11.4.2 Other anti-inflammatory preparations

NHS England (NHSE) has published new prescribing guidance for various common conditions for which over the counter (OTC) items should not be routinely prescribed in primary care (quick reference guide). These conditions include mild to moderate hay fever/seasonal allergic rhinitis.

Products such as sodium cromoglicate eye drops are cheap to buy and are readily available OTC along with advice from pharmacies. Some self-care medicines are available from shops and supermarkets. Please click here for further information, exceptions, and a patient leaflet.

Iatrogenic allergy should be considered as a cause for any allergic conjunctivitis. Common irritants include neomycin, framycetin, atropine and the preservative benzalkonium chloride.

Sodium cromoglicate
  • Aqueous eye drops 2% (£4.41 = 13.5ml)

Indications

  • Allergic conjunctivitis

Dose

  • Apply 4 times daily
Olopatadine
  • Eye drops 1mg/ml (£4.68 = 5ml)

Indications

  • Seasonal allergic conjunctivitis

Dose

  • Apply twice daily, maximum duration of treatment 4 months
Ciclosporin
  • Ikervis® eye drops 1mg/ml 0.3ml single use vials (£72.00 = 30 units)
  • Eye ointment 0.2% (unlicensed preparation)

Notes

  1. Patients prescribed ciclosporin 1mg/ml single use eye drops must be reviewed by the Hospital Eye Service at least every six months
  2. NICE TA369: Ciclosporin (Ikervis) is recommended as an option for treating severe keratitis in adults with dry eye disease that has not improved despite treatment with tear substitutes (December 2015)

 

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