dexamethasone 0.1%
  • Neomycin 0.35%
  • Polymyxin B sulphate 6000 units/g  
  •    
    Prednisolone eye drops 0.5%, 1%
    View adult BNF View SPC online
    Formulary Preservative-free eye drops 0.5% available on request 
       
    Sofradex® eye drops
    View adult BNF View SPC online
    Formulary Contains:
  • Dexamethasone 0.05%
  • Framycetin sulphate 0.5%
  • Gramicidin 0.005%  
  •    
    Triamcinolone injection (Intracinol ophthalmic suspension 40 mg in 1mL)
    (Medical device)
    Formulary
    Red

    Approved for:

    • Opacification of the vitreous in eye surgery
    • Treatment and prevenetion of macular oedema in inflammatory eye conditions (off-label)

     Dosing:

    • 4mg (0.1mL) if given intravitreally
    • up to 40 mg (1mL) if given sub-Tenon's/orbital floor
     
       
    11.04.02  Other anti-inflammatory preparations
    Ciclosporin 0.1% eye drops (dry eye disease)
    View adult BNF View SPC online
    Restricted Drug Restricted
    Amber 2

    For dry eye disease as per NICE TA369

    Specialist ophthalmologist initiation only

     
    Link  NICE TA369: Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears
       
    Ciclosporin 0.1% eye drops (atopic & vernal keratoconjunctivitis (AKC & VKC) - off-label)
    View adult BNF View SPC online
    Restricted Drug Restricted
    Amber 2

    Approved off-label indication:

    For atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) in adults and children aged over 4 years, in accordance with APC recommendation

    Specialist ophthalmologist initation and first prescription from hospital

     
    Link  Ciclosporin 0.1% (Ikervis™) eye drops for atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) in children aged over 4 years
       
    Tacrolimus 0.1% ointment (ocular off-label use)
    View adult BNF View SPC online
    Restricted Drug Restricted
    Red

    Approved off-label indications:

    • Vernal keratoconjunctivitis (VKC),
    • Atopic keratoconjunctivitis (AKC)
    • Ocular graft-versus-host disease (GVHD) (off-label topical ocular administration)

    Restricted to use in where where ciclosporin eye drops are ineffective or inappropriate

     
       
    Lodoxamide eye drops 0.1%
    View adult BNF View SPC online
    Formulary  
       
    Olopatadine eye drops 0.1%
    View adult BNF View SPC online
    Formulary
    Green
     
    Link  SE London APC Recommendation: Olopatadine eye drops for allergic conjunctivitis
       
    Otrivine-Antistin® eye drops
    View adult BNF View SPC online
    Formulary Contains:
  • Antazoline sulphate 0.5%
  • Xylometazoline hydrochloride 0.05%  
  •    
    Sodium cromoglicate eye drops 2%
    View adult BNF View SPC online
    Formulary  
       
    11.05  Mydriatics and cycloplegics to top
    11.05  Antimuscarinics
    Atropine sulphate eye drops/ointment 1% (for mydriasis)
    View adult BNF View SPC online
    Restricted Drug Restricted USE UNDER SPECIALIST SUPERVISION ONLY 
       
    Cyclopentolate eye drops 0.5%, 1%
    View adult BNF View SPC online
    Formulary  
       
    Tropicamide eye drops 0.5%, 1%
    View adult BNF View SPC online
    Formulary

    Tropicamide eye drops in combination with phenylephrine eye drops may be required for pre-operative mydriasis in opthalmic surgery for certain scenarios e.g. contraindications to Mydrane and Mydriasert (see chapter 11.05)

    Note: Preservative-free eye drops available on request

     
       
    11.05  Sympathomimetics
    Phenylephrine and tropicamide ophthalmic insert (Mydriasert®)
    View adult BNF View SPC online
    Formulary
    Red
    Reserved for patients on the femtosecond laser assisted surgery list requiring pre-operative mydriasis in ophthalmic surgery 
       
    Phenylephrine hydrochloride eye drops 2.5%, 10%
    View adult BNF View SPC online
    Formulary

    USE UNDER SPECIALIST SUPERVISION ONLY

    Phenylephrine eye drops may be required in combination with tropicamide eye drops for pre-operative mydriasis in opthalmic surgery for certain scenarios e.g. contraindications to Mydrane and Mydriasert

     
       
    Tropicamide, phenylephrine and lidocaine solution for intracameral injection  (Mydrane®)
    View adult BNF View SPC online
    Formulary
    Red

    For all patients on the general cataract surgery list requiring pre-operative mydriasis in ophthalmic surgery

     
       
    11.06  Treatment of glaucoma
    11.06  Beta-blockers
    Betaxolol eye drops 0.25%, 0.5%
    View adult BNF View SPC online
    Formulary  
       
    Levobunolol eye drops 0.5%
    View adult BNF View SPC online
    Formulary  
       
    Timolol 0.1% unit dose eye gel (Tipoex®)
    View adult BNF View SPC online
    Restricted Drug Restricted
    Amber 2

    Preservative-free preparation

    Restricted to patients who have either:

    • Sensitivity to higher concentrations of timolol
    • Sensitivity to preservative containing preparations of timolol
     
    Link  SE London APC Recommendation: Timolol 0.1% eye gel (Tiopex)
       
    Timolol eye drops 0.25%, 0.5%
    View adult BNF View SPC online
    Formulary  
       
    Timolol opthalmic gel-forming solution 0.25%, 0.5% (Timoptol-LA®)
    View adult BNF View SPC online
    Formulary  
       
    11.06  Prostaglandin analogues to top
    Latanoprost eye drops 0.05mgs/mL
    View adult BNF View SPC online
    First Choice

    First-line prostaglandin analogue

    A preservative-free preparation (Monopost®) is available on request

     
    Travoprost eye drops 0.04mg/ml
    View adult BNF View SPC online
    Second Choice

    Second-line prostaglandin analogue

    First-line in patients with a proven sensitivity to the preservative benzalkonium chloride

     
       
    Bimatoprost eye drops 0.1mg/mL
    View adult BNF View SPC online
    Third Choice

    Third-line prostaglandin analogue

    A preservative-free preparation of 0.3mg/mL is available on request

     
       
    Latanoprost 0.05mg with timolol 5mg/mL eye drops
    View adult BNF View SPC online
    Formulary Treatment of open-angle glaucoma and ocular hypertension when monotherapy alone is not adequate 
       
    Travoprost 0.04mg & timolol 5mg/mL eye drops (DuoTrav®)
    View adult BNF View SPC online
    Formulary

    Treatment of open-angle glaucoma and ocular hypertension when monotherapy alone is not adequate

    First-line in patients requiring combination therapy but with a proven sensitivity to the preservative benzalkonium chloride

     
       
    Bimatoprost 0.3mg & timolol 5mg/mL eye drops (Ganfort®)
    View adult BNF View SPC online
    Formulary

    Treatment of open-angle glaucoma and ocular hypertension when monotherapy alone is not adequate

    Note: preservative-free drops available on request

     
       
    Tafluprost eye drops 0.015mg/mL
    View adult BNF View SPC online
    Restricted Drug Restricted

    Initiation by Consultant Ophthalmologists only

    For the reduction of elevated intraocular pressure in open angle glaucoma and ocular hypertension for patients in the immediate postoperative phase following glaucoma tube surgery

     
       
    11.06  Sympathomimetics
    Brimonidine eye drops 0.2%
    View adult BNF View SPC online
    Formulary  
       
    Brimonidine 0.2% & timolol 0.5% eye drops (Combigan®)
    View adult BNF View SPC online
    Formulary  
       
    11.06  Carbonic anhydrase inhibitors and systemic drugs
    Acetazolamide tabs, m/r caps, injection
    View adult BNF View SPC online
    Formulary  
       
    Dorzolamide eye drops 2%
    View adult BNF View SPC online
    Formulary Note: preservative-free drops available on request 
       
    Brinzolamide eye drops 1%
    View adult BNF View SPC online
    Formulary  
       
    Dorzolamide 2% & timolol 0.5% eye drops
    View adult BNF View SPC online
    Formulary

    Treatment of open-angle glaucoma, ocular hypertension, and pseudoexfoliative glaucoma when betablocker alone is not adequate.

    Note: preservative-free drops available on request

     
       
    Brinzolamide 1% & timolol 0.5% eye drops (Azarga®)
    View adult BNF View SPC online
    Formulary Decrease of intraocular pressure (IOP) in adult patients with openangle glaucoma or ocular hypertension for whom monotherapy provides insufficient IOP reduction 
       
    Brinzolamide 10mg/ml & brimonidine 2mg/ml eye drops (Simbrinza®)
    View adult BNF View SPC online
    Formulary
    Amber 2
    For intraocular hypertension and open angle glaucoma where monotherapy is insufficient.  
    Link  SE London APC Recommendation: Brinzolamide & brimonidine eye drops (Simbrinza®) for reduction of elevated intraocular pressure
       
    11.06  Miotics
    Pilocarpine eye drops 1%, 2%, 4%
    View adult BNF View SPC online
    Formulary Preservative-free eye drops available on request (not all strengths available) 
       
    11.07  Local anaesthetics
    Lidocaine 4% & Fluorescein 0.25% preservative-free eye drops
    (Minims®)
    View adult BNF View SPC online
    Formulary  
       
    Oxybuprocaine 0.4% preservative-free eye drops
    (Minims®)
    View adult BNF View SPC online
    Formulary  
       
    Proxymetacaine 0.5% preservative-free eye drops
    (Minims®)
    View adult BNF View SPC online
    Formulary  
       
    Tetracaine (amethocaine) 0.5%, 1% preservative-free eye drops  (Minims®)
    View adult BNF View SPC online
    Formulary  
       
    11.08  Miscellaneous ophthalmic preparations to top
    11.08.01  Tear deficiency, ocular lubricants, and astringents
    Hypromellose 0.3% eye drops
    View adult BNF View SPC online
    First Choice Preservative-free version available on request 
    Carmellose eye drops 0.5%, 1%
    View adult BNF View SPC online
    Second Choice Preservative-free 
       
    Carbomer 980 eye drops 0.2% (polyacrylic acid)
    View adult BNF View SPC online
    Formulary Preservative-free version available on request 
       
    Hypromellose eye drops 0.5%
    View adult BNF View SPC online
    Formulary  
       
    Ilube® eye drops
    View adult BNF View SPC online
    Formulary Contains:
  • Acetylcysteine 5%
  • Hypromellose 0.35% 
  •    
    Liquid paraffin eye ointment (Xialin night®, Lacri-lube®, VitA-POS®)
    View adult BNF View SPC online
    Formulary  
       
    Polyvinyl alcohol eye drops 1.4%
    View adult BNF View SPC online
    Formulary  
       
    Simple eye ointment
    View adult BNF View SPC online
    Formulary  
       
    Sodium chloride eye drops 0.9%
    View adult BNF View SPC online
    Formulary  
       
    Sodium chloride eye ointment 5%
    View adult BNF View SPC online
    Formulary

    For use in corneal oedema

     
       
    Sodium hyaluronate eye drops 0.1% (HyloTear®)
    View adult BNF View SPC online
    Formulary Approved for:
  • First-line use in corneal graft/ulcer
  • Second-line use after hypromellose preservative-free eye drops in patients with preservative induced adverse reaction 
  •    
    Sodium chloride 5% preservative free eye drops
    View adult BNF View SPC online
    Formulary For use in corneal oedema 
       
    11.08.02  Ocular diagnostic and peri-operative preparations and photodynamic treatment
    11.08.02  Ocular diagnostic preparations
    Fluorescein sodium eye drops 2%
    View adult BNF View SPC online
    Formulary  
       
    Rose Bengal eye drops 1%
    View adult BNF View SPC online
    Formulary  
       
    11.08.02  Ocular peri-operative drugs
    Acetylcholine intra-ocular irrigation 1%
    View adult BNF View SPC online
    Formulary  
       
    Apraclonidine eye drops 0.5% (chronic glaucoma)
    View adult BNF View SPC online
    Formulary
    Amber 2

    Suitable for GP prescribing if prolonged treatment greater than 3 months is required.

    Initial 3 month supply from hospital

     
       
    Apraclonidine eye drops 1%
    View adult BNF View SPC online
    Formulary
    Red
     
       
    Diclofenac 0.1% unit dose eye drops
    View adult BNF View SPC online
    Formulary
    Red

    Inhibition of perioperative miosis in cataract surgery only

     
       
    Cytotoxic Drug Fluorouracil 5mg intravitreal injection
    View adult BNF View SPC online
    Formulary
    Red
    For swelling reduction post trabeculectomy 
       
    Flurbiprofen sodium eye drops 0.03%
    View adult BNF View SPC online
    Formulary  
       
    Ketorolac eye drops 0.5%
    View adult BNF View SPC online
    Formulary  
       
    Nepafenac 1mg/ml eye drops
    View adult BNF View SPC online
    Restricted Drug Restricted
    Red

    Restricted to the following indication only:

    Reduction in the risk of postoperative macular oedema associated with cataract surgery in diabetic patients

    Full supply to come from hospital on discharge

     
       
    Povidone-iodine eye drops 5%
    View adult BNF View SPC online
    Formulary  
       
    Histoacryl® skin adhesive
    View adult BNF
    Formulary
    Red
    Approved off-label indication:
    Management of corneal perforations 
       
    Alteplase intravitreal injection (unlicensed product - submacular haemorrhage)
    View adult BNF View SPC online
    Unlicensed Drug Unlicensed
    Red

    Treatment of submacular haemorrhage

     
       
    11.08.02  Subfoveal choroidal neovascularisation to top
    Aflibercept intravitreal injection
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE technology appraisal guidance

    Refer to APC guidance for Wet Age-Related Macular Degeneration, Diabetic Macular Oedema, Central Retinal Vein Occlusion and Branch Retinal Vein Occlusion (see link below)

     
    Link  NICE TA294: Macular degeneration (wet age-related) - aflibercept
    Link  NICE TA305: Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion
    Link  NICE TA346: Aflibercept for treating diabetic macular oedema
    Link  NICE TA409: Aflibercept for treating visual impairment caused by macular oedema after branch retinal vein occlusion
    Link  NICE TA486: Aflibercept for treating choroidal neovascularisation
       
    Dexamethasone intravitreal implant (Ozurdex ®)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE technology appraisal guidance

    Refer to APC guidance for Wet Age-Related Macular Degeneration, Diabetic Macular Oedema, Central Retinal Vein Occlusion and Branch Retinal Vein Occlusion (see link below)

     
    Link  NICE TA229: Dexamethasone intravitreal implant for the treatment of macular oedema
    Link  NICE TA349: Dexamethasone intravitreal implant for treating diabetic macular oedema
    Link  NICE TA460: Adalimumab and dexamethasone for treating non-infectious uveitis
       
    Fluocinolone intravitreal implant (Iluvien®)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE technology appraisal guidance

    Refer to APC guidance for Wet Age-Related Macular Degeneration, Diabetic Macular Oedema, Central Retinal Vein Occlusion and Branch Retinal Vein Occlusion (see link below)

     
    Link  NICE TA301: Fluocinolone acetonide intravitreal implant for treating chronic diabetic macular oedema after an inadequate response to prior therapy (rapid review of technology appraisal guidance 271)
       
    Ranibizumab intravitreal injection
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE technology appraisal guidance

    Refer to APC guidance for Wet Age-Related Macular Degeneration, Diabetic Macular Oedema, Central Retinal Vein Occlusion and Branch Retinal Vein Occlusion (see link below)

     
    Link  NICE TA155: Ranibizumab and pegaptanib for the treatment of age-related macular degeneration
    Link  NICE TA274: Macular oedema (diabetic) - ranibizumab
    Link  NICE TA283: Macular oedema (retinal vein occlusion) - ranibizumab: guidance
    Link  NICE TA298: Choroidal neovascularisation (pathological myopia) - ranibizumab
       
    Verteporfin injection (chronic central serous chorio-retinopathy - off-label)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved off-label use:

    Treatment of chronic central serous chorio-retinopathy (CSC)

    Restricted to Consultant Specialists in medical retinal disease

     
       
    Verteporfin injection (licensed use)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Refer to NICE NG82 for details on approved use of photodynamic therapy

     
    Link  NICE NG82: Age-related macular degeneration
       
    Bevacizumab intravitreal injection (1.25 mg in 0.05 mL)
    View adult BNF View SPC online
    Unlicensed Drug Unlicensed
    Red
    Approved for:
  • Neovascular glaucoma
  • Rubeosis iridis (iris neovascularisation) not responding to conventional treatment
  • Use prior to vitrectomy surgery in severe proliferative diabetic retinopathy  
  •    
    11.08.02  Vitreomacular traction
    Ocriplasmin intravitreal injection
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
     
    Link  NICE TA297: Ocriplasmin for treating vitreomacular traction
       
    11.09  Contact lenses
    Boston Lens® cleaning solution
    Formulary  
       
    Boston Lens® wetting/ soaking solution
    Formulary  
       
    Ciba Vision Miraflow® dialy cleaner
    Formulary For soft, hard, and gas permeable lenses 
       
    Midoptic preservative free saline
    Formulary  
       
    Oxysept® 1 Step solution
    Formulary  
       
    Quattro® multipurpose solution
    Formulary  
       
    Sodium chloride 0.9% sachets
    Formulary  
       
    Ultrazyme® protein remover tablets
    Formulary  
       
    11.99.99.99  Miscellaneous
    Adalimumab injection (uveitis)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    Approved for treating non-infectious uveitis as per NICE TA460

     
    Link  NICE TA460: Adalimumab and dexamethasone for treating non-infectious uveitis
       
    Rituximab injection (neuromyelitis optica - off-label)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved off-label indication:

    Neuromyelitis optica as per NHS England service specification D04/S(HSS)/b

    Category B* form required

    First 2 courses given and funded by NHS England commissioned centres. If ongoing care is needed it may be given locally via local funding

    Biosimilar products available, to be prescribed by brand name.

    Contact pharmacy department for advice on brand for routine prescribing if unsure

     
    Link  NHSE D04/S(HSS)/b: Neuromyelitis optica service (adults and children)
       
    EDTA eye drops 0.37% (Disodium edetate)
    View adult BNF View SPC online
    Formulary
    Red
    Approved for the following indication:
  • Chelating agent in calcific band keratopathy  
  •    
    Acetylcysteine eye drops 10%
    Unlicensed Drug Unlicensed Dry eye associated with increased mucous production 
       
    Acetylcysteine preservative-free eye drops 5%
    Unlicensed Drug Unlicensed Dry eye associated with increased mucous production 
       
    EDTA eye drops 0.37% (Disodium edetate)
    Unlicensed Drug Unlicensed
    Red
    Approved for the following indication:
  • Chelating agent for chemical burns to eye  
  •    
    Healonid GV injection
    Unlicensed Drug Unlicensed

    Corneal endothelial protection

     
       
    Miraflow cleaning solution
    Unlicensed Drug Unlicensed Contact lens cleaner 
       
    Cytotoxic Drug Mitomycin eye drops 0.04%
    Unlicensed Drug Unlicensed
    Red
    Prevention of scar tissue formation following glaucoma filtering surgery 
       
    Mydricaine ampoule No. 2
    Unlicensed Drug Unlicensed
    Red

    ADULT USE ONLY

    Contains:

    • Procaine hydrochloride
    • Atropine sulphate
    • Adrenaline Mydriatic given by subconjunctival injection prior to vitroretinal surgery
     
       
    Perfluoro-N-Octane injection
    Unlicensed Drug Unlicensed Aid to ocular surgery 
       
    Potassium ascorbate eye drops
    Unlicensed Drug Unlicensed Chemical burns to eye 
       
    Sodium citrate eye drops 10.11%
    Unlicensed Drug Unlicensed
    Red
    Chemical burns to eye 
       
     ....
     Non Formulary Items
    Pegaptanib intravitreal injection

    View adult BNF View SPC online
    Non Formulary
    Grey

    Not approved for use in SE London

    See NICE TA155

     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Red

    Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   

    Amber 1

    Treatment can be initiated in primary care after a recommendation from an appropriate specialist  

    Amber 2

    Specialist initiation followed by maintenance prescribing in primary care  

    Amber 3

    Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  

    Green

    Specialist and non-specialist initiation  

    Grey

    Not recommended for prescribing  

    netFormulary