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 Formulary Chapter 11: Eye - Full Chapter
11.01  Administration of drugs to the eye
11.02  Control of microbial contamination
11.03  Anti-infective eye preparations
11.03.01  Antibacterials
Chloramphenicol
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First Choice Eye drops
Eye ointment
Single use eye drops (Minims®)



 
Fusidic Acid
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Formulary Eye drops 
   
Ofloxacin Eye drops
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Formulary Eye drops

 
   
Levofloxacin
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Formulary Eye drops
Unit dose eye drops 
   
Ciprofloxacin
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Formulary Eye drops
 
   
Gentamicin (Genticin®)
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Formulary 0.3% eye/ear drops
1.5% eye drops unlicensedunlicensed special
 
   
Azithromycin (Azyter®)
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Formulary

Eye drop solution in single-dose container

For use in paediatric conjunctivitis - see policy

 
Link  Paediatric Antibiotic policy
   
Cefuroxime
(Eye Drops)
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Formulary Eye drops unlicensedunlicensed special

STORE IN FREEZER PRIOR TO USE. Once thawed, store in fridge for a maximum of 7 days.
 
   
Erythromycin
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Formulary Eye ointment unlicensedunlicensed special 
   
Penicillin G
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Formulary Eye drops unlicensedunlicensed special

 
   
Propamidine Isetionate (Brolene®)
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Formulary
Green 1
Eye drops

Restricted Item Used with chlorhexidine for treatment of acanthamoeaba keratitis only 
   
Chlorhexidine
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Formulary Eye drops unlicensedunlicensed special

Restricted Item Used with propamidine for acanthamoeaba keratitis only 
   
11.03.02  Antifungals to top
11.03.03  Antivirals
Aciclovir
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First Choice Eye ointment

 
Ganciclovir
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Formulary Eye gel
Restricted Item Specialist ophthalmologist only 
   
11.04  Corticosteroids and other anti-inflammatory preparations
11.04.01  Corticosteroids
Dexamethasone
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First Choice Eye drops
Single use eye drops (Minims®)

 
Prednisolone
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First Choice Eye drops (0.5% and 1%)
Single use eye drops 0.5% (Minims®)


 
Fluorometholone (FML®)
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Formulary Eye drops

Intra-ocular penetration is poor. It may be considered useful in a few patients with chronic low grade uveitis where raised intra-ocular pressure has been problematic.  
   
Rimexolone (Vexol®)
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Formulary Eye drops 
   
Betamethasone
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Formulary Eye/ear/nose drops
Eye ointment 
   
Betamethasone with Neomycin
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Formulary Eye/ear/nose drops 
   
Dexamethasone with Antibacterials (Sofradex®)
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Formulary Eye/ear drops 
   
Dexamethasone with Neomycin and Polymyxin B sulphate (Maxitrol®)
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Formulary Eye drops
Eye ointment
 
   
Dexamethasone intravitreal implant (Ozurdex®)
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Formulary Intravitreal injection

Restricted Item Specialist use only 
Link  NICE TA229: Dexamethasone intravitreal implant for the treatment of macular oedema
   
Fluocinolone intravitreal implant (Iluvien®)
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Formulary Intravitreal implant

Restricted Item Specialist use only 
Link  NICE TA301: Diabetic macular oedema - fluocinolone acetonide intravitreal implant (TA271)
   
11.04.02  Other anti-inflammatory preparations
Sodium Cromoglicate
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First Choice Eye drops 
Antazoline 0.5% with Xylometazoline 0.05% (Otrivine-Antistin®)
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Formulary Eye drops 
   
Lodoxamide (Alomide®)
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Formulary Eye drops 
   
Nedocromil (Rapitil®)
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Formulary Eye drops 
   
Olopatadine (Opatanol®)
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Formulary Eye drops 
   
11.05  Mydriatics and cycloplegics to top
11.05  Antimuscarinics
Atropine Sulphate
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First Choice 0.5% eye drops
1% eye drops
1% single-use eye drops (Minims®)

 
Cyclopentolate Hydrochloride
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Formulary 0.5% and 1% eye drops
0.5% and 1% single-use eye drops (Minims®)
 
   
Tropicamide (Mydriacyl®)
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Formulary 0.5% and 1% Eye drops
0.5% and 1% single-use eye drops (Minims®)
 
   
11.05  Sympathomimetics
Phenylephrine Hydrochloride (Minims® Phenylephrine Hydrochloride )
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Formulary 2.5% and 10% Single-use eye drops  
   
11.06  Treatment of glaucoma
11.06  Beta-blockers
Timolol
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First Choice Eye drops
Unit dose eye drops
Long acting gel drops (Timolol LA®)
 
Levobunolol
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Formulary Eye drops
Unit dose eye drops 
   
Betaxolol
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Formulary Eye drops
Unit dose eye drops 
   
Carteolol (Teoptic®)
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Formulary Eye drops 
   
11.06  Prostaglandin analogues to top
Latanoprost
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First Choice Eye drops
Single-use eye drops 
Bimatoprost (Lumigan®)
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Formulary Eye drops
Single-use eye drops
 
   
Travoprost (Travatan®)
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Formulary Eye drops

Does not contain benzalkonium chloride as the preservative and therefore may be used in patients where a known allergy to benzalkonium chloride exists.

 
   
Latanoprost 0.005% with Timolol 0.5%
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Formulary Eye drops

Combination products are licensed for once daily use where prostaglandin analogue alone is not adequate. Only use where patient has difficulty with compliance/administration.  
   
Bimatoprost with Timolol (Ganfort®)
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Formulary Eye drops
Single-use eye drops

Combination products are licensed for once daily use where prostaglandin analogue alone is not adequate. Only use where patient has difficulty with compliance/administration.

 
   
Travoprost with Timolol (DuoTrav®)
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Formulary Eye drops

Does not contain benzalkonium chloride as the preservative and therefore may be used in patients where a known allergy to benzalkonium chloride exists.

Combination products are licensed for once daily use where prostaglandin analogue alone is not adequate. Only use where patient has difficulty with compliance/administration.
 
   
11.06  Sympathomimetics
Brimonidine Tartrate (Alphagan®)
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First Choice Eye drops

 
Apraclonidine (Iopidine®)
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Formulary
Green 3
Eye drops

Restricted Item Ophthalmic consultant initiation only: Apraclonidine can be used long term for certain complex glaucoma cases where surgery is high risk. See also section 11.8.

unlicensed 1% - unlicensed use 
   
Brimonidine Tartrate 0.2% with Timolol 0.5% (Combigan®)
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Formulary Eye drops

Combination products are licensed for use when beta blocker monotherapy does not provide adequate treatment. Only use where patient has difficulty with compliance/administration.

 
   
11.06  Carbonic anhydrase inhibitors and systemic drugs
Brinzolamide (Azopt®)
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First Choice Eye drops

 
Dorzolomide
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Formulary Eye drops
Unit dose eye drops

 
   
Brinzolamide 1% with Timolol 0.5%  (Azarga®)
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Formulary Eye drops

Only use combination products where patient has difficulty with compliance/administration.  
   
Dorzolomide 2% with Timolol 0.5%
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Formulary Eye drops
Unit dose eye drops

Only use combination products when patient has difficulty with compliance/administration.

 
   
Acetazolamide (Diamox®)
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Formulary
Green 3
Tablets
Sustained release capsules
Injection

Restricted Item Ophthalmic specialist initiation only 
   
11.06  Miotics
Pilocarpine
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Formulary 1%, 2%, 4% eye drops
2% single-use eye drops (Minims®)

 
   
11.07  Local anaesthetics
Lidocaine Hydrochloride 4% with Fluorescein 0.25% (Minims®)
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Formulary Single-use eye drops 
   
Oxybuprocaine Hydrochloride (Minims® )
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Formulary Single-use eye drops 
   
Proxymetacaine Hydrochloride (Minims®)
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Formulary Single-use eye drops 
   
Tetracaine Hydrochloride (Minims® Amethocaine Hydrochloride)
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Formulary Single-use eye drops 
   
Controlled Drug Cocaine
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Formulary Eye drops

unlicensedunlicensed 
   
11.08  Miscellaneous ophthalmic preparations to top
11.08.01  Tear deficiency, ocular lubricants, and astringents
 note  Not for outpatient use: use non-urgent prescribing notes to GP.
Hypromellose
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First Choice 0.3% eye drops
0.5% eye drops
 
Liquid Paraffin (Lacri-Lube®)
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Formulary Eye ointment 
   
Polyvinyl Alcohol (Liquifilm Tears or Sno Tears®)
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Formulary Eye drops

Brand with lowest aquisition cost will be supplied.  
   
Carbomers
(e.g. Viscotears®)
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Formulary Eye drops
Single-use eye drops

Brand with lowest aquisition cost will be supplied.  
   
Carmellose
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Formulary Eye drops
Single-use eye drops

Brand with lowest aquisition cost will be supplied.  
   
Sodium Hyaluronate
(e.g. Lubristil®)
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Formulary Eye drops (brand with lowest aquisition cost will be supplied)
1.2% syringe (BVI OVD®)
2.5% syringe (BVI Multivisc®)

 
   
Sodium Chloride 0.9% Solutions
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Formulary Single-use eye drops
 
   
11.08.02  Ocular diagnostic and peri-operative preparations and photodynamic treatment
11.08.02  Ocular diagnostic preparations
Fluorescein Sodium (Minims®)
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Formulary Single-use eye drops

Also available with local anaesthetic - see section 11.7 
   
11.08.02  Ocular peri-operative drugs
Ketorolac (Acular®)
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First Choice Eye drops

Restricted Item Ophthalmic specialist initiation only 
Apraclonidine (Iopidine®)
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Formulary
Red
0.5% Eye drops
1% Single-use eye drops

Apraclonidine 1% is licensed for control or prevention of postoperative elevation of intraocular pressure after anterior segment laser surgery.

See also section 11.06.

Restricted Item Ophthalmic specialist initiation only
 
   
Diclofenac (Voltarol® Ophtha)
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Formulary Eye drops
Single use eye drops

(Not on GMMMG formulary) 
   
Bromfenac (Yellox®)
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Formulary

0.9mg/mL eye drops

(Not on GMMMG formulary)

 
   
Acetylcholine Chloride
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Formulary Intraocular irrigation 
   
11.08.02  Subfoveal choroidal neovascularisation to top
Ranibizumab (Lucentis®)
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First Choice
Red
High Cost Medicine
Intravitreal injection

Restricted Item Ophthalmic consultant only

Use as per GMMMG Macular Drugs Pathway 
Aflibercept (Eylea®)
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First Choice
Red
High Cost Medicine
Intravitreal injection

Restricted Item Ophthalmic consultant only

Use as per GMMMMG Macular Drugs Pathway 
Bevacizumab intravitreal injection
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Formulary
Red
Ocular injection

Restricted Item Named-patient use only. For existing patients only. Ophthalmic consultant only

unlicensedunlicensed 
   
11.08.02  Vitreomacular traction
11.99.99.99  Miscellaneous
11.99.99.99  Cytotoxics / wound healing modulators
Fluorouracil
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Formulary Subconjunctival injection

Prepared by pharmacy aseptics unit for named-patient use.  
   
Mitomycin C
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Formulary Subconjunctival injection

Prepared by pharmacy aseptics unit on named-patient basis 
   
11.99.99.99  Treatment of burns
Potassium Ascorbate
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Formulary Eye drops

unlicensedunlicensed 
   
11.99.99.99  Other to top
Disodium Edetate 0.37%
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Formulary Eye lotion 
   
Sodium Chloride 5%
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Formulary Preservative-free Eye drops

unlicensedunlicensed 
   
 ....
 Non Formulary Items
Acetylcysteine 5% with Hypromellose 0.35%  (Ilube®)

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Non Formulary Not on GMMMG formulary
 
Amikacin

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Non Formulary Eye drops unlicensedunlicensed special
 
Azelastine  (Optilast®)

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Non Formulary
 
Brilliant Peel®

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Non Formulary
 
Cefuroxime  (Catacef®)
(Intracameral Injection)

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Non Formulary unlicensedunlicensed special

 
Dexamethasone with Antibacterials  (Tobradex®)

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Non Formulary
 
Dipivefrine Hydrochloride  (Propine®)

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Non Formulary DISCONTINUED
 
Econazole 1% eye drops

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Non Formulary unlicensedunlicensed special
 
Emedastine  (Emadine®)

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Non Formulary
 
Epinastine  (Relestat®)

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Non Formulary
 
Flurbiprofen Sodium  (Ocufen®)

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Non Formulary Not on GMMMG formulary
 
Foscarnet intravitreal injection

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Non Formulary
 
Glycerol (glycerin)

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Non Formulary Eye drops
 
Homatropine Hydrobromide

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Non Formulary DISCONTINUED
 
Hydrocortisone Acetate with Neomycin  (Neo-Cortef®)

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Non Formulary DISCONTINUED
 
Hydrocortisone eye ointment

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Non Formulary DISCONTINUED
 
Hydroxyethylcellulose  (Minims® Artificial Tears)

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Non Formulary Not on GMMMG formulary
 
Hydroxypropyl Guar  (Systane®)

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Non Formulary Not on GMMMG formulary

 
Hypromellose 0.3% with Dextran 70 0.1%  (Tears naturale®)

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Non Formulary Not on GMMMG formulary
 
Hypromellose 1%  (Isopto Alkaline®)

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Non Formulary Not on GMMMG formulary

 
Indocyanine green

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Non Formulary
 
Ketotifen  (Zaditen®)

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Non Formulary
 
Loteprednol  (Lotemax®)

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Non Formulary
 
Metipranolol  (Minims® Metipranolol)

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Non Formulary DISCONTINUED
 
Miconazole 1% eye drops

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Non Formulary unlicensedunlicensed special
 
Moxifloxacin

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Non Formulary Eye drops
 
Neomycin Sulphate

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Non Formulary Eye ointment unlicensedunlicensed special

 
Nepafenac  (Nevanac®)

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Non Formulary Not on GMMMG formulary
 
Ocriplasmin  (Jetrea®)

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Non Formulary
Link  NICE TA297: Ocriplasmin for treating vitreomacular traction
 
Paraffin Yellow Soft
(Simple Eye Ointment)

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Non Formulary Not on GMMMG formulary
 
Pegaptanib Sodium  (Macugen®)

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Non Formulary
 
Phenylephrine with tropicamide  (Mydriasert®)

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Non Formulary Ophthalmic insert
 
Pilocaprine long acting  (Pilogel®)

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Non Formulary DISCONTINUED
 
Pilocarpine preservative free

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Non Formulary
 
Polihexanide
(Polyhexamethylene biguanide (PHMB))

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Non Formulary Eye drops unlicensedunlicensed special
 
Povidone  (Oculotect®)

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Non Formulary Not on GMMMG formulary

 
Prednisolone 0.5% with Neomycin 0.5%  (Predsol-N®)

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Non Formulary DISCONTINUED
 
Proxymetacaine Hydrochloride 0.5% with Fluorescein Sodium 0.25%  (Minims®)

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Non Formulary Single-use eye drops

DISCONTINUED
 
Rose Bengal  (Minims® Rose Bengal)

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Non Formulary DISCONTINUED
 
Sodium Citrate

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Non Formulary
 
Soybean oil unit dose eye drops  (Emustil®)

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Non Formulary Not on GMMMG formulary

 
Tafluprost (Preservative Free) 15micrograms/ml  (Saflutan®)

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Non Formulary
 
Timolol  (Tiopex®)

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Non Formulary
 
Tobramycin

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Non Formulary Eye drops
 
Trifluorothymidine eye drops

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Non Formulary
 
Verteporfin  (Visudyne®)

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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 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

Amber

Drugs designated amber are suitable for shared care arrangements under a shared care protocol. Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.   

Black

These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products.  

Green

Not used   

Green 1

Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

Green 2

Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required.  

Green 3

Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required.  

Grey

Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient.   

Red

Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.   

netFormulary