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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 11: Eye - Full Chapter
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11.03.03  Expand sub section  Antivirals
Foscarnet intravitreal injection
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Restricted Drug Restricted
Red

2.4mg in 0.1mL (NUH only)

  • Opthalmology use only
  • Manufactured by Pharmacy Sterile Production Unit (Unlicensed Product)
  • Likely indications: acute retinal necrosis or cytomegalovirus retinitis
 
   
Ganciclovir eye gel (Virgan)
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Restricted Drug Restricted
Amber 2
  • Ophthalmology recommendation only
  • Amber 2 - specialist initiation.
  • Courses longer than 21 days or for prophylaxis rather than treatment are off-label use.
  • Ganciclovir eye gel may be an appropriate alternative to now discontinued aciclovir eye ointment - liaise with ophthalmology.
 
Link  UKMI Memo on alternatives to discontinued aciclovir eye ointment
   
Ganciclovir intravitreal injection
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Restricted Drug Restricted
Red

Intravitreal injection

  • Opthalmology use only
  • Manufactured by Pharmacy Sterile Production Unit (Unlicensed Product)
  • Likely indications: acute retinal necrosis or cytomegalovirus retinitis
  • At SFH available as 6mg in 0.3ml (for 2mg doses) and 12mg in 0.3ml (for 4mg doses)(as 0.2ml extra volume counts for the dead space in the needle)
  • At NUH 2mg in 0.1mL available
 
   
Trifluorothymidine eye drops
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Restricted Drug Restricted
Red

Eye drops 1% (Unlicensed Product)

  • Also known as trifluridine.
  • Specialist use only.
  • 2nd line after aciclovir and ganciclovir.
 
   
 ....
 Non Formulary Items
Aciclovir eye ointment 3%  (Zovirax)

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Non Formulary
  • Discontinuation due June 2019, but exisiting supplies already exhausted.
  • Ganciclovir eye gel may be an appropriate alternative - liaise with ophthalmology.
  • Patients with suspected dendritic herpetic ulcers should receive ophthalmology assessment.
Link  UKMI Memo and advice on alternatives
 
  
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
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Link to children's BNF
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SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
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High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Grey

Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
  

Red

Medicines which should normally be prescribed by specialists only. eg hospital only.
For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
  

Amber 1

Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
  

Amber 2

Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
*Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
  

Amber 3

Primary care/ non specialist may initiate as per APC guideline.
The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
  

Green

Medicines suitable for routine use within primary care.
Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

OTC

  

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