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NHS Bath and North East Somerset, Swindon and Wiltshire CCG
Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
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 Formulary Chapter 11: Eye - Full Chapter
Notes:

Ophthalmology-related Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Ophthalmology-related Shared Care Agreements

There are no shared care agreements (SCAs) relating to this chapter.

 

Self-care

Many of the products in this chapter are available for purchase over-the-counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/

 Details...
11.06  Expand sub section  Treatment of glaucoma
11.06  Expand sub section  Beta-blockers
 note 

Systemic absorption may occur with eye drops containing beta-blockers so these are contra-indicated in patients with bradycardia, heart block and uncontrolled heart failure and should be used with extreme care in patients with asthma.

Timolol 
(Ophthalmic drops)
View adult BNF View SPC online
First Choice
Green
  • 0.25% and 0.5% drops

 

 

 
Betaxolol 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 0.5% ophthalmic drops and 0.25% ophthalmic solution

 

 
   
Timolol 
(Preservative Free drops)
View adult BNF View SPC online
Formulary
Green
  • BaNES and Swindon
  • Non formulary in Salisbury
  • 2.5mg/ml and 5mg/ml preservative free ophthalmic drops
 
   
Timolol 
(Ophthalmic gel)
View adult BNF View SPC online
Formulary
  •  Amber - Swindon
  • Non formulary- Bath & Salisbury
  • 0.1 % ophthalmic gel
 
   
11.06  Expand sub section  Prostaglandin analogues
Latanoprost 
(Drops)
View adult BNF View SPC online
First Choice
Green
  • 50microgram/ml ophthalmic drops
  • Preservative free available if indicated as per BSW glaucoma guidance

 

 
Bimatoprost with Timolol

(Drops)
View adult BNF View SPC online
Formulary
Green
  • 300micrograms and 5mg/ml combination ophthalmic drops

 

 
   
Latanoprost 0.005% with Timolol 0.5%

(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • Latanoprost 50micrograms, Timolol 5mg/ml
  • Note: Fixapost® preservative free included on formulary at SFT 
 
   
Travoprost 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 40microgram ophthalmic drops

 

 
   
Travoprost with Timolol

(Drops)
View adult BNF View SPC online
Formulary
Green
  • 40microgram with 5mg/ml Timolol ophthalmic drops
 
   
Bimatoprost 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 100microgram/ml ophthalmic drops
  • 300microgram/ml preservative free single use eyedrops available where indicated as per BSW glaucoma guidance
 
   
11.06  Expand sub section  Sympathomimetics
Brimonidine Tartrate

(Drops)
View adult BNF View SPC online
Formulary
Green
  • 0.2% ophthalmic eye drops
  • Note - higher risk of side-effects and sensitivity.

 

 
   
11.06  Expand sub section  Carbonic anhydrase inhibitors and systemic drugs to top
Brinzolamide 1% with Timolol 0.5%

View adult BNF View SPC online
Second Choice
Green
  • Brinzolamide 1% with Timolol 0.5% 
 
   
Acetazolamide 
(Tablets/capsules)
View adult BNF View SPC online
Formulary
  • Green BaNES and Salisbury for glaucoma
  • Amber Swindon for glaucoma
  • 250mg tablets and 250mg MR capsules (NB capsules more costly and stock shortages until at least July 2020)
  • Note: at RUH and GWH, acetazolamide is included on the formulary for idiopathic intracranial hypertension as Amber Unlicensed indication
  • Note - Private prescription only for prophylaxis of mountain sickness. Not licensed and NOT for prescribing on NHS. For further information see link below 
 
Link  SPS: Prevention of Acute Mountain Sickness
   
Acetazolamide Injection

View adult BNF View SPC online
Formulary
Red
  • 500mg injection
 
   
Brinzolamide 
(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • 1% eye drops

 

 
   
Brinzolamide 10mg/ml & brimonidine 2mg/ml

View adult BNF View SPC online
Formulary
Green
  • ophthalmic drops containing 10 mg/mL of brinzolamide and 2 mg/mL of brimonidine tartrate equivalent to 1.3 mg of brimonidine.

BaNES/Wilts - For use as per Glaucoma guidance 
Swindon - Not on formulary

 
   
Dorzolomide 
(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • 2% eye drops
 
   
Dorzolomide 2% with Timolol 0.5%

(Ophthalmic solution)
View adult BNF View SPC online
Formulary
Green
  • 5ml ophthalmic drops

 

 
   
11.06  Expand sub section  Miotics
Pilocarpine 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 2% and 4% eyedrops.
  • 2% preservative-free minims (Swindon only).

 

 
   
 ....
 Non Formulary Items
Carteolol 
(Ophthalmic drops 1%)

View adult BNF View SPC online
Non Formulary
 
Dipivefrine Hydrochloride
(Propine)

View adult BNF View SPC online
Non Formulary
 
Levobunolol 
(Drops)

View adult BNF View SPC online
Non Formulary
  • 0.5% ophthalmic drops
  • Note Jan 2020 - Non-formulary for new patients as discontinued by manufacturer. See glaucoma guidance for alternatives  

 

 
Metipranolol (Minims Metipranolol)

View adult BNF View SPC online
Non Formulary
 
Tafluprost and Timolol
(Taptiqom)

View adult BNF View SPC online
Non Formulary
 
  
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 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
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Red

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Amber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Amber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Green

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Self

Suitable for patient to be directed to buy themselves  

Grey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Black

Not currently used. We intend to include this TLS in future to highlight where a decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.  

Red Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

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