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Notes for: Eye
Last edited [12/08/2013 14:18:17]

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

3. All Minims® and other single use products are preservative free.

 

Last edited [29/09/2020 16:25:47]


 

Cornwall Joint Formulary Recommended Choices     (...Top)
Displaying 38 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
Pilocarpine 1% single use eye drops
1 % single use eye drops Pack of 1
- PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered QDS Treatment Of GlaucomaView BNF Article on 'Pilocarpine 1% single use eye drops'View SPC on 'Pilocarpine 1% single use eye drops'View PIL on 'Pilocarpine 1% single use eye drops'
Administered QDS
Pilocarpine 3% eye drops
3 % eye drops Pack of 1
- PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered QDS Treatment Of GlaucomaView BNF Article on 'Pilocarpine 3% eye drops'View SPC on 'Pilocarpine 3% eye drops'View PIL on 'Pilocarpine 3% eye drops'
Administered QDS
Timolol Eye Drops
0.25 % 5ml unit Pack of 5
£1.59PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Timolol Eye Drops'View SPC on 'Timolol Eye Drops'View PIL on 'Timolol Eye Drops'
Administered BD
Timolol Eye Drops
0.5 % 5ml unit Pack of 5
£1.70PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Timolol Eye Drops'View SPC on 'Timolol Eye Drops'View PIL on 'Timolol Eye Drops'
Betaxolol Eye Drops (Betoptic)
0.5 % Drops (5ml Unit) Pack of 5
£1.90PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Betaxolol Eye Drops'View SPC on 'Betaxolol Eye Drops'View PIL on 'Betaxolol Eye Drops'
Administered BD
Dorzolamide / Timolol Eye Drops
20 mg/ml / Timolol 5mg/ml eye drops ml Pack of 5
£2.07PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Dorzolamide / Timolol Eye Drops'View SPC on 'Dorzolamide / Timolol Eye Drops'View PIL on 'Dorzolamide / Timolol Eye Drops'
Latanoprost Eye Drops
2.5 ml Unit Pack of 1
£2.16PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Latanoprost Eye Drops'View SPC on 'Latanoprost Eye Drops'View PIL on 'Latanoprost Eye Drops'
Betaxolol Eye Drops (Betoptic)
0.25 % Drops (5ml Unit) Pack of 5
£2.66PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Betaxolol Eye Drops'View SPC on 'Betaxolol Eye Drops'View PIL on 'Betaxolol Eye Drops'
Administered BD
Brinzolamide
10 mg/ml (5ml unit) Pack of 1
£3.11PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Brinzolamide'View SPC on 'Brinzolamide'View PIL on 'Brinzolamide'
Timolol Eye Gel (Timoptol-LA)
0.25 % 2.5ml Unit Pack of 1
£3.12PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] When a once daily timolol preparation is necessary Treatment Of GlaucomaView BNF Article on 'Timolol Eye Gel'View SPC on 'Timolol Eye Gel'View PIL on 'Timolol Eye Gel'
When a once daily timolol preparation is necessary
Timolol Eye Gel (Timoptol-LA)
0.5 % 2.5ml Unit Pack of 1
£3.12PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] When a once daily timolol preparation is necessary Treatment Of GlaucomaView BNF Article on 'Timolol Eye Gel'View SPC on 'Timolol Eye Gel'View PIL on 'Timolol Eye Gel'
When a once daily timolol preparation is necessary
Latanoprost / Timolol Eye Drops
2.5 ml Unit Pack of 1
£3.54PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Latanoprost / Timolol Eye Drops'View SPC on 'Latanoprost / Timolol Eye Drops'View PIL on 'Latanoprost / Timolol Eye Drops'
Bimatoprost
100 micrograms/ml eye drops 3 ml Pack of 3
£4.26PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Bimatoprost 'View SPC on 'Bimatoprost 'View PIL on 'Bimatoprost '
Pilocarpine nitrate Eye Drops (Minims)
4 % (0.5ml units) Pack of 20
£4.92PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered QDS Treatment Of GlaucomaView BNF Article on 'Pilocarpine nitrate  Eye Drops'View SPC on 'Pilocarpine nitrate  Eye Drops'View PIL on 'Pilocarpine nitrate  Eye Drops'
Administered QDS
Dorzolamide (Trusopt)
2 % eye drops (Ocumeter Plus MDU) Pack of 5
£6.33PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered TDS (mono therapy) BD (dual therapy) Treatment Of GlaucomaView BNF Article on 'Dorzolamide'View SPC on 'Dorzolamide'View PIL on 'Dorzolamide'
Administered TDS (mono therapy) BD (dual therapy)
Brimonidine Tartrate (Alphagan)
0.2 % drops (5ml unit) Pack of 1
£6.85PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Brimonidine Tartrate'View SPC on 'Brimonidine Tartrate'View PIL on 'Brimonidine Tartrate'
Administered BD
Brinzolamide (Azopt)
10 mg/ ml (5 ml unit) Pack of 1
£6.92PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Brinzolamide'View SPC on 'Brinzolamide'View PIL on 'Brinzolamide'
Administered BD
Carteolol (Teoptic)
1 % eye drops 5ml unit Pack of 5
£7.60PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Carteolol'View SPC on 'Carteolol'View PIL on 'Carteolol'
Administered BD
Carteolol (Teoptic)
2 % eye drops 5ml unit Pack of 5
£8.40PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Carteolol'View SPC on 'Carteolol'View PIL on 'Carteolol'
Administered BD
Latanoprost eye drops (Monopost)
50 mg/ml eye drops 0.2ml preservative free Pack of 30
£8.49PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Monopost eye drops (latanoprost unit dose vials) are accepted for use in patients who have proven sensitivity to the preservative benzalkonium chloride and should be used in preference to tafluprost. Monopost  is substantially more expensive than the equivalent generic multi-dose eye drop preparation with preservative. Treatment Of GlaucomaView BNF Article on 'Latanoprost eye drops'View SPC on 'Latanoprost eye drops'View PIL on 'Latanoprost eye drops'
Monopost eye drops (latanoprost unit dose vials) are accepted for use in patients who have proven sensitivity to the preservative benzalkonium chloride and should be used in preference to tafluprost. Monopost is substantially more expensive than the equivalent generic multi-dose eye drop preparation with preservative.
Brinzolamide / Brimonidine eye drops (Simbrinza)
10 mg/ml 2mg/ml 5ml unit Pack of 5
£9.23PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Simbrinza – a combination of brinzolamide and brimonidine– is accepted onto the formulary for decrease of elevated intraocular pressure (IOP) in adult patients with open-angle glaucoma or ocular hypertension for whom monotherapy provides insufficient IOP reduction. Treatment Of GlaucomaView BNF Article on 'Brinzolamide / Brimonidine eye drops 'View SPC on 'Brinzolamide / Brimonidine eye drops 'View PIL on 'Brinzolamide / Brimonidine eye drops '
Simbrinza – a combination of brinzolamide and brimonidine– is accepted onto the formulary for decrease of elevated intraocular pressure (IOP) in adult patients with open-angle glaucoma or ocular hypertension for whom monotherapy provides insufficient IOP reduction.
Levobunolol Eye Drops (Betagan)
0.5 % drops in 0.4ml Unit Dose Vials Pack of 30
£9.98PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered OD or BD Treatment Of GlaucomaView BNF Article on 'Levobunolol Eye Drops'View SPC on 'Levobunolol Eye Drops'View PIL on 'Levobunolol Eye Drops'
Administered OD or BD
Brimonidine / Timolol (Combigan)
0.2 % / 0.5% (5ml unit) Pack of 1
£10.00PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Brimonidine / Timolol'View SPC on 'Brimonidine / Timolol'View PIL on 'Brimonidine / Timolol'
Administered BD
Brinzolamide / Timolol Eye Drops (Azarga)
10 mg / 5mg 5ml unit Pack of 1
£11.05PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered BD Treatment Of GlaucomaView BNF Article on 'Brinzolamide / Timolol Eye Drops'View SPC on 'Brinzolamide / Timolol Eye Drops'View PIL on 'Brinzolamide / Timolol Eye Drops'
Administered BD
Tafluprost Eye Drops (Saflutan)
15 mcg (0.3ml unit) Pack of 30
£11.39PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered OD (night/evening) Treatment Of GlaucomaView BNF Article on 'Tafluprost Eye Drops'View SPC on 'Tafluprost Eye Drops'View PIL on 'Tafluprost Eye Drops'
Administered OD (night/evening)
Pilocarpine nitrate Eye Drops (Minims)
2 % (0.5ml units) Pack of 20
£12.47PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered QDS Treatment Of GlaucomaView BNF Article on 'Pilocarpine nitrate  Eye Drops'View SPC on 'Pilocarpine nitrate  Eye Drops'View PIL on 'Pilocarpine nitrate  Eye Drops'
Administered QDS
Latanoprost / Timolol (Fixapost)
50 mcgs ml / 5mg/ml eye drops 0.2ml unit dose preservative free Pack of 30
£13.49PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Latanoprost / Timolol 'View SPC on 'Latanoprost / Timolol 'View PIL on 'Latanoprost / Timolol '
Bimatoprost (Lumigan)
300 micrograms/mL, Single use 0.4mL Pack of 30
£13.75PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Bimatoprost'View SPC on 'Bimatoprost'View PIL on 'Bimatoprost'
Bimatoprost / Timolol Eye Drops (Ganfort)
0.3 mg & 5mg/ml (3ml unit) Pack of 1
£14.16PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered OD (night/evening) Treatment Of GlaucomaView BNF Article on 'Bimatoprost / Timolol Eye Drops'View SPC on 'Bimatoprost / Timolol Eye Drops'View PIL on 'Bimatoprost / Timolol Eye Drops'
Administered OD (night/evening)
Tafluprost (Taptiqom)
15 mcgs/ml / 5mg/ml eye drops Pack of 30
£14.50PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Taptiqom (timolol and tafluprost) preservative-free eye drops for glaucoma are accepted onto the formulary. It is expected this product would be first line consideration for the small proportion of new patients requiring a beta-blocker and prostaglandin derivative preservative-free combination product . Treatment Of GlaucomaView BNF Article on 'Tafluprost'View SPC on 'Tafluprost'View PIL on 'Tafluprost'
Taptiqom (timolol and tafluprost) preservative-free eye drops for glaucoma are accepted onto the formulary. It is expected this product would be first line consideration for the small proportion of new patients requiring a beta-blocker and prostaglandin derivative preservative-free combination product .
Acetazolamide injection 500mg vial (Diamox)
500 mg vial, powder for reconstitution Pack of 1
£14.76PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Acetazolamide injection 500mg vial'View SPC on 'Acetazolamide injection 500mg vial'View PIL on 'Acetazolamide injection 500mg vial'
Acetazolamide Tablet (Diamox)
250 mg tab Pack of 112
£15.22PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Acetazolamide Tablet'View SPC on 'Acetazolamide Tablet'View PIL on 'Acetazolamide Tablet'
Acetazolamide M/R Caps (Diamox SR)
250 mg SR cap Pack of 30
£16.66PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Acetazolamide M/R Caps'View SPC on 'Acetazolamide M/R Caps'View PIL on 'Acetazolamide M/R Caps'
Pilocarpine Eye Drops
1 % eye drops Pack of 10
£23.42PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered QDS Treatment Of GlaucomaView BNF Article on 'Pilocarpine Eye Drops'View SPC on 'Pilocarpine Eye Drops'View PIL on 'Pilocarpine Eye Drops'
Administered QDS
Pilocarpine Eye Drops
2 % eye drops Pack of 10
£23.93PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered QDS Treatment Of GlaucomaView BNF Article on 'Pilocarpine Eye Drops'View SPC on 'Pilocarpine Eye Drops'View PIL on 'Pilocarpine Eye Drops'
Administered QDS
Dorzolamide / Timolol eye drops p/f (Cosopt iMulti)
20 mg/ml / 5mg/ml eye drops p/f Pack of 10
£28.00PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Dorzolamide / Timolol eye drops p/f 'View SPC on 'Dorzolamide / Timolol eye drops p/f 'View PIL on 'Dorzolamide / Timolol eye drops p/f '
Pilocarpine Eye Drops
4 % eye drops Pack of 10
£29.82PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Administered QDS Treatment Of GlaucomaView BNF Article on 'Pilocarpine Eye Drops'View SPC on 'Pilocarpine Eye Drops'View PIL on 'Pilocarpine Eye Drops'
Administered QDS
Dorzolamide
20 mg/ml eye drops 0.2ml unit dose p/f Pack of 60
£31.55PCT FORMULARY STATUS: Specialist Initiated Drugs Treatment Of GlaucomaView BNF Article on 'Dorzolamide'View SPC on 'Dorzolamide'View PIL on 'Dorzolamide'

 
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