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Other - Cost: £697,875,227.36 Trimbow - Cost: £10,324,890.00 Atorvastatin - Cost: £12,062,751.27 Empagliflozin (Jardiance) - Cost: £13,056,158.02 Beclometasone / Formoterol MDI (Fostair) - Cost: £15,201,921.56 Rivaroxaban - Cost: £19,148,081.40 FreeStyle Libre 2 Sensor  - Cost: £19,152,735.00 Edoxaban (Lixiana) - Cost: £20,533,835.00 Dapagliflozin (Forxiga) - Cost: £22,535,048.30
Formulary Notes (BNF Chapter)
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Notes for: Eye
Last edited [13/11/2023 16:03:01]

Administration of drugs to the eye

1. Eye drops and eye ointments are instilled into the pocket formed by gently pulling down the lower eyelid. For eye drops, one drop is all that is needed as long as instillation is successful. For eye ointments, a small amount is applied similarly; the ointment melts rapidly and blinking helps to spread it.

2. When two or more different drops are required at the same time of day, the patient should leave an interval of 5 minutes between drops to avoid dilution and overflow. Also to use ointment preparations 5 minutes after drops.

3. Certain preparations included within this chapter of the formulary are unlicensed and marked with *. These products will be ordered specially and are not stocked; therefore a delay in obtaining stocks may be incurred. These 'specials' may be supplied when clinical need for the individual patient demands, given no commercial alternative is available. Specials are often very costly.

Administration aids: Eye drop dispensers are available to aid the instillation of eye drops especially amongst the elderly, visually impaired, arthritic, or otherwise physically limited patients. They can be purchased from most community pharmacies or prescribed on FP10 prescription. Please refer to the Drug Tariff for details - Appliances: Eye Drops Dispensers.

Preservatives and sensitisers:

1. Long-term administration of preservative containing eye drops may cause ocular irritation.

2. RCHT Eye Unit offer the following recommendations for when to use preservative free treatments:

    the patient has a proven allergy to the preservative
    frequent use of the drops - six or more time a day (long-term use)
    the patient is wearing a soft contact lens or bandage lens at the time of instillation, on specialist advice
    after a corneal transplant in selected cases, depending on indication, and in cases where the cornea is compromised, on specialist advice

    Prescribing Guidelines for Dry Eye Management

     

    Cornwall Joint Formulary Recommended Choices     (...Top)
    Displaying 12 Drugs

    Key:
    First Line Drugs First Line Drugs
    Second Line Drugs Second Line Drugs
    Specialist Initiated Drugs Specialist Initiated Drugs
    Hospital Only Drugs Hospital Only Drugs
    Discouraged Discouraged
    No comment available No comment available
    Antibiotics Antibiotics

    NameTariffBNF Sub Paragraph
    Fluorescein 1% single use eye drops (Minims)
    1 % single use eye drops Pack of 20
    £9.71PCT FORMULARY STATUS: First Line Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Fluorescein 1% single use eye drops'View SPC on 'Fluorescein 1% single use eye drops'View PIL on 'Fluorescein 1% single use eye drops'
    Fluorescein 2% single use eye drops (Minims)
    2 % single use eye drops Pack of 20
    £9.90PCT FORMULARY STATUS: First Line Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Fluorescein 2% single use eye drops'View SPC on 'Fluorescein 2% single use eye drops'View PIL on 'Fluorescein 2% single use eye drops'
    Ketorolac Trometamol Eye Drops (Acular)
    0.5 % drops (5 ml unit) Pack of 5
    £3.00PCT FORMULARY STATUS: Specialist Initiated Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Ketorolac Trometamol Eye Drops'View SPC on 'Ketorolac Trometamol Eye Drops'View PIL on 'Ketorolac Trometamol Eye Drops'
    Apraclonidine (Iopidine)
    0.5 % Eye Drops (5ml unit) Pack of 1
    £10.88PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Apraclonidine 1% and 0.5% can be prescribed in primary care after Ophthalmic Consultant initiation.  The 1% strength is sometimes used as complex glaucoma management  in  patients sensitive to preserved eye drops . Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Apraclonidine'View SPC on 'Apraclonidine'View PIL on 'Apraclonidine'
    Apraclonidine 1% and 0.5% can be prescribed in primary care after Ophthalmic Consultant initiation. The 1% strength is sometimes used as complex glaucoma management in patients sensitive to preserved eye drops .
    Diclofenac (Voltarol Ophtha)
    0.1 % eye drops Pack of 40
    £32.00PCT FORMULARY STATUS: Specialist Initiated Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Diclofenac'View SPC on 'Diclofenac'View PIL on 'Diclofenac'
    Apraclonidine (Iopidine)
    1 % Eye Drops (0.25ml single units) Pack of 24
    £95.19PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Apraclonidine 1% and 0.5% can be prescribed in primary care after Ophthalmic Consultant initiation.  The 1% strength is sometimes used as complex glaucoma management  in  patients sensitive to preserved eye drops . Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Apraclonidine'View SPC on 'Apraclonidine'View PIL on 'Apraclonidine'
    Apraclonidine 1% and 0.5% can be prescribed in primary care after Ophthalmic Consultant initiation. The 1% strength is sometimes used as complex glaucoma management in patients sensitive to preserved eye drops .
    Disodium Edetate
    0.4 % Eye lotion Pack of 1
    - PCT FORMULARY STATUS: Hospital Only Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Disodium Edetate'View SPC on 'Disodium Edetate'View PIL on 'Disodium Edetate'
    Acetylcholine chloride 1% solution for intra-occular irrigation (Miochol-E)
    1 % solution for intra-occular irrigation 10mg/ml Pack of 2
    - PCT FORMULARY STATUS: Hospital Only Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Acetylcholine chloride 1% solution for intra-occular irrigation'View SPC on 'Acetylcholine chloride 1% solution for intra-occular irrigation'View PIL on 'Acetylcholine chloride 1% solution for intra-occular irrigation'
    Ranibizumab (Ongavia)
    2.3 mg/0.23ml solution for injection vials Pack of 1
    - PCT FORMULARY STATUS: Hospital Only Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Ranibizumab'View SPC on 'Ranibizumab'View PIL on 'Ranibizumab'
    Ranibizumab 10mg/ml intravitreal injection (Lucentis)
    10 mg/ml intravitreal injection Pack of 1
    - PCT FORMULARY STATUS: Hospital Only Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Ranibizumab 10mg/ml intravitreal injection'View SPC on 'Ranibizumab 10mg/ml intravitreal injection'View PIL on 'Ranibizumab 10mg/ml intravitreal injection'
    Aflibercept (Eylea)
    2 mg Pack of 1
    - PCT FORMULARY STATUS: Hospital Only Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Aflibercept'View SPC on 'Aflibercept'View PIL on 'Aflibercept'
    Brolucizumab (Beovu)
    19.8 mg/0.165ml solution for injection pre-filled syringes Pack of 1
    - PCT FORMULARY STATUSHospital Only Drugs Ocular Diagnos/Peri-op Prepn&Photodyn TtView BNF Article on 'Brolucizumab 'View SPC on 'Brolucizumab 'View PIL on 'Brolucizumab '

     
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