Eye

KP Wellness

11:43 AM (edited)  -  Public

12. Ophthalmology

12.1 Beta-Blockers
TIER 1
+ Betaxolol HCl (Betoptic)
+ Carteolol HCl (Ocupress)
+ Levobunolol HCl (Betagan)
+ Metipranolol (OptiPranolol)
+ Timolol Maleate (Timoptic-XE)
+ Timolol Maleate Drops (Timoptic)
TIER 2
Betimol (Timolol Drops)
TIER 3
Betaxolol Hydrochloride Ophthalmic Suspension (Betoptic S)
Timolol Maleate Ophthalmic Solution (Istalol)

 12.2  Cholinesterase Inhibitor Miotics
TIER 2
Phospholine Iodide (Echothiophate Iodide)

12.3  Direct Acting Miotics
TIER 1
+ Pilocarpine HCl (Isopto Carpine 0 .5%, 1%,  2%, 4%, 6%)
TIER 2
Pilopine HS (Pilocarpine HCl Gel)

12.4  Other Glaucoma Drugs
TIER 1
+ Dorzolamide HCl (Trusopt)
+ Latanoprost (Xalatan)
TIER 2
Azopt (Brinzolamide)
Combigan (Brimonidine Tartrate/Timolol)
+ Dorzolamide HCl/Timolol Maleate (Cosopt)**
Lumigan (Bimatoprost)
Travatan Z (Travoprost)

12.5  Oral Drugs For Glaucoma
TIER 1
+ Acetazolamide (Diamox)
+ Acetazolamide Capsule, Sustained-Action (Diamox Sequel)
+ Methazolamide (Neptazane)

12.6  Cycloplegic Mydriatics
TIER 1
+ Atropine Sulfate (Isopto Atropine)
+ Cyclopentolate HCl (Cyclogyl 1%)
+ Homatropine HBr (Homatropine HBr 5%)
+ Tropicamide (Mydriacyl)
TIER 2
Isopto Homatropine (Homatropine HBr)
TIER 3
Cyclopentolate hydrochloride (Cyclogyl 0 .5, 2%)
Hydroxyamphetamine Hydrobromide, Tropicamide (Paremyd)

12.7  Non-Steroidal Anti-Inflammatory  Agents
TIER 1
+ Diclofenac Sodium (Voltaren)
+ Flurbiprofen Sodium (Ocufen)
+ Ketorolac Tromethamine (Acular)
+ Ketorolac Tromethamine (Acular LS)
TIER 3
Ketorolac Tromethamine Ophthalmic Solution (Acuvail)
+ Bromfenac Sodium (Xibrom)*
Nepafenac Ophthalmic Suspension (Nevanac)

12.8  Vasoconstrictor Decongestants
TIER 1
+ Naphazoline HCl (Albalon)
+ Phenylephrine HCl (Neo-Synephrine) 

KP Wellness

12:03 PM (edited)  -  Public

Ophthalmology

12.9 Antibiotics
TIER 1
+ Bacitracin/Polymyxin B Sulfate (Polysporin)
+ Ciprofloxacin HCl Drops (Ciloxan)
+ Erythromycin Base (Ilotycin)
+ Gentamicin Sulfate (Garamycin)
+ Levofloxacin (Quixin)
+ Neomycin Sulfate/Bacitracin/Polymyxin B  Ointment (Neosporin)
+ Neomycin Sulfate/Gramicidin D/Polymyxin B  Drops (Neosporin)
+ Ofloxacin (Ocuflox)
+ Polymyxin B Sulfate/Trimethoprim (Polytrim)
+ Tobramycin Sulfate Drops (Tobrex)
TIER 3
Azithromycin Ophthalmic Solution (Azasite)
Ciprofloxacin HCL (Ciloxan Ointment)
Levofloxacin ophthalmic solution) 1.5% (Iquix)
Natamycin (Natacyn)
Tobramycin Ophthalmic Ointment (Tobrex Ointment)
Moxifloxacin (Vigamox)
Gatifloxacin Ophthalmic Solution (Zymaxid)

12.10 Sulfonamides
TIER 1
+ Sulfacetamide Sodium (Bleph-10, Sodium Sulamyd) 

KP Wellness

12:10 PM (edited)  -  Public

Ophthalmology

12.11 Steroids
TIER 1
+ Dexamethasone Sodium Phosphate (Decadron)
+ Fluorometholone (FML)
+ Prednisolone Acetate (Pred Forte)
+ Prednisolone Sodium Phosphate (Inflamase Forte)
TIER 2
FML Forte (Fluorometholone)
Pred Mild (Prednisolone Acetate)
Vexol (Rimexolone)
TIER 3
(Loteprednol Etabonate Ophthalmic Suspension (Alrex)
Loteprednol Etabonate Ophthalmic Suspension (Lotemax)

12.12 Steroid-Antibiotic Combinations
TIER 1
+ Neomycin Sulfate/Bacitracin Zinc/Polymyxin B/
Hydrocortisone Ointment (Cortisporin)
+ Neomycin Sulfate/Dexamethasone Sodium  Phosphate
(NeoDecadron)
+ Neomycin Sulfate/Polymyxin B Sulfate/
Hydrocortisone Suspension, Drops (Cortisporin)
+ Neomycin/Polymyxin B Sulfate/Dexamethasone (Maxitrol)
TIER 2
+ Tobramycin/Dexamethasone Suspension (Tobradex)**
TIER 3
Neomycin, Polymyxin B, Prednisolone (Poly-Pred)
Gentamicin and Prednisolone Acetate (Pred-G)
Tobramycin and Dexamethasone (Tobradex ST)
Loteprednol Etabonate and Tobramycin (Zylet)

12.13 Steroid-Sulfonamide Combinations
TIER 1
+ Sulfacetamide Sodium/Prednisolone Sodium Phosphate
(Vasocidin)
TIER 2
Blephamide S .O .P .
(Sulfacetamide Sodium/ Prednisolone Acetate Ointment)
TIER 3
Sulfacetamide/prednisolone  (Blephamide Suspension, Drops)

12.14 Sympathomimetics
TIER 1
+ Apraclonidine HCl Drops (Iopidine 0 .5%)
+ Brimonidine Tartrate 0.15% (Alphagan P)
+ Dipivefrin HCl (Propine)
TIER 2
Alphagan P (Brimonidine Tartrate 0.1%) SL
TIER 3
Apraclonidine (Iopidine 1%) 

KP Wellness

12:15 PM (edited)  -  Public

12.15 Miscellaneous Ophthalmologics
TIER 1
+ Cromolyn Sodium (Crolom)
TIER 2
Lacrisert (Hydroxypropyl Methylcellulose)
Optivar^^ (Azelastine HCl)
TIER 3
Pemirolast Potassium Ophthalmic Solution (Alamast)
Nedocromil (Alocril)
Lodoxamide Tromethamine (Alomide)
+ Azelastine HCl Drops (Optivar)***
Bepotastine besilate ophthalmic solution (Bepreve)
Emedastine Difumarate Ophthalmic Solution (Emadine)
+ Epinastine HCl Drops (Elestat)***
Alcaftadine Ophthalmic Solution (Lastacaft)
Cromolyn Sodium Ophthalmic Solution (Opticrom)
Olopatadine Hydrochloride Ophthalmic Solution 0.2% (Pataday)
Olopatadine Hydrochloride Solution 0.1% (Patanol)
Cyclosporine ophthalmic emulsio) 0.05% (Restasis)

12.16 Antivirals
TIER 1
+ Trifluridine (Viroptic)
TIER 3
Ganciclovir Ophthalmic Gel (Zirgan)