Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
11. Eye

11.6. Treatment of glaucoma

11.6.1. Beta - blockers

Total Formulary
Specialist and GP
TIMOLOL MALEATE (eye drops)

Restrictions: Restricted to specialist initiation.

Prescribing Notes:

The preserved eye drops are the first choice preparation. However, long-acting preparations of timolol should be reserved only for patients with compliance issues. For preservative-free preparations of timolol, see the Total Formulary     

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Specialist and GP
TIMOLOL MALEATE (TIOPEX) (single-dose eye gel)

Restrictions: Restricted to use in patients who have proven sensitivity to preservatives.

Prescribing Notes:

Timolol maleate preserved eye drops are considerd the first line topical beta-blocker for glaucoma (see preferred list)

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Specialist and GP
LEVOBUNOLOL

Restrictions:

Restricted to specialist initiation.

BNF Link

Specialist and GP
BETAXOLOL

Restrictions: Restricted to specialist initiation.

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11.6.2. Prostaglandin analogues and prostamides

Total Formulary
Specialist and GP
LATANOPROST (eye drops)

Restrictions: The preservative-free presentations are further restricted to use in patients who have proven sensitivity to the preservative benzalkonium chloride.

Prescribing Notes:

The preservative-containing eye drops are the first choice preparation.

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Specialist and GP
TRAVOPROST

Restrictions: Restricted to specialist initiation.

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Specialist and GP
TAFLUPROST

Restrictions: Restricted to specialist initiation. Restricted to use only in patients who cannot tolerate other prostaglandin preparations due to proven sensitivity to the preservative benzalkonium chloride.

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Specialist and GP
BIMATOPROST

Restrictions: Restricted to specialist initiation. Prescribing of the single-dose eye drop preparation is further restricted to use only in patients who have a proven sensitivity to the preservative benzalkonium chloride.

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11.6.3. Sympathomimetics

Total Formulary
Specialist and GP
BRIMONIDINE

Restrictions: Restricted to specialist initiation.

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11.6.4. Carbonic anhydrase inhibitors and systemic drugs

Total Formulary
Specialist and GP
DORZOLAMIDE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
BRINZOLAMIDE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
ACETAZOLAMIDE

Restrictions: Restricted to specialist initiation.

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11.6.5. Miotics

Total Formulary
Specialist and GP
PILOCARPINE

Restrictions: Restricted to specialist initiation.

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11.6.6. Combination preparations

Combination preparations that consist of drugs from different classes of glaucoma medicines are included in this sub-section.
Total Formulary
Specialist and GP
BRINZOLAMIDE AND TIMOLOL (AZARGA)

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
TRAVOPROST AND TIMOLOL

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
BRIMONIDINE AND TIMOLOL

Restrictions: Restricted to specialist initiation.

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Specialist and GP
DORZOLAMIDE AND TIMOLOL

Restrictions:

Restricted to specialist initiation. Preservative-free preparations are restricted to patients in whom a combination of these two agents is appropriate and who have proven sensitivity to benzalkonium chloride.

BNF Link

Specialist and GP
LATANOPROST AND TIMOLOL

Restrictions:

Restricted to specialist initiation. Preservative-free latanoprost and timolol eye drops (Fixapost®) are further restricted to use in patients who have proven sensitivity to preservatives.

BNF Link

Specialist and GP
BIMATOPROST AND TIMOLOL

Restrictions: Restricted to specialist initiation. Preservative-free unit dose eye drops are further restricted to use only in patients who have proven sensitivity to preservatives.

BNF Link

Specialist and GP
TAFLUPROST AND TIMOLOL (TAPTIQOM) (preservative-free eye drops)

Restrictions: Use for the reduction of intraocular pressure in adults with open angle glaucoma or ocular hypertension who are insufficiently responsive to topical monotherapy with beta blockers is restricted to specialist initiation in patients who have proven sensitivity to preservatives.

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Specialist and GP
BRINZOLAMIDE AND BRIMONIDINE (SIMBRINZA)

Restrictions: Restricted to specialist initiation.

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11.6.7. Other agents for glaucoma and intra-ocular pressure

Total Formulary
Specialist and GP
APRACLONIDINE

Restrictions: Restricted to specialist initiation. Apraclonidine 0.5% eye drops are restricted to use on specialist advice only for short term adjunctive therapy of chronic glaucoma.

BNF Link