Formulary Chapter 11: Eye - Full Chapter
|
Notes: |
Criteria for Preservative Free (PF) and Single Dose Unit (SDU) presentations:
These are restricted to patients with • true preservative allergy and/or • evidence of epithelial toxicity from preservatives and/or • severe dry eyes and/or • require/ may require surgery in the near future and/or • neonates |
|
Details... |
11.00 |
Antioxidants and Multivitamins for Age Related Macular Degeneration |
|
|
11.01 |
Administration of drugs to the eye |
|
|
11.02 |
Control of microbial contamination |
|
|
11.03 |
Anti-infective eye preparations |
|
|
11.03.01 |
Antibacterials |
|
|
Levofloxacin (Oftaquix)
|
Second Choice
|
- Amber £££ 2nd line
- Use SDU if using 1or 2 hourly or if significant OSD/toxicity.
|
|
Azithromycin (Azyter®)
|
Formulary
|
- First line for ophthalmic chlamydia
|
|
Chloramphenicol
|
Formulary
|
0.5% eye drops First line
0.5% Minims (SDU)
1% eye ointment
|
UKMI Q&A: Chloramphenicol: is it safe in breastfeeding?
|
Cefuroxime
|
Formulary
|
Hospital only
|
|
Ciprofloxacin 0.3% (Eye drops )
|
Formulary
|
- Specialist Ophthalmologist recommendation(Corneal consultant)
|
|
Fusidic Acid 1% (M/R Eye Drops)
|
Formulary
|
|
|
Gentamicin 0.3% eye drops
|
Formulary
|
- Possible 2nd Line after chloramphenicol- specialist opthalmologist recommendation.
|
|
Ofloxacin Eye drops 0.3%
|
Formulary
|
|
|
Penicillin 500o units in 1 ml eye drops
|
Formulary
|
Unlicensed
Hospital use only- Ophthalmologists
|
|
11.03.02 |
Antifungals |
|
|
Amphotericin (eye)
|
Formulary
|
|
|
Econazole 1% eye drops
|
Formulary
|
|
|
Miconazole 1% eye drops
|
Formulary
|
|
|
11.03.03 |
Antivirals |
|
|
Aciclovir 3% eye ointment
|
Formulary
|
|
|
Ganciclovir 0.15% ophthalmic gel (Virgan®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation.
|
|
Trifluorothymidine eye drops
|
Formulary
|
|
|
11.04 |
Corticosteroids and other anti-inflammatory preparations |
|
|
11.04.01 |
Corticosteroids |
|
|
Betamethasone 0.1% eye drops
|
Formulary
|
|
|
Betamethasone 0.1% eye ointment
|
Formulary
|
|
|
Betamethasone 0.1% with Neomycin 0.5% eye drops
|
Formulary
|
|
|
Dexamethasone 0.1% eye drops (Maxidex®)
|
Formulary
|
|
|
Dexamethasone 0.1% eye drops (Single dose units)
|
Formulary
|
- for post corneal implants or OSD
- Use the agent with the lowest acquisition cost
|
|
Dexamethasone with Antibacterials (Tobradex®)
|
Formulary
|
|
|
Dexamethasone with Neomycin and Polymyxin B sulphate (Maxitrol®) (Eye Drops/Eye Ointment)
|
Formulary
|
- Specialist Ophthalmologist Recommendation.
|
|
Fluorometholone 0.1% (FML®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation.
|
|
Loteprednol Etabonate 0.5% (Lotemax®)
|
Formulary
|
|
|
Prednisolone 0.5% eye drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation .
|
|
Prednisolone 1% eye drops (Pred Forte®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation.
- For Anterior Uveitis in A&E-prednisolone acetate 1% as the drug of choice unless the patient has a preference for dexamethasone 0.1%
|
|
Prednisolone preservative free eye drops 0.5% (Minims SDU)
|
Formulary
|
- Specialist Ophthalmologist recommendation
- Use in patients with severe Chronic Allergic Eye Disease who present to A&E with a flare up.
|
|
11.04.01 |
Intravitreal corticosteroids |
|
|
Dexamethasone 700mcg intravitreal implant (Ozurdex®)
|
Restricted
|
For macular oedema secondary to retinal vein occlusion -use in line with NICE
For diabetic macular oedema- use in line with NICE
|
NICE TA229: Dexamethasone intravitreal implant for the treatment of macular oedema
NICE TA349: Dexamethasone intravitreal implant for treatment of diabetic macular oedema
|
Fluocinolone intravitreal implant (Iluvien®)
|
Formulary
|
|
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)
NICE TA590: Fluocinolone acetonide intravitreal implant for treating recurrent non-infectious uvetitis
|
11.04.02 |
Other anti-inflammatory preparations |
|
|
Sodium Cromoglicate 2% eye drops
|
First Choice
|
|
|
Olopatadine (Opatanol®)
|
Second Choice
|
2nd line ŁŁŁ
|
|
Azelastine (Optilast®)
|
Third Choice
|
|
|
Sodium Cromoglicate 2% eye drops (preservative free)
|
Formulary
|
- Specialist Ophthalmologist recommendation as Catacrom
|
|
11.05 |
Mydriatics and cycloplegics |
|
|
11.05 |
Antimuscarinics |
|
|
Atropine Sulphate 0.5% drops
|
Formulary
|
|
|
Atropine Sulphate 1% drops
|
Formulary
|
|
|
Atropine Sulphate single use (Minims® )
|
Formulary
|
- Specialist Ophthalmologist Recommendation -used by glaucoma surgeons for neovascular glaucoma.
|
|
Cyclopentolate Hydrochloride 0.5% eye drops
|
Formulary
|
|
|
Cyclopentolate Hydrochloride 1% eye drops
|
Formulary
|
|
|
Cyclopentolate Hydrochloride single use (Minims® )
|
Formulary
|
- Specialist Ophthalmologist Recommendation.
|
|
Tropicamide 0.5% and 1% (Mydriacyl®)
|
Restricted
|
Hospital only
|
|
Tropicamide single use (Minims® Tropicamide)
|
Restricted
|
Hospital only
|
|
11.05 |
Sympathomimetics |
|
|
Phenylephrine Hydrochloride (Minims® Phenylephrine Hydrochloride )
|
Formulary
|
|
|
11.06 |
Treatment of glaucoma |
|
|
|
11.06 |
Beta-blockers |
|
|
Betaxolol 0.25% eye drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Betaxolol 0.5% eye drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Betaxolol 0.5% Unit Dose Eye Drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Timolol 0.1% unit dose eye gel (Tiopex ®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
- Once daily preparation
|
|
Timolol 0.25% eye drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Timolol LA 0.25% Eye Drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation
- Once daily preparation
|
|
11.06 |
Prostaglandin analogues |
|
|
Latanoprost eye drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation
- 1st Line
|
|
Bimatoprost 0.01% eye drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation.
- 2nd line
|
|
Bimatoprost with Timolol (Ganfort®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Latanoprost 0.005% with Timolol 0.5%
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Latanoprost PF Eye Drops (Monopost)
|
Formulary
|
Specialist Ophthalmologist Recommendation
1st Line PF option
|
|
Latanoprost with Timolol preservative free (Fixapost®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Tafluprost (Preservative Free) 15micrograms/ml
|
Formulary
|
- Specialist Ophthalmologist Recommendation
- 2nd line PF option
|
|
11.06 |
Sympathomimetics |
|
|
Brimonidine Tartrate
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Brimonidine Tartrate 0.2% with Timolol 0.5% (Combigan®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
11.06 |
Carbonic anhydrase inhibitors and systemic drugs |
|
|
Acetazolamide (Injection)
|
Formulary
|
Hospital Only
|
|
Acetazolamide (Tablets)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Acetazolamide M/R (capsules)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Brinzolamide 10mg/ml
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Brinzolamide 10mg/ml with Timolol 5mg/ml
|
Formulary
|
- Specialist Ophthalmologist Recommendation
- 2nd/3rd line
|
|
Dorzolamide 2%
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Dorzolamide 2% eye drops (SDU) (Trusopt®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Brinzolamide 10mg/ml with Brimonidine 2mg/ml (Simbrinza® )
|
Formulary
|
- Specialist Ophthalmologist Recommendation
- Third line option, after prostaglandin analogues (1st line) and beta-blocker/ prostaglandin analogue plus beta-blocker (2nd line)
- For patients in whom monotherapy provides insufficient IOP reduction.
|
|
Dorzolamide 2% with Timolol 0.5%
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Dorzolamide 2% with Timolol 0.5% SDU Eye Drops (Cosopt®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
11.06 |
Miotics |
|
|
Pilocarpine 1%,2% and 4% eye drops
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Pilocarpine preservative free (Single dose units)
|
Restricted
|
Hospital only
|
|
11.07 |
Local anaesthetics |
|
|
11.08 |
Miscellaneous ophthalmic preparations |
|
|
11.08.01 |
Tear deficiency, ocular lubricants, and astringents |
|
|
Xailin Night
|
First Choice
|
|
|
HYLO Night® eye ointment
|
Second Choice
|
Brand name changed from VitA POS eye ointment to HYLO Night April 2020
|
|
Acetylcysteine 5% with Hypromellose 0.35% (Ilube®)
|
Formulary
|
|
|
Acetylcysteine 10% eye drops
|
Formulary
|
|
|
Carbomers (Clinitas Gel®)
|
Formulary
|
Clinitas Gel does not have benzalkonium chloride (BAK) as a preservative. It is preserved with cetrimide.
|
|
Carmellose 0.5% SDU (Xailin Fresh ®)
|
Formulary
|
|
|
Carmellose1% multi (Moorfields)
|
Formulary
|
|
|
Hypromellose 0.5% eye drops
|
Formulary
|
All other strengths are non formulary
|
|
Sodium Chloride (Minims® Saline)
|
Restricted
|
Hospital only. Diluent for impregnated dye strips
|
|
Sodium Chloride 0.9% Solutions
|
Restricted
|
Hospital only- Theatre use
|
|
Sodium Chloride 5% eye ointment
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Sodium Chloride 5% PF drops (Moorfields)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Sodium Hyaluronate 0.15% Multi (Hyabak®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Sodium Hyaluronate 0.2% eye drops PF (Evolve HA ®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
Approved onto formulary January 2019
|
|
Sodium Hyaluronate 0.2% PF Multi (Hylo-Forte®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
|
|
Sodium Hyaluronate 0.4% SDU (Clinitas®)
|
Formulary
|
- Specialist Ophthalmologist Recommendation
- Each preservative-free unit is resealable and may be used for up to 12 hours.
|
|
Viscotears eye drops
|
Formulary
|
|
|
Viscotears Liquid gel single dose units
|
Formulary
|
|
|
Xailin gel
|
Formulary
|
|
|
11.08.02 |
Ocular diagnostic and peri-operative preparations and photodynamic treatment |
|
|
11.08.02 |
Ocular diagnostic preparations |
|
|
11.08.02 |
Ocular peri-operative drugs |
|
|
Apraclonidine 1% SDU eye drops
|
Formulary
|
|
|
Apraclonidine 0.5% (eye drops)
|
Formulary
|
|
|
Diclofenac (Voltarol® Ophtha SDU)
|
Formulary
|
|
|
Diclofenac Sodium (Voltarol® Ophtha multidose)
|
Formulary
|
|
|
Ketorolac (Acular®)
|
Formulary
|
|
|
11.08.02 |
Subfoveal choroidal neovascularisation |
|
|
Aflibercept (Eylea®)
|
Restricted
|
Use in line with NICE
|
NICE TA 486: Aflibercept for treating choroidal neovascularisation
NICE TA409: Visual impairment caused by macular oedema after branch retinal vein occlusion- aflibercept.
NICE TA346: Macular oedema (diabetic)- aflibercept
NICE TA305: Macular oedema (retinal vein occlusion)- aflibercept
NICE TA294: Macular degeneration (wet age-related) - aflibercept
|
Bevacizumab intravitreal injection (Avastin®)
|
Formulary
|
|
|
Brolucizumab (Beovu®
|
Formulary
|
Use in line with NICE
|
NICE TA672: Brolucizumab for treating wet age-related macular degeneration (Feb 2021)
|
Ranibizumab (Lucentis®)
|
Restricted
|
Use in line with NICE
|
NICE TA155: Age-related Macular Degeneration- ranibizumab
NICE TA274: Macular oedema (diabetic) - ranibizumab
NICE TA283: Macular oedema (retinal vein occlusion) - ranibizumab: guidance
NICE TA298: Choroidal neovascularisation (pathological myopia) - ranibizumab
|
Verteporfin (Visudyne®)
|
Restricted
|
|
NICE guideline [NG82] Age-related macular degeneration
|
11.08.02 |
Vitreomacular traction |
|
|
Ocriplasmin (Jetrea®)
|
Restricted
|
|
NICE TA297: Ocriplasmin for treating vitreomacular traction
|
11.09 |
Contact lenses |
|
|
11.99.99.99 |
Miscellaneous |
|
|
11.99.99.99 |
Eyelid wipes |
|
|
11.99.99.99 |
Cytotoxics / wound healing modulators |
|
|
Fluorouracil
|
Restricted
|
hospital only
|
|
Mitomycin C
|
Restricted
|
Hospital only
|
|
11.99.99.99 |
Fibrinolytic drugs |
|
|
11.99.99.99 |
Glues - ocular |
|
|
11.99.99.99 |
Immunosuppressants |
|
|
Ciclosporin 1 mg/mL eye drops, emulsion (Ikervis®)
|
Formulary
|
- Specialist initiation.
- In line with NICE
|
NICE TA369: Ciclosporin for treating dry eye disease (Dec 2015)
|
Adalimumab (Humira®)
|
Formulary
|
In line with NICE
|
NICE TA460: Adalimumab and dexamethasone for treating non-infectious uveitis
|
Ciclosporin 2mg/g eye ointment (Optimmune®)
|
Formulary
|
|
|
Ciclosporin 1mg/ml eye drops, emulsion (Verkazia® )
|
Formulary
|
- Specialist Opthalmologist Initiation
- Treatment of severe vernal keratoconjunctivitis (VKC) in children from 4 years of age and adolescents
|
|
11.99.99.99 |
Treatment of burns |
|
|
11.99.99.99 |
Visco-elastics |
|
|
11.99.99.99 |
Other |
|
|
Hyaluronidase (Hyalase®)
|
Restricted
|
Hospital only
|
|
.... |
Non Formulary Items |
Acetylcholine Chloride (Miochol-E®)

|
Non Formulary
|
|
|
Alteplase intravitreal injection

|
Non Formulary
|
|
|
Amikacin

|
Non Formulary
|
|
|
Amo Complete

|
Non Formulary
|
|
|
Antazoline 0.5% with Xylometazoline 0.05% (Otrivine-Antistin®)

|
Non Formulary
|
|
|
Boston Advance Cleaner

|
Non Formulary
|
|
|
Boston Advance Conditioning Solution

|
Non Formulary
|
|
|
Brilliant Peel®

|
Non Formulary
|
|
|
Bromfenac (Yellox®)

|
Non Formulary
|
Update July 2020: Change to non formulary status as supply issue resolved with ketorlac
Approved January 2019. Interim measure due to supply issues with ketorolac eye drops |
|
Carbomers (GelTears®)

|
Non Formulary
|
|
|
Carbomers (Liposic®)

|
Non Formulary
|
|
|
Carbomers (liquivisc®)

|
Non Formulary
|
|
|
Carmellose Sodium (Carmize®)

|
Non Formulary
|
|
|
Carmellose1% SDU (Celluvisc®)

|
Non Formulary
|
|
|
Carteolol (Teoptic®)

|
Non Formulary
|
|
|
Ceftazidime

|
Non Formulary
|
|
|
Chlorhexidine

|
Non Formulary
|
|
|
Chlortetracycline

|
Non Formulary
|
|
|
Ciprofloxacin 0.3% (eye ointment)

|
Non Formulary
|
Discontinued May 2017 |
|
Cocaine

|
Non Formulary
|
|
|
Dexamethasone with Antibacterials (Sofradex®)

|
Non Formulary
|
|
|
Dipivefrine Hydrochloride (Propine®)

|
Non Formulary
|
|
|
Disodium Edetate 0.37%

|
Non Formulary
|
|
|
Emedastine (Emadine®)

|
Non Formulary
|
|
|
Epinastine (Relestat®)

|
Non Formulary
|
|
|
Erythromycin

|
Non Formulary
|
|
|
Eyelid wipes for blepharitis

|
Non Formulary
|
Blephaclean Sterile Eyelid wipes Supranettes Sterile Eye-cleansing wipes |
|
Fluorescein (Anatera®)

|
Non Formulary
|
|
|
Fluorescein Sodium

|
Non Formulary
|
|
|
Flurbiprofen Sodium (Ocufen®)

|
Non Formulary
|
|
|
Foscarnet intravitreal injection

|
Non Formulary
|
|
|
Ganciclovir intravitreal injection

|
Non Formulary
|
|
|
Gentamicin single use (Minims® Gentamicin Sulphate)

|
Non Formulary
|
Discontinued |
|
Glycerol (glycerin)

|
Non Formulary
|
|
|
Homatropine Hydrobromide

|
Non Formulary
|
|
|
Hydrocortisone Acetate with Neomycin (Neo-Cortef®)

|
Non Formulary
|
|
|
Hydrocortisone eye ointment

|
Non Formulary
|
|
|
Hydroxyethylcellulose (Minims® Artificial Tears)

|
Non Formulary
|
|
|
Hydroxypropyl Guar (Systane®)

|
Non Formulary
|
Except for existing patients |
|
Hypromellose 0.3% eye drops

|
Non Formulary
|
|
|
Hypromellose 0.3% with Dextran 70 0.1% (Tears naturale®)

|
Non Formulary
|
|
|
Hypromellose 1% eye drops

|
Non Formulary
|
|
|
Hypromellose preservative free ( SDU)

|
Non Formulary
|
|
|
Indocyanine green

|
Non Formulary
|
|
|
Ketotifen (Zaditen®)

|
Non Formulary
|
|
|
Levobunolol

|
Non Formulary
|
|
|
Lidocaine Hydrochloride 4% with Fluorescein 0.25% (Minims®)

|
Non Formulary
|
|
|
Liquid Paraffin (Lacri-Lube®)

|
Non Formulary
|
|
|
Lodoxamide (Alomide®)

|
Non Formulary
|
|
|
Lubristil ®gel

|
Non Formulary
|
|
|
Metipranolol (Minims® Metipranolol)

|
Non Formulary
|
|
|
Multivitamins and antioxidants

|
Non Formulary
|
e.g. Icaps,Vitalux Plus, Macushield, Ocuvite All non formulary
Please refer to section 9.06.07
|
|
Nedocromil 2% eye drops (Rapitil®)

|
Non Formulary
|
Discontinued by manufacturer 2018 |
|
Neomycin Sulphate with antibacterials (Neosporin®)

|
Non Formulary
|
|
|
Nepafenac (Nevanac®)

|
Non Formulary
|
|
|
Oxybuprocaine Hydrochloride (Minims® )

|
Non Formulary
|
|
|
Oxysept 1 Step

|
Non Formulary
|
|
|
Paraffin Yellow Soft (Simple Eye Ointment)

|
Non Formulary
|
Replaced by Xailin Night or VitA-POS |
|
Pegaptanib Sodium (Macugen®)

|
Non Formulary
|
|
NICE TA155: guidance on pegaptanib in AMD (August 2008)
|
Phenylephrine Hydrochloride (Mydriasert®)

|
Non Formulary
|
|
|
Pilocaprine long acting (Pilogel®)

|
Non Formulary
|
|
|
Polihexanide

|
Non Formulary
|
|
|
Polymyxin B Sulphate eye ointment (Polyfax®)

|
Non Formulary
|
|
|
Polyvinyl Alchohol Single Dose Units (Liquifilm Tears®)

|
Non Formulary
|
|
|
Polyvinyl Alcohol (Sno Tears or Liquifilm Tears ®)

|
Non Formulary
|
|
|
Potassium Ascorbate

|
Non Formulary
|
|
|
Povidone (Oculotect®)

|
Non Formulary
|
|
|
Prednisolone 0.5% with Neomycin 0.5% (Predsol-N®)

|
Non Formulary
|
|
|
Propamidine Isetionate (Brolene®)

|
Non Formulary
|
|
|
Proxymetacaine Hydrochloride (Minims®)

|
Non Formulary
|
|
|
Rimexolone (Vexol®)

|
Non Formulary
|
|
|
Rose Bengal (Minims® Rose Bengal)

|
Non Formulary
|
|
|
Saline Solution

|
Non Formulary
|
|
|
Sodium Citrate

|
Non Formulary
|
|
|
Sodium Hyaluronate (Hylo-Tear®)

|
Non Formulary
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|
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Sodium Hyaluronate (Vismed® Gel and SDU)

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Non Formulary
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|
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Sodium Hyaluronate (Vismed® multi)

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Non Formulary
|
|
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Sodium Hyaluronate with Lidocaine

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Non Formulary
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Soybean oil unit dose eye drops (Emustil®)

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Non Formulary
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Tear flow test strips

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Non Formulary
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Tetracaine Hydrochloride (Minims® Amethocaine Hydrochloride)

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Non Formulary
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Timolol 0.25% single dose units

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Non Formulary
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Timolol 0.5% eye drops

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Non Formulary
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Not for new patients, existing patients to remain on treatment. |
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Timolol 0.5% single dose units

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Non Formulary
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Timolol LA 0.5% Eye Drops

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Non Formulary
|
Not for new patients
Existing patients to remain on treatment |
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Timolol Once-daily (Nyogel®)

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Non Formulary
|
|
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Tissue Adhesive (Histacryl®)

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Non Formulary
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Total Care Daily Cleaner

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Non Formulary
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Total Care Disinfecting and Wetting Solution

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Non Formulary
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Travoprost (Travatan®)

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Non Formulary
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|
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Travoprost with Timolol (DuoTrav®)

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Non Formulary
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Vancomycin

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Non Formulary
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|
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Viscoat Viscoelastic

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Non Formulary
|
|
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Zinc Sulphate

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Non Formulary
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|
|
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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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Prescribing in children
The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.
The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing. |

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Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians. |

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Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |

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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist. |

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Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |

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Medicines for initiation and maintenance prescribing by Specialists only. |

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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |

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Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |

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The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest. |
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