Sodium hyaluronate eye drops for severe dry eye – Formulary update
Key messages:
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Sodium hyaluronate eye drops are on the NHSGGC Adult Medicines Formulary restricted to use in severe dry eye only
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Blink Intensive Tears® (sodium hyaluronate 0.2%) eye drops (containing a preservative) are considered the first line sodium hyaluronate preparation
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Eyeaze® 0.4% (sodium hyaluronate 0.4%) preservative free eye drops have been added to the NHSGGC Adult Medicines Formulary following a Formulary appeal
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In some patients requiring to use drops >4 times daily, in atopic patients or permanent treatment, it may be appropriate to use a preservative free option as preservative toxicity can be a complication of the treatment of dry eyes
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Thealoz Duo® eye drops (sodium hyaluronate 0.15%/trehalose 3%) are restricted to use in severe dry eyes when Blink Intensive Tears® or Eyeaze® are not appropriate and the addition of trehalose is desirable. (e.g. corneal damage)
Background:
Patients presenting with dry eye should be assessed on an individual basis. Pharmacological intervention for dry eye include tear supplementation by artificial tear drops, lubricant gels and ointments. Due to the range of products and active ingredients available, consideration should be given to those products contained within the NHSGGC Adult Medicines Formulary in order to ensure cost-effective prescribing. Most dry eyes can be managed effectively in the community, however patients should be considered for referral to secondary care if their symptoms do not respond to a second line agent within 4-6 weeks. The Clinical Guideline for Dry Eye Management, Primary Care is available HERE.
Following a formulary appeal, Evolve HA® and Hylo Forte® were removed and Eyeze® 0.4% was added as a treatment option. Eyeaze® 0.4% eye drops are stocked by all major wholesalers and stock levels will be monitored in order to ensure reliable supply. At present, NHSGGC are not undertaking an active programme of switching patients already established on other sodium hyaluronate eye drop preparations.
Published: 14/09/2022. Medicines Update blogs are correct at the time of publishing