Pharmacists are frequently requested to prepare sterile products intended for ophthalmic administration when a suitable sterile ophthalmic product is not available from a licensed manufacturer or when there is a shortage of commercially available products. These products may be administered topically, in the form of solutions, suspensions, or ointments, or by subconjunctival or intraocular (e.g., intravitreal and intracameral) injections. These prepared products are called “extemporaneous ophthalmic products” and are mostly given off-label. Although these products are off-label, they are supported by evidence-based medicine and are well controlled and regulated by many of authorities. The American Society of Hospital Pharmacists (ASHP) established guidelines for the preparation of such products [1]. In the following chapter, the ASHP guidelines are fully discussed.

N.B.: Off-Label means “unapproved indication, age group, dose, or form of administration.”