netFormulary NHS
Nottinghamshire Area Prescribing Committee
Joint Formulary
 Search
 Formulary Chapter 11: Eye - Full Chapter
Chapter Links...
 Details...
11.08.01  Expand sub section  Tear deficiency, ocular lubricants, and astringents
Hypromellose
View adult BNF View SPC online View childrens BNF
First Choice
Green
  • First line ocular lubricants (with preservative):
    • 0.3% (generic £1)
    • 0.5% (Isopto Plain® £1)  
  • Also preservative free available:
    • 0.3% (multi dose bottle - Evolve® Hypromellose - £2, 3 month expiry)
    • 0.3% (preservative free) (unit dose vials, Hydromoor® at NUH)
  • Other brands = non-formulary eg: Artelac®, Lumecare®
  • See Eye lubricant guidelines and Eye lubricants table of products.
  • OTC Patients should be advised to purchase over the counter

  • May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
 
Acetylcysteine 5% (Ilube®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber 2

Eye drops. £15

 
   
Acetylcysteine 5% eye drops
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
Unlicensed medicine - named patient use only
  • Preservative free multidose
  • Listed in Drug Tariff specials list
  • confirm preservative free required before prescribing. Ilube available if preserved is acceptable 
  •    
    Carbomer eye drops
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green

    Eye drops 0.2%

    • Clinitas® carbomer is the current recommended brand for prescribing in primary care. See Preferred Prescribing List.
    • Other non-formulary brands include GelTears®, Viscotears®, Xailin®, Liquivisc®. See Eye lubricant guidelines and Eye lubricants table of products.
    • At NUH & SFH generic carbomer 0.2% eye gel is available.
    • OTC Patients should be advised to purchase a suitable product over the counter.

    • May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased.
     
       
    Carmellose
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Green

    Available as:
    - Preservative free 10ml bottle (Evolve® carmellose 0.5%, 3 months expiry once opened, £5)
    - Preservative free UDVs (Celluvisc®) 0.5% (£6 per 30) and more viscous 1% (£3 per 30).

    • OTC Patients should be advised to purchase a suitable product over the counter

      • May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
      • Non formulary brands include Carmize® - See Eye lubricant guidelines and Eye lubricants table of products.
      • SFH advice only: Each dose unit contains 8 drops and can be re-capped and used within 24 hours of opening.
     
       
    Hydroxyethylcellulose (Minims® Artificial Tears)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted Eye drops (preservative free)- NUH only 
       
    Hydroxypropyl Guar (Systane®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Amber 2

    Systane Balance® (with mineral oil). 10ml bottle, 6 months expiry.

     
       
    Hypromellose 0.3% with Dextran 70 0.1% (Tears naturale®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red

    Eye drops- NUH only

    • preservative free unit dose is non-formulary
     
       
    Polyvinyl Alcohol (Liquifilm Tears or Sno Tears®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green

    Eye drops 1.4%
    Eye drops with Povidone 0.6% (preservative free)

    • NUH: Liquifilm Tears
    • OTC Patients should be advised to purchase a suitable product over the counter

    • May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
     
       
    Retinol palmitate with soft paraffins (HYLO Night®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green

    5g tube, 6 months expiry

    • OTC Patients should be advised to purchase a suitable product over the counter

    • See Eye lubricant guidelines and Eye lubricants table of products.
    • May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
    •  Brand name changed from VitA POS to HYLO Night, April 20 
     
       
    Sodium Chloride
    (Balanced salt solution)
    Formulary
    Red
    Solutions 19mL, 500mL, 500mL (latex free) 
       
    Sodium Chloride (Minims® Saline)
    Formulary
    Green

    Eye drops 0.9% (preservative free) - 0.5 mL

    • multidose preparation is an unlicensed special and non-formulary
    • OTC Patients should be advised to purchase over the counter

    • May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
     
       
    Sodium Hyaluronate
    (eye drops)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green

    Available as:


    - Evolve HA® 10ml bottle 0.2% preservative free - £6, 3 month shelf life once opened.
    - Hylo-forte® 10ml bottle 0.2% preservative free - £10, 6 months shelf life once opened.
    - Clinitas® UDVs (or Multi bottle) 0.4% preservative free (Amber2 Traffic Light Ophthalmologist recommendation only for very severe dry eyes), recappable, and 12 hour expiry once opened.
    - Oxyal® 0.15% 10ml bottle, 2 months expiry. (Amber2 Traffic Light Ophthalmologist recommendation only for punctuate keratitis)

     
       
     ....
     Non Formulary Items
    Acetylcysteine 10% eye drops

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    preserved or preservative free
  • Unlicensed special listed in drug tariff
  • for severe dry eye with mucous tear film
  •  
    Carboxymethylcellulose, glycerine & castor oil eye drops  (Optive Plus®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey

    10ml bottle (6 months expiry)

     
    Hydroxypropyl Guar  (Systane Ultra®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey

    Systane Ultra®  10ml bottle, 6 months expiry.

     
    Liquid Paraffin and Liquid Paraffin light eye drops

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Unlicensed medicine
  • other licensed ocular lubricants available
  •  
    Liquid Paraffin eye ointment

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey

    Brands include Lacri-lube® & Xailin night®.

    Use Hylo Night® instead.

     
    Optive® eye drops

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey

    Eye drops - all non-formulary GREY, no formal assessment. See Eye lubricant guidelines and Eye lubricants table of products for alternatives.

    • Optive® - Carmellose 0.5% & glycerin 0.9% (preserved)
    • Optive Fusion® - Hyaluronate 0.1%, carmellose 0.5%, glycerol 0.9% (preserved and preservative free)
    • (Optive Plus® are formulary for ophthalmologist recommendation only - see above).
     
    Paraffin Yellow Soft
    (Simple eye ointment)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey

    Eye Ointment 4g

    • Current cost is £18! (Oct 2017)
    • Use Hylo Night® instead.
     
    Sodium Hyaluronate 0.1%, Co-enzyme Q10 0.1%, Vitamin E 0.5%  (VisuXL®,®)

    View adult BNF View childrens BNF
    Non Formulary
    Grey

    Reviewed and rejected at the APC, September 2019. See Eye lubricant guidelines and Eye lubricants table of products for alternatives.

    Link  Link to reviews
     
    Sodium hyaluronate 0.15% with trehalose 3%  (Thealoz Duo®)

    View adult BNF View childrens BNF
    Non Formulary
    Grey

    Reviewed and rejected at the APC, March 2019. 

    Link  Link to reviews
     
    Soybean oil unit dose eye drops  (Emustil®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
  • No formal submission
  •  
      
    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

    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

      

    netFormulary