[Skip to Content]

Member access to Injectable Medicines Guide (IMG) ocular injection project

The IMG group has produced over 300 monographs on adult intravenous medicines. The group has recently expanded into producing monographs for paediatric intravenous drugs, intramuscular (for mental health) drugs and ocular injection drugs.

In general ocular injections are considered high risk because they are often unlicensed preparations, involve multiple manipulations to prepare and the routes of administration are complex.

The UK Ophthalmic Pharmacy Group (UKOPG) co-ordinates a scheme for the IMG to write monographs on commonly used and / or high risk ocular injections. The monographs reflect current practice in ophthalmic centres throughout the UK.

To date eight ocular injection (adult) monographs are on the IMG website:

  • Amikacin 400micrograms in 0.1ml intravitreal injection
  • Amphotericin (non-lipid) 5micrograms in 0.1mL intravitreal injection
  • Ceftazidime 2mg in 0.1mL intravitreal injection
  • Cefuroxime 1mg in 0.1mL intracameral injection
  • Foscarnet 2.4mg in 0.1mL intravitreal injection
  • Lidocaine 10mg in 1mL (1% w/v) intracameral injection
  • Phenylephrine hydrochloride 2.25mg in 0.15mL (1.5% w/v) intracameral injection
  • Vancomycin 1mg in 0.1mL intravitreal injection

There are also two intravenous (adult) medicine monographs relevant to ophthalmic practice on the IMG website:

  • Fluorescein sodium intravenous injection
  • Indocyanine green intravenous injection

More monographs are in preparation and the following are near to completion :-

  • Alteplase 25micrograms in 0.1mL intravitreal injection
  • Rituximab 1mg in 0.1mL intravitreal injection

Members of The Royal College of Ophthalmologists can now access the short version of all current ocular injection and relevant ophthalmic intravenous adult monographs using the following link http://medusa.wales.nhs.uk/?ID=d9e0da4aaa4361404a0c3a69f84b91293130 on a NHS computer only.

Each short monograph contains information on ‘ready to administer’ preparations and, if these are not available, details of how to safely prepare the injection in a clinical area. Also included are sections on therapeutic indication, adult dose, adverse effects, compatibilities, excipients, storage, latex status, and more. Each monograph is quality checked by two ophthalmic specialist pharmacists and an UKMi pharmacist.

Most NHS hospitals, and some private hospitals, have full access to the IMG website on their local intranets and may give their clinicians access to full monographs. These have additional information on osmolarity, pH, risk assessment plus references. Please discuss access with your local Pharmacy department. Terms and conditions and copyright for using the IMG can be found on the home page of the IMG website.

It is strongly recommended that a risk assessment of the use of a new injection in your Trust is always undertaken and discussed with your Pharmacy department.

It is hoped that this initiative to allow members limited access to IMG monographs will help reduce clinical risks in ophthalmic practice. If you have any queries please contact -.

Jacqueline Jones PhD, FRPharmS, UKOPG ocular injection project co-ordinator, jacqueline.jones@nuh.nhs.uk

Nottingham University Hospitals NHS Trust

Melanie Hingorani  MD, FRCOphth, Chair of the Quality and Safety Group, The Royal College of Ophthalmologists, Melanie.Hingorani@moorfields.nhs.uk

Want more information?