Formulary Chapter 11: Eye - Full Chapter
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Natamycin 5% eye drops
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First Choice
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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.
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Chlorhexidine 0.2% eye drops
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Unlicensed
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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.
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
Status |
Description |

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

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Specialist initiation followed by maintenance prescribing in primary care |

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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 |

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Specialist and non-specialist initiation |

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Not recommended for prescribing |
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