F- 15 CLINICAL OPHTHALMIC THERAPEUTIC PHARMACEUTICAL AGENTS (TPA) QUICK REFERENCE GUIDE Assembled by: Tim Maillet, OD, BSc NSAO Practice Innovations Committee Chairperson September 2009
F- 16 Ocular Allergies Acute Allergy Therapy: Brand Generic Manufacturer Bottle Size Dosing Acular LS Ketorolac Allergan 5ml, 10ml QID tromethamine 0.4% Alrex Loteprednol Bausch & 5ml, 10ml QID etabonate 0.2% Lomb Emadine Emedastine Alcon 5ml QID difumarate 0.05% Patanol Olopatadine Alcon 5ml BID Refresh Eye Antazoline Allergan 5ml BID Allergy Relief phosphate 0.51%, 0.051% Zaditor Ketotifen fumarate 0.025% Novartis 5ml BID Chronic Allergy Therapy: Brand Generic Manufacturer Bottle Size Dosing Alocril Nedocromil Allergan 5ml BID sodium 2% Alomide Iodoxamide Alcon 10ml QID tromethamine Opticrom Cromolyn sodium 4% Allergan 10ml QID Antimicrobial Agents Fluoroquinolones: Brand Generic Ciloxan, Ciprofloxacin and 0.3% Ocuflox, Ofloxacin and 0.3% Vigamox Moxifloxacin Zymar Gatifloxacin 0.3% Manufacturer Preparation Pediatric Bottle/Tube Alcon, and Sol/ung 1yr/ 2yr 2.5ml, 5ml, 10ml/3.5g Allergan, and Sol 1yr 5ml, 10ml Alcon Sol 1yr 3ml Allergan Sol 1yr 2.5ml, 5ml Aminoglycosides: Brand Generic Manufacturer Preparation Pediatric Bottle/Tube Tobrex, and Tobramycin Alcon, and Sol/ung 2mos. 5ml/3.5g
F- 17 0.3% Polymyxin B Combinations: Brand Generic Polytrim Polymyxin B and trimethoprim Polysporin Polymyxin B and bacitracin Neosporin Polymyxin B, neomycin, and gramicidin Manufacturer Preparation Pediatric Bottle/Tube Allergan, and Sol 2mos. 10ml Monarch, and Monarch, and Ung N/A 3.5g Sol/ung N/A 10ml/3.5g Fusidic Acid: Brand Fucithalmic Generic 1% fusidic acid Manufacturer Preparation Pediatric Bottle/Tube Leo Pharma Viscous sol >2 years Unit dose Inc. 3 or 5g tube Erythromycin: Brand Erythromycin ophthalmic Generic Erythromycin Manufacturer Preparation Pediatric Bottle/Tube Bausch & Ointment Yes 3.5g Lomb Over-the-counter Anti-Infectives: Product Antibiotic Preservative Optimyxin Eye/Ear gramicidin 0.025mg/mL polymyxin B 10 000 IU/mL Optimyxin Ointment bacitracin 500 IU/g polymyxin B 10 000 IU/mL None Polysporin Eye/Ear Polysporin Ophthalmic Ointment gramicidin 0.025mg/mL polymyxin B 10 000 IU/mL bacitracin 500 IU/g polymyxin B 10 000 IU/mL None Herpes Infections: Brand Generic Manufacturer Preparation Bottle/Tube Viroptic Trifluridine 1% Monarch Pharm Solution 7.5ml Zovirax Acyclovir GlaxoSmithKline Capsules 200mg Valtrex Valacyclovir GlaxoSmithKline Caplets 500mg Famvir Famciclovir Novartis Tablets 500mg
F- 18 Anti-inflammatory Agents Corticosteroid/Antibiotic Combination Drugs: Brand Manufacturer Steroid Antibiotic Preparation Bottle/Tube Blephamide Allergan Prednisolone acetate 0.2% Sodium sulfacetamide Susp./ung. 2.5ml, 5ml, 10ml/3.5g Cortisporin Monarch Hydrocortisone 1% FML-S Allergan Fluorometholone Maxitrol Alcon Dexamethasone Tobradex Alcon Dexamethasone 10% Neomycin 0.35%, polymyxin B 10,000u/ml Sodium sulfacetamide 10% Neomycin 0.35%, polymyxin B 10,000u/ml Tobramycin 0.3% Suspension Suspension Susp./ung. Susp./ung. 7.5ml 5ml, 10ml 5ml/3.5g 2.5ml, 5ml/3.5g Maximum Strength Topical Corticosteroid Drugs: Brand Generic Manufacturer Preparation Bottle/Tube Lotemax Loteprednol etabonate Bausch & Lomb Suspension 2.5ml, 5ml, 10ml, 15ml Pred forte, and Prednisolone acetate 1% Allergan, and Suspension 1ml, 5ml, 10ml, 15ml Vexol Rimexolone 1% Alcon Suspension 5ml, 10ml Moderate Strength Topical Corticosteroid Drugs: Brand Generic Manufacturer Preparation Bottle/Tube Flarex, and Fluorometholone Alcon Suspension 5ml, 10ml acetate FML, and Fluorometholone alcohol Allergan Suspension 5ml, 10ml, 15ml Pred Mild, and Prednisolone acetate 0.12% Allergan Suspension 5ml, 10ml To Taper Steroids: An important reason for tapering steroids is the rebound effect of local inflammation. Abruptly discontinuing topical steroids may allow the suppressed inflammation to bounce back. A good rule of thumb: taper dosage frequency by about a 50% reduction once inflammation is under control. Example: Q1H for two days, Q2H for two days, QID for four days, BID for four days. Non-steroidal Anti-inflammatory Drugs: Brand Generic Manufacturer Preparation Bottle/Tube Voltaren diclofenac Novartis Solution 5ml sodium Ophthalmics Ocufen 0.03% Allergan Solution 2.5ml flurbiprofen sodium Acular ketorolac Allergan Solution 3ml, 5ml, 10ml tromethamine Acular LS 0.4% ketorolac tromethamine Allergan Solution 3ml, 5ml, 10ml
F- 19 Topical Glaucoma Drugs Beta Blockers: Brand Generic Manufacturer Concentration Bottle Size Betagan, and Levobunolol Allergan 0.25% 5ml, 10ml 2ml, 5ml, 10ml, 15ml Betoptic-S Betaxolol Alcon 0.25% 2.5ml, 5ml, Timoptic, and Timoptic-XE, and Timolol maleate Timolol maleate Merck, and Merck, and 10ml, 15ml 0.25%, Unit-dose, 2.5ml, 5ml, 10ml, 15ml 0.25%, 2.5ml, 5ml Prostaglandin Analogs: Brand Generic Manufacturer Concentration Bottle Size Lumigan Bimatoprost Allergan 0.03% 2.5ml, 5ml, 7.5ml Travatan Travoprost Alcon 0.004% 2.5ml, 5ml Travatan Z Travoprost Alcon 0.004% 2.5ml, 5ml Xalatan Latanoprost Pfizer 0.005% 2.5ml Alpha Agonists: Brand Generic Manufacturer Concentration Bottle Size Alphagan P, and Brimonidine Allergan,, 0.15%, 0.2% 5ml, 10ml, 15ml Iopidine Apraclonidine Alcon 1% 5ml, 10ml unit-dose Carbonic Anhydrase Inhibitors: Brand Generic Manufacturer Concentration Bottle Size Azopt Brinzolamide Alcon 1% 5ml, 10ml, 15ml Trusopt Dorzolamide Merck 2% 5ml, 10ml Combination Glaucoma Medications: Brand Generic Manufacturer Concentration Bottle Size Combigan Brimonidine/timolol Allergan 2%/ 5ml, 10ml Cosopt Dorzolamide/timolol Merck 2%/ 5ml, 10ml Miscellaneous Hyperosmolar Agents: Brand Generic Muro 128 5% sodium 5% chloride Muro 128 5% sodium 5% chloride Manufacturer Preparation Bottle/Tube Dosing Bausch & Lomb Bausch & Lomb Solution 15ml, 30ml 1gt/2gtt Q3-4H Ointment 3.5g Q3-4H
F- 20 Mydriatics and Cycloplegics: Generic Trade Concentration Onset Duration of Action Phenylephrine AK-Dilate Sol, 2.5%, 10% 30-60 min 3-5 h Mydfrin Sol, 2.5% Atropine sulfate Isopto Atropine Sol, 1% 45-120 min 7-14 days Cyclopentolate AK-Pentolate Sol, 1% 30-60 min 6-24 h Cyclogyl Cylate Sol,, 1%, 2% Homatropine Isopto Sol, 2%, 5% 30-60 min 3 days hydrobromide Homatropine Tropicamide Mydriacyl Sol,, 1% 20-40 min 4-6 h Topical Anesthetic Agents: USP or NF Trade Concentration Proparacaine Alcaine Ophthetic Dry Eye Therapy Temporary Preservative: Product Preservative Lubricant Refresh Tears Purite CMC Refresh Contacts Purite CMC Refresh Ultra Purite Castor oil + glycerin 1% + polysorbate 80 GenTeal Sodium perborate HPMC 0.3% GenTeal Gel Sodium perborate HPMC + CMC Blink Purite Sodium hyaluronate Chemical Preservative: Product Preservative Lubricant Tears Naturale II Polyquad Duasorb: Dextran + HPMC 0.3% Tears Naturale Forte Polyquad Trisorb: Dextran + HPMC 0.3% + Glycerin Tears Naturale + EDTA Duasorb: Dextran + HPMC 0.3% Eyestil multidose Sodium Hyaluronate Hypotears + EDTA PEG 400 + PVA 1% Murine + EDTA PVA Visine PEG + Glycerin + HPMC 0.2% Systane Polyquad PEG + Propylene Glycol + HP Guar Systane Ultra Polyquad PEG + Propylene Glycol + HP Guar Isopto Tears HPMC Isopto Tears 1% HPMC 1% Blink n Clean PHMB Tears Plus Chlorbutanol PVA + Povidone Moisture Eyes Propylene Glycol 1% + Glycerin 0.3%
F- 21 Preservative-Free: Product Preservative Lubricant Artelac None Hypromellose USP 0.32% Refresh Plus None CMC Thera Tears None CMC 0.25% Tears Natural Free None Duasorb Bion Tears None Duasorb Eyestil unidose None Sodium Hyaluronate Tears Plus None PVA + PEG Gels with Temporary Preservative: Product Preservative Lubricant Refresh Liquigel Purite CMC 1% GenTeal Gel Sodium perborate HPMC 0.3% Gels with Chemical Preservative: Product Preservative Lubricant Tear Gel Cetremide Carbomer 980 Liposic Cetremide Carbomer 980 Preservative-Free Gels: Product Preservative Lubricant Celluvisc None CMC 1% Preservative-Free Emulsion: Product Preservative Lubricant Refresh Endura None Castor Oil + Polysorbate 80 + Glycerin + Carbomer 1342 Preservative-Free Ointments: Product Preservative Lubricants Hypotears Ointment None White petrolatum + mineral oil Duolube None White petrolatum + mineral oil Lacrilube None White petrolatum + mineral oil Tears Natural PM None White petrolatum + mineral oil + Lanolin
F- 22 Ocular Decongestants Product Decongestant Antihistamine Other Preservative Albalon PVA + EDTA Albalon-A antazoline PVA + EDTA phosphate B&L Allergy PEG 0.012% Cromolyn Eye Clear Eyes 0.012% Naphcon-A 0.025% Naphcon Forte Opcon-A 0.025% Opticrom Vasocon Vasocon-A Visine Allergy Eye Visine Cool eye Visine Original Eye Visine Workplace Eye 0.05% 0.05% tetrahydrozoline 0.05% tetrahydrozoline 0.05% tetrahydrozoline 0.025% oxymetazoline 0.3% pheniramine maleate 0.3% pheniramine maleate antazoline phosphate 2% sodium cromoglycate HPMC 2% sodium cromoglycate 0.25% zinc sulfate 1% polyethylene glycol