Ocular diagnostic, peri-operative and specialist-use preparations (Formulary)

Botulinum toxin type A (Drugs used in Parkinsonism and related disorders) is also used under specialist advice for blepharospasm.

ADALIMUMAB

Important: Therapy notes

  • Amgevita® first-line
  • Humira® second-line, for specialist treatment of sight threatening, non-infectious, inflammatory eye disease off-label.

Important: Formulation and dosage details

Formulation:

Solution for injection, pre-filled syringe 20mg/0·4mL, 40mg/0·8mL (Amgevita®) (specialist use only) 

Dosage:

Homecare is the preferred option - contact nhsh.homecare@nhs.scot

Important: Formulation and dosage details

Formulation:

Solution for injection, pre-filled pen 40mg/0·8mL (Amgevita®) (specialist use only)

Dosage:

Homecare is the preferred option - contact nhsh.homecare@nhs.scot

Important: Formulation and dosage details

Formulation:

Solution for injection pre-filled syringe 20mg/0·4mL, 40mg/0·4mL (Humira®) (specialist use only)

Dosage:

Homecare is the preferred option - contact nhsh.homecare@nhs.scot

Important: Formulation and dosage details

Formulation:

Solution for injection, pre-filled pen 40mg/0·4mL (Humira®) (specialist use only)

Dosage:

Homecare is the preferred option - contact nhsh.homecare@nhs.scot

ACETYLCHOLINE CHLORIDE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for intra-ocular irrigation (acetylcholine 1%, mannitol 3%) (Miochol-E®) (specialist use only)

AFLIBERCEPT

Important: Therapy notes

MHRA alert: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk)

Important: Formulation and dosage details

Formulation:

Solution for intravitreal injection 40mg/ml (4mg/0·1ml) providing a 2mg dose (specialist use only)

Dosage:

See SMC advice:

  • 857/13 - in adults for the treatment of neovascular (wet) age-related macular degeneration. 
  • 878/13 - in combination with irinotecan/5-fluorouracil/folinic acid (FOLFIRI) chemotherapy, aflibercept is indicated in adults with metastatic colorectal cancer (mCRC) that is resistant to or has progressed after an oxaliplatin-containing regimen.
  • 954/14 - for adults for the treatment of visual impairment due to macular oedema secondary to central retinal vein occlusion. 
  • 1003/14 - for adults for the treatment of visual impairment due to diabetic macular oedema (DMO).  SMC restriction: treatment of visual impairment due to DMO in adults with best corrected visual acuity (BCVA) 75 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or less at baseline. 
  • 1074/15 - for adults for the treatment of visual impairment due to macular oedema secondary to branch retinal vein occlusion.

BEVACIZUMAB

Important: Therapy notes

MHRA alert: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Intravitreal injection, pre-filled syringe 5mg/0·2mL unlicensed (specialist use only)

BROLUCIZUMAB

Important: Therapy notes

MHRA advice: Brolucizumab (Beovu): risk of intraocular inflammation and retinal vascular occlusion increased with short dosing intervals (January 2022) (www.gov.uk).

Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Solution for injection 120mg/ml in pre-filled syringe (specialist use only)

Dosage:

SMC advice 2272.

CEFUROXIME

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for solution for injection 50mg (Aprokam®) (specialist use only)

CICLOSPORIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Preservative-free eye drops 0·1% (Ikervis®) (specialist use only)

Dosage:

Apply 1 drop at bedtime.

FLUORESCEIN SODIUM

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Preservative-free eye drops 1%, 2%

Important: Formulation and dosage details

Formulation:

Solution for injection 10%

OCRIPLASMIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for intravitreal injection 500 micograms/0·2mL vial (specialist use only)

POVIDONE IODINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for intra-ocular irrigation 5% in balanced salt solution unlicensed (specialist use only)

RANIBIZUMAB

Important: Therapy notes


Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Solution for intravitreal injection 1·65mg/0·165mL prefilled syringe, 2·3mg/0·23mL vial (specialist use only)

SODIUM CHLORIDE

Important: Therapy notes

  • Available for specialist use from special-order manufacturers; for information contact Medicines Information.

Important: Formulation and dosage details

Formulation:

Preservative free eye drops 5% 10ml (specialist initiation only)

Editorial Information

Last reviewed: 29/04/2021

Document Id: F207