North East and North Cumbria
ICS Formulary
 
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11 Eye

Preservative Free Eye Drops
Microbial contamination of multidose bottles of eye drops can cause eye infections that may lead to damage of the eye and in extreme cases loss of sight. To minimise the risk, multidose bottles of eye drops contain an antimicrobial preservative such as benzalkonium chloride. The preservatives used in eye drops are normally well tolerated, but they are not completely harmless. They can cause irritation and damage to the corneal epithelium. This risk is understood to be greater in patients with pre-existing damage to the ocular surface and where large quantities of preservative containing eye drops are applied repeatedly over a prolonged period (e.g. if applied more than 4 to 6 times daily for several weeks/ months).
To avoid these problems the use of preservative-free eye drops is recommended in:
 Patients who have experienced hypersensitivity reactions or irritation due to preservatives in eye drops.
 Patients who have received corneal grafts.
 Patients with conditions where there is already damage to the ocular surface as a result of disease or trauma, such as dry eye, blepharitis, ocular burns etc.
Treatment with preservative-free eye drops will usually be initiated by an ophthalmologist.

11-06 Prostaglandin analogues

Latanoprost eye drops
First Choice

  • 50 microgram/ml drops

  • 50 microgram/ml preservative free SDU (Monopost)

Link  MHRA Drug Safety Update (July 2015): Latanoprost (Xalatan): increased reporting of eye irritation since reformulation

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Travoprost
Formulary

Eye drops: 40 micrograms/1 mL


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Travoprost with Timolol
Formulary

Eye drops: travoprost 40 micrograms/1 mL, timolol 5 mg/1 mL (DuoTrav®)


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Bimatoprost eye drops
Formulary

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Bimatoprost with Timolol eye drops
Formulary
  • For use as a second/third-line agent in patients insufficiently responsive
    to monotherapy with a prostaglandin analogue or beta blocker

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Latanoprost 0.005% with Timolol 0.5% eye drops
Formulary
  • For use as a second/third-line agent in patients insufficiently responsive
    to monotherapy with a prostaglandin analogue or beta blocker.

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Tafluprost Saflutan®
Formulary
  • Tafluprost 15micrograms/ml eye drops

  • Tafluprost 15micrograms/ml eye drops 0.3ml unit dose preservative free

  • Reserved for patients who cannot tolerate other prostaglandin analogues

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Tafluprost 15microg with timolol 0.5% eye drops
Formulary

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