South East London Joint Medicines Formulary Formulary

	South East London Joint Medicines Formulary
	Guy's and St Thomas' NHS Foundation Trust Kings College Hospital NHS Foundation Trust Lewisham and Greenwich NHS Trust

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Formulary Chapter 11: Eye - Full Chapter

11.03.02

Antifungals

Natamycin 5% eye drops

First Choice

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

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

For fungal keratitis with confirm/suspected candida infection

Amphotericin 5 micrograms intravitreal injection

Unlicensed

Acute treatment of candida/fungal endogenous endophthalmitis

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Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG

Traffic Light Status Information

Status	Description
	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.
	Treatment can be initiated in primary care after a recommendation from an appropriate specialist
	Specialist initiation followed by maintenance prescribing in primary care
	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
	Specialist and non-specialist initiation
	Not recommended for prescribing