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Buckinghamshire Formulary
Buckinghamshire Healthcare NHS Trust
Buckinghamshire CCG
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 Formulary Chapter 11: Eye - Full Chapter
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11.03.03  Expand sub section  Antivirals
Trifluorothymidine 1%
(eye drops, preservative-free)
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Restricted Drug Restricted unlicensedunlicensed - Low Risk
In secondary care restricted - Consultant only prescribing when aciclovir has proved unsuitable and patient requires a preservative-free preparation .
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Aciclovir 3%
(eye ointment)
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Formulary
Green

Supplies will cease as of June 2019, use ganciclovir 0.15% gel as an alternative product.

 
   
Ganciclovir 0.15% in gel basis
(ophthalmic gel)
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Formulary
Green
 
   
Trifluorothymidine 1%
(eye drops)
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Restricted Drug Restricted
Red
unlicensedunlicensed - Low Risk
In secondary care restricted - to consultant only prescribing when aciclovir has proved unsuitable.
Phone Pharmacy to order 
   
Valaciclovir 500mg
(tablets)
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Restricted Drug Restricted
Red

Restricted to prescribing by Consultant Ophthalmologists with microbiology approval for the treatment of Acute Retinal Necrosis (ARN) in accordance with Uveitis guideline (BHTCG 374FM)

 
   
Valganciclovir 450mg
(tablets)
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Restricted Drug Restricted
Red
High Cost Medicine

Restricted to prescribing by Consultant Ophthalmologists for the induction and maintenance treatment of cytomegalovirus (CMV) retinitis in adult patients with acquired immunodeficiency syndrome (AIDS) in accordance with Uveitis guideline (BHTCG 374FM)


Valganciclovir is indicated for the prevention of CMV disease in CMV-negative adults and children (aged from birth to 18 years) who have received a solid organ transplant from a CMV-positive donor.

 
   
Foscarnet 6g/250mL
(solution for infusion)
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Restricted Drug Restricted
Red

For intravitreal injection (unlicensed use).

Prescribing and administration by Consultant Ophthalmologists only for the treatment of cytomegalovirus (CMV) retinitis and acute retinal necrosis (ARN) in conjunction with systemic therapy (valganciclovir) for patients with immediate sight-threatening disease.

 
   
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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
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Link to adult BNF
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Link to children's BNF
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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

Black

Not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.
Drugs which have been evaluated and rejected by the Medicines Value Group (MVG)
Drugs defined as ‘Low Priority’ by the South Central Priorities Committee
New drugs which have not as yet been evaluated by the MVG
Any drug not listed in the Buckinghamshire Formulary  

Red

Drugs which should only be prescribed in secondary care by a specialist.
Require specialist knowledge and/or equipment for patient selection and initiation
Require long term on-going monitoring and dose adjustment to ensure efficacy and minimise toxicity by a specialist
Designated as “hospital only“ by product licence, NICE, DoH or BNF
May need further evaluation by a specialist
Are hospital initiated clinical trial materials  

Red Specialist Centre

As for ‘red’ (above) with the addition of the following:
Designated by NHS England to require initiation by or in prior agreement with a Specialist Centre. Continuation where appropriate by BHT (or other secondary care provider)
Detailed requirements for Specialist Centre initiation to be described in the wording of the formulary restriction  

Amber Protocol

Drugs which should be initiated in secondary care by the specialist with follow-on prescription and monitoring according to a drug specific Shared Care Protocol(SCP). Prescribing may be continued in primary care following the SCP
Require specialist knowledge and/or equipment for patient selection and initiation
Require short or medium term (eg. 3 to 6 months) specialist monitoring of efficacy or toxicity. The need for stabilisation will vary with different drugs and patients, but is usually a minimum of 2 months (see principles for shared care)
Require significant long term monitoring
Require ongoing communication between the GP and the specialist
Have clearly defined consultant, GP and patient responsibilities documented in a shared care protocol (see responsibilities for amber protocol drugs)  

Amber Initiation

Drugs suitable for primary care prescribing following specialist initiation
Require specialist knowledge and/or equipment for patient selection
Monitoring does not require specialist knowledge or equipment
If the drug is one with which the primary care prescriber is unfamiliar the specialist is expected to provide sufficient information on the drug indication, dose, duration , monitoring and any further necessary dose adjustments
Require the first prescription to be written by the specialist  

Amber Recommended

Drugs suitable for primary care prescribing following specialist recommendation
As for amber initiation except that:- The first prescription may be written by the GP after specialist recommendation.  

Green

Drugs for which primary care prescribers would normally take full responsibility for prescribing and monitoring
Drugs not included in the Traffic Light list but included on joint formulary.
New drugs classified as red or amber but as greater experience regarding their safety and efficacy is established may move to Green after re-consideration by the MVG and APC.  

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