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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