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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 11: Eye - Full Chapter
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11.99.99.99  Expand sub section  Miscellaneous
11.99.99.99  Expand sub section  Cytotoxics / wound healing modulators
Cytotoxic Drug Fluorouracil
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
At NUH: Subconjunctival injection 7.5mg in 0.3mL
  • Specialist use only
  • Manufactured by Pharmacy Sterile Production Unit (Unlicensed Product)
    At SFH: Subconjunctival injection 7.5mg in 0.3mL (Prescribed when 5mg/ 0.2ml is required) or 50mg/1ml prepared by Aseptic dispensing unit (x3169) 
  •    
    Cytotoxic Drug Mitomycin
    (eyes)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Available as:
    - Eye drops 0.04%(preservative free) (Multi dose bottles)- NUH only
    - Solution for sub-conjunctival use 0.2mg in 1mL
    - Solution for sub-conjunctival use 0.4mg in 1mL (and several other concentrations at KMH aseptic unit)
  • Sub-conjunctival injection manufactured by Pharmacy Sterile Production Unit (Unlicensed Products) 
  • Link  Link to reviews
       
    11.99.99.99  Expand sub section  Fibrinolytic drugs
    Alteplase intravitreal injection
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Intravitreal injection 25microgram in 0.1mL
  • Opthalmology specialist at NUH use only
  • Manufactured by Pharmacy Sterile Production Unit (Unlicensed Product) Lower strengths available upon request 
  •    
    11.99.99.99  Expand sub section  Glues - ocular
    11.99.99.99  Expand sub section  Immunosuppressants to top
    Ciclosporin
    (Eye)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red

    Oily eye drops 2% (Unlicensed Product), formulated in arachis oil. Avoid in peanut allergy
    Eye ointment 0.2% (Unlicensed Vetinary Product, Optimmune®)used only as alternative when 2% drops unavailable. Preservative free but contains lanolin

    • both specialist use at NUH only
    • 2% eye ointment = non-formulary
    • 0.05% preservative free = non-formulary
    • 0.06% preservative free multidose = non-formulary
    • Neoral® for Uveitis Red Traffic Light
    • Ikervis® 0.1% eye drops single use- Subject of NICE TA369 - see link below for information sheet
    • Verkazia® 0.1% eye drops for vernal keratoconjuntivitis licensed for children (over 4years old) and adolecents (not adults)  = - see link below for information sheet
     
    Link  Ciclosporin eye drops information sheet - Ikarvis
    Link  Ciclosporin eye drops information sheet - Verkazia
    Link  NICE TA369 - Ciclosporin for treating eye disease that has not improved despite treatment with artificial tears
       
    Cytotoxic Drug Methotrexate
    (Eye)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Homecare
    • For use in Uveitis
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
       
    11.99.99.99  Expand sub section  Treatment of burns
    Potassium Ascorbate (Ascorbic acid)
    (eye drops)
    Formulary
    Red
    Eye drops 10% (Unlicensed Product)
  • Available from NUH and SFH Pharmacy.
     
  •    
    Sodium Citrate
    (eye drops)
    Formulary
    Red
    Eye drops 10.11% (preservative free) (Unlicensed Product)
  • Used for acid and alkali burns to the cornea
  • Available from NUH and SFH Pharmacy. 
  •    
    11.99.99.99  Expand sub section  Visco-elastics
    Sodium Hyaluronate
    Formulary
    Red
    NUH use
  • Injection 8.5mg in 0.85mL (Haelonid)
  • Injection 7.7mg in 0.55mL (Healon G.V.)
  • Injection 1.2% - 0.8mL syringe (Amvisc)
    SFH use
  • Biolon
  • Haelon 5 
  •    
    Sodium Hyaluronate with Lidocaine
    Formulary
    Red
    Intracameral injection (Visthesia)
    Intracameral injection (Visthesia Light)
  • NUH only 
  • Link  Link to reviews
       
    Viscoat Viscoelastic
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    0.5mL
     
    Link  Link to reviews
       
    11.99.99.99  Expand sub section  Other
    Disodium Edetate 0.37%
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Solution 20mL (preservative free) (Unlicensed Product)
  • Specialist use only
  • At SFH, used by ophthalmology in Daycase. Not routinely stocked, but may be ordered in if needed 
  •    
    Sodium Chloride 5% eye products
    Formulary
    Amber 2
    • For the treatment of corneal oedema or recurrent corneal erosion syndrome.
    • Eye drops 5% (Benzalkonium and thiomersol preservatives free). [picture]. 3 month expiry. Licensed as a medical device rather than a medicinal product.
    • Eye ointment 5% (Unlicensed Product). Alissa is the most cost effective PF to prescribe in primary care. Prescribe as 5g containers as product expires 4 weeks from opening.
    • At SFH, send patients to SFH Pharmacy for supplies of unlicensed medicines
     
       
     ....
    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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