Policy:
The American Academy of Ophthalmology endorses the uniform use of a color-coding system for the caps and labels of topical ocular medications.
Background:
The Academy's policy on color coding of eyedrop bottle caps was prompted by reports to the Academy and the National Registry of Drug-Induced Ocular Side Effects of serious adverse events resulting from patient difficulty in distinguishing among various ocular medications. With input from the pharmaceutical industry and the Food and Drug Administration (FDA), the Academy's Committee on Drugs developed a uniform color-coding system. Specific pantone colors were assigned to defined classes of ocular drugs according to the nature of the disease being treated, the product's side-effect profile, and the risk of serious sequelae if a product is inadvertently switched with another.
To date, voluntary cooperation between the pharmaceutical industry, the FDA, and the American Academy of Ophthalmology has been very effective in meeting the interest of patient safety.
Evaluation:
The objective of the uniform color-coding system for topical ocular medications is to help patients distinguish among various medications, thereby minimizing the risk of patients selecting the incorrect medication. Major medical problems thus may be averted.
Representatives of the pharmaceutical industry have been involved in developing this color-coding system and have been largely supportive of the color-coding policy. Although it is impossible to achieve one-hundred-percent consensus among industry representatives when choosing among a limited number of available colors, aspects of patient safety, common prescribing patterns, and available color options have all been taken into consideration in making these recommendations.
Recommendation:
The American Academy of Ophthalmology recommends to the FDA and the pharmaceutical industry that a uniform color-coding system for the caps and labels of all topical ocular medications be established. No other topical medications should carry the same color.
The recommended color codes are:
Class | Color | Pantone Number |
Adrenergic agonist combinations |
Light Green |
373C |
Adrenergic agonists |
Purple |
2583 |
Anti-infectives |
Tan |
467 |
Anti-inflammatory, non-steroidal |
Gray |
4 |
Anti-inflammatory, steroids |
Pink |
197 |
Anti-inflammatory, immunomodulators |
Olive Green |
5763C |
Beta-blocker combinations |
Dark Blue |
281 |
Beta-blockers |
Yellow |
Yellow C |
Carbonic anhydrase inhibitors |
Orange |
1585 |
Cytotoxic |
Black |
6 |
Miotics |
Dark Green |
348 |
Mydriatics and cycloplegics |
Red |
1797 |
Prostaglandin analogues |
Turquoise |
326 |
As new classes of drugs are developed, it may be necessary to assign new colors to additional classes of drug products. However, given the potential for confusion with existing color-coding, the Academy recommends introducing new colors only when those agents are associated with risk to patient safety.
It may be necessary to consider alternative identification technologies, which further reduce the likelihood of drug errors.
Approved by: Board of Directors, February 1983
Revised and Approved by: Board of Directors, June 1991
Revised and Approved by: Board of Trustees, June 1996
Revised and Approved by: Board of Trustees, February 2000
Revised and Approved by: Board of Trustees, October 2006
Reaffirmed and Approved by: Board of Trustees, May 2010
Revised and Approved by: Board of Trustees, June 2015
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