NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

October Formulary Updates: Eye Section and Recent Decisions

Adult Formulary: Eye section update

This part of the Formulary has recently been reviewed with input from specialists in acute and primary care. All sections have been reviewed, with some major changes to the format for section 11.8.1 (Tear deficiency, ocular lubricants and astringents).

 

  • All products will be listed by brand name to prevent confusion
  • Hypromellose is no longer the first-line treatment option. It may contain the preservative benzalkonium chloride which has been linked to problems with the tear film and so may exacerbate dry eyes over a long period of time.
  • The first line product is Clinitas Gel® eye drops which contains carbomer 980 0.2% as the active ingredient with cetrimide as the preservative.

 

A general prescribing note has been added to highlight that patients with chronic dry eye conditions should be educated that long-term and regular use of eye lubricants is recommended to achieve maximum benefit.

 

ADTC Decisions

The following are among those added to the Adult Formulary. See here for more details.

  • Lurasidone for schizophrenia: Restricted to specialist initiation in accordance with local protocol as an alternative treatment option in patients in whom it is important to avoid weight gain and metabolic adverse effects.
  • Simeprevir for chronic hepatitis C: Restricted to specialist use in accordance with local protocol
  • Empagliflozin for type 2 diabetes. Restricted to use in the following situations:
    • dual therapy in combination with metformin, when a sulphonylurea is inappropriate
    • triple therapy in combination with metformin plus standard care
    • add-on therapy in combination with insulin plus standard care.

Trastuzumab emtansine was not added to Formulary for treatment of adults with human epidermal growth factor type 2 (HER2)-positive, unresectable locally advanced or metastatic breast cancer. SMC did not recommend it for use in Scotland as its health benefits were not sufficient to justify the costs.