New Drugs Added to Prescribing List

The Ministry of Health and Long-Term Care (MOHLTC) has announced it has expanded the list of drugs that optometrists may prescribe for the treatment of eye and vision conditions. As of February 6, 2017, an additional 11 drugs have been included in the list of drugs controlled by Ontario’s Designated Drugs Regulation. Optometrists should familiarize themselves with the new drugs and prescribe them only in line with the standards of practice set out in the regulation and in OPR 4.4 (updated version coming soon). Optometrists are expected to understand the benefits and risks, including contraindications, of any drug prior to prescribing.

Click here for the amended regulation, including the listing of new drugs.

Please note that drugs are listed by drug name (not trade name) and that the MOHLTC have considered only drugs that have been approved by Health Canada. Drugs that you might be familiar with from other jurisdictions (e.g., the U.S.A.) may be absent if they are not available in Canada.

The added drugs are:

Corticosteroids (topical):

difluprednate

Corticosteroids (topical) – for the purpose of treating conditions of the eye and adnexa:

triamcinolone

Immunomodulators (topical):

cyclosporine

Nonsteroidal anti-inflammatory agents (topical):

bromfenac

Mydriatics (topical):

tropicamide

Antiallergic agents (topical):

bepotastine

tacrolimus – for the purpose of treating conditions of the eye and adnexa and for a duration not exceeding 42 days

Prostaglandin analogs (topical):

tafluprost

Carbonic anhydrase inhibitors/β-adrenergic blocking agents (topical):

brinzolamide/timolol

Carbonic anhydrase inhibitors (oral) – to lower intraocular pressure only; a member shall immediately refer the patient to a physician or to a hospital:

acetazolamide

Secretagogues (oral) – for Sjögren’s syndrome only and only in collaboration with a physician with whom the member has established a co-management model of care:

pilocarpine

Losing the List?

In September 2016, College Council approved for submission to the MOHLTC further proposed amendments to the Optometry Act, Designated Drugs Regulation (DDR), and Controlled Acts. This new proposal would replace the drug list with the authority of optometrists to prescribe all Health Canada–approved topical and oral drugs within the scope of practice. The proposal would also allow optometrists to dispense drugs for the sole purpose of trialling a therapy.

Please know that the College remains committed to these proposals and plans to submit them to the MOHLTC later this spring; however the only change approved at this time is the addition of the 11 drugs named above.