Recently, I was surprised to learn that eyedrop cap colors coordinate with their therapeutic class. This practice has been around since 1983, but I asked several other seasoned pharmacists, and they also did not know.
Maybe it’s because we see the boxes, and not the actual eyedrops, that most of us don’t know about this incredibly smart practice. How many times a day does a patient say, 'I need my little white pill?' Yet, I have never once, in all my years, heard any patient say 'I need my blue eyedrops.' As soon as I heard this, I immediately ran upstairs to check my own eyedrops.
Recently, I had a corneal abrasion and, sure enough, my ciprofloxacin eyedrop cap was color-coded tan, and my ketorolac (NSAID) eyedrop cap was gray. It was so surprising to learn this, because we dispense eyedrops all day long, but no one (patients or doctors) mentions the color-coding.
Today, at work, I looked at the eyedrop boxes (not caps, as I did not open the boxes, of course). Sure enough, I noticed just a few examples of the strength, on the box, highlighted in the designated color:
- Timolol (beta blocker) highlighted in yellow
- Dorzolamde (carbonic anhydrase inhibitor) in orange
- Moxifloxacin, ciprofloxacin, ofloxacin, and gatifloxacin (anti-infectives) in tan
- Diclofenac in gray (non-steroidal anti-inflammatory)
- prednisolone (steroid) in pink
- Cyclopentolate (mydriatic/cycloplegic) in red
Specific Pantone colors were assigned to different classes of ocular drugs according to the nature of the disease, side-effect profile, and risk of serious events if a product is inadvertently switched with another. The AAO reports that voluntary cooperation between the pharmaceutical industry, the FDA, and the AAO has been very effective in achieving the goal of patient safety, when each drug class is assigned a specific Pantone color as described.
The American Glaucoma Society (AGS) strongly endorses this practice, stating that this color-coded system is essential for patients, their families/caregivers, and practitioners, to easily identify eyedrops. The system is essential for visually impaired patients to independently manage and administer their own eyedrops for chronic diseases of the eye, such as glaucoma. The system also enhances communication between the patient and provider when assessing patient adherence.
The AGS also states that this system is important for those patients with multiple topical eye medications, or with other eye diseases, and it is important for patients recovering from surgery, who need to rely on eyedrop color codes while their vision recovers. There are also many illiterate patients who can only maintain adherence with color-coded tops. Even when a patient cannot recall the name of the medication, he/she can usually recall the color. Physicians often provide patients with schedule aids that reference the color codes.
I think color-coding is brilliant! This is certainly both fascinating and informational for me, and I hope I have 'opened your eyes' to a practice that many pharmacists do not know about.
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Karen Berger, PharmD
Karen Berger, PharmD, graduated from the University of Pittsburgh School of Pharmacy in 2001. She has worked in community pharmacies for over 17 years as a Pharmacist in Charge, staff, and floater pharmacist for a large chain. Currently, she is a pharmacist at an independent pharmacy in Northern NJ. She can be reached at firstname.lastname@example.org