netFormulary Leicestershire Health Community NHS
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 Formulary Chapter 11: Eye - Full Chapter
11.06  Expand sub section  Treatment of glaucoma
 note  Treatment of glaucomamay be undertaken with eye drops following the local glaucoma treatment algorithm. In most cases a prostaglandin analogue would be the first choice treatment. For some patients a combination of eye drops is required, introducing eye drops from different classes in a stepwise fashion according to the algorithm above. Combination eye drops are available for those requiring three or more different eye drops to control the condition.
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
Brinzolamide
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First Choice
Green
Topical use. Almost as effective as treatment with acetazolamide with much reduced systemic side effects. Incidence of topical side effects is relatively low. 
Acetazolamide Tablets
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First Choice
Green
Used to lower intra-ocular pressure by reduction of aqueous humour production. Usually used on a short-term basis as it has less effect with long-term use; it should only be used long-term in exceptional cases. If used long term appropriate monitoring of electrolytes is recommended. 
Acetazolamide Slow-release capsules
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Second Choice
Green
Often better tolerated but are more expensive than the tablets. 
   
Dorzolamide
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Second Choice
Green
 
   
Brinzolamide with timolol (Azarga)
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Formulary
Green
May be used when three or more eye drop preparations are required to manage the condition 
   
Dorzolamide with timolol
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Formulary
Green
Use of generic dorzolamide and timolol eye drops is approved in Leicestershire  
   
Dorzolamide with timolol (in unit doses) (Cosopt)
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Formulary
Green
For use only in patients who require preservative free eye drops and require three or more eye drop preparations to control the condition. 
Link  MHRA Advice: Dorzolamide hydrochloride/timolol maleate (Cosopt) preservative-free eye drops: new pipette design
   
 ....
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
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

Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety. All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry   

Red

Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).  

Amber SCA

Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.   

Amber Simple

Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.  

Green Conditional

Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence see comments under individual entries.   

Green

Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.   

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