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 Formulary Chapter 11: Eye - Full Chapter
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11.06  Expand sub section  Treatment of glaucoma
11.06  Expand sub section  Beta-blockers
11.06  Expand sub section  Prostaglandin analogues
11.06  Expand sub section  Sympathomimetics
11.06  Expand sub section  Carbonic anhydrase inhibitors and systemic drugs to top
Dorzolamide 2%
(eye drops, preserved)
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Restricted Drug Restricted
Amber Initiation

1st Choice topical carbonic anhydrase inhibitor
Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

 
Brinzolamide 10mg/1mL
(eye drops, preserved)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber Initiation

2nd Choice topical carbonic anhydrase inhibitor
Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

 
   
Brinzolamide/Brimonidine 10mg/2mg in 1mL
(ophthalmic suspension, preserved)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber Initiation
Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs for use in adults with open angle glaucoma/intra-ocular hypertension for whom beta blockers and prostaglandin analogues are unsuitable and the use of the two components (brinzolamide/brimonidine) as separate entities in inappropriate 
   
Brinzolamide/Timolol 10mg/5mg in 1mL
(ophthalmic suspension, preserved)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber Initiation

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

 
   
Dorzolamide/Timolol maleate (2%/0.5%)
(multidose preservative free eye drops)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber Initiation

As an alternative to single dose units in patients unable to tolerate preservatives in eye drops.


Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs for patients who have an established allergy to preservatives or who are using more than 6 drops daily in the affected eye(s).


2 brands available:
• Cosopt iMulti® 10mL - can be used for 2 months from date of 1st opening
• Eylamdo® 5mL - can be used for 28 days from date of 1st opening

 
   
Dorzolomide/Timolol 2%/0.5%
(eye drops, preserved)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber Initiation

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

 
   
Dorzolomide/Timolol 2%/0.5% (e.g. Cosopt®)
(eye drops, unit dose, preservative-free)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber Initiation
Restricted - to initiation by Consultant Ophthalmologists with continuaton by GPs for patients who have an established allergy to preservatives or who are using more than 6 drops daily in the affected eye(s).  
   
Acetazolamide 250mg
(tablet)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber Initiation

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

 
   
Acetazolamide 250mg
(capsule)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber Initiation

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

 
   
Acetazolamide 500mg (e.g. Diamox®)
(injection)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
11.06  Expand sub section  Miotics
 ....
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

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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