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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 11: Eye - Full Chapter
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11.08.02  Expand sub section  Ocular diagnostic and peri-operative preparations and photodynamic treatment
11.08.02  Expand sub section  Ocular diagnostic preparations
11.08.02  Expand sub section  Ocular peri-operative drugs
11.08.02  Expand sub section  Subfoveal choroidal neovascularisation
Aflibercept (Eylea)
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Restricted Drug Restricted
Red
High Cost Medicine

Pre-filled syringe 3.6mg in 0.09mL
(Each pre-filled syringe contains 3.6mg in 0.09mL solution - this contains a usable amount to deliver a dose of 2mg in 0.05ml i.e. treatment for 1 eye. If the patient is having 2 eyes treated, 2 syringes must be used)
Intravitreal injection 40mg in 1mL - Discontinued 2020
(Each vial contains 4mg in 0.1ml solution- this contains a usable amount to deliver a dose of 2mg in 0.05ml i.e. treatment for 1 eye. If the patient is having 2 eyes treated, 2 vials must be used)

Available for use at NUH and SFH in line with NICE for:
- Age-related Macular Degeneration (AMD) NICE TA294
- Visual impairment due to macular oedema secondary to central retinal vein occlusion (CRVO) NICE TA305
- Diabetic Macular Oedema NICE TA346
- NUH only - Visual impairment in adults caused by macular oedema after branch retinal vein occlusion (BRVO) NICE TA409
- NUH only - Treating choroidal neovascularization NICE TA486

 
Link  Link to reviews
Link  NICE TA409:Aflibercept for treating visual impairment caused by macular oedema after branch retinal vein occlusion
Link  NICE TA486:Aflibercept for treating choroidal neovascularisation
   
Bevacizumab intravitreal injection (Avastin)
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Restricted Drug Restricted
Red
NUH only
Intravitreal injection (Unlicensed Product)
1.25mg in 0.05mL or 625micrograms in 0.025mL
Restricted for;
1. age related macular degeneration
2. Diabetic maculopathy and/or proliferative diabetic retinopathy, unresponsive to conventional treatments such as laser, vitrectomy or intravitreal Triamcinolone
3. Retinal vein occlusions
4. Retinopathy of prematurity only where treatment is required and laser is not a suitable option 
   
Ranibizumab (Lucentis)
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Formulary
Red
High Cost Medicine

Intravitreal injection 10mg in 1mL
(Each vial contains 2.3 mg of ranibizumab in 0.23 ml solution)
(NUH:Each pre-filled syringe contains 1.65 mg of ranibizumab in 0.165 ml solution)

  • Available for use at NUH and SFH in line with NICE for:
    - Age-related Macular Degeneration (AMD) NICE TA155
    - Diabetic Macular Oedema (DMO) NICE TA274
    - Macular Oedema secondary to Retinal Vein Occlusion (RVO) NICE TA283
    - Choroidal neovascularisation associated with pathological myopia NICE TA298
 
Link  Link to reviews
   
Verteporfin (Visudyne)
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Restricted Drug Restricted
Red
High Cost Medicine
Injection 15mg
  • Specialist only at NUH 
  • Link  NICE Guidance 82: Age-related macular degeneration
       
    11.08.02  Expand sub section  Vitreomacular traction to top
     ....
     Non Formulary Items
    Pegaptanib Sodium  (Macugen)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine

    Link  Link to reviews
    Link  NICE guidance on pegaptanib in AMD (August 2008)
     
      
    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

      

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