Adult Advanced Life Support Algorithm
Medical emergencies in the community
Drug treatment outlined below is intended for use by
appropriately qualified healthcare professionals . Only
drugs that are used for immediate relief are shown; advice on
supporting care is not given. Where the patient’s condition
requires investigation and further treatment, the patient
should be transferred to hospital promptly.
Aspirin dispersible tablets p. 121 (75 mg, 300 mg)
BY MOUTH (DISPERSED IN WATER OR CHEWED)
▶ EITHER Glyceryl trinitrate aerosol spray p. 218
▶ Adult: 1–2 sprays, repeated as required
▶ OR Glyceryl trinitrate tablets (300 micrograms,
500 micrograms, 600 micrograms)
▶ Adult: 0.3–1 mg, repeated as required
▶ MYOCARDIAL INFARCTION: NON-ST-SEGMENT ELEVATION
▶ MYOCARDIAL INFARCTION: ST-SEGMENT ELEVATION
Aspirin dispersible tablets (75 mg, 300 mg)
BY MOUTH (DISPERSED IN WATER OR CHEWED)
Glyceryl trinitrate aerosol spray (400 micrograms/metered
▶ Adult: 1–2 sprays, repeated as required
▶ OR Glyceryl trinitrate tablets (300 micrograms,
500 micrograms, 600 micrograms)
▶ Adult: 0.3–1 mg, repeated as required
Metoclopramide hydrochloride injection p. 432 (5 mg/mL)
▶ Adult 18–19 years (body-weight up to 60 kg): 5 mg
▶ Adult 18–19 years (body-weight 60 kg and over): 10 mg
Diamorphine hydrochloride injection p. 456 (5 mg powder for
BY SLOW INTRAVENOUS INJECTION (1–2 MG/MINUTE)
▶ Adult: 5 mg followed by a further 2.5–5 mg if necessary
▶ Elderly or frail patients, reduce dose by half
▶ OR Morphine sulfate injection p. 463 (10 mg/mL)
BY SLOW INTRAVENOUS INJECTION (1–2 MG/MINUTE)
▶ Adult: 5–10 mg followed by a further 5–10 mg if
▶ Elderly or frail patients: reduce dose by half
Regard each emergency consultation as being for severe
acute asthma until shown otherwise; failure to respond
adequately at any time requires immediate transfer to
▶ EITHER Salbutamol aerosol inhaler p. 252
(100 micrograms/metered inhalation)
BY AEROSOL INHALATION VIA LARGE-VOLUME SPACER
(AND A CLOSE-FITTING FACE MASK IF CHILD UNDER 3 YEARS)
▶ Adult and child: 2–10 puffs each inhaled separately,
repeated every 10–20 minutes or as necessary
▶ OR Salbutamol nebuliser solution (1 mg/mL, 2 mg/mL)
BY INHALATION OF NEBULISED SOLUTION (VIA OXYGEN-DRIVEN
▶ Child 4 years and below: 2.5 mg every 20–30 minutes
▶ Child 5–11 years: 2.5–5 mg every 20–30 minutes
▶ Child 12–17 years: 5 mg every 20–30 minutes
▶ Adult: 5 mg every 20–30 minutes or as necessary
▶ OR Terbutaline sulfate nebuliser solution p. 255 (2.5 mg/mL)
BY INHALATION OF NEBULISED SOLUTION (VIA OXYGEN-DRIVEN
▶ Child 4 years and below: 5 mg every 20–30 minutes or as
▶ Child 5–11 years: 5–10 mg every 20–30 minutes or as
▶ Child 12–17 years: 10 mg every 20–30 minutes or as
▶ Adult: 10 mg every 20–30 minutes or as necessary
▶ EITHER Prednisolone tablets p. 678 (or prednisolone soluble
▶ Child 11 years and below: 1–2 mg/kg (max. 40 mg) once
daily for up to 3 days or longer if necessary; if child has
been taking an oral corticosteroid for more than a few
days, give prednisolone 2 mg/kg (max. 60 mg) once
▶ Child 12–17 years: 40–50 mg once daily for at least 5 days
▶ Adult: 40–50 mg once daily for at least 5 days
▶ OR Hydrocortisone p. 676 (preferably as sodium succinate)
▶ Child 17 years and below: 4 mg/kg (max. 100 mg) every
6 hours until conversion to oral prednisolone is
possible; alternative dose if weight unavailable:
▶ Child 1 year and below: 25 mg
▶ Adult: 100 mg every 6 hours until conversion to oral
High-flow oxygen should be given if available (via face mask
Monitor response 15 to 30 minutes after nebulisation; if any
signs of acute asthma persist, arrange hospital admission.
While awaiting ambulance, repeat nebulised beta2 agonist
Ipratropium bromide nebuliser solution p. 246
BY INHALATION OF NEBULISED SOLUTION (VIA OXYGEN-DRIVEN
▶ Child 11 years and below: 250 micrograms, repeated every
20–30 minutes for the first 2 hours, then every
▶ Child 12–17 years: 500 micrograms every 4–6 hours as
▶ Adult: 500 micrograms every 4–6 hours as necessary
Dexamethasone oral solution p. 675 (2 mg/5 mL)
▶ Child 1 month–2 years: 150 micrograms/kg as a single dose
Adrenaline/epinephrine injection p. 222 (1 mg/mL (1 in 1000))
▶ Child 5 years and below: 150 micrograms (0.15 mL),
repeated every 5 minutes if necessary
▶ Child 6–11 years: 300 micrograms (0.3 mL), repeated every
▶ Child 12–17 years: 500 micrograms (0.5 mL), repeated
every 5 minutes if necessary; 300 micrograms (0.3 mL)
should be given if child is small or prepubertal
▶ Adult: 500 micrograms (0.5 mL), repeated every
High-flow oxygen and intravenous fluids should be given
Chlorphenamine maleate injection p. 283
BY INTRAMUSCULAR OR INTRAVENOUS INJECTION
May help counter histamine-mediated vasodilation and
Hydrocortisone (preferably as sodium succinate)
Has delayed action but should be given to severely affected
patients to prevent further deterioration.
Benzylpenicillin sodium injection p. 547 (600 mg, 1.2 g)
BY INTRAVENOUS INJECTION (OR BY INTRAMUSCULAR INJECTION IF
▶ Child 1 month–11 months: 300 mg
NOTE A single dose should be given before urgent transfer to
hospital, so long as this does not delay the transfer.
▶ OR if history of allergy to penicillin
Cefotaxime injection p. 527 (1 g)
BY INTRAVENOUS INJECTION (OR BY INTRAMUSCULAR INJECTION IF
▶ Child 1 month–11 years: 50 mg/kg (max. 1 g)
NOTE A single dose can be given before urgent transfer to
hospital, so long as this does not delay the transfer.
▶ OR if history of immediate hypersensitivity reaction
(including anaphylaxis, angioedema, urticaria, or rash
immediately after administration) to penicillin or to
Chloramphenicol injection p. 568 (1 g)
NOTE A single dose can be given before urgent transfer to
hospital, so long as this does not delay the transfer.
See also Central nervous system infections, antibacterial
▶ Adult and child over 2 years: approx. 10–20 g (110–220 mL
Lucozade ® Energy Original or 100–200 mL
Coca-Cola ®—both non-diet versions or
2–4 teaspoonfuls of sugar or 3–6 sugar lumps)
repeated after 10–15 minutes if necessary
▶ OR if hypoglycaemia unresponsive or if oral route
Glucagon injection p. 724 (1 mg/mL)
BY SUBCUTANEOUS OR INTRAMUSCULAR INJECTION
▶ Child body-weight up to 25 kg: 500 micrograms (0.5 mL)
▶ Child body-weight 25 kg and over: 1 mg (1 mL)
▶ OR if hypoglycaemia prolonged or unresponsive to glucagon
Glucose intravenous infusion p. 1041 (10%)
BY INTRAVENOUS INJECTION INTO LARGE VEIN
▶ Child: 5 mL/kg (glucose 500 mg/kg)
Glucose intravenous infusion (20%)
BY INTRAVENOUS INJECTION INTO LARGE VEIN
▶ CONVULSIVE (INCLUDING FEBRILE) SEIZURES LASTING
▶ EITHER Diazepam rectal solution p. 343 (2 mg/mL, 4 mg/mL)
▶ Neonate: 1.25–2.5 mg, repeated once after
▶ Child 1 month–1 year: 5 mg, repeated once after
▶ Child 2–11 years: 5–10 mg, repeated once after
▶ Child 12–17 years: 10–20 mg, repeated once after
▶ Adult: 10–20 mg, repeated once after 10–15 minutes if
▶ Elderly: 10 mg, repeated once after 10–15 minutes if
▶ OR Midazolam oromucosal solution p. 340
BY BUCCAL ADMINISTRATION, REPEATED ONCE AFTER 10 MINUTES IF
▶ Neonate: 300 micrograms/kg [unlicensed]
▶ Child 1–2 months: 300 micrograms/kg (max. 2.5 mg)
▶ Child 3 months–11 months: 2.5 mg
Approximate Conversions and Units
Conversion of pounds to kilograms
Conversion of stones to kilograms
1 metre (m) = 1000 millimetres (mm)
1 kilogram (kg) = 1000 grams (g)
1 gram (g) = 1000 milligrams (mg)
1 milligram (mg) = 1000 micrograms
1 litre = 1000 millilitres (mL)
1 millilitre (1 mL) = 1000 microlitres
1 kilocalorie (kcal) = 4186.8 joules (J)
1000 kilocalories (kcal) = 4.1868 megajoules (MJ)
1 megajoule (MJ) = 238.8 kilocalories (kcal)
1 millimetre of mercury (mmHg) = 133.3 pascals (Pa)
1 kilopascal (kPa) = 7.5 mmHg (pressure)
Plasma-drug concentrations in BNF publications are
expressed in mass units per litre (e.g. mg/litre). The
approximate equivalent in terms of amount of substance
units (e.g. micromol/litre) is given in brackets.
The table below shows the mean values for weight, height,
and gender by age; these values have been derived from the
UK-WHO growth charts 2009 and UK1990 standard centile
charts, by extrapolating the 50th centile, and may be used to
calculate doses in the absence of measurements. However,
an individual’s weight and height might vary considerably
from the values in the table and it is important to ensure that
the value chosen is appropriate. In most cases the actual
measurement should be obtained as soon as possible and the
Recommended wording of cautionary and advisory labels
For details including Welsh Language translation see p. 1588
1 Warning: This medicine may make you sleepy
2 Warning: This medicine may make you sleepy. If this
happens, do not drive or use tools or machines. Do not
3 Warning: This medicine may make you sleepy. If this
happens, do not drive or use tools or machines
4 Warning: Do not drink alcohol
5 Do not take indigestion remedies 2 hours before or after
6 Do not take indigestion remedies, or medicines containing
iron or zinc, 2 hours before or after you take this medicine
7 Do not take milk, indigestion remedies, or medicines
containing iron or zinc, 2 hours before or after you take
8 Warning: Do not stop taking this medicine unless your
9 Space the doses evenly throughout the day. Keep taking
this medicine until the course is finished, unless you are
10 Warning: Read the additional information given with this
11 Protect your skin from sunlight—even on a bright but
cloudy day. Do not use sunbeds
12 Do not take anything containing aspirin while taking this
13 Dissolve or mix with water before taking
14 This medicine may colour your urine. This is harmless
15 Caution: flammable. Keep your body away from fire or
flames after you have put on the medicine
16 Dissolve the tablet under your tongue—do not swallow.
Store the tablets in this bottle with the cap tightly closed.
Get a new supply 8 weeks after opening
17 Do not take more than... in 24 hours
18 Do not take more than... in 24 hours. Also, do not take
19 Warning: This medicine makes you sleepy. If you still feel
sleepy the next day, do not drive or use tools or machines.
21 Take with or just after food, or a meal
22 Take 30 to 60 minutes before food
23 Take this medicine when your stomach is empty. This
means an hour before food or 2 hours after food
25 Swallow this medicine whole. Do not chew or crush
26 Dissolve this medicine under your tongue
27 Take with a full glass of water
28 Spread thinly on the affected skin only
29 Do not take more than 2 at any one time. Do not take
30 Contains paracetamol. Do not take anything else
containing paracetamol while taking this medicine. Talk to
a doctor at once if you take too much of this medicine,
32 Contains aspirin. Do not take anything else containing
aspirin while taking this medicine
Internationally recognised units and symbols are used in the
BNF publications where possible.
ACBS Advisory Committee on Borderline Substances, see
ACE Angiotensin-converting enzyme
ADHD Attention deficit hyperactivity disorder
AIDS Acquired immunodeficiency syndrome
AWMSG All Wales Medicines Strategy Group
BP British Pharmacopoeia 2013, unless otherwise stated
BPC British Pharmaceutical Codex 1973 and Supplement 1976,
CAPD Continuous ambulatory peritoneal dialysis
a preparation in Schedule 1 of the Misuse of Drugs
Regulations 2001 (and subsequent amendments). For
regulations see Controlled drugs and drug dependence p. 8.
b preparation in Schedule 2 of the Misuse of Drugs
Regulations 2001 (and subsequent amendments). For
regulations see Controlled drugs and drug dependence p. 8.
c preparation in Schedule 3 of the Misuse of Drugs
Regulations 2001 (and subsequent amendments). For
regulations see Controlled drugs and drug dependence p. 8.
preparation in Schedule 4 (Part I) of the Misuse of Drugs
Regulations 2001 (and subsequent amendments). For
regulations see Controlled drugs and drug dependence p. 8.
preparation in Schedule 4 (Part II) of the Misuse of Drugs
Regulations 2001 (and subsequent amendments). For
regulations see Controlled drugs and drug dependence p. 8.
m preparation in Schedule 5 of the Misuse of Drugs
Regulations 2001 (and subsequent amendments). For
regulations see Controlled drugs and drug dependence p. 8.
CHM Commission on Human Medicines
CHMP Committee for Medicinal Products for Human Use
CSM Committee on Safety of Medicines (now subsumed under
Commission on Human Medicines)
DMARD Disease-modifying antirheumatic drug
DPF Dental Practitioners’ Formulary
e/c enteric-coated (termed gastro-resistant in BP)
eGFR estimated glomerular filtration rate, see Prescribing in
FSRH Faculty of Sexual and Reproductive Healthcare
G6PD glucose 6-phosphate dehydrogenase
high-density lipoprotein cholesterol
HIV Human immunodeficiency virus
HRT Hormone replacement therapy
INR international normalised ratio
JCVI Joint Committee on Vaccination and Immunisation
low-density lipoprotein cholesterol
MAOI Monoamine-oxidase inhibitor
MHRA Medicines and Healthcare products Regulatory Agency
NCL no cautionary labels (prescription endorsement made by
prescriber when recommended cautionary labels are not
NICE National Institute for Health and Care Excellence
NPF Nurse Prescribers’ Formulary
NSAID Non-steroidal anti-inflammatory drug
NSTEMI non-ST-segment elevation myocardial infarction
PARP poly (ADP-ribose) polymerase
PHE Public Health England (formerly Health Protection Agency
P prescription-only medicine, see Fig. 1 How to use BNF
rINN Recommended International Non-proprietary Name
RSV respiratory syncytial virus
SMC Scottish Medicines Consortium
SPC Summary of Product Characteristics
SSRI Selective serotonin reuptake inhibitor
STEMI ST-segment elevation myocardial infarction
Units for SI units see Prescription writing p. 5
A limited experience of the use of this product and the MHRA
requests that all suspected adverse reactions should be
reported, see Adverse reactions to drugs p. 12
f drug-class monograph, see How to use BNF Publications,
eiiF 1234i drug monograph has a corresponding drug-class
monograph; the page number of the class monograph is
indicated within the tab, see How to use BNF Publications,
precedes evidence graded content, see How BNF
Publications are constructed p. ix
h to l symbols will be displayed – grades reflect the strengths of
recommendations in evidence graded content, see How
BNF Publications are constructed p. ix
Directions should be in English without abbreviation.
However, Latin abbreviations have been used when
The following is a list of appropriate abbreviations. It
should be noted that the English version is not always an
a. c. = ante cibum (before food)
o. m. = omni mane (every morning)
o. n. = omni nocte (every night)
p. c. = post cibum (after food)
p. r. n. = pro re nata (when required)
q. d. s. = quater die sumendum (to be taken four times daily)
q. q. h. = quarta quaque hora (every four hours)
t. d. s. = ter die sumendum (to be taken three times daily)
t.i.d. = ter in die (three times daily)
The following is a list of common E numbers and the inactive
ingredients to which they correspond.
E172 Iron oxides, iron hydroxides
E901 Beeswax (white and yellow)
significant ocular viral infections . inflammatory ocular
conditions (no experience of use). narrow-angle glaucoma
(no experience of use). neovascular glaucoma (no
posterior lens capsule or anterior chamber lenses .risk
factors for cystoid macular oedema .risk factors for iritis . risk factors for uveitis
▶ Common or very common Dry eye . eye discolouration . eye
▶ Uncommon Asthenia . dizziness . madarosis . nausea . retinal haemorrhage
▶ Frequency not known Asthma . bradycardia . dyspnoea . hypotension .reactivation of infection
l PREGNANCY Manufacturer advises use only if potential
l BREAST FEEDING Manufacturer advises avoid—present in
l HEPATIC IMPAIRMENT Manufacturer advises use with
caution in moderate-to-severe impairment—no
l RENAL IMPAIRMENT Use with caution—no information
l PRESCRIBING AND DISPENSING INFORMATION Although
multi-dose bimatoprost eye drops commonly contain
preservatives, preservative-free unit dose vials may be
Changes to eye colour Before initiating treatment, patients
should be warned of a possible change in eye colour as an
increase in the brown pigment in the iris can occur, which
may be permanent; particular care is required in those
with mixed coloured irides and those receiving treatment
to one eye only. Changes in eyelashes and vellus hair can
also occur, and patients should also be advised to avoid
repeated contact of the eye drop solution with skin as this
can lead to hair growth or skin pigmentation.
l NATIONAL FUNDING/ACCESS DECISIONS
Scottish Medicines Consortium (SMC) decisions
The Scottish Medicines Consortium has advised (March
accepted for restricted use within NHS Scotland for the
reduction of elevated intra-ocular pressure in chronic
open-angle glaucoma and ocular hypertension (as
monotherapy or as adjunctive therapy to beta-blockers) in
adults who have proven sensitivity to benzalkonium
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Benzalkonium chloride
▶ Bimatoprost (Non-proprietary)
Bimatoprost 300 microgram per 1 ml Bimatoprost
300micrograms/ml eye drops | 3 ml P £10.30 DT = £10.30
Bimatoprost 300 microgram per 1 ml Eyreida 0.3mg/ml eye drops
Bimatoprost 100 microgram per 1 ml Lumigan 100micrograms/ml
eye drops | 3 ml P £11.71 DT = £11.71 | 9 ml P £35.13
Bimatoprost 300 microgram per 1 ml Lumigan 300micrograms/ml
eye drops 0.4ml unit dose | 30 unit dose P £13.75 DT = £13.75
Bimatoprost 300 microgram per 1 ml Sturiban 0.3mg/ml eye drops
| 3 ml P £9.27 DT = £10.30 | 9 ml P £27.81
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, bimatoprost above, timolol maleate p. 1180.
Raised intra-ocular pressure in patients with open-angle
glaucoma or ocular hypertension when beta-blocker or
prostaglandin analogue alone not adequate
l INTERACTIONS → Appendix 1: beta blockers, non-selective
l NATIONAL FUNDING/ACCESS DECISIONS
Scottish Medicines Consortium (SMC) decisions
The Scottish Medicines Consortium has advised (October
2013) that Ganfort ® unit dose eye drops are accepted for
restricted use within NHS Scotland for the reduction of
intra-ocular pressure in patients with open-angle
glaucoma or ocular hypertension insufficiently responsive
to topical beta-blockers or prostaglandin analogues who
have proven sensitivity to preservatives.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Benzalkonium chloride
Bimatoprost 300 microgram per 1 ml, Timolol (as Timolol
Ganfort 0.3mg/ml / 5mg/ml eye drops 0.4ml unit dose | 30 unit
Raised intra-ocular pressure in open-angle glaucoma |
▶ Adult: Apply once daily, to be administered preferably
MHRA/CHM ADVICE: LATANOPROST (XALATAN ®): INCREASED
REPORTING OF EYE IRRITATION SINCE REFORMULATION (JULY
1184 Glaucoma and ocular hypertension BNF 78
increase in the number of reports of eye irritation from
across the EU. Patients should be advised to tell their
health professional promptly (within a week) if they
experience eye irritation (e.g. excessive watering) severe
enough to make them consider stopping treatment.
Review treatment and prescribe a different formulation
(no experience of use). contact lens wearers . do not use
ocular conditions (no experience of use). narrow-angle
glaucoma (no experience of use). neovascular glaucoma
(no experience of use). peri-operative period of cataract
surgery . pseudophakia with torn posterior lens capsule or
anterior chamber lenses .risk factors for cystoid macular
oedema .risk factors for iritis .risk factors for uveitis
▶ Common or very common Eye discolouration . eye
discomfort. eye disorders . eye inflammation . vision
▶ Rare or very rare Asthma . chest pain . dyspnoea . unstable
l PREGNANCY Manufacturer advises avoid.
l BREAST FEEDING May be present in milk—manufacturer
l PRESCRIBING AND DISPENSING INFORMATION Although
multi-dose latanoprost eye drops commonly contain
preservatives, preservative-free unit dose vials may be
Changes in eye colour Before initiating treatment, patients
should be warned of a possible change in eye colour as an
increase in the brown pigment in the iris can occur, which
may be permanent; particular care is required in those
with mixed coloured irides and those receiving treatment
to one eye only. Changes in eyelashes and vellus hair can
also occur, and patients should also be advised to avoid
repeated contact of the eye drop solution with skin as this
can lead to hair growth or skin pigmentation.
l NATIONAL FUNDING/ACCESS DECISIONS
Scottish Medicines Consortium (SMC) decisions
The Scottish Medicines Consortium has advised (June 2013)
that Monopost ® is accepted for restricted use within NHS
Scotland for the reduction of elevated intra-ocular
pressure in patients with open-angle glaucoma and ocular
hypertension who have proven sensitivity to
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Benzalkonium chloride
▶ Latanoprost (Non-proprietary)
Latanoprost 50 microgram per 1 ml Latanoprost 50micrograms/ml
eye drops | 2.5 ml P £12.48 DT = £7.92
▶ Medizol (Medicom Healthcare Ltd)
Latanoprost 50 microgram per 1 ml Medizol 0.005% eye drops | 2.5 ml P s DT = £7.92
▶ Monopost (Thea Pharmaceuticals Ltd)
Latanoprost 50 microgram per 1 ml Monopost 50micrograms/ml
eye drops 0.2ml unit dose | 30 unit dose P £8.49 DT = £8.49 | 90 unit dose P £25.47 DT = £25.47
Latanoprost 50 microgram per 1 ml Xalatan 50micrograms/ml eye
drops | 2.5 ml P £12.48 DT = £7.92
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, latanoprost p. 1184, timolol maleate
Raised intra-ocular pressure in patients with open-angle
glaucoma and ocular hypertension when beta-blocker or
prostaglandin analogue alone not adequate
l INTERACTIONS → Appendix 1: beta blockers, non-selective
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Benzalkonium chloride
▶ Latanoprost with timolol (Non-proprietary)
Latanoprost 50 microgram per 1 ml, Timolol (as Timolol maleate)
5 mg per 1 ml Latanoprost 50micrograms/ml / Timolol 5mg/ml eye
drops | 2.5 ml P £14.32 DT = £6.57
▶ Fixapost (Thea Pharmaceuticals Ltd)
Latanoprost 50 microgram per 1 ml, Timolol (as Timolol maleate)
5 mg per 1 ml Fixapost 50micrograms/ml / 5mg/ml eye drops 0.2ml
unit dose | 30 unit dose P £13.49
▶ Medox (Medicom Healthcare Ltd)
Latanoprost 50 microgram per 1 ml, Timolol (as Timolol maleate)
5 mg per 1 ml Medox 50micrograms/ml / 5mg/ml eye drops | 2.5 ml P s DT = £6.57
Latanoprost 50 microgram per 1 ml, Timolol (as Timolol maleate)
5 mg per 1 ml Xalacom eye drops | 2.5 ml P £14.32 DT = £6.57
Raised intra-ocular pressure in open-angle glaucoma |
▶ Adult: Apply once daily, to be administered preferably
(no experience of use). contact lens wearers . history of
significant ocular viral infections . inflammatory ocular
conditions (no experience of use). narrow-angle glaucoma
(no experience of use). neovascular glaucoma (no
experience of use). pseudophakia with torn posterior lens
capsule or anterior chamber lenses .risk factors for cystoid
macular oedema .risk factors for iritis .risk factors for
▶ Common or very common Dry eye . eye discolouration . eye
discomfort. eye disorders . eye inflammation . headache . vision disorders
▶ Frequency not known Asthma exacerbated . dyspnoea
l PREGNANCY Manufacturer advises avoid unless potential
benefit outweighs risk—toxicity in animal studies.
BNF 78 Glaucoma and ocular hypertension 1185
l BREAST FEEDING Manufacturer advises avoid—present in
l HEPATIC IMPAIRMENT Manufacturer advises caution (no
l RENAL IMPAIRMENT Use with caution—no information
l PRESCRIBING AND DISPENSING INFORMATION Although
multi-dose tafluprost eye drops commonly contain
preservatives, preservative-free unit dose vials may be
Changes to eye colour Before initiating treatment, patients
should be warned of a possible change in eye colour as an
increase in the brown pigment in the iris can occur, which
may be permanent; particular care is required in those
with mixed coloured irides and those receiving treatment
to one eye only. Changes in eyelashes and vellus hair can
also occur, and patients should also be advised to avoid
repeated contact of the eye drop solution with skin as this
can lead to hair growth or skin pigmentation.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Disodium edetate
Tafluprost 15 microgram per 1 ml Saflutan 15micrograms/ml eye
drops 0.3ml unit dose | 30 unit dose P £12.20 DT = £12.20
Tafluprost with timolol 30-Mar-2016
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, tafluprost p. 1185, timolol maleate p. 1180.
Raised intra-ocular pressure in open-angle glaucoma and
ocular hypertension when beta-blocker or prostaglandin
▶ Adult: Apply 1 drop once daily
l INTERACTIONS → Appendix 1: beta blockers, non-selective
Driving and skilled tasks Blurred vision may affect
performance of skilled tasks (e.g. driving or operating
l NATIONAL FUNDING/ACCESS DECISIONS
Scottish Medicines Consortium (SMC) decisions
The Scottish Medicines Consortium has advised (September
2015) that Taptiqom® (tafluprost with timolol) is accepted
for restricted use within NHS Scotland, within the licensed
indications, in patients who have proven sensitivity to
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Disodium edetate
Tafluprost 15 microgram per 1 ml, Timolol (as Timolol maleate)
5 mg per 1 ml Taptiqom 15micrograms/ml / 5mg/ml eye drops 0.3ml
unit dose | 30 unit dose P £14.50 DT = £14.50
Raised intra-ocular pressure in open-angle glaucoma |
▶ Adult: Apply once daily, to be administered preferably
▶ Common or very common Dry eye . eye discolouration . eye
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