Antibiotic Agents2 |
Amikacin 2.5% (fortified) solution | Compounding pharmacy | | |
Azithromycin (AzaSite) | $247.45/2.5 mL | 1 drop two times daily for 2 days, then once daily for 5 days | Bacterial conjunctivitis |
Bacitracin 500 units/g ointment (various)3 | $118.44/3.5 g | Apply small amount (0.5 inch) into lower conjunctival sac or to eyelids three to four times daily for 7–10 days | Bacterial conjunctivitis, blepharitis, sty |
Bacitracin/Polymyxin ointment (Polysporin, AK-Poly) | $25.70/3.5 g | Apply small amount (0.5 inch) into lower conjunctival sac and then three to four times daily, then as required | Corneal abrasion Following corneal foreign body removal |
Besifloxacin ophthalmic suspension, 0.6% (Besivance) | $215.42/5 mL | 1–2 drops every 2 hours while awake for 2 days, then every 4 hours for 5 days 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Bacterial conjunctivitis Bacterial keratitis |
Cefazolin 5–10% (fortified) solution | Compounding pharmacy | | |
Ceftazidime 5% (fortified) solution | Compounding pharmacy | | |
Cefuroxime 5% (fortified) solution | Compounding pharmacy | | |
Chloramphenicol 1% ointment4 | Compounding pharmacy | | |
Chloramphenicol 0.5% solution4 | Compounding pharmacy | | |
Ciprofloxacin HCl 0.3% solution (Ciloxan) | $10.20/5 mL | 1–2 drops every 2 hours while awake for 2 days, then every 4 hours for 5 days 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Bacterial conjunctivitis Bacterial keratitis |
Ciprofloxacin HCl 0.3% ointment | $257.23/3.5 g | Apply small amount (0.5 inch) into lower conjunctival sac three times daily for 2 days, then two times daily for 5 days | Bacterial conjunctivitis |
Erythromycin 0.5% ointment (various)5 | $17.96/3.5 g | 1-cm ribbon up to six times daily (depending on severity of infection) | Bacterial infection of the eye |
Fusidic acid 1% gel (Fucithalmic) | Not available in United States | 1 drop two times daily | Bacterial conjunctivitis, blepharitis, sty, keratitis |
Gatifloxacin 0.5% solution (Zymaxid) | $118.16/2.5 mL | 1 drop every 2 hours while awake, up to eight times on day 1, then two to four times daily while awake, days 2–7 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Bacterial conjunctivitis Bacterial keratitis |
Gentamicin sulfate 0.3% solution (various) | $19.18/5 mL | 1–2 drops every 4 hours up to 2 drops every hour for severe infections | Ocular surface infection |
Gentamicin sulfate 0.3% ointment (various) | $35.44/3.5 g | Apply small amount (0.5 inch) into lower conjunctival sac two to three times daily | Ocular surface infection |
Gentamicin sulfate 1.5% (fortified preparation) | Compounding pharmacy | 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Bacterial keratitis |
Levofloxacin 0.5% solution (various) | $74.76/5 mL | 1–2 drops every 2 hours while awake for 2 days (maximum eight times per day), then every 4 hours for 5 days (maximum four times per day) 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Bacterial conjunctivitis Bacterial keratitis |
Moxifloxacin 0.5% solution (Vigamox) | $167.35/3 mL | 1 drop three times daily for 7 days 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Bacterial conjunctivitis Bacterial keratitis |
Neomycin/Polymyxin B/Gramicidin (Neosporin) | $61.26/10 mL | 1–2 drops every 4 hours for 7–10 days or more frequently, as required | Ocular surface infection |
Norfloxacin 0.3% solution | Not available in United States | 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Ocular surface infection Bacterial keratitis |
Ofloxacin 0.3% solution (Ocuflox) | $20.94/5 mL | 1–2 drops every 2–4 hours for 2 days, then four times daily for 5 days 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Bacterial conjunctivitis Bacterial keratitis |
Polymyxin B 10,000 U/mL/Trimethoprim sulfate 1 mg/mL (Polytrim)6 | $12.87/10 mL | 1 drop every 3 hours for 7–10 days (maximum of 6 doses per day) | Ocular surface infection |
Propamidine isethionate 0.1% solution | Not available in the United States | 1–2 drops every 2–4 hours for 2 days, then four times daily for 5 days | Ocular surface infection (including Acanthamoeba keratitis) |
Propamidine isethionate 0.1% ointment | Not available in the United States | Apply small amount (0.5 inch) into lower conjunctival sac up to four times daily | |
Sulfacetamide sodium 10% solution (various) | $55.65/15 mL | 1 or 2 drops every 2–3 hours initially; taper by increasing time intervals as condition responds; usual duration 7–10 days | Bacterial infection of the eye |
Sulfacetamide sodium 10% ointment (various) | $65.86/3.5 g | Apply small amount (0.5 inch) into lower conjunctival sac once every 3–4 hours and at bedtime; taper by increasing time intervals as condition responds; usual duration 7–10 days | Bacterial infections of the eye |
Tobramycin 0.3% solution (various) | $14.10/5 mL | 1–2 drops every 4 hours for a mild to moderate infection or hourly until improvement (then reduce prior to discontinuation) for a severe infection | |
Tobramycin 1.5% (fortified) solution | Compounding pharmacy | 1 drop every hour during the day and every 2 hours during the night for 48 hours, then gradually reducing | Bacterial keratitis |
Tobramycin 0.3% ointment (Tobrex) | $257.23/3.5 g | Apply small amount (0.5 inch) into lower conjunctival sac two to three times daily for a mild to moderate infection or every 3–4 hours until improvement (then reduce prior to discontinuation) for a severe infection | |
Antifungal Agents |
Amphotericin 0.1–0.5% solution | Compounding pharmacy | | |
Natamycin 5% suspension (Natacyn) | $395.00/15 mL | 1 drop every 1–2 hours initially | Fungal blepharitis, conjunctivitis, keratitis |
Voriconazole 1% solution | Compounding pharmacy | | |
Antiviral Agents |
Acyclovir 3% ointment (Zovirax) | Not available in United States | Five times daily | Herpes simplex virus keratitis |
Ganciclovir 0.15% gel (Zirgan) | $446.81/5 g | Five times daily | Herpetic keratitis |
Trifluridine 1% solution (Viroptic) | $178.28/7.5 mL | 1 drop onto cornea every 2 hours while awake for a maximum daily dose of 9 drops until resolution occurs; then an additional 7 days of 1 drop every 4 hours while awake (minimum five times daily) | Herpes simplex virus keratitis |
Anti-Inflammatory Agents |
Antihistamines7 |
Emedastine difumarate 0.05% solution (Emadine) | Not available in the United States | 1 drop four times daily | Allergic eye disease |
Levocabastine (Livostin) | Not available in United States | 1 drop twice daily | |
Mast cell stabilizers | |
Cromolyn sodium 4% solution (Crolom) | $37.25/10 mL | 1 drop four to six times daily | |
Lodoxamide tromethamine 0.1% solution (Alomide) | $205.28/10 mL | 1 or 2 drops four times daily (up to 3 months) | |
Nedocromil sodium 2% solution (Alocril) | $256.58/5 mL | 1 drop twice daily | |
Pemirolast potassium 0.1% solution (Alamast) | Not available in the United States | 1 drop four times daily | |
Combined antihistamines and mast cell stabilizers | |
Alcaftadine 0.25% ophthalmic solution (Lastacaft) | $270.47/3 mL | 1 drop once daily | |
Azelastine HCl 0.05% ophthalmic solution (Optivar) | $102.90/6 mL | 1 drop two to four times daily (up to 6 weeks) | |
Bepotastine besilate 1.5% solution (Bepreve) | $528.11/10 mL | 1 drop twice daily | |
Epinastine hydrochloride 0.05% ophthalmic solution (Elestat) | $106.95/5 mL | 1 drop twice daily (up to 8 weeks) | |
Ketotifen fumarate 0.025% solution (Zaditor) | OTC $7.79/5 mL | 1 drop two to four times daily | |
Olopatadine hydrochloride 0.1% solution (Patanol) | $13.80/5 mL | 1 drop twice daily | |
Nonsteroidal anti-inflammatory agents8 |
Bromfenac 0.09% solution (Xibrom) | $/1.7 mL | 1 drop to operated eye twice daily beginning 24 hours after cataract surgery and continuing through first 2 postoperative weeks | Treatment of postoperative inflammation following cataract extraction |
Diclofenac sodium 0.1% solution (Voltaren) | $17.50/5 mL | 1 drop to operated eye four times daily beginning 24 hours after surgery and continuing through first 2 postoperative weeks. | Treatment of postoperative inflammation following cataract extraction and laser corneal surgery |
Flurbiprofen sodium 0.03% solution (various) | $43.20/2.5 mL | 1 drop every half hour beginning 2 hours before surgery; 1 drop to operated eye four times daily beginning 24 hours after cataract surgery | Inhibition of intraoperative miosis; treatment of cystoid macular edema and inflammation after cataract surgery |
Indomethacin 1% solution (Indocid) | Not available in United States | 1 drop four times daily | Treatment of allergic eye disease, postoperative inflammation following cataract extraction and laser corneal surgery |
Ketorolac tromethamine 0.5% solution (Acular) | $105.50/5 mL | 1 drop four times daily | Treatment of allergic eye disease, postoperative inflammation following cataract extraction and laser corneal surgery |
Nepafenac 0.1% suspension (Nevanac) | $325.96/3 mL | 1 drop to operated eye three times daily beginning 24 hours after cataract surgery and continuing through first 2 postoperative weeks | Treatment of postoperative inflammation following cataract extraction |
Corticosteroids9 |
Dexamethasone sodium phosphate 0.1% solution (various) | $21.10/5 mL | 1 or 2 drops as often as indicated by severity; use every hour during the day and every 2 hours during the night in severe inflammation; taper off as inflammation decreases | Treatment of steroid-responsive inflammatory conditions |
Dexamethasone sodium phosphate 0.05% ointment | Compounding pharmacy | Apply thin coating on lower conjunctival sac three or four times daily | |
Fluorometholone 0.1% suspension (various)10 | $170.50/10 mL | 1 or 2 drops as often as indicated by severity; use every hour during the day and every 2 hours during the night in severe inflammation; taper off as inflammation decreases | |
Fluorometholone 0.25% suspension (FML Forte)10 | $384.97/10 mL | 1 drop two to four times daily | |
Fluorometholone 0.1% ointment (FML S.O.P.) | $183.31/3.5 g | Apply thin coating on lower conjunctival sac three or four times daily | |
Loteprednol etabonate 0.5% (Lotemax) | $512.86/10 mL | 1 or 2 drops four times daily | |
Prednisolone acetate 0.12% suspension (Pred Mild) | $366.64/10 mL | 1 or 2 drops as often as indicated by severity of inflammation; use every hour during the day and every 2 hours during the night in severe inflammation; taper off as inflammation decreases | |
Prednisolone sodium phosphate 0.125% solution | Compounding pharmacy | | |
Prednisolone acetate 1% suspension (various) | $105.60/10 mL | 2 drops four times daily | |
Prednisolone sodium phosphate 1% solution (various) | $63.25/10 mL | 1–2 drops two to four times daily | |
Immunomodulators |
Cyclosporine 0.05% emulsion (Restasis) 0.4 mL/container | $351.35/30 containers | 1 drop twice daily | Dry eyes and severe allergic eye disease |
Tacrolimus 0.1% ointment | $260.45/30 g tube | Not yet established (no label to support) | Severe allergic eye disease; no indication in United States |
Glaucoma and Ocular Hypertension Agents |
Sympathomimetics |
Apraclonidine HCl 0.5% solution (Iopidine) | $86.77/5 mL | 1 drop three times daily | Reduction of intraocular pressure; expensive; reserve for treatment of resistant cases |
Apraclonidine HCl 1% solution (Iopidine) | $33.27/unit dose | 1 drop 1 hour before and immediately after anterior segment laser surgery | To control or prevent elevations of intraocular pressure after laser trabeculoplasty or iridotomy |
Brimonidine tartrate 0.2% solution (Alphagan, Alphagan P [benzalkonium chloride-free]) | $17.50/5 mL | 1 drop two or three times daily | Reduction of intraocular pressure |
Beta-adrenergic blocking agents |
Betaxolol HCl 0.5% solution (Betoptic) and 0.25% suspension (Betoptic S)11 | 0.5%: $117.91/10 mL 0.25%: $372.64/10 mL | 1 drop twice daily | Reduction of intraocular pressure |
Carteolol HCl 1% and 2% solution (various, Teoptic)12 | 1%: $40.10/10 mL | 1 drop twice daily | |
Levobunolol HCl 0.25% and 0.5% solution (Betagan)13 | 0.5%: $21.49/5 mL | 1 drop once or twice daily | |
Metipranolol HCl 0.3% solution (OptiPranolol)13 | $29.67/5 mL | 1 drop twice daily | |
Timolol 0.25% and 0.5% solution (Betimol)13 | 0.5%: $169.28/5 mL | 1 drop once or twice daily | |
Timolol maleate 0.25% and 0.5% solution (Istalol, Ocudose [preservative-free], Timoptic) and 0.1%, 0.25%, and 0.5% gel (Timoptic-XE, Timoptic GFS)13 | 0.5% solution: $6.03/5 mL 0.5% gel: $217.27/5 mL | 1 drop once or twice daily | |
Miotics |
Pilocarpine HCl 1–4% solution14 | 1% solution: $94.81/15 mL | 1 drop up to four times daily for elevated intraocular pressure | Reduction of intraocular pressure, treatment of acute or chronic angle-closure glaucoma, and pupillary constriction |
Carbonic anhydrase inhibitors |
Brinzolamide 1% suspension (Azopt) | $390.41/10 mL | 1 drop three times daily | Reduction of intraocular pressure |
Dorzolamide HCl 2% solution (Trusopt) | $40.79/10 mL | 1 drop three times daily | |
Prostaglandin analogs |
Bimatoprost 0.03% solution (Lumigan) | $154.30/3 mL | 1 drop once daily at night | Reduction of intraocular pressure |
Latanoprost 0.005% solution (Xalatan, Monopost [preservative-free]) | $15.00/2.5 mL (Monopost not available in United States) | 1 drop once or twice daily at night | |
Latanoprostene bunod 0.024% solution (Vyzulta) | $292.70/2.5 mL | 1 drop daily at night | |
Tafluprost 0.0015% solution (Saflutan [preservative-free], Taflotan, Zioptan [preservative-free]) | $255.61/30 units (Saflutan not available in United States) | 1 drop once daily at night | |
Travoprost 0.004% solution (Travatan, Travatan Z [benzalkonium chloride-free]) | $198.36/2.5 mL | 1 drop once daily at night | |
Unoprostone isopropyl 0.15% solution (Rescula) | $153.84/5 mL | 1 drop twice daily | |
Rho kinase inhibitor |
Netarsudil ophthalmic solution 0.02% (Rhopressa) | $376.48/2.5 mL | 1 drop daily in the evening | Reduction of intraocular pressure |
Combined preparations |
Bimatoprost 0.03% and timolol 0.5% (Ganfort) | Not available in United States | 1 drop daily in the morning | Reduction of intraocular pressure |
Brimonidine 0.2% and timolol 0.5% (Combigan) | $222.18/10 mL | 1 drop twice daily | |
Brimonidine 0.2% and brinzolamide 1% (Simbrinza) | $206.02/8 mL | 1 drop three times a day | |
Brinzolamide 1% and timolol 0.5% (Azarga) | Not available in United States | 1 drop twice daily | |
Dorzolamide 2% and timolol 0.5% (Cosopt, Cosopt PF [preservative-free]) | $67.49/10 mL | 1 drop twice daily | |
Latanoprost 0.005% and timolol 0.5% (Xalacom) | Not available in United States | 1 drop daily in the morning | |
Tafluprost 0.0015% and timolol 0.5% (Taptiqom [preservative-free]) | Not available in United States | 1 drop daily | |
Travoprost 0.004% and timolol 0.5% (DuoTrav) | Not available in United States | 1 drop daily | |