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.
Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
Prostaglandin analoguesAdvise patients to tell their health professional if they experience severe eye irritation. See MHRA (July 2015) for Latanoprost (Xalatan): increased reporting of eye irritation since reformulation.
Latanoprost50mcg/ml eye drop: £1.62 (2.5ml)First line
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: £7.99 (3ml)
Bimatoprost Preservative-free
as Bimi®
300mcg/ml eye drop:
£8.33 (3ml), £21.97 (9ml)
Cost effective alternative during Monoprost® shortage, seek advice from specialist before switching.
Beta-adrenoceptor blockersTimolol2.5mg/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)
Carbonic anhydrase inhibitorsAcetazolamide250mg tablet: £5.39 (112)NHS Somerset classify as an Amber drug for the reduction in intra-ocular pressure in glaucoma and epilepsy.
250mg modified-release capsule: £16.66 (30)
Dorzolomide 20mg/ml eye drop: £3.25 (5ml)
Dorzolomide Preservative-free
as Dimaz®
20mg/ml eye drop: £6.98 (5ml)
as Eydelto®20mg/ml eye drop: £7.08 (5ml)
Carbonic anhydrase inhibitor with beta-adrenoceptor blockerDorzolomide and timolol Preservative-free
as Codimaz®
20mg and 5mg/ml eye drop: £8.03 (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.
Prostaglandin analogue with beta-adrenoceptor blockerLatanoprost 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)
Bimatoprost and Timolol300mcg and 5mg/ml eye drop: £4.08 (3ml)