Related guidance: Glaucoma: diagnosis and management NICE guideline (NG81 November 2017, updated January 2022)

 

As advised by secondary care

  • Where a prostaglandin analogue is indicated for reducing intraocular pressure (IOP), Latanoprost is first line. Patients currently using other forms of prostaglandin analogues may be reviewed when seen routinely by secondary care.
  • Offer another pharmacological treatment to people with an IOP of 24 mmHg or more who cannot tolerate their current treatment. The first choice should be an alternative generic prostaglandin analogue (PGA), and if this is not tolerated, offer a beta-blocker. If neither of these options is tolerated, offer a non-generic PGA, carbonic anhydrase inhibitor, sympathomimetic, miotic or a combination of treatments.
  • Offer preservative free formulation for the reduction of elevated intra-ocular pressure in people with open-angle glaucoma and ocular hypertension who have proven sensitivity to benzalkonium chloride.
Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
First line:Latanoprost50mcg/ml eye drop: £1.62 (2.5ml)See MHRA safety update on Latanoprost (Xalatan®) increased reporting of eye irritation since reformulation (July 2015)
Latanoprost Preservative-free single use
as Monopost®
50mcg/ml eye drop: £8.49 (30 x 0.2ml)
Bimatoprost300mcg/ml eye drop: £14.54 (3ml)
Bimatoprost Preservative-free
as Eyreida®
300mcg/ml eye drop: £9.79 (3ml)
Bimatoprost Preservative-free
as Zimed®
300mcg/ml eye drop: £10.99 (3ml)
Timolol2.5mg/ml eye drop: £2.80 (5ml)
5 mg/ml eye drop: £2.72 (5ml)
Timolol Preservative-free
as Eysano®

2.5mg/ml eye drop: £8.45 (5ml)
5mg/ml eye drop: £9.65 (5ml)
Timolol Preservative-free single use
as Tiopex®
1mg/g eye gel: £7.49 (30)
Dorzolomide 20mg/ml eye drop: £3.25 (5ml)
Dorzolomide Preservative-free
as Eydelto®
20mg/ml eye drop: £7.08 (5ml)
Dorzolomide and timolol Preservative-free
as Eylamdo®
20mg and 5mg/ml eye drop: £8.13 (5ml)
Dorzolomide and timolol Preservative-free
as Cosopt iMulti®
20mg and 5mg/ml eye drop: £28.00 (10ml) Provides two months treatment.
Latanoprost and timolol 50mcg and 5mg/ml eye drop: £3.33 (2.5ml)
Latanoprost and timolol Preservative-free
as Fixapost®
50mcg and 5mg/ml eye drop: £13.49 (30 x 0.2ml)
OpticareFor use with 2.5, 5, 10, 15 and 20ml bottle: £4.95For patients who find administration of eye drops difficult we recommend prescription of these devices. See Opticare website for details.
Opticare Arthro 5 For use with 2.5 and 5ml bottle: £4.95
Opticare Arthro 10 For use with 10, 15 and 20ml bottle: £4.95