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South Staffordshire Joint Formulary
Cannock Chase Clinical Commissioning Group
East Staffordshire Clinical Commissioning Group
South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group
Stafford and Surrounds Clinical Commissioning Group
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 Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
12.01  Expand sub section  Drugs acting on the ear
12.01.01  Expand sub section  Otitis externa
12.01.01  Expand sub section  Astringent preparations
12.01.01  Expand sub section  Anti-inflammatory preparations
Dexamethasone with Antibacterial (Otomize®)
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Formulary
Green
Otomize_Ear Spy 5ml 
   
Dexamethasone with Antibacterial (Sofradex®)
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Formulary
Green
Sofradex_Ear/Eye Dps 
   
Flumetasone 0.02% with Clioquinol 1%
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Formulary
Green

Flumetasone 0.02% with Clioquinol 1%_Ear Dps

 
   
Hydrocortisone Acetate 1% with Gentamicin 0.3% (Gentisone® HC)
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Formulary
Green

Gentisone HC_Ear Dps

Note: more expensive

 
   
12.01.01  Expand sub section  Anti-infective preparations to top
Ciprofloxacin Eye Drops
(Specialist initiation-first-treatment)
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Unlicensed Drug Unlicensed
Green
Ciprofloxacin_Eye Dps 0.3%

Local antimicrobial guidelines recommend an aminoglycoside antibiotic (contraindicated if the tympanic membrane is perforated), with or without a corticosteroid, as second line to a non-aminoglycoside antibiotic and a corticosteroid e.g.flumetasone–clioquinol (Locorten–Vioform®)


 
   
12.01.01  Expand sub section  Other aural preparations
12.01.02  Expand sub section  Otitis media
12.01.03  Expand sub section  Removal of ear wax
Olive Oil Ear Drops
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Formulary
Green

Olive Oil_Ear Dps

Only remove if deaf or obscures ear drum
Remove by syringing when softened or under direct vision using a Jobson-horn probe

 

    Self Care Self Care Medicine -Available OTC for self-care. For the removal of earwax. Allow to warm to room temperature before use.

 
   
Sodium Bicarbonate 5%
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Formulary
Green

Sod Bicarb_Ear Dps 5%

Only remove if deaf or obscures ear drum
Remove by syringing when softened or under direct vision using a Jobson-horn probe

 

   Self Care Self Care Medicine-Available OTC for self-care. For the removal of ear wax

 
   
12.02  Expand sub section  Drugs acting on the nose
12.02.01  Expand sub section  Drugs used in nasal allergy to top
Azelastine and Fluticasone (Dymista)
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Formulary
Green

Dymista 137micrograms/dose / 50micrograms/dose nasal spray

Second-line option to be considered for prescribing only when OTC products are ineffective or not suitable

 
   
12.02.01  Expand sub section  Antihistamines
12.02.01  Expand sub section  Corticosteroids
Fluticasone furoate (Avamys®)
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Second Choice
Green
 
   
Beclometasone Dipropionate (Beconase®)
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Formulary
Green
Beconase_Aq Nsl Spy 50mcg (200 D) 22g 
   
Budesonide (Rhinocort Aqua®)
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Formulary
Green
Budesonide_Aq Nsl Spy 64mcg (120 D)
Rhinocort Aqua 64_Nsl P/Spy 64mcg (120D) 
   
Ipratropium Bromide (Rinatec®)
(For watery Rhinorrhoea ONLY)
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Formulary
Green
Ipratrop Brom_Aq Nsl Spy 21mcg (180D)CFF 
Link  UKMI Q&A: Drug induced hypersalivation
   
Mometasone furoate
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Formulary
Green

Mometasone Fur_Aq N/Spy 50mcg (140 D)

 
   
12.02.01  Expand sub section  Cromoglicate
12.02.02  Expand sub section  Topical nasal decongestants
12.02.02  Expand sub section  Sympathomimetics to top
Ephedrine (7 Day Use ONLY)
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Formulary
Red

Ephed HCl_Nsl Dps 0.5% BP
Ephed HCl_Nsl Dps 1% BP

7 Day Use ONLY

 

 

 
   
Xylometazoline 0.05% (Paediatric) (Otrivine®)
(7 Day Use ONLY)
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Formulary
Green

Xylomet HCl_Nsl Dps Paed 0.05%

7 Day Use ONLY

Self Care Self Care Medicine-Available OTC for self care.

 

 

 

 
   
12.02.02  Expand sub section  Antimuscarinic
12.02.03  Expand sub section  Nasal preparations for infection
Sterimar
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Restricted Drug Restricted
Red
 
   
12.02.03  Expand sub section  Nasal Staphylococci
Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5% (Naseptin®)
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Formulary
Green

Naseptin_Crm

Contains arachis (peanut) oil, not suitable for patients with an allergy to peanuts.

Patients with soya allergy should also avoid Naseptin®

 
   
Mupirocin 2% in White Soft Paraffin (Bactroban Nasal®)
(Reserve for MRSA)
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Formulary
Green
Mupirocin_Nsl Oint 2%
Bactroban_Nsl Oint 2%

Reserve for MRSA 
Link  UKMi memo regarding Bactroban shortage and alternatives
   
Octenidine Hydrochloride  (Octenisan® md nasal gel)
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Formulary
Green

Added to formulary as an alternative due to supply issues with Bactroban® nasal ointment

 
   
12.03  Expand sub section  Drugs acting on the oropharynx
12.03.01  Expand sub section  Drugs for oral ulceration and inflammation to top
Benzydamine (Difflam®)
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Formulary
Green

Benzydamine HCl_Mthwsh 0.15% S/F
Difflam_Oral Rinse Soln 0.15%

   Self Care Self Care Medicine-Available OTC for self-care for oral ulceration and inflammation.

 

 
   
Hydrocortisone (Corlan®)
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Formulary
Green
Corlan_Pellets 2.5mg
 
   
12.03.02  Expand sub section  Oropharyngeal anti-infective drugs
12.03.02  Expand sub section  Oropharyngeal Fungal infections
Miconazole Oral Gel (Daktarin)
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Formulary
Green

Daktarin®miconazole 20mg/g oromucosal gel

 

   Self Care Self Care Medicine  Self Care Medicine. Available to purchase over the counter for fungal and associated bacterial infections of the mouth and throat in adults and children 4 months and over.

1 measuring spoon (provided) is equivalent to 124 mg miconazole per 5mL gel.

 
   
Nystatin Oral Suspension (Nystan®)
(Nystan)
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Formulary
Green
 
   
12.03.02  Expand sub section  Oropharyngeal Viral infections
Chlorhexidine mouthwash
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Formulary
Green

Chlorhexidine gluconate 0.2% mouthwash

 

  Self Care Self Care Medicine-Available OTC for self-care for the prevention of dental caries.

 

 

 
   
12.03.03  Expand sub section  Lozenges and sprays
12.03.04  Expand sub section  Mouthwashes, gargles, and dentifrices to top
12.03.05  Expand sub section  Treatment of dry mouth
12.03.05  Expand sub section  Local Treatment
A. S. Saliva Orthana®
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Formulary
Green
This is a saliva substitute recommended for use in dentate patients by NICE. This product is also lower cost than Glandosane, which remains on the formulary. 
   
Glandosane®
(Glandosane should not to given to dentate patients as it is Acidic)
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Formulary
Green
Glandosane_A/Spy 50ml (Lem)
Glandosane_A/Spy 50ml (Peppermint)
 
   
Gelclair
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Restricted Drug Restricted
Red
 
   
12.03.05  Expand sub section  Systemic treatment
 ....
 Non Formulary Items
Acetic Acid 2%  (Earcalm ®)

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Non Formulary
 
ACETIC ACID 5% solution in IMS

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Non Formulary
 
Aciclovir

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Non Formulary
 
Almond Oil

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Non Formulary

 Self Care Self Care Medicine-Available OTC for self-care

 
Amphotericin Lozenges  (Fungilin®)

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Non Formulary
 
Antacid with Oxetacaine

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Non Formulary
 
Azelastine and fluticasone  (Dymista)

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Non Formulary
 
Azelastine Hydrochloride  (Rhinolast®)

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Non Formulary
 
Beclometasone Dipropionate

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Non Formulary
 
Benzocaine

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Non Formulary
 
Betamethasone

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Non Formulary
 
Betamethasone 0.1% with Neomycin 0.5% ear drops  (Betnesol N®)

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Non Formulary
 
Betamethasone ear drops

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Non Formulary
 
Betamethasone nasal drops

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Non Formulary
 
Betamethasone Sodium Phosphate  (Betnesol®)

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Non Formulary
 
Betamethasone Sodium Phosphate  (Vista-Methasone®)

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Non Formulary
 
Betamethasone Sodium Phosphate  (Vista-Methasone®)

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Non Formulary
 
Betamethasone Sodium Phosphate 0.1% with Neomycin Sulphate 0.5%

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Non Formulary
 
Betamethasone Sodium Phosphate with Antibacterial  (Vista-Methasone N®)

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Non Formulary
 
Biotene Oralbalance®

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Non Formulary
 
BioXtra®

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Non Formulary
 
Budesonide

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Non Formulary
 
Caphosol®

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Non Formulary
 
Carmellose Sodium  (Orabase®)

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Non Formulary
 
Carmellose Sodium  (Orahesive®)

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Non Formulary
 
Cerumol®

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Non Formulary

Self Care Self Care Medicine-Available OTC for self-care

 
Cetylpyridinium, Chlrocresol, Lidocaine  (Anbesol®)

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Non Formulary
 
Chloramphenicol

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Non Formulary
 
Chlorhexidine & Chlorobutanol  (Eludril®)

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Non Formulary
 
Chlorhexidine mouthwash

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Non Formulary
 
Choline Salicylate  (Bonjela® Adult)

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Non Formulary
 
Clotrimazole  (Canesten®)

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Non Formulary
 
Docusate Sodium 0.5%  (Waxsol®)

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Non Formulary
 
Doxycycline

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Non Formulary
 
Doxycycline

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Non Formulary
 
Doxycycline  (Periostat®)

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Non Formulary
 
Exterol®

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Non Formulary
 
Flunisolide  (Syntaris®)

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Non Formulary
 
Flurbiprofen lozenge

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Non Formulary
 
Fluticasone Propionate

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Non Formulary
 
Fluticasone Propionate  (Flixonase Nasule®)

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Non Formulary
 
Fluticasone Propionate  (Nasofan®)

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Non Formulary
 
Gelclair®

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Non Formulary
 
Gentamicin  (Genticin®)

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Non Formulary
 
Hydrocortisone with Antibacterial  (Neo-Cortef®)

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Non Formulary
 
Hydrocortisone with Antibactrial  (Otosporin®)

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Non Formulary
 
Hydrogen Peroxide

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Non Formulary
 
Hydrogen Peroxide  (Peroxyl®)

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Non Formulary
 
Lidocaine 10% mouth spray

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Non Formulary
 
Lidocaine 5% ointment

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Non Formulary
 
Lidocaine and Cetylpyridinium  (Dentinox® Teething Gel)

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Non Formulary
 
Lidocaine and Chlorhexidine  (Instillagel®)

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Non Formulary Is formulary for use in incontinence patients see chapter 27
 
Lidocaine and Phenylephrine  (Cophenalcaine®)

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Non Formulary
 
Luborant®

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Non Formulary
 
Miconazole  (Daktarin®)

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Non Formulary
 
Molcer®

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Non Formulary
 
Mometasone Furoate  (Nasonex®)

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Non Formulary
  • Prescribe generically
 
Mouth Swabs

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Non Formulary
 
Neomycin Sulphate with corticosteroids  (Neo-Cortef®)

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Non Formulary
 
Neomycin Sulphate with corticosteroids  (Otosporin®)

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Non Formulary
 
Otex®

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Non Formulary
 
pilocarpine Hydrochloride  (Salagen®)

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Non Formulary
 
Povidone Iodine  (Betadine®)

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Non Formulary
 
Prednisolone 0.5% with Neomycin 0.5%  (Predsol-N®)

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Non Formulary
 
Prednisolone ear drops  (Predsol®)

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Non Formulary
 
Salicylates - Salicylic acid  (Pyralvex®)

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Non Formulary
 
Salinum®

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Non Formulary
 
Saliveze®

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Non Formulary
 
Salivix®

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Non Formulary
 
Sodium Chloride

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Non Formulary
 
Sodium Cromoglicate  (Rynacrom®)

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Non Formulary
 
Sodium Cromoglicate  (Vividrin®)

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Non Formulary
 
SST

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Non Formulary
 
Thymol

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Non Formulary
 
Tranexamic Acid Mouthwash

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Non Formulary
 
Triamcinolone Acetonide  (Nasacort®)

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Non Formulary
 
Triamcinolone Acetonide 0.1% in Adhesive Basis  (Adcortyl in Orabase®)

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Non Formulary
 
Triamcinolone with Antibacterial  (Tri-Adcortyl Otic®)

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Non Formulary
 
Xerotin(r)  (Xerotin®)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs which require special consideration. These are drugs for Consultant Prescribing ONLY. They should not be prescribed in Primary Care.  

Amber

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care. For some drugs there may be a Ricad in place to aid the transition to primary care.  

Amber E

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care but also require and ESCA (Shared Care Agreement)   

Green

Suitable first-line drugs for implementation in Primary Care  

On Formulary

South Staffs Formulary Choice  

netFormulary