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System Formulary Update
Ocular Lubricants
Situation
The ocular lubricants class review and formulary standardization was approved at the April 2021 System Pharmacy and Therapeutics (P&T) Committee meeting. Also, therapeutic interchanges for this class were approved at the May 2021 System P&T Committee meeting.
Background
The following medications were reviewed: Carboxymethylcellulose, carboxymethylcellulose/glycerin, dextran 70/glycerin/hypromellose, hypromellose, mineral oil/white petrolatum, polyethylene glycol 400/propylene glycol, polyvinyl alcohol/povidone, polyvinyl alcohol
Assessment/Recommendation
Changes effective: Tuesday June 29, 2021
System P&T voted to include the following products on the UNC Health Medication Formulary:
- Carboxymethylcellulose 0.25% ophthalmic solution
- Preservative-free, single-dose dropperette (0.4 mL, 30 count)
- Multi-dose bottle (15 mL, 30 mL)
- Carboxymethylcellulose 1% ophthalmic gel
- Preservative-free, single-dose dropperette (0.4 mL, 30 count)
- Multi-dose bottle (15 mL)
- Hypromellose 0.3% ophthalmic gel
- Multi-dose tube (10 g)
- Mineral oil 20% and white petrolatum 80% ophthalmic ointment
- Preservative-free, multi-dose tube (3.5 g and 5 g)
- Polyvinyl alcohol 0.5% and povidone 0.6% ophthalmic solution
- Multi-dose bottle (15 mL)
Note: Stock of these formulary products may vary at individual entities
As a result, the following products will be removed from the UNC Health Medication Formulary:
- Carboxymethylcellulose (all other strengths)
- Carboxymethylcellulose/glycerin
- Dextran 70/glycerin/hypromellose
- Hypromellose (all other strengths)
- Mineral oil/white petrolatum (all other strengths)
- Polyethylene glycol 400/propylene glycol
- Polyvinyl alcohol and povidone (all other strengths)
- Polyvinyl alcohol
Non-formulary orders will be converted according to the following therapeutic interchange:
|
Ocular Lubricants |
|
|
Non-Formulary Order |
Formulary Equivalent Order |
|
Carboxymethylcellulose 0.5% ophthalmic solution 1 drop three times daily 1 drop four times daily 1 drop four times daily as needed 2 drop three times daily 2 drop four times daily 2 drop four times daily as needed |
Carboxymethylcellulose 0.25% ophthalmic solution 1 drop three times daily 1 drop four times daily 1 drop four times daily as needed 2 drop three times daily 2 drop four times daily 2 drop four times daily as needed |
|
Carboxymethylcellulose-Glycerin 0.5%-0.9% ophthalmic solution 1 drop three times daily 1 drop four times daily 1 drop four times daily as needed 2 drop three times daily 2 drop four times daily 2 drop four times daily as needed |
Carboxymethylcellulose 0.25% ophthalmic solution 1 drop three times daily 1 drop four times daily 1 drop four times daily as needed 2 drop three times daily 2 drop four times daily 2 drop four times daily as needed |
|
Cyclosporine 0.05% ophthalmic solution 1 drop twice daily 1 drop three times daily |
Carboxymethylcellulose 0.25% ophthalmic solution 1 drop twice daily 1 drop three times daily |
|
Cyclosporine 0.09% ophthalmic solution 1 drop twice daily 1 drop three times daily |
Carboxymethylcellulose 0.25% ophthalmic solution 1 drop twice daily 1 drop three times daily |
|
Mineral Oil-White Petrolatum 3%-94% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
Mineral Oil-White Petrolatum 20%-80% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
|
Mineral Oil-White Petrolatum 15%-83% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
Mineral Oil-White Petrolatum 20%-80% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
|
Mineral Oil-White Petrolatum 15%-85% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
Mineral Oil-White Petrolatum 20%-80% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
|
Mineral Oil-White Petrolatum 31.9%-57.7% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
Mineral Oil-White Petrolatum 20%-80% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
|
Mineral Oil-White Petrolatum 42.5%-56.8% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
Mineral Oil-White Petrolatum 20%-80% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
|
Mineral Oil-White Petrolatum 42.5%-57.3% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
Mineral Oil-White Petrolatum 20%-80% ophthalmic ointment 1 application once 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application nightly |
|
Polyethylene Glycol 400-Propylene Glycol 0.3%-0.4% ophthalmic gel 1 drop twice daily |
Carboxymethylcellulose 1% ophthalmic gel 1 drop twice daily |
|
Polyethylene Glycol 400-Propylene Glycol 0.3%-0.4% ophthalmic solution 1 drop twice daily |
Carboxymethylcellulose 0.25% ophthalmic solution 1 drop twice daily |
|
Polyethylene Glycol 400 1%, hypromellose 0.2%, and glycerin 0.2% ophthalmic solution 1 drop every 2 hours if needed 1 drop every 4 hours if needed 1 drop every 6 hours if needed 2 drop every 2 hours if needed 2 drop every 4 hours if needed 2 drop every 6 hours if needed |
Carboxymethylcellulose 0.25% ophthalmic solution 1 drop every 2 hours if needed 1 drop every 4 hours if needed 1 drop every 6 hours if needed 2 drop every 2 hours if needed 2 drop every 4 hours if needed 2 drop every 6 hours if needed |
|
Polyvinyl Alcohol-Povidone 1.4%-0.6% ophthalmic solution 1 drop every 2 hours if needed 1 drop every 4 hours if needed 1 drop every 6 hours if needed 2 drop every 2 hours if needed 2 drop every 4 hours if needed 2 drop every 6 hours if needed |
Mineral Oil-White Petrolatum 20%-80% ophthalmic ointment 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed 1 application every 2 hours as needed 1 application every 4 hours as needed 1 application every 6 hours as needed |