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 Formulary Chapter 11: Eye - Full Chapter
Notes:

Preservative-free (PF) formulations - Preservative intolerance should be diagnosed by an ophthalmologist. If PF formulation is warranted, proprietary preservative-free formulations (often available as unit dose preparations) should be prescribed if at all possible. Manufactured “specials” are unlicensed and almost invariably cost significantly more.  PF formulations are appropriate, for example when a patient wears soft contact lenses or daily disposable contact lenses and wearing glasses instead is not a viable option such as for long courses OR where patient shows signs of preservative toxicity sometimes seen with multiple daily administrations.

 Details...
11.03  Expand sub section  Anti-infective eye preparations
11.03.01  Expand sub section  Antibacterials
Chloramphenicol
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First Choice
Green

Chloramphen_Eye Dps 0.5%
Chloramphen_Eye Oint 1%
Chloramphen_PF Eye Dps 0.5% - preservative free eye drops prescribe as Eykappo as more cost effective

Chloramphenicol eye drops and ointment are  Self Care Self Care Medicine- Available OTC for self-care. (Please note exceptions may apply)

Updated advice for healthcare professionals on Chloramphenicol Eye Drop prescribing in children aged 0-2 years

- In March 2021 some licences for chloramphenicol eye drops containing borax/boric acid buffers were updated to restrict use in children younger than 2 years of age
- MHRA has now reviewed the available evidence and sought independent expert evidence and concluded that the benefits of chloramphenicol eye drops containing borax or boric acid outweigh the potential risks for children, including those aged 0 to 2 years
- Hence, chloramphenicol eye drops can now be safely administered to children aged 0 to 2 years where antibiotic eye drop treatment is indicated
 
Fusidic Acid
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Second Choice
Green
Fusidic Acid_Viscous Eye Dps 1%

2nd Line - Useful for Staphylococcal Infections 
   
Ciprofloxacin (used post-operatively)
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Restricted Drug Restricted
Red
 
   
11.03.02  Expand sub section  Antifungals
11.03.03  Expand sub section  Antivirals
Aciclovir 3% eye ointment
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Formulary
Amber

Urgently refer all patients with suspected herpes simplex to the hospital eye department

DISCONTINUED: GSK, the sole supplier of aciclovir eye ointment, plans to discontinue it from the worldwide market in 2018. Stock is anticipated to continue to be available in the UK until the end of June 2019, subject to demand.

An alternative agent is Ganciclovir 0.15% w/w eye gel (licensed for acute herpetic keratitis).

 
   
 ....
 Non Formulary Items
Amikacin

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Non Formulary
 
Amphotericin (eye)

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Non Formulary
 
Azithromycin  (Azyter®)

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Non Formulary
 
Ceftazidime

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Non Formulary
 
Cefuroxime

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Non Formulary
 
Chlorhexidine

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Non Formulary
 
Chlortetracycline

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Non Formulary
 
Econazole 1% eye drops

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Non Formulary
 
Erythromycin

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Non Formulary
 
Foscarnet intravitreal injection

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Non Formulary
 
Ganciclovir 0.15% ophthalmic gel  (Virgan)

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Non Formulary
 
Ganciclovir intravitreal injection

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Non Formulary
 
Gentamicin  (Genticin)

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Non Formulary
 
Gentamicin  (ophthalmic)

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Non Formulary
 
Gentamicin single use  (Minims Gentamicin Sulphate)

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Non Formulary
 
Levofloxacin (Inhaled)

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Non Formulary This is a Specialised Drug which would not be routinely commissioned by CCGs for Cystic Fibrosis. This would go through a South Staffs CCGs Individual Funding Request (IFR)
 
Miconazole 1% eye drops

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Non Formulary
 
Neomycin Sulphate

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Non Formulary
 
Neomycin Sulphate with antibacterials  (Neosporin)

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Non Formulary
 
Ofloxacin Eye drops  (Exocin)

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Non Formulary
 
Penicillin G

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Non Formulary
 
Polihexanide

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Non Formulary
 
Polymyxin B Sulphate eye ointment  (Polyfax)

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Non Formulary
 
Propamidine Isetionate  (Brolene)

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Non Formulary

     Self Care Self Care Medicine -Available OTC for self-care.

(Please note exceptions may apply)

 
Trifluorothymidine eye drops

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Non Formulary
 
Vancomycin

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Non Formulary
 
  
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 children's 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

Drugs which require special consideration. These are drugs for Consultant Prescribing ONLY. They should not be prescribed in Primary Care.  

Amber

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care. For some drugs there may be a Ricad in place to aid the transition to primary care.  

Amber E

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care but also require and ESCA (Shared Care Agreement)   

Green

Suitable first-line drugs for implementation in Primary Care  

On Formulary

South Staffs Formulary Choice  

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