netFormulary
 Report : A-Z of formulary items 13/06/2021 12:02:14
[Back]
 
Section Name Details
08.01 Nintedanib 

This is a Specialised Drug which would not be routinely commissioned by CCGs for Cancer. This would go through a South Staffs CCGs Individual Funding Request (IFR)

 

 

 

28.01 (Abbott ®) Similac Alimentum Abbott Nutrition

First line choice for cows milk protein allergy

Birth to 12 months

Lactose and gluten free

12.03.05 A. S. Saliva Orthana®  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.
10.01.03 Abatacept Orencia® This is an NHS England Specialised Commissioning Drug for Paediatric Indications (where adult TA available) or Juvenile arthritis
02.09 Abciximab Reopro®

   DISCONTINUED

08.01.05 Abemaciclib Verzenios®

This is an NHS England Specialised Commissioning drug

 

 

08.03.04.02 Abiraterone Acetate 

This is an NHS England Specialised Commissioning Drug for Hormone Antagonists

 

04.10.01 Acamprosate 

Restriction: Initiation by substance abuse unit, no prescribing by General Practice

Patients with alcohol dependence should be referred using the GP surgeries clinical systems online referral form.

  • Staffordshire CCG’s – Humankind - Staffordshire treatment and recovery service (STARS) – Link to website


 

11.06 Acetazolamide Diamox® Acetazolamide_Tab 250mg

05.03.02.01 Aciclovir 

Aciclovir Tab 200mg
Aciclovir Tab 400mg
Aciclovir Tab 800mg
Aciclovir Tab Disper 200mg
Aciclovir Tab Disper 400mg
Aciclovir Tab Disper 800mg

Acute Herpes Zoster (Shingles):- Antiviral treatment always indicated for the elderly, immunocompromised, ophthalmic or herpes zoster.

If onset of rash is less than 24 hours and the patient is aged 14 years and over, or in severe pain, or dense/oral rash, or secondary household case, taking steroids or a smoker, consider aciclovir. Aciclovir is NOT recommended for children with chickenpox and do NOT prescribe or advise ibuprofen in chickenpox.

11.03.03 Aciclovir 3% eye ointment 

Urgently refer all patients with suspected herpes simplex to the hospital eye department

DISCONTINUED: GSK, the sole supplier of aciclovir eye ointment, plans to discontinue it from the worldwide market in 2018. Stock is anticipated to continue to be available in the UK until the end of June 2019, subject to demand.

An alternative agent is Ganciclovir 0.15% w/w eye gel (licensed for acute herpetic keratitis).

13.10.03 Aciclovir Cream and Oral Zovirax®

Aciclovir cream  Self Care Self Care Medicine-Available OTC for self-care.(Please note exceptions may apply)

03.01.02 Aclidinium Bomide Eklira Genuair® Aclidinium Bomide 375mcg/dose Dry Powder Inhaler
Eklira 322mcg/dose Genuair Inhalation Powder

Long Acting Antimuscarinic
Indication for COPD ONLY.


NOTE: This is a twice daily preparation therefore not suitable for all patients.
19 Actico  Sizes
8cm x 6m (1)
10cm x 6m (1)
12cm x 6m (1)

Indications - For venous leg ulcers with OR without oedema, chronic oedema and lymphoedema
  • Apply at 100% full stretch, close to the limb with 50% overlap
  • Suitable for mobile and immobile patients
  • Apply a padding bandage (e.g. K soft prior to Actico application)
  • Refer to Leg Ulcer Guidelines for further guidance

    Contra-Indications - High-level compression is contra-indicated in patients suffering from an arterial condition (arterial or predominantly arterial ulcer; known or suspected arterial disease)
  • 19 ActiFast (All varieties) 
  • Helps keep dressings in situ and provides light support
  • 2-way stretch for reduced wastage
  • Cut-to-fit for easy measurement

    Actifast Red
    3.5cm x 1m (1)
    3.5cm x 10m (1)
    Actifast Green
    5cm x 1m (1)
    5cm x 3m (1)
    5cm x 5m (1)
    5cm x 10m (1)
    Actifast Blue
    7.5cm x 1m (1)
    7.5cm x 3m (1)
    7.5cm x 5m (1)
    7.5cm x 10m (1)
    Actifast Yellow
    10.75cm x 1m (1)
    10.75cm x 3m (1)
    10.75cm x 5m (1)
    10.75cm x 10m (1)
    Actifast Beige
    17.5cm x 1m (1)
    17.5cm x 10m (1)
    Actifast Purple
    20cm x 1m (1)
    20cm x 5m (1)
    20cm x 10cm (1)


  • 19.07 ActiFormCool  Sizes
    5cm x 6.5cm (5)
    10cm x 10cm (5)

    Mode of Action - It has the ability to donate or absorb while allowing the passage of water vapour and oxygen to the wound surface.

    Indicatons - Autolytic debribement can be used in sloughy, necrotic wounds. Suitable for painful wounds, burns, scalds, radiation burns, nociceptive pain. Can be used through the entire wound healing process. Moderate to highly exuding wounds.

    Method of Use - Use a film top liner if there is little or no exudate.

    Contra-Indicatons - Should not be used for deep, narrow cavities or sinuses. Wounds should be checked frequently as rapid absorption can lead to a drying out of the wound. Haemostasis should be achieved prior to dressing application.

    Frequency of Dressing change - ActiFormCool should be changed if it becomes discoloured or apaque and as often as the wound condition dictates. As with all absorptive dressings, frequent monitoring is required to ensure the dressing does not dry out and adhere to the wound. The dressing should be changed at the first sign of strikethrough. If infection is suspected, frequent changes and monitoring are advised. The wound should be checked frequently as the absorption process may be rapid and the wound may become drier than expected.
    13.08.01 Actikerall®  Superficial malignant and pre-malignant skin lesions.
    19 Actiwrap  Indications - For difficult to dress areas for retention of dressings
    Size
    6cm x 4cm (1)
    01.05.03 Adalimumab 

    Restriction: In line with NICE Guidance only

    Clinicians must ensure the biosimilar brand for their region is prescribed first-line.

    10.01.03 Adalimumab Humira® This is a Specialised Drug which would not be routinely commissioned by CCGs for Uveitis or Hidradenitis Suppurativa. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    See all NICE Guidance
    13.05.03 Adalimumab Humira®

    Commissioned by NHS England for treating moderate to severe hidradenitis suppurativa

    Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people is commissioned by NHS England for patients treated in specialised dermatology centres and CCGs for treatments in non-specialist centres.

    In line with NICE

    13.06.01 Adapalene Differin®
    09.05.01.01 Adcal® 
    A2.07 Add-Ins® 
    05.03.03 Adefovir Dipivoxil Hepsera® This is a Specialised Drug which would not be routinely commissioned by CCGs for Hepatitis B. This would go through a South Staffs CCGs Individual Funding Request (IFR)
    03.04.03 Adrenaline / Epinephrine Soln for Injection Auto-Injector

    Please prescribe generically - There are variable stock shortages of each of the three brands Jext, Emerade and Epipen therefore it is best to prescribe generically.

    19.11 Advazorb and Advasorb Lite  Sizes
    7.5cm x 7.5cm (10)
    10cm x 10cm (10)
    10cm x 20cm (10)
    12.5cm x 12.5cm (10)
    15cm x 15cm (10)
    20cm x 20cm (10)

    An absorbent, breathable, non-adherent hydrophillic foam dressing with film backing. The film backing helps prevent wound exudate strikethrough and acts as a barrier to outside contamination.

    Mode of Action - The foam absorbs exudate and allows evaporation through the backing of the dressing.

    Indications - Low (Advazorb Lite) to heavily exuding wounds (Advazorb) such as pressure ulcers, skin tears, leg ulcers and abrasions, can be used as a secondary dressing.

    Method of Use - Primary or secondary layer. Dressing should overlap the wound by 2 to 3 cm.

    Frequency of Use - Dressing can be left in place for up to 7 days. Highly exuding wounds need changing when strikethrough appears and the exudate spreads to the edge of the dressing.

    Contra-Indications - Arterial bleeds, heavily bleeding wounds and vascular fungating wounds.
    19.12 Advazorb Silfix and Advazorb Silfix Lite  Sizes
    7.5cm x 7.5cm (10)
    10cm x 10cm (10)
    10cm x 20cm (10)
    12.5cm x 12.5cm (10)
    15cm x 15cm (10)
    20cm x 20cm (10)

    The film backing helps prevent wound exudate strikethrough and acts as a barrier to outside contamination.

    Mode of Action - The foam absorbs exudate and allows evaporation through the backing of the dressing.

    Indications - Low (Advazorb Silfix Lite) to heavily exuding wounds (Advazorb Silfix) such as presure ulcers, skin tears, leg ulcers and abrasions, can be used as a secondary dressing.
    For use in patients with fragile skin

    Method of Use - Primary or secondary layer. Dressing should overlap the wound by 2 to 3 cm.

    Frequency of Use - Dressing can be left in place for up to 7 days. Highly exuding wounds need changing when strikethrough appears and the exudate spreads to the edge of the dressing.

    Contra-Indications - Arterial bleeds, heavily bleeding wounds and vascular fungating wounds.
    08.01.05 Afatinib 

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    08.01 Aflibercept Zaltrap®

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Cancer. This would go through a South Staffs CCGs Individual Funding Request (IFR)

     

     

    11.08.02 Aflibercept Eylea®

    Restriction: In line with NICE Guidance only

    08.01.05 Alectinib Alecensa®

    This is an NHS England specialised commissioning drug

     

     

     

     

    08.02.03 Alemtuzumab MabCampath®

    This is an NHS England Specialised Commissioning Drug for Multiple Sclerosis, Pre-transplant immunosuppression or CLL

     

    MHRA advice (May 2019): Lemtrada (alemtuzumab) and serious cardiovascular and immune-mediated adverse reactions: new restrictions to use and strengthened monitoring requirements

    06.06.02 Alendronic Acid  First Line Choice - Prescribe generically as 70mg once weekly. Combination products with Vitamin D are not on the formulary. People at risk of osteoporosis need to maintain an adequate intake of Calcium and Vitamin D; Vitamin D dosage should be 800iu per day.
    06.06.02 Alendronic Acid Effervescent tablets Binosto 70mg effervescent Tablets

    Please note these are for patients with swallowing difficulties only.

    People at risk of osteoporosis need to maintain an adequate intake of Calcium and Vitamin D; Vitamin D dosage should be 800iu per day.
    09.06.04 Alfacalcidol One-Alpha® Alfacalcidol_Cap 1mcg
    Alfacalcidol_Cap 250ng
    Alfacalcidol_Cap 500ng
    Alfacalcidol_Dps 5mcg/ml
    28.02 Alfamino  SMA / Nestle

    Prescribe in primary care only as recommended by Paediatric Dietician or Paediatrician

    From birth until able to tolerate over the counter products

    If a patient presents with clear anaphylactic reaction to cows milk these fomulae should be commenced in primary care, with immediate onward referral to secondary or specialist care.

    If formulae top-ups are needed for a child who is otherwise breastfed (mother on a a milk free diet) AAF will be required

    07.04.01 Alfuzosin  Alfuzosin HCl_Tab 2.5mg

    Treatment depends on cause and therefore rule out urinary trat infections.
    19 Algivon  Tissue Viability Nurse approval needed
    This product requires and exemption form. Prescribe for two weeks ONLY

    Sizes
    5cm x 5cm (5)
    10cm x 10cm (5)

    An alginate dressing impregnated with active honey. An absorbent sterile, non adherent wound contact layer which comprises of calcium alginate and medical grade Munuka honey.
    Mode of Action- This provides a moist environment which can absorb exudate, it can aid de-sloughing and has antibacterial protection. The exudate allows the fibres to swell and forms a gel, which prolongs the action of the honey at the wound site.
    Indications - For colonised/infected wounds with low to moderate levels of exudate, can be used in malodourous wounds
    Method of Use - A primary dressing which needs to be cut to size and placed directly over the wound.
    Secondary dressing is required.
    Frequency of Dressing change - Can be left in situ for 3 to 4 days. Requires changing when strikethrough appears.
    Contra-Indications - In diabetic patients monitor blood glucose levels. Known allergy to bee venom or calcium alginate. Stinging sensation on application. Heavily bleeding wounds.
    02.12 Alirocumab Praluent®

    Restriction: In line with NICE Guidance only

    13.05.01 Alitretinoin Toctino®
    09.05.01.01 Alliance calcium syrup®  Replacement for Calcium Sandoz - discontinued
    10.01.04 Allopurinol  Allopurinol_Tab 100mg
    Allopurinol_Tab 300mg


    Prophylaxis - 100mg - 600mg daily. Start 1 month after acute episode. Start 100mg, build up in weekly steps.
    06.01.02.03 Alogliptin Vipidia®

    Maximal effect is seen in 3-6 months; if no response to therapy in 6 months in terms of achieving patients target then review

    07.04.05 Alprostadil Caverject® There are differences in the delivery devices so prescribe by brand
    07.04.05 Alprostadil Viridal® Duo There are differences in the delivery devices so prescribe by brand
    07.04.05 Alprostadil MUSE® There are differences in the delivery devices so prescribe by brand
    02.10.02 Alteplase 
    28.01 Althera  SMA Nestle

    From birth to 12 months

    Contains Lactose

    May be tried if the infant/child is not tolerating first-line products because of taste

    09.04 Altraplen Compact 
    09.04 Altrashot 

    Initiation by specialist dietician services prior to continuation within primary care.

    04.09.01 Amantadine 

    •Capsules
    •Syrup- for patients with swallowing difficulties
    To be initiated by a specialist and then transferred to primary care

    02.02.03 Amiloride Hydrochloride 

    Amiloride hydrochloride 5mg Tablet

    This item is expensive. If combining this drug with a loop diuretic consider combination preparation co-amilofruse.

    02.03.02 Amiodarone Hydrochloride 

    Amiodarone hydrochloride 100mg Tablet
    Amiodarone hydrochloride 200mg Tablet

    Only initiated in hospital.

    Beware of potential problems and recognise who is responsible for spotting them e.g. Micro Corneal deposits Photosensitivity Thyroid, Liver, Lung Disorders (Check every 6 months).

    NICE CG180 (Atrial fibrillation): Do not offer amiodarone for long-term rate control.

    04.02.01 Amisulpride 

    Amisulpride Tablet 50mg
    Amisulpride Tablet 100mg
    Amisulpride Tablet 200mg
    Amisulpride Tablet 400mg
    Amisulpride Oral Solution 100mg/ml SF

    See link below for ESCA's.  Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

    04.03.01 Amitriptyline  Amitriptyline HCl Tablet 10mg
    Amitriptyline HCl Tablet 25mg
    Amitriptyline HCl Tablet 50mg
    Amitriptyline HCl Oral Solution 25mg/5ml S/F
    Amitriptyline HCl Oral Solution 50mg/5ml S/F
    04.07.03 Amitriptyline  Amitriptyline Tablets 10mg, 25mg, 50mg




    Unlicensed use in Neuropathic Pain is recommended by NICE CG96
    02.06.02 Amlodipine 

    Amlodipine 5mg Tablet
    Amlodipine 10mg Tablet

    05.01.01.03 Amoxicillin 

    Amoxicillin 250mg Capsules
    Amoxicillin 500mg Capsules
    Amoxicillin 125mg/5ml oral Suspension
    Amoxicillin 125mg/5ml oral Suspension SF
    Amoxicillin 250mg/5ml oral Suspension
    Amoxicillin 250mg/5ml oral Suspension SF

    Amoxicillin 3g oral powder sachets SF Sachets should be prescribed by Dentist only for dental use

    05.02 Amphotericin Abelcet®
    05.02 Amphotericin AmBisome®
    05.02 Amphotericin 
    05.02 Amphotericin Liposomal 

    This is an NHS England Specialised Commissioning Drug for Fungal Infection

    09.01.04 Anagrelide 

    Hospital ONLY

    08.03.04.01 Anastrozole 
    13.12 Anhydrol Forte  Solution 60ml bottle with roll-on applicator
    05.02.04 Anidulafungin 

    This is an NHS England Specialised Commissioning Drug for Fungal Infection

    11.04.02 Antazoline 0.5% with Xylometazoline 0.05% Otrivine-Antistin®

    Otrivine-Antistin_Eye Drops

     

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

    01.07.02 Anusol 
    Anusol Cream
    Anusol Ointment
    Anusol Suppository

    Self Care Self Care Medicine-Available OTC for self care

    01.07.02 Anusol-HC 

    Anusol HC Ointment
    Anusol HC Suppository

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

    02.08.02 Apixaban Eliquis®

    Apixaban 2.5mg Tablet
    Apixaban 5mg Tablet

    04.09.01 Apomorphine 

    Apomorphine HCl Injection 10mg/ml 2ml Amp

    Supported by ESCA only where agreed from initiating trust 

    10.01.03 Apremilast Otzela®

     This is commissioned by CCGs but is a hospital only drug

     In Line with NICE guidance

    For use in psoriasis click here

    13.05.02 Apremilast Otezla®

    Restriction: In line with NICE Guidance only
     

    04.06 Aprepitant Emend®
    19 Aquacel Ag  Tissue Viability Nurse approval needed.
    This product requires and exemption form. Prescribe for two weeks ONLY


    Sizes
    2cm x 45cm (5)
    10cm x 10cm (5)

    A non woven pad or ribbon dressing composed of hydrocolloid fibres
    Mode of Action- It is highly absorbebt and converts the exudate into a soft gel. It contains silver ions which exert a sustained antimicrobial effect.

    Indications - Primary dressing for moderate to heavily exuding infected wounds. Facilitates the control of minor bleeding.

    Method of Use - Should be placed directly onto the wound surface overlapping the skin by 1cm. Cavity wounds shold be loosely packed allowing a tail of 2.5cm to facilitate removal. Secondary dressings needs to be applied. Irrigation with saline or water to remove.

    Frequency of Dressing change - Depends on the wound characteristics and the absorbency of the secondary dressing. Can be left in situ for up to 7 days.

    Contra-Indications - Known sensitivity to product or silver. Should not be used on dry wounds or those covered with hard, black necrosis.


    13.02.01 Aquadrate10% Cream 

    Cream with 10% Urea

    100g Cream

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

     

    19.07 Aquaform Hydrogel  Size
    8g (1)

    Mode of Action - Keeps the wound bed moist, allowing hydration of necrotic tissue and assists in loosening and facilitating the removal of slough.

    Indicatons - Low exudate wounds, necrotic, sloughy, granulating, epithelialising wounds.

    Method of Use - Apply directly to the wound bed and apply a minimum depth of 5mm, can be used in cavity wounds. Requires secondary dressing. The gel is removed by irrigation with warmed sterile normal saline, warm water or during bathing.

    Frequency of Dressing change - Maximum wear time - 3 days. If applied to a necrotic wound, daily changes are required to optimise rehydration of the wound. The frequency of dressing change depends on the amount of exudate.

    Contra-Indicatons - Heavily exuding wounds.
    13.02.01 Aquamax Cream  Lowest Greasy Preparation

    100g and 500g Cream


    Please refer to the Supplementary ’Emollient Guide’ for more detail
    06.02.01 Aqueous Iodine Solution 
    04.02.01 Aripiprazole 

    FIRST CHOICE
    Aripiprazole Tablet 5mg
    Aripiprazole Tablet 10mg
    Aripiprazole Tablet 15mg
    Aripiprazole Tablet 30mg

    SECOND CHOICE
    Aripiprazole Orodispersible Tablet 10mg S/F
    Aripiprazole Orodispersible Tablet 15mg S/F

    THIRD CHOICE
    Aripiprazole Oral Solution 5mg/5ml- Use liquid only in patients with swallowing difficulties

    prescribe generically

    See link below for ESCA's.  Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

    04.02.02 Aripiprazole  Abilify Maintena®

    Aripiprazole 400mg powder and solvent for sust-release susp for inj in vial or pre-filled syringe

    08.01.05 Arsenic Trioxide Trisenox®

    In line with NICE

     

    09.06.03 Ascorbic Acid  Ascorbic Acid_Tab 50mg
    Ascorbic Acid_Tab 100mg
    Ascorbic Acid_Tab 200mg
    Ascorbic Acid_Tab 500mg
    09.08.01 Asfotase alfa 

    In line with NICE Highly Specialised technology guidance

    02.09 Aspirin  

    Aspirin Dispersible 75mg Tablet


    Use of low dose aspirin for the primary prevention of heart attacks and strokes in people without cardiovascular disease including diabetic patients is no longer recommended as the increased risk of bleeding outweighs any vascular benefits.

    Prescribing of antiplatelets for secondary prevention should be in line with NICE Guidelines.

    Patients with mild to moderate dyspeptic symptoms taking aspirin should be prescribed a PPI or H2 antagonist before switching to clopidogrel (which may also cause gastro-intestinal adverse effects).

    04.07.04.01 Aspirin  Aspirin Tablet 300mg

    Because of an association with Reye's syndrome, preparations containing aspirin should not be offered to people aged under 16 years.
    02.04 Atenolol 

    Atenolol 25mg Tablet
    Atenolol 50mg Tablet
    Atenolol 100mg Tablet
    Atenolol 25mg/5ml Oral Solution SF

    25mg - 50mg dose ONLY needed in hypertension
    100mg is useful in Angina patients.

    08.02.03 Atezolizumab Tecentriq®

    Restriction: In line with NICE Guidance only

     

    04.04 Atomoxetine Strattera®

    Atomoxetine HCl Capsule 10mg
    Atomoxetine HCl Capsule 18mg
    Atomoxetine HCl Capsule 25mg
    Atomoxetine HCl Capsule 40mg
    Atomoxetine HCl Capsule 60mg
    Atomoxetine HCl Capsule 80mg
    Atomoxetine HCl Capsule 100mg

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

    02.12 Atorvastatin 

    Atorvastatin 10mg Tablet
    Atorvastatin 20mg Tablet
    Atorvastatin 40mg Tablet
    Atorvastatin 80mg Tablet

    19 Atrauman   Sizes
    5cm x 5cm (10)
    7.5cm x 10cm (10)
    10cm x 20cm (10)

    Mode of Action - Low adherent non-medicated knitted polyester dressing, impregnated with neutral triglycerides which prevent adherance to the wound bed and coated with metallic silver. It does not contain Vaseline or paraffins. Primary dressing for use on dry or lightly exuding wounds, superficial wounds such as lacerations or abraisons.

    Method of Use - Apply directly to the wound surface with a secondary dressing.

    Frequency of Dressing change - Effective for up to 7 days, changed due to the nature and conditions of the wound. Can be removed with saline or water.

    19 Atrauman Ag  Tissue Nurse approval needed
    This product requires and exemption form. Prescribe for two weeks ONLY


    Sizes
    5cm x 5cm (10)
    10cm x 10cm (10)
    10cm x 20cm (10)

    Mode of Action - A low adherent non-medicated kinitted polyester dressing, impregnated with neutral triglycerides which prevent adherence to the wound bed and coated with metalic silver. It does not contain Vaseline or paraffins.

    Indications - Primary dressing for use on dry or lightly exuding infected or colonised wounds, superficial wounds such as lacerations or abrasions.

    Method of Use - Apply directly to the wound surface with a secondary dressing.

    Frequency of Dressing change - Effective for up to 7 days, changed due to nature and conditions of the wound. Can be removed with saline or water.

    Contra-Indications - Known allergy to ingrediants and silver.
    11.05 Atropine sulphate 1% eye drops  10ml drops are started in secondary care but should be changed to Minims in primary care as they are more cost effective.
    09.01.04 Avatrombopag Doptelet®

    Restriction: In line with NICE Guidance only

    08.02.03 Avelumab Bavencio®

    Restriction: In line with NICE Guidance only

     

    08.02.04 Axicabtagene ciloleucel Yescarta®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    08.01.05 Axitinib Inlyta®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    09.04 Aymes® Savoury 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Aymes®Complete Milkshake Style
    09.04 Aymes®Shake 
    08.01.03 Azacitidine Vidaza®

    Azacitidine for the treatment of myelodysplastic syndromes chronic myelomonicytic leukaemia 
    This is an NHS England Specialised Commissioning Drug for Cancer

     

    08.03.01 Azacitidine 

     

    01.05.03 Azathioprine 
    Azathioprine 25mg Tablet
    Azathioprine 50mg Tablet


    ESCA covers rheumatology and gastroenterology patients only

    08.02.01 Azathioprine  ESCA required
    10.01.03 Azathioprine 

    25mg and 50mg Tablets

    ESCA covers rheumatology and gastroenterology patients only

    13.06.01 Azelaic Acid Skinoren® Cream 30g
    12.02.01 Azelastine and Fluticasone Dymista

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

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

    05.01.05 Azithromycin  

    Azithromycin is only included in Antibiotic Guidelines for Chlamydia as 1g stat dose

    Azithromycin Tab 250mg
    Azithromycin Tab 500mg
    Azithromycin oral susp 200mg/5ml

    Note prescribe tablets as capsules are very expensive

    05.01.02.03 Aztreonam Lysine  This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis
    10.02.02 Baclofen  Baclofen_Tab 10mg
    Baclofen_Oral Soln 5mg/5ml S/F
    13.02.01 Balneum 5% Cream  Cream with 5% Urea

    50g and 500g pump pack

    10.01.03 Baricitinib Olumiant®

    Restriction: In line with NICE Guidance

    MHRA/CHM advice: Baricitinib (Olumiant®): risk of venous thromboembolism (March 2020)

    MHRA/CHM advice: Baricitinib (Olumiant®): increased risk of diverticulitis, particularly in patients with risk factors (August 2020)

    13.05.03 Baricitinib Olumiant®

    Restriction: In line with NICE Guidance only

     

    MHRA/CHM advice: Baricitinib (Olumiant®): risk of venous thromboembolism (March 2020)

    MHRA/CHM advice: Baricitinib (Olumiant®): increased risk of diverticulitis, particularly in patients with risk factors (August 2020)

    08.02.02 Basiliximab Simulect®

    Not Routinely Commissioned for Renal Transplant

    06.01.01.03 BD AutoShield DUO BD AutoShield DUO® Lengths/Gauges available:
    5mm/30g:
    Safety needles only for use in line with policy.
    Most expensive of the safety needles.
    Compatible with ALL devices (including flextouch)
    06.01.01.03 BD Safe-clip 
    03.02 Beclometasone Easyhaler® Beclometasone Easyhaler 200mcg/dose DPI

    Easyhaler is the most cost effective dry powder device
    03.02 Beclometasone Clenil Modulite® Clenil Modulite Inhalation 100mcg (200D)
    Clenil Modulite Inhalation 200mcg (200D)
    Clenil Modulite Inhalation 250mcg (200D)
    Clenil Modulite Inhalation 50mcg (200D)
    03.02 Beclometasone Qvar® Qvar 50 Easi-Breathe Inhalation 50mcg (200 D)
    Qvar 50 Inhalation 50mcg (200 D)
    Qvar 100 Easi-Breathe Inhalation 100mcg (200 D)
    Qvar 100 Inhalation 100mcg (200 D)


    Qvar does not have a paediatric license. Qvar has microfine particles and is used at half the dose of Clenil.
    03.02 Beclometasone and formoterol Fostair NEXThaler Fostair NEXThaler 100mcg/dose / 6mcg/dose DPI

    Fostair NEXThaler 200mcg/dose / 6mcg/dose DPI (ASTHMA ONLY)

    ONLY USE THE HIGHER STRENGTH 200/6 PREPARATION IN ASTHMA, 100/6 CAN BE USED IN ASTHMA AND COPD
    12.02.01 Beclometasone Dipropionate Beconase® Beconase_Aq Nsl Spy 50mcg (200 D) 22g
    03.02 Beclometasone/formoterol/glycopyrronium  Trimbow®

    Trimbow® 87microgram/dose / 5microgram/dose /9microgram/dose Inhaler
     
     
     
    For patients with COPD who are classified in Gold category D and found to be suitable, upon patient assessment, for triple therapy with ICS/LABA and LAMA. This provides a cost effective option to have this treatment as one inhaler.

    10.01.03 Belimumab 

    Restriction: In line with NICE Guidance

     

    MHRA advice (May 2019):Belimumab (Benlysta▼)- increased risk of serious psychiatric events seen in clinical trials

    08.01.01 Bendamustine 

    Bendamustine for the first-line treatment of chronic lymphocytic leukaemia 
    This is an NHS England Specialised Commissioning Drug for Cancer

     

     

    02.02.01 Bendroflumethiazide 

    Bendroflumethiazide 2.5mg Tablet

    2.5mg dose (Higher doses not indicated in hypertension). NICE Guidance recommends Indapamide (Greater Evidence Base).

    03.04.02 Benralizumab Fasenra®

    This is an NHS England Specialised Commissioning drug for severe eosinophilic asthma.

    13.09 Benzalkonium chloride 0.5% Therapeutic Shampoo Dermax® Antimicrobial
    13.06.01 Benzoyl Peroxide 2.5%/Adapalene 0.1% Epiduo Gel Pump 45g
    13.06.01 Benzoyl Peroxide 5% gel 

    Benzoyl Peroxide 5% gel 30g,60g

    Benzoyl Peroxide 5% gel wash 50g

    12.03.01 Benzydamine Difflam®

    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.

     

    05.01.01.01 Benzylpenicillin  
    Benzylpenicillin sodium 600mg powder for solution for injection vials
    Benzylpenicillin sodium 1.2g powder for solution for injection vials

    IM use only: For suspected meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) parenteral antibiotics (intramuscular benzylpenicillin) should be given at the earliest opportunity, either in primary or secondary care. However -urgent transfer to hospital should not be delayed in order to give the parenteral antibiotics.
    19 Betadine Spray  Tissue Nurse approval needed
    This product requires and exemption form. Prescribe for two weeks ONLY


    Size
    150g unit (1)

    Povidone iodine is known as an antiseptic preparation. It exerts its antiseptic effect by slowly releasing iodine.

    Indications - Betadine dry powder spray can be used for the treatment and prevention of infection in wounds including ulcers, burns, cuts and other minor injuries.

    Precautions - Decreased kidney function

    Contra-Indications - Allergy to iodine
    Deep wounds which are weeping. Children under two years of age.
    04.06 Betahistine Dihydrochloride 

    Betahistine HCl Tablet 8mg
    Betahistine HCl Tablet 16mg

    ONLY Licensed for Meniere's Disease.

    13.04.01 Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 3% Diprosalic® Potent Potency for scaly skin

    Diprosalic ointment 30g and 100g

    Diprosalic scalp application 100ml

    Please refer to Topical Corticosteroid Potency Ladder for more details
    13.04 Betamethasone (as Valerate) 0.025% Betnovate-RD® Moderate Potency

    Full Range

    Please refer to Topical Corticosteroid Potency Ladder for more details
    13.04 Betamethasone (as Valerate) 0.1% Betnovate® Moderate Potency

    Cream and Ointment 30g and 100g

    Scalp Application 100ml

    Please refer to Topical Corticosteroid Potency Ladder for more details
    13.04.01 Betamethasone (as Valerate) 0.1% with Fucidic Acid 2% Fucibet® Potent Potency, use ONLY when sensitivity to fusidic acid confirmed on microbiology report

    Cream 30g and 60g
    Lipid Cream 30g

    Please refer to Topical Corticosteroid Potency Ladder for more details
    13.04.01 Betamethasone Dipropionate 0.064% with Clotrimazole 1% Lotriderm® Potent Potency with Antifungal

    Cream 30g

    Please refer to Topical Corticosteroid Potency Ladder for more details
    11.04.01 Betamethasone eye drops  Betameth Sod Phos_Eye Oint 0.1%
    Betameth Sod Phos_Eye/Ear/Nose Dps 0.1%
    Betameth/Neomycin_Eye Dps 0.1%/0.5%
    08.01.05 Bevacizumab Avastin®
    19.11 Biatain Adhesive  Size
    12.5cm x 12.5cm (10)

    Absorbent foam dressing, vapour permeable film backing.

    Mode of Action - The foam absorbs exudate and allows evaporation through the backing of the dressing.

    Indications - Can be used under compression. Can be used on leg ulcers, pressure ulcers, donor sites and postoperative wounds. Low to moderately exuding wounds.

    Contra-Indications - Do not use with hydrogen peroxide. Biatain soft is a skin friendly adherent dressing. Biatain silicone for use in patients with fragile skin.
    19.11 Biatain Adhesive - Sacral  Size
    23cm x 23cm (5)

    19.11 Biatain Non-Adhesive  Sizes
    5cm x 7cm (10)
    10cm x 10cm (10)
    10cm x 20cm (5)
    15cm x 15cm (5)

    Mode of Actions - The foam absorbs exudate and allows evaporation thrugh the backing of the dressing.

    Indications - Can be used under compression. Can be used on leg ulcers, pressure ulcers, donor sites and postoperative wounds. Low to moderately exuding wounds.

    Contra-Indications - Do not use with hydrogen peroxide.
    19.12 Biatain Silicone  Sizes
    7.5cm x 7.5cm (10)
    10cm x 10cm (10)
    12.5cm x 12.5cm (10)
    15cm x 15cm (5)
    17.5cm x 17.5cm (5)
    19.11 Biatain Soft Hold Dressing  Sizes
    5cm x 7cm (5)
    10cm x 10cm (5)

    08.03.04.02 Bicalutamide 
    11.06 Bimatoprost Lumigan® Bimatoprost_Eye Dps 100mcg/ml
    11.06 Bimatoprost with Timolol Ganfort® Bimatoprost/Timolol_Eye Dps 300mcg/5mg
    06.01.01.02 Biphasic Insulin Aspart NovoMix® 30
    06.01.01.02 Biphasic Insulin Lispro Humalog® Mix25
    06.01.01.02 Biphasic Isophane Insulin Humulin® M3
    06.01.01.02 Biphasic Isophane Insulin Insuman® Comb

    DISCONTINUATION (from June 2020)

    Insuman Comb 15 100IU/mL suspension for injection in a cartridge (expected end of supply June 2020). Alternative is Humulim M3 cartridge.

    Insuman Comb 25 100IU/mL suspension for injection in a vial (expected end of supply June 2020). Alternative is Humumlin M3 vial, Insuman Comb 25 cartridge/solostar.

     

    01.06.02 Bisacodyl 
    Bisacodyl 5mg EC Tablet
    Bisacodyl 10mg Suppository

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

     

     

     

    02.04 Bisoprolol Fumarate 

    Bisoprolol Fumarate 1.25mg Tablet
    Bisoprolol Fumarate 2.5mg Tablet
    Bisoprolol Fumarate 3.75mg Tablet
    Bisoprolol Fumarate 5mg Tablet
    Bisoprolol Fumarate 7.5mg Tablet
    Bisoprolol Fumarate 10mg Tablet

    08.02.03 Blinatumomab Blincyto®

    NHS England specialist commissioning responsibility for treating Philadelphia-chromosome-negative relapsed or refractory precursor B-cell acute lymphoblastic leukemia in adults

     

     

    05.03.03 Boceprevir Victrelis®

    This is an NHS England Specialised Commissioning Drug for Hepatitis C

    Boceprevir is no longer available in the UK

    08.01.05 Bortezomib Velcade®

    This is an NHS England Specialised Commissioning drug

     

    08.01.05 Bortezomib Velcade® Bortezomib monotherapy for relapsed multiple myeloma TA129
    Bortezomib and thalidomide for the first-line treatment of mutiple myeloma TA228
    Bortezomib for induction therapy in multiple myeloma before high-dose chemotherapy and autologous stem cell transplantation TA311
    08.01.05 Bosutinib Bosulif®

    This is an NHS England Specialised Commissioning Drug for Cancer

    04.12 Botulinum neurotoxin Type A Xeomin®

    Restriction: In line with NICE Guidance only

    An option for treating chronic sialorrhoea caused by neurological conditions in adults. Specialist use only. 

    04.07.04.02 Botulinum Toxin Type A Botox®

    Restriction: In line with NICE Guidance only

    08.01.05 Brentuximab vedotin Adcetris®

    Restriction: In line with NICE Guidance only

     

     

    08.01.05 Brigatinib Alunbrig®

    This is an NHS England Specialised Commissioning drug

     

    11.06 Brimonidine Tartrate 

    Brimonidine Tart_Eye Dps 0.2%
    Brimonidine/Timolol_Eye Dps 2mg/5mg/ml

    prescribe generically

    13.06.03 Brimonidine tartrate 3mg/g gel Mirvaso®
    11.06 Brinzolamide  

    Brinzolamide 10mg/ml eye drops

    11.06 Brinzolamide with timolol 

    Brinzolamide/Timolol_Eye Dps 10mg/5mg/ml

    prescribe generically

    04.08.01 BRIVARACETAM Briviact®

    Brivaracetam 10mg tablets
    Brivaracetam 25mg tablets
    Brivaracetam 50mg tablets
    Brivaracetam 75mg tablets
    Brivaracetam 100mg tablets
    Brivaracetam 10mg/ml oral solution
    Brivaracetam 50mg/5ml solution for injection vials

    For adjunctive therapy in the treatment of partial onset seizures with or without secondary generalisation in adult, adolescent and paediatric patients from 4 years of age with severe refractory epilepsy warrenting epilepsy specialist input who have

    1. Tried 3 or more antiepileptic medications, and
    2. Have used Levetiracetam and has documented intolerance, and would not be suitable for other 3rd line agents; and
    3. Is currently on a 3rd line agent which would be replaced by Brivaracetam: or
    4. Has 3 or more antiepileptic medications and has insufficient symptom control and requires rapid attainment of therapeutic levels.

    Restriction: For initiation and stabilisation by a specialist
    Unnecessary to maintain patient on specific manufacturer's products.

    After stabilisation, primary care may continue its prescribing on receipt of Specialist Clinic patient-specific letter which must include:

    • The previous antiepileptic medications tried
    • Intolerance to Levetiracetam
    • An improvement in side effects after switching from Levetiracetam to Brivaracetam
    10.01.03 Brodalumab Kyntheum®

    This is commissioned by CCGs but is a hospital only drug

    In line with NICE

    11.08.02 Brolucizumab Beovu®

    Restriction: In line with NICE Guidance only

    01.05.02 Budesonide Budenofalk®

    Budenofalk 3mg gastro-resistant Capsule

    MHRA/CHM advice: Corticosteroids: rare risk of central serous chorioretinopathy with local as well as systemic administration (August 2017)

     

     

    01.05.02 Budesonide Budenofalk®

    Budesonide 2mg/dose foam enema

    Approved July 2018- first line choice whilst hydrocortisone is out of stock.

    We have been advised that the steroid foam enemas are interchangable. Due to current stock issues with hydrocortisone budesonide enema is the current preferred choice.

    03.02 Budesonide Pulmicort® Budesonide Turbohaler 200mcg/dose

    only where patients are not suitable for easyhaler device
    03.02 Budesonide  Easyhaler Budesonide Easyhaler 200mcg/dose DPI

    Easyhaler is the most cost effective dry powder device
    12.02.01 Budesonide Rhinocort Aqua® Budesonide_Aq Nsl Spy 64mcg (120 D)
    Rhinocort Aqua 64_Nsl P/Spy 64mcg (120D)
    03.02 Budesonide and formoterol Symbicort® For ASTHMA ONLY

    Symbicort Turbohaler 100mcg/6mcg (120 D)
    Symbicort Turbohaler 200mcg/6mcg (120 D)
    Symbicort Turbohaler 400mcg/12mcg (60 D)
    03.02 Budesonide/formoterol DuoResp Spiromax DuoResp Spiromax 160mcg/dose / 4.5mcg/dose DPI
    DuoResp Spiromax 320mcg/dose / 9mcg/dose DPI


    For ASTHMA ONLY. NOT to be used for anyone under the age of 18.
    In asthma, the 160/4.5 inhaler may be used both as regular maintenance treatment and as needed in response to symptoms.
    The 320/9 inhaler must be used with a separate reliever.


    02.02.02 Bumetanide 

    Bumetanide 1mg Tablet
    Bumetanide 5mg Tablet
    Bumetanide 1mg/5ml S/F Oral Solution Expensive Item

    Monitor Potassium Levels - Risk of Hypokalaemia

    04.10.03 Buprenorphine Subutex®

    Buprenorphine_Tab Subling 400mcg S/F
    Buprenorphine_Tab Subling 2mg S/F
    Buprenorphine_Tab Subling 8mg S/F
    Subutex_Tab Subling 2mg
    Subutex_Tab Subling 400mcg
    Subutex_Tab Subling 8mg 
     
     

    From April 1st 2017 there should be no prescribing of medications within primary care for alcohol or substance misuse. New patients should be referred into the One Recovery specialist service.

    One Recovery are working to repatriate patients back into their specialist services but if there any queries related to specific patients it is recommended that these are directed to the service.

    Stafford Tel: 01785- 270080

    Cannock Tel: 01543-468667


     
     

    04.07.02 Buprenorphine 35mcg Patch Transtec® patch
    Note: Low dose may be useful for frail elderly patients or similar patients sensitive to side-effects of morphine sulphate or fentanyl

    Self-adhesive, skin-coloured, buprenorphine, ‘35’ patch (releasing 35 micrograms/hour for 96 hours)

    See the Strong Opioids for Persistant Non-Cancer Pain Guidelines for further information
    04.07.02 Buprenorphine 5mcg Patch BuTec® patch

    Please prescribe by brand Butec® (equivalent to Butrans®) as more cost effective (Applicable in Primary care only).

    Note: Low dose may be useful for frail elderly patients or similar patients sensitive to side-effects of morphine sulphate or fentanyl

    Self-adhesive, beige, buprenorphine, ‘5’ patch (releasing 5 micrograms/hour for 7 days)

    See the Strong Opioids for Persistant Non-Cancer Pain Guidelines for further information

    04.10.03 Buprenorphine and Naloxone Suboxone®

    Suboxone_Tab Subling 2mg/0.5mg
    Suboxone_Tab Subling 8mg/2mg 
     

    From April 1st 2017 there should be no prescribing of medications within primary care for alcohol or substance misuse. New patients should be referred into the One Recovery specialist service.

    One Recovery are working to repatriate patients back into their specialist services but if there any queries related to specific patients it is recommended that these are directed to the service.

    Stafford Tel: 01785- 270080

    Cannock Tel: 01543-468667

     

    04.10.02 Bupropion Hydrochloride Zyban®

    Bupropion HCl Tablet 150mg M/R
     
    Restriction: As part of a smoking cessation programme only.
     

    MHRA/CHM advice: Bupropion (Zyban®): risk of serotonin syndrome with use with other serotonergic drugs (November 2020)

    08.01.05 Cabazitaxel Jevtana®

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Cancer. This would go through a South Staffs CCGs Individual Funding Request (IFR)

     

    08.01.05 Cabozantinib  Cabometyx®

    This is an NHS England Specialised Commissioning drug

     

     

     

    09.05.01.01 Calcichew® 
    09.06.04 Calci-D® calcium and colecalciferol CALCI-D 1000 mg /1000 IU chewable tablets
    Note dose is 1 tablet chewed or sucked ONCE daily, advisabable to take with evening meal.
    In pregnant women 1/2 a tablet a day (tablets are scored)
    Preferred formulary choice for calcium and vitamin D preparation
    13.05.02 Calcipotriol (as monohydrate) 50 microgram, betamethasone (as dipropionate) 500 microgram/g  Enstilar®

    Cutaneous foam formulation

    Apply Once Daily to max 30% body surface area (maximum 15g daily, maximum 100g weekly) for 4 weeks.  If necessary, subsequent courses can be repeated after an interval of at least 4 weeks.

    13.05.02 Calcipotriol ointment and scalp application  Prescribe Generically

    Calcipotriol 50mcg/g Ointment 30g and 60g
    06.06.01 Calcitonin (salmon) / Salcatonin 
    13.05.02 Calcitriol Ointment 3micrograms/g Silkis® Calitroil 3mcg/g 100g

    Can be used on the face and in the flexures
    09.05.02.02 Calcium Acetate Phosex® For use as a Phosphate Binder
    09.05.02.02 Calcium Carbonate Calcichew® For use as a Phosphate Binder
    09.02.01.01 Calcium Gluconate 10% Injection  
    09.02 Calcium Gluconate Injection 
    09.02.01 Calcium Gluconate Injection  Hospital only
    18 Calcium gluconate Injection 
    09.02.01 Calcium Polystyrene sulfonate  Calcium Resonium Powder® Hospital only
    09.04 Calogen® 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Calogen® Extra 

    Initiation by specialist dietician services prior to continuation within primary care.

    06.01.02.03 Canagliflozin Invokana®
    02.05.05.02 Candesartan cilexetil 

    Candesartan Cilexetil 2mg Tablet
    Candesartan Cilexetil 4mg Tablet
    Candesartan Cilexetil 8mg Tablet
    Candesartan Cilexetil 16mg Tablet
    Candesartan Cilexetil 32mg Tablet

    02.09 Cangrelor 

    Not Recommended by NICE for reducing atherothrombotic events in people undergoing percutaneous coronary intervention or awaiting surgery requiring interruption of anti-platlet therapy

    04.08.01 Cannabidiol Epidyolex®

    Restriction: In line with NICE Guidance only

    • For treating seizures associated with Lennox-Gastaut syndrome [adjunctive treatment with clobazam] specialist use only
    • For treating seizures associated with Dravet syndrome [adjunctive treatment with clobazam] specialist use only
    13.09 Capasal Shampoo  For Scaly Scalps
    08.01.03 Capecitabine Xeloda®

    Advanced Breast Cancer CG81.
    Guidance on the use of capecitabine and tegafur with uracil for metastic colorectal cancer.
    Capecitabine for the treatment of advanced gastric cancer.

     

     

    08.02.03 Caplacizumab Cablivi®

    Restriction: In line with NICE Guidance

    05.01.09 Capreomycin   All drugs for tuberculosis are hospital only
    10.03.02 Capsaicin 

    Capsaicin_Crm 0.075% ONLY use 0.075%

    Limited Conditions - Painful diabetic neuropathy (Prescribed under the supervision of a Hospital Consultant) and post herpetic pain (after lesions have healed)

    10.03.02 Capsaicin 179mg (8%) Cutaneous patch   A self-adhesive patch containing capsaicin 8% is licensed for the treatment of peripheral neuropathic pain in non-diabetic patients.

    04.07.03 Carbamazepine  Tablets 100mg
    Tablets 200mg
    Tablets 400mg

    04.08.01 Carbamazepine 

    Prescribe by Brand

    Drug choice for simple/partial seizures and tonic clonic seizures.
    Start low dose (100-200mg daily) and build up every two weeks.

    Restriction: Initiation and stabilisation by specialist
    Maintain patient on specific manufacturer's products.

     

    06.02.02 Carbimazole  Tablets 5mg and 20mg

    Carbimazole and Propylthiouracil are associated with rare cases of neutropenia and agranulocytosis due to bone marrow suppression.
    • Patients should be advised to report symptoms suggestive of infection, especially sore throat.
    • Blood Count should be performed if there is clinical evidence of infection.
    • Carbimazole/Propylthiouracil should be stopped if there is clinical or lab evidence of neutropenia.
    03.07 Carbocisteine  Carbocisteine Capsule 375mg
    carbocistiene 750mg/10ml oral solution 10ml S/F
    Carbocisteine Oral Solution 250mg/5ml

    For patients with swallowing difficulties please use the sachets in preference to the oral solution as it is more cost effective.

    For use in prevention of exacerbations in copd

    If 2 or more exacerbations in the last 12 months, consider adding in carbocisteine 750mg three times a day (once symptoms improve maintenance dose of 750mg twice daily should be continued) especially if chronic productive cough

    Review on-going need/ benefit and stop if ineffective after 4 – 6 weeks of treatment
    11.08.01 Carbomer 980 0.2% Clinitas®

    Prescribe as Clinitas carbomer_eye gel 0.2%

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

                                            

     

     

    08.01.05 Carfilzomib Kyprolis ®

    Restriction: In line with NICE Guidance only

     

     

    MHRA advice (Aug 2019): Carfilzomib (Kyprolis▼)- reminder of risk of potentially fatal cardiac events

    11.08.01 Carmellose sodium 

    Carmellose Sod_Eye Dps 0.5%
    Carmellose Sod_Eye Dps 0.5% 0.4ml Ud
    Carmellose Sod_Eye Dps 1% 0.4ml Ud

     

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

     

     

    08.01.01 Carmustine Gliadel®

     Restriction: In line with NICE Guidance only

     

    02.04 Carvedilol 
    Carvedilol 3.125mg Tablet
    Carvedilol 6.25mg Tablet
    Carvedilol 12.5mg Tablet
    Carvedilol 25mg Tablet
    05.02.04 Caspofungin Cancidas®

    Prescribed in hospital on Advice by Microbiologist ONLY.

    This is an NHS England Specialised Commissioning Drug for Fungal Infections

    05.01.02.01 Cefalexin 
    Cefalexin 250mg Capsules
    Cefalexin 500mg Capsules
    Cefalexin 250mg Tablets
    Cefalexin 500mg Tablets
    Cefalexin 125mg/5ml Oral Suspension
    Cefalexin 250mg/5ml Oral Suspension
     

    Broad Spectrum Antibiotics are associated with the development of clostridium difficile and its use should be limited.

    Please refer to the Staffordshire and Stoke-On-Trent Antimicrobial Prescribing Guidelines for clinical indications and guidance
    05.01.02.01 Cefotaxime  Cefotaxime injection may be used as an alternative in penicillin allergy. GPs do not need to carry an alternative to benzylpenicillin. However, if a GP wishes to carry one, a third generation cefalosporin, such as cefotaxime, may be used, before urgent transfer to hospital.
    05.01.02.01 Ceftazidime 
    05.01.02.01 Ceftriaxone 

    Ceftriaxone 1g powder for solution injection vials

    Please refer to the Staffordshire and Stoke-On-Trent Antimicrobial Prescribing Guidelines for clinical indications and guidance

    10.01.01 Celecoxib  MHRA Advice COX-2 NSAIDs have a higher cardiovascular risk profile -LIMIT USE

    Celecoxib_Cap 100mg
    Celecoxib_Cap 200mg

    08.01.05 Cemiplimab Libtayo®

    This is an NHS England Specialised Commissioning drug

     

    08.01.05 Ceritinib Zykadia®

    This is an NHS England Specialised Commissioning Drug

     

     

    10.01.03 Certolizumab Pegol Cimzia® This is a Specialised Drug which would not be routinely commissioned by CCGs for Paediatric Indications. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    For adults this is commissioned from CCGs in line with NICE but is hospital only prescribing.

    Available via Home Care


    03.04.01 Cetirizine 

    Cetirizine HCl Oral Solution 1mg/1ml S/F
    Cetirizine HCl Tablet 10mg

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

    08.01.05 Cetuximab Erbitux®

    This is an NHS England Specialised Commissioning Drug for Cancer

    Hospital only

     

    08.01.05 Cetuximab Erbitux® Cetuximab for the first-line treatment of metastic colorectal cancer TA176
    Cetuximab for the treatment of locally adavanced squamous cell cancer of the head and neck TA145
    11.03.01 Chloramphenicol 

    Chloramphen_Eye Dps 0.5%
    Chloramphen_Eye Oint 1%
    Chloramphen_PF Eye Dps 0.5% - preservative free eye drops prescribe as Eykappo as more cost effective

    The product literature for chloramphenicol eye drops 0.5% states that it is contraindicated in children under 2 years of age due to the boron content which may impair fertility. Chloramphenicol eye ointment 1% is a licensed option if required in this age group.

    Chloramphenicol eye drops and ointment are  Self Care Self Care Medicine- Available OTC for self-care. (Please note exceptions may apply)

    04.01.02 Chlordiazepoxide  Chlordiazepoxide HCl Capsule 5mg
    Chlordiazepoxide HCl Capsule 10mg

    CSM Advice: Hypnotics and Anxiolytics are indicated for the short-term relief of sleep disturbance and/or anxiety. (For continuous use up to a maximum of 14 days).



    12.02.03 Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5% Naseptin®

    Naseptin_Crm

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

    Patients with soya allergy should also avoid Naseptin®

    12.03.02 Chlorhexidine mouthwash 

    Chlorhexidine gluconate 0.2% mouthwash

     

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

     

     

    03.04.01 Chlorphenamine 

    Chlorphenamine Maleate Oral Solution 2mg/5ml
    Chlorphenamine Maleate Tablet 4mg

    Self Care Self Care Medicine- Available OTC for self care. Please note exceptions may apply.

     


    Sedating.

    04.02.01 Chlorpromazine  Chlorpromazine HCl Oral Solution 100mg/5ml
    Chlorpromazine HCl Oral Solution 25mg/5ml
    Chlorpromazine HCl Tablet 25mg
    Chlorpromazine HCl Tablet 50mg
    Chlorpromazine HCl Tablet 100mg
    02.02.01 Chlortalidone 

    Chlortalidone 50mg Tablet

    Very Expensive.

    01.05.03 Ciclosporin I/V Infusion

    For use in severe acute ulcerative colitis refractory to corticosteroid treatment [unlicensed indication]

    08.02.02 Ciclosporin  Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching.
    10.01.03 Ciclosporin  Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching.

    25mg, 50mg and 100mg Capsules available in all Brands

    10mg Capsules only availble as Neoral
    11.08.01 Ciclosporin  Ikervis

    Ciclosporin for treating dry eye disease that has not improved  despite treatment with artificial tears

    Prescribing should be reviewed by a specialist every 6 months and if there is no improvement treatment should be stopped

    13.05.03 Ciclosporin  Initiation by Dermatologist
    09.05.01.02 Cinacalcet Mimpara® This is an NHS England Specialised Commissioning Drug for Hyperparathyroidsm - Dialysis patients ONLY
    04.06 Cinnarizine  Cinnarizine Tablet 15mg
    05.01.12 Ciprofloxacin 

    Ciprofloxacin 100mg Tablets
    Ciprofloxacin 250mg Tablets
    Ciprofloxacin 500mg Tablets
    Ciprofloxacin 750mg Tablets
    Ciprofloxacin 250mg/5ml Oral Suspension

    Broad Spectrum Antibiotics are associated with the development of clostridium difficile and its use should be limited.

    Please refer to the Staffordshire and Stoke-On-Trent Antimicrobial Prescribing Guidelines for clinical indications and guidance

    11.03.01 Ciprofloxacin (used post-operatively) 
    12.01.01 Ciprofloxacin Eye Drops  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®)


    04.03.03 Citalopram  Citalopram Hydrobromide Tablet 10mg
    Citalopram Hydrobromide Tablet 20mg
    Citalopram Hydrobromide Tablet 40mg
    Citalopram HCl Oral Drops 40mg/ml S/F

    Cost effective choice in patients where QT interval prolongation is not an issue (see MHRA advice below for detail) Maximum daily dose 40 mg for adults; 20 mg for patients older than 65 years; and 20 mg for those with hepatic impairment.
    08.01.03 Cladribine Mavenclad®

    Restriction: In line with NICE Guidance only

     

    05.01.05 Clarithromycin 

    Clarithromycin Tab 250mg
    Clarithromycin Tab 500mg
    Clarithromycin Oral Susp 125mg/5ml
    Clarithromycin Oral Susp 250mg/5ml

    05.01.06 Clindamycin  Clindamycin Capsules 150mg

    Oral Clindamycin should not be used first line, it is reserved for those not able to tolerate first line treatments in diabetic foot infection
    13.06.01 Clindamycin 1% Dalacin T®

    clindamycin 1% topical solution

     

    for acne and rosacea

    13.04 Clobetasol Propionate 0.05% Dermovate®

    Very Potent Potency

    Cream  30g and 100g

    Ointment 30g and 100g

    Scalp application 30ml and 100ml

    13.04.01 Clobetasol Propionate with neomycin and nystatin Dermovate-NN® Very potent potency with antibacterial & antifungal - generic expensive
    13.04 Clobetasone Butyrate 0.05% Eumovate®

    Moderate Potency

    Do NOT Presctibe 15g Cream Preparation (Expensive OTC)

    Prescribe Generically

    Please refer to Topical Corticosteroid Potency Ladder for more details

    06.05.01 Clomifene citrate  

    Fertility drugs should not be prescribed in Primary care. They are funded as part of the fertility treatment and will be provided from the fertility clinic

    04.03.01 Clomipramine  Clomipramine HCl Capsule 10mg
    Clomipramine HCl Capsule 25mg
    Clomipramine HCl Capsule 50mg
    04.08.02 Clonazepam 

    Clonazepam Tablets 500mcg
    Clonazepam Tablets 2mg
    Oral solution 500mcg/5ml
    Oral Solution 2mg/5ml 
     
     

     

    02.09 Clopidogrel 

    Clopidogrel 75mg Tablet

    The MHRA has updated its advice on the interaction between PPI's and clopidogrel. It now recommends that use of either omeprazole or esomeprazole with clopidogrel should be discouraged. This does not include lansoprazole.

    07.02.02 Clotrimazole  Clotrimazole_C/Pk 1 Pess/20g Crm 2%
    Clotrimazole_Crm 1%
    Clotrimazole_Crm 2%
    Clotrimazole_Pess 500mg
    13.10.02 Clotrimazole 1%  

    Full Range

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

     

    04.02.01 Clozapine Clozaril®

    Clozapine Tablet 25mg
    Clozapine Tablet 50mg
    Clozapine Tablet 100mg 
    Clozapine Tablet 200mg

    Clozapine for treatment resistant schizophrenia in patients who have failed to respond to 2 Antipsychotics - NICE CG178

    Restriction: Initiation by psychiatrist registered with Clozapine monitoring service

    Patient, prescriber and supplying pharmacist must be registered with the Patient Monitoring Service. Treatment is only continued if there are acceptable leucocyte and neutrophil counts.

    Brands include Clozaril, Denzapine or Zaponex

    MHRA/CHM advice: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus (October 2017)

    13.05.02 Coal Tar 2.5%/lecithin 0.3% Scalp Lotion Shampoo Psoriderm

    Psoriderm Scalp Lotion 250ml

     

    Self Care  Most of these preparations are available for purchase over the counter in pharmacies.

    13.05.02 Coal tar lotion 5% Exorex®

    Lotion 100ml and 250ml

    CHILD under 12 years and ELDERLY - lotion can be diluted with a few drops of water before applying.

     

    Self Care  Most of these preparations are available for purchase over the counter in pharmacies.

    02.02.04 Co-amilofruse  

    Co-Amilofruse 2.5mg/20mg Tablet
    Co-Amilofruse 5mg/40mg Tablet

    05.01.01.03 Co-Amoxiclav 
    Co-Amoxiclav 250mg/125mg Tablets
    Co-Amoxiclav 500mg/125mg Tablets
    Co-Amoxiclav 125mg/31mg/5ml oral Suspension SF
    Co-Amoxiclav 125mg/31mg/5ml oral Suspension
    Co-Amoxiclav 250mg/62mg/5ml oral Suspension SF
    Co-Amoxiclav 250mg/62mg/5ml oral Suspension

    Co-amoxiclav is more likely than amoxicillin to cause antibiotic-associated diarrhoea and C. difficile infection (CDI). Co-amoxiclav should therefore be avoided in patients at increased risk of CDI, such as age >65 years of age, patients on proton-pump inhibitors (PPIs), taking laxatives or with recent hospitalisation.
    It is included within the local Antibiotic Guidelines as a option ONLY for the treatment of diverticular disease, upper UTI (if hospital admission not required), facial cellulitis and bites. Second-line use should be directed by sensitivities or on advice of microbiology.
    04.09.01 Co-Beneldopa Madopar®

    Co-Beneldopa Capsule 12.5mg/50mg
    Co-Beneldopa Capsule 25mg/100mg
    Co-Beneldopa Capsule 25mg/100mg M/R
    Co-Beneldopa Capsule 50mg/200mg
    Co-Beneldopa Tablet Dispersible 12.5mg/50mg S/F
    Co-Beneldopa Tablet Dispersible 25mg/100mg S/F

    04.09.01 Co-careldopa  Co-Careldopa Tablet 10mg/100mg 25mg/100mg 25mg/250mg
    Co-Careldopa Tablet MR tablets 25mg/100mg 50mg/200mg

    Prescribe Generically.
    04.09.01 Co-careldopa and entacapone Stanek®

    Please prescribe by brand Stanek® (equivalent to stalevo®) as more cost effective

    Stanek 50 mg/12.5 mg/200 mg
    Stanek 75 mg/18.75 mg/200mg
    Stanek 100 mg/25 mg/200 mg
    Stanek 125 mg/31.25 mg/200 mg
    Stanek 150 mg/37.5 mg/200 mg
    Stanek 175 mg/43.75 mg/200 mg
    Stanek 200 mg/50 mg/200 mg


    Ingredients are levodopa/carbidopa/entacapone

    04.07.01 Co-Codamol - 30/500mg 

    Co-Codamol Capsule 30mg/500mg
    Co-Codamol Tablet 30mg/500mg
    Co-Codamol Effervescent Tablet 30mg/500mg

    Prescribing as separate components allows dosing flexibility and is less expensive (Applicable to primary care only).

    Ensure soluble forms are prescribed only if appropriate.

    04.07.01 Co-Codamol - 8/500mg 

    Co-Codamol Tablet 8mg/500mg
    Co-Codamol Effervescent Tablet 8mg/500mg

    NOT an evidence based choice but patients may perceive benefit.
    Please note over the counter (OTC) sale is limited to three days only.

    13.06.02 Co-Cyprindiol  Known also as "Dianette" - ensure prescribed generically
    01.06.02 Co-danthramer 

    Co-Danthramer 25mg/200mg Capsule (withdrawn from UK market- August 2016)
    Co-Danthramer 37.5mg/500mg Capsule Strong (withdrawn from UK market)
    Co-Danthramer 25mg/200mg/5ml S/F Oral Suspension

    Use ONLY for the terminally ill to prevent constipation in patients receiving opiates - In Specialist circumstances, stool softners may be used eg. Docusate Sodium.

    Suspension for Swallowing difficulties.

    01.06.02 Co-danthrusate 

    Co-danthrusate 50mg/60mg/5ml S/F Oral Suspension

    Restriction: Terminally ill patients only

    01.04 Codeine phosphate 

    Codeine phosphate 15mg Tablet
    Codeine phosphate 30mg Tablet
    Codeine phosphate 25mg/5ml Syrup

    Any patient with altered bowel habit of either constipation or diarrhoea for more than 2-3 weeks with no known cause should be invistigated further.

    04.07.02 Codeine Phosphate  Codeine Phos Tablet 15mg
    Codeine Phos Tablet 30mg
    Codeine Phos Tablet 60mg
    Codeine Phos Linctus 15mg/5ml S/F
    10.01.04 Colchicine  Colchicine_Tab 500mcg

    Acute gout (If NSAID not indicated)

    500 micrograms 2–4 times daily until symptoms relieved, max. 6 mg per course; course not to be repeated within 3 days
    09.06.04 Colecalciferol Adcal-D3® Adcal-D3_Dissolve Tab Eff 1.5g/400u(Lem)

    Dispersible preparations are more expensive and are reserved for patients with swallowing difficulties

    09.06.04 Colecalciferol  Colecalciferol Capsule 800u
    Colecalciferol Tablet 800u
    09.06.04 Colecalciferol and Calcium Carbonate Adcal-D3® Adcal-D3_Capl 750mg/200u

    Only caplets are formulary and for use where chewable Calci-D tablets not tolerated .
    Where a chewable preparation is suitable use Calci-D
    01.09.02 Colestyramine 

    Colestyramine 4g oral powder sachets sugar free

     

    02.12 Colestyramine 

    Colestyramine 4g oral powder sachets

    05.01.07 Colistimethate inhaler Colobreathe®

    NHS England commissioned

    In line with NICE

    05.01.07 Colistimethate sodium Colomycin®

    Colistimethate Sodium Injection 1,000,000u Vl (Dry)
    Colistimethate Sodium Injection 2,000,000u Vl (Dry)

    Restriction: Non-CF Bronchiectasis


    Treatment by Inhalation not IV.
    Note Colomycin® Injection may be used for nebulisation; administer required dose in 2-4 mL of sodium chloride 0.9%, (or water for injections) or a 1:1 mixture of sodium chloride 0.9% and water for injection.

    01.01.01 Co-magaldrox 

    Mucogel Suspension
    Maalox Suspension

    Magnesium hydroxide, dried aluminium hydroxide (low Na+)

    Combination of aluminium and magnesium may reduce GI side effects.

    Self Care Self Care Medicine-Available OTC for self care

     

     

    19.09 Comfeel Plus  Size
    9cm x 11cm Contour (10)

    Mode of Action Dressing consists of moisture absorbing cellulose particles encapsulated in a synthetic, elastic and sticky mass.

    Indications - low/moderate exudate. Waterproof. Necrotic/sloughy/granulating/epithelialising wounds. Can act as a secondary dressing over a hydrogel.

    Method of Use - No secondary dressing required. Requires 1-2cm overlap around the wound. Smooth and mould the dressing into place.

    Frequency of Use - Maximum wear time - 7 days. The built-in colour guide will change colour to milky-white as the dressing absorbs exudate. When the colour change reaches the edge of the dressing, the dressing requires changing.

    Contra-Indications -
    DO NOT use on exposed muscle, tendon or bone.
    DO NOT use in cases known allergy or adverse reaction to one or most of the components.
    DO NOT use on deep partial thickness and full thickness burns.
    19.09 Comfeel Plus Transparent  Sizes
    5cm x 7cm (10)

    Comfeel Plus Transparent Dressing consists of moisture absorbing, cellulose particles encapsulated in a synthetic, elastic and sticky mass. When the CMC particles come into contact with the wound exudate it forms a viscous gel that absorbs exudate and does not adhere to the wound.

    Indications - Treatment of low exuding chronic wounds and superficial acute wounds such as pressure ulcers, traumatic wounds, leg ulcers, post-operative wounds, superficial burns, skin abrasions and donor sites. The dressing can also be used as secondary dressing and to protect the skin in especially vulnerable areas, skin in the final stages of healing and skin in areas which are difficult to dress.

    Method of Use - No secondary dressing required. Requires 1-2cm overlap around wound. Smooth and mould the dressing into place.

    Frequency of Use - Maximum wear time - 7 days. The built-in colour guide will change colour to milky-white as the dressing absorbs exudate. When the colour change reaches the edge of the dressing, the dressing requires changing.

    Contra-indications
    DO NOT use on exposed muscle, tendon or bone
    DO NOT use in cases of known allergy or adverse reaction to one or more of the components.
    DO NOT use on deep partial thickness and full thickness burns.

    19.09 Comfeel Plus Ulcer Dressing  Size
    10cm x 10cm (10)

    This consists of moisture absorbing cellulose particles encapsulated in a synthetic, elestic and sticky mass. When the CMC articles come into contact with the wound exudate it forms a viscous gel that absorbs exudate and does not adhere to the wound. Calcium alginate has been added to the dressing to increase absorption.

    Indications - Comfeel Plus Dressing is uded for treatment of low to moderately exuding chronic wounds and superficial acute wounds such as Pressure ulcers, leg ulcers, superficial burns, donor sites, post-operative wounds and skin abrasions. It has a butterfly shape for difficult-to-dress areas such as elbows and knees. Comfeel Plus Pressure Relieving Dressing has a foam that disperses pressure from the wound bed. The dressing can also be used as secondary dressing and to protect the skin.

    Method of Use - Allow a minimum of 2-3cm overlay from the wound edge.

    Frequency of Use - The dressing can stay on for up to 7 days depending on the specific wound charactistics. The built-in colour guide will change colour to milky-white as the dressing absorbs exudates. When the coulour change reaches the edge of the dressing, the dressing requires changing.

    Contra-Indications
    DO NOT use on exposed muscle, tendon or bone
    DO NOT use in cases known allergy or adverse reaction to one or more of the components.
    DO NOT use on deep, partial thickness and full thickness burns.

    13.02.02 Conotrane Conotrane®

    Cream 100g (now discontinued) and 500g

    For nappy and urinary rash and pressure sores

    05.01.08 Co-trimoxazole  In antibiotic guidelines for use as second-line choice in Whooping Cough if macrolide allergic.
    08.01.05 Crizotinib 

    This is an NHS England Specialised Commissioning Drug for Cancer
    Hospital only In line with NICE

     

    19 C-View  Sizes
    6cm x 7cm (10)
    12cm x 12cm (10)

    Mode of ActionPrevention of friction, i.e. pressure ulcer prevention. Water proof/Bacteria proof.

    Indications - Low exuding, superficial, clean, granulating, epithelialising wounds. Used on abraisions, lacerations and donor sites.

    Method of Use - Position on skin without stretching, gently smooth over the skin. Remove by stretch - release. Can be cut. Can be used as a primary or secondary dressing. All adhesive dressings should be removed with care to prevent skin stripping/trauma, particularly when used on fragile oedematous skin.

    Frequency of Use - Maximum wear time 7 days.
    19 C-View Post-Op Dressing  Sizes
    6cm x 7cm (10)
    10cm x 12cm (10)
    10cm x 25cm (10)

    As with C-View but has a pad within the dressing so will take up to low exuding wounds. Suitable for low exuding wounds and post op sites.
    04.06 Cyclizine  Cyclizine HCl Tablet 50mg
    08.01.01 Cyclophosphamide 
    05.01.09 Cycloserine  All drugs for tuberculosis are hospital only
    08.03.04.02 Cyproterone Acetate 
    08.01.03 Cytarabine-Daunorubicin liposomal Vyxeos®

    This is an NHS England specialised commissioning drug

     

    02.08.02 Dabigatran Pradaxa®

    Dabigatran Etexilate 75mg Capsule
    Dabigatran Etexilate 110mg Capsule
    Dabigatran Etexilate 150mg Capsule

    If used for DVT or PE it needs to have an intial 5 days of parenteral anticoagulation prescribed.

    08.01.05 Dabrafenib mesilate Tafinlar®

    Restriction: In line with NICE Guidance only

     

     

    05.03.03.02 Daclatasvir Daklinza

    NHS England commissioned

    In line with NICE

    Bristol-Myers Squibb has discontinued daclatasvir (Daklinza)

    08.02.02 Daclizumab 

    This Drug has been discontinued

    08.01.05 Dacomitinib Vizimpro®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    06.07.02 Danazol 

    Danazol 100mg Capsules
    Danazol 200mg Capsules

     

    DRUG DISCONTINUATION (MAY 2020)
    Danazol 100mg and 200mg capsules have been discontinued in the UK, and remaining supplies are now exhausted. Clinicians are advised to no longer initiate new patients on this drug. (See DHSC alert SDA/2020/009)

    10.02.02 Dantrolene 
    06.01.02.03 Dapagliflozin Forxiga®

    Dapagliflozin Tablets 5mg
    Dapagliflozin Tablets 10mg

    Restriction: In line with NICE Guidance only

    For the treatment of symptomatic chronic heart failure with reduced ejection fraction.

    MHRA/CHM advice (updated April 2016): Risk of diabetic ketoacidosis with sodium-glucose co-transporter 2 (SGLT2) inhibitors (canagliflozin, dapagliflozin or empagliflozin)

    MHRA advice- SGLT2 inhibitors: reports of Fournier’s gangrene (necrotising fasciitis of the genitalia or perineum) (Feb 2019)

     

    06.01.02.03 Dapagliflozin Forxiga®

    Dapagliflozin Tablets 5mg

    Restriction: as per NICE Guidance - Dapagliflozin with insulin for treating type 1 diabetes

    Initiation and stabilisation by diabetic specialist and 6 month review to take place by the specialist


    MHRA/CHM advice (updated April 2016): Risk of diabetic ketoacidosis with sodium-glucose co-transporter 2 (SGLT2) inhibitors (canagliflozin, dapagliflozin or empagliflozin)

    MHRA advice- SGLT2 inhibitors: reports of Fournier’s gangrene (necrotising fasciitis of the genitalia or perineum) (Feb 2019)

    06.01.02.03 Dapagliflozin Forxiga®

    Restriction: In line with NICE Guidance only

    MHRA/CHM advice (updated April 2016): Risk of diabetic ketoacidosis with sodium-glucose co-transporter 2 (SGLT2) inhibitors (canagliflozin, dapagliflozin or empagliflozin)

    MHRA advice- SGLT2 inhibitors: reports of Fournier’s gangrene (necrotising fasciitis of the genitalia or perineum) (Feb 2019)

    08.01.05 Daratumumab  Darzalex®

    This is an NHS England Specialised Commissioning Drug

    In line with NICE

     

     

    MHRA advice (Aug 2019): Daratumumab (Darzalex▼)- risk of reactivation of hepatitis B virus

    09.01.03 Darbepoetin Alfa Aranesp®

    This is an NHS England Specialised Commissioning Drug for Dialysis-induced anaemia

    07.04.02 Darifenacin Emselex® Darifenacin MR Tablets 7.5mg
    Darifenacin MR Tablets 15mg


    First line treatments as stated in the NICE Guidelines CG171. (Not commonly used in Practice)
    08.03.04.02 Darolutamide Nubeqa®

    Restriction: In line with NICE Guidance only

    08.01.05 Dasatinib Sprycel®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

     

    19 Debrisoft  Tissue Nurse approval needed
    This product requires and exemption form. Prescribe for two weeks ONLY

    Size
    10cm x 10cm (5)

    A rapid, highly effective, safe and easy method of debridement for wounds containing loose slough, debris and hyperkeratosis.

    Indications - This includes leg ulcers, pressure ulcers, diabetic foot ulcers, trauma wounds and post operative wounds healing by secondary intention. Debrisoft is also very effective in the removal of hyperkeratosis from the skin.

    Method of Use - Monofilament fibres, single use only. Ensure the pad is fully moistened with tap water or saline, always use the soft fibre side, not the knitted. Gently, with light pressure using a circular moistened Debrisoft. Use a new piece of Debrisoft for each separate wound/area of skin.

    Contra-Indications - Should not be used as wound dressing, shoud not be used if there is a known sensitivity to any components of the product (100% polyester).


    08.03.04.02 Degarelix Firmagon®

    Commissioned by CCG's

    In line with NICE

    06.06.02 Denosumab Prolia®

    Amber with RICaD ONLY where local services are agreed.

    For use under specific circumstances for postmenopausal women who are unable to comply with the special instructions for administering alendronate and either risedronate or etidronate, or have an intolerance of, or a contraindication to, those treatments and who also have a specific combination of T-score, age and number of independent clinical risk factors for fracture.

    MHRA/CHM advice: Denosumab: atypical femoral fractures (February 2013)

    MHRA/CHM advice: Denosumab: minimising the risk of osteonecrosis of the jaw; monitoring for hypocalcaemia—updated recommendations (September 2014) and Denosumab: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

    MHRA/CHM advice: Denosumab: reports of osteonecrosis of the external auditory canal (June 2017)

    MHRA/CHM advice: Denosumab 60 mg (Prolia®): increased risk of multiple vertebral fractures after stopping or delaying ongoing treatment (August 2020)

    06.06.02 Denosumab XGEVA®

    Denosumab for the prevention of skeletal related events in adults with bone metastases from solid tumours TA265

    MHRA/CHM advice: Denosumab: atypical femoral fractures (February 2013)

    MHRA/CHM advice: Denosumab: minimising the risk of osteonecrosis of the jaw; monitoring for hypocalcaemia—updated recommendations (September 2014) and Denosumab: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

    MHRA/CHM advice: Denosumab: reports of osteonecrosis of the external auditory canal (June 2017)

    MHRA/CHM advice: Denosumab (Xgeva®) for giant cell tumour of bone: risk of clinically significant hypercalcaemia following discontinuation (June 2018)

    MHRA/CHM advice: Denosumab (Xgeva®) for advanced malignancies involving bone: study data show new primary malignancies reported more frequently compared to zoledronic acid (zoledronate) (June 2018)

    13.02.01 Dermatonics 25% Cream Dermatonics Once Heel Balm Cream with 25% Urea

    Cream 75 mL & 200 mL

    For Dry skin on soles of feet.
    For Diabetics ONLY
    ADULT and CHILD over 12 years, apply once daily


    03.04.01 Desloratadine Neoclarityn® Desloratadine 5mg Tablets

    Note: Desloratadine Oral Solution EXPENSIVE ITEM.
    06.05.02 Desmopressin  For Licensed Indications, please refer to individual formulations as per BNF
    07.03.02.01 Desogestrel  Desogestrel Tablet 75mcg
    06.03.02 Dexamethasone 

    Tablets 500mcg
    Tablets 2mg

    soluble tablets 2mg, 4mg and 8mg

    Oral Solution very expensive 400mcg/1ml 2mg/1ml 4mg/1ml

    If a soluble preparation is needed please prescribe the dispersible tablets as much more cost effective. Tablets must be dispersed in at least 50ml of water prior to swallowing

    In house studies have shown multiple tablets can be dispersed in 50mls of water please see link for information

    11.04.01 Dexamethasone eye drops Maxidex® Maxidex_Susp Eye Dps 0.1%
    11.04.01 Dexamethasone intravitreal implant Ozurdex®

    Dexamethasone Intravitreal Implant for treating Diabetic macular oedema

    12.01.01 Dexamethasone with Antibacterial Otomize® Otomize_Ear Spy 5ml
    12.01.01 Dexamethasone with Antibacterial Sofradex® Sofradex_Ear/Eye Dps
    11.04.01 Dexamethasone with Antibacterials Tobradex® Tobradex_Susp Eye Dps 3mg/ml / 1mg/ml
    11.04.01 Dexamethasone with Neomycin and Polymyxin B sulphate 

    Dexamethasone 0.1%, neomycin sulf. 0.35%, polymyxin B sulf. 6,000 iu per g

     

    eye ointment and eye suspension

    04.04 Dexamfetamine 

    Dexamfet Sulfate Tablet 5mg

    See link below for ESCA's. Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

    04.07.02 Diamorphine 

    Diamorphine Tablets 10mg

    5mg Powder for Soln for Injection Ampoules 
    10mg Powder for Soln for Injection Ampoules
    30mg Powder for Soln for Injection Ampoules
    100mg Powder for Soln for Injection Ampoules

    500mg Powder for Soln for Injection Ampoules

    04.08.02 Diazepam Rectal Tubes  Diazepam Solution 2.5mg/1.25ml Rectal Tube
    04.01.02 Diazepam Tablets  Diazepam Tablet 2mg
    Diazepam Tablet 5mg
    Diazepam Tablet 10mg
    Diazepam 2mg/5ml Oral Solution SF

    Diazepam 10mg/5ml Oral Solution SF SPECIAL ITEM Expensive


    CSM Advice: Hypnotics and Anxiolytics are indicated for the short-term relief of sleep disturbance and/or anxiety. (For continuous use up to a maximum of 14 days).
    13.08 Diclofenac 3% gel Solaraze Gel Diclofenac 3% Actinic Keratosis.
    Prescribe by brand Solaraze

    Actinic Keratosis- For treatment of superficial lesions in mild disease
    13.08.01 Diclofenac 3% gel Solaraze Diclofenac 3% gel (Solaraze gel ) Actinic Keratosis- For treatement of superficial lesions in mild disease

    Prescribe by Brand
    10.01.01 Diclofenac Sodium  MHRA Advice Diclofenac has a similar adverse effect profile to COX-2 NSAIDs which have a higher cardiovascular risk use is being limited to patients with renal colic where started by a specialist

    Diclofenac Sod_Tab E/C 25mg
    Diclofenac Sod_Tab E/C 50mg
    Diclofenac Sod_Tab 75mg M/R
    Diclofenac Sod_Tab 100mg M/R


    01.02 Dicycloverine 

    Dicycloverine HCI 10mg/5ml Oral Solution
    Dicycloverine HCI 10mg Tablet
    Dicycloverine HCI 20mg Tablet

    Please note very expensive. ONLY to be used for patients with swallowing difficulties. (Applicable in primary care only)

    08.03.01 Diethylstilbestrol 
    02.01.01 Digibind 
    02.01.01 Digifab 
    02.01.01 Digoxin 
    Digoxin 62.5microgram Tablet
    Digoxin 125microgram Tablet
    Digoxin 250microgram Tablet
    Digoxin 50microgram/mL Elixir

    Levels can be useful to assess toxicity, but need taking at least 6 hours post dose (best to give at night)
    In A.F. patients, the pulse rate can be used to guide dosing.
    04.07.02 Dihydrocodeine Tartrate  Dihydrocodeine Tartrate Tablet 30mg
    02.03.02 Diltiazem 

    Use Post M.I. if beta blockers contraindicated.

    To avoid confusion between different formulations of Diltiazem, prescribers should specify the Brand to be dispensed - as per BNF.

    Drug discontinuations
    Slozem® 120mg, 180mg, 240mg and 300mg capsules* –discontinued from December 2019 (stock should run out by end of Feb 2020).

    02.06.02 Diltiazem (sustained release) 

    To avoid confusion between different formulations of Diltiazem, prescribers should specify the Brand to be dispensed - as per BNF.

    Drug discontinuations
    Slozem® 120mg, 180mg, 240mg and 300mg capsules* –discontinued from December 2019 (stock should run out by end of Feb 2020).

    08.02.04 Dimethyl fumarate Tecfidera®

    This is an NHS England Specialised Commissioning Drug for Multiple Sclerosis

     

    13.05.03 Dimethyl fumerate Skilarence®

    This is commissioned by CCGs but is a hospital only drug

    In line with NICE

    13.10.04 Dimeticone Hedrin®

    Hedrin
    4% Lotion 50ml and 150ml
    4% Lotion Spray 120ml

    Hedrin Once
    4% liquid gel 100ml and 250ml
    4% spray gel 60ml and 100ml

    Non-insecticide, preferred first line to avoid resistance and insecticide cumulative exposure

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

    08.02.03 Dinutuximab Qarziba®

    NHS England commissioned - hospital only

     

    02.09 Dipyridamole 

    Dipyridamole M/R 200mg Capsule
    Dipyridamole 50mg/5ml Oral Suspension SF 


    There is a difference in indication between the modified-release preparation of dipyridamole and the standard-release tablets and liquid.

    National recommendations for secondary prevention of occlusive vascular events recommend the use of modified-release dipyridamole, according to the licensed indications.

    06.06.02 Disodium Pamidronate 
    02.03.02 Disopyramide 

    Disopyramide 100mg Capsule
    Disopyramide 150mg Capsule

    08.01.05 Docetaxel Taxotere®

    NHS England Specialised Services

     

     

    01.06.02 Docusate sodium 

    Docusate sodium 100mg Capsule
    Docusate sodium 50mg/5ml SF Oral Solution
    Docusate sodium Paediatric 12.5mg/5ml SF Oral Solution
    Docusate sodium Micro-Enema 120mg in 10g unit

    01.02 Domperidone 

    Domperidone 10mg Tablet
    Domperidone 5mg/5ml SF Oral Suspension

    MHRA/CHM advice—Domperidone: risk of cardiac side-effects—restricted indication, new contra-indications, reduced dose and duration of use (May 2014)

    MHRA (Dec 2019): Domperidone is no longer licensed for use in children younger than 12 or those weighing less than 35 kg. 

    04.06 Domperidone 

    Domperidone Tablet 10mg

    The MHRA has advised that there is a small risk of serious ventricular arrhythmia and sudden cardiac death with domperidone. See link below

    MHRA advice: Domperidone- risk of cardiac side-effects (Dec 2014)

    MHRA (Dec 2019): Domperidone is no longer licensed for use in children younger than 12 or those weighing less than 35 kg. 

    04.07.04.01 Domperidone  Please refer to Section 4.6
    04.11 Donepezil Aricept®

    Donepezil HCl Tablet 5mg
    Donepezil HCl Tablet 10mg
    Donepezil HCl_Orodisper Tablet 5mg
    Donepezil HCl_Orodisper Tablet 10mg

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

    03.07 Dornase Alfa Pulmozyme®

    This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis

    11.06 Dorzolomide 

    Dorzolamide_Eye Dps 2%

    Dorzolamide_Eye Dps 2% preservative free - prescribe as Eydelto brand as more cost effective

    11.06 Dorzolomide 2% with Timolol 0.5% 

    Dorzolamide/Timolol_Eye Dps 2%/0.5%

    Dorzolamide/Timolol_Eye Dps 2%/0.5% preservative free - prescribe as Eylamdo brand as more cost effective

    04.03.01 Dosulepin 

    Dosulepin HCl Capsule 25mg
    Dosulepin HCl Tablet 75mg

    NOT for new patients - more toxic in overdose. (MHRA December 2007).

    NHS England has identified this product as an item that should not be routinely prescribed in primary care. Where ongoing primary care prescribing is agreed in exceptional circumstances, there should be a co-operative relationship within a multidisciplinary team (July 2017).

    13.05.02 Dovobet Ointment 30g & Gel 30g and 60g 

    Gel is cheaper when prescribing large quantities, i.e. 120g upwards, than Ointment

    Apply Once Daily to max 30% body surface area (maximum 15g daily, maximum 100g weekly) for 4 weeks.
    If necessary, subsequent courses can be repeated after an interval of at least 4 weeks.

    02.05.04 Doxazosin mesilate 

    Doxazosin Mesilate 1mg Tablet
    Doxazosin Mesilate 2mg Tablet
    Doxazosin Mesilate 4mg Tablet


    **Not MR Preparation**. NHS England have advised there should be no prescribing. Patients can be converted to the normal release tablets.

    ONLY use when other classes of antihypertensives have been tried, or are contraindicated.

    05.01.03 Doxycycline 

    Doxycycline Hyclate Cap 50mg
    Doxycycline Hyclate Cap 100mg
    Doxycycline Hyclate Sol Tab 100mg

    13.06.02 Doxycycline  Once Daily
    Doxycycline can cause Photosensitivity reactions
    02.03.02 Dronedarone Multaq®

    Dronedarone 400mg Tablet

    04.06 Droperidol 

    Restriction: For initiation by specialists in anaesthetics only

    Rescue therapy (3rd line antiemetic) for post-operative nausea and vomiting (PONV) in children and adolescents aged 2 – 18 years old who do not respond adequately to dexamethasone or ondansetron (as monotherapy or in combination)

    13.06.01 Duac Gel Duac® Once Daily Benzoyl peroxide 3% w/w,clindamycin 1% w/w 30g
    Benzoyl peroxide 5% w/w,clindamycin 1% w/w 30g
    Benzoyl peroxide 5% w/w,clindamycin 1% w/w 60g
    Benzoyl peroxide 3% w/w,clindamycin 1% w/w 60g
    06.01.02.03 Dulaglutide Trulicity®

    To be initiated by a diabetes specialist

    Once weekly GLP1 injection

    0.75mg and 1.5mg solution for injection in a pre-filled pen

    Not for monotherapy

    Only continue if reduction in HBA1c of at least 1.0 percentage points and a weight loss of at least 3% is achieved within 6 months of starting treatment

    04.03.04 Duloxetine Cymbalta® Duloxetine HCl Capsule G/R 30mg
    Duloxetine HCl Capsule G/R 60mg
    07.04.02 Duloxetine 

    Duloxetine HCl_Cap G/R 30mg
    Duloxetine HCl_Cap G/R 60mg 
     

     

    13.05.03 Dupilumab Dupixent®

    This is commissioned by CCG's but is a hospital only drug

    In line with NICE

    19 Durafiber / Durafiber ribbon  Sizes
    10cm x 10cm (10)
    2cm x 45cm (5)

    Mode of Action - forms a cohesive gel when in contact with exudate. It maintains its integrity and does not disintegrate during handling, allowing easy, atraumatic removal. Facilitates the control of minor bleeding and debriding of slough.

    Indications - Primary dressing for moderate to heavily exuding wounds, suitable for leg ulcers, burns, pressure ulcers and lacerations. The ribbon is suitable for cavities, sinus tracts and fistulae.

    Method of Use - Should be placed directly onto the wound surface; cavity wounds should be loosely packed allowing a tail of at least 2.5cm to facilitate removal. Cover with a secondary dressing. Irrigation with saline or water may be required to facilitate easy removal of the dressing.

    Frequency of Dressing change - Dressings may be left in situ for 7 days, but requires more frequent changes id exudate is heavy.

    Contra-Indications - Not to be used for eschar or dry wounds.
    08.01.05 Durvalumab Imfinzi®

    In line with NICE

     

    06.04.02 Dutasteride Avodart® Avodart Capsules 500mcg
    A2.07 Easiphen® 
    02.08.02 Edoxaban Lixiana®

    Edoxaban 15mg Tablet
    Edoxaban 30mg Tablet
    Edoxaban 60mg Tablet

    Edoxaban is not licensed in VTE.

    If used for DVT or PE it needs to have an intial 5 days of parenteral anticoagulation prescribed.

    05.03.03.02 Elbasvir-grazoprevir Zepatier®

    This is an NHS England Specialised Commissioning Drug for Hepatitis C
     

    06.04.01.01 Elleste Duet Conti 

    Elleste-Duet Conti Tablets 2mg (estradiol) 1mg (norethisterone acetate)

    Continuous combined HRT for women with an intact uterus.

     

    SHORTAGES (June 2019)

    Current supply issues with this drug. An equivalent alternative brand is Kliofem® (estradiol 2mg/ norethisterone 1mg).

    09.01.04 Eltrombopag  Revolade®

    Restriction: In line with NICE Guidance only

     

     

    MHRA/CHM advice: Eltrombopag (Revolade®): reports of interference with bilirubin and creatinine test results (July 2018)

    01.04.02 Eluxadoline Truberzi®

    To be started by a specialist in gastroenterology and then transferred to GP surgery

    Prescribe in line with NICE guidance and review efficacy after 4 weeks

     

    MHRA/CHM advice: Eluxadoline (Truberzi®): risk of pancreatitis; do not use in patients who have undergone cholecystectomy or in those with biliary disorders (December 2017)

    06.01.02.03 Empagliflozin Jardiance
    13.02.01 Emulsifying Ointment 

    Greasy Preparation

    500g Emulsifying Ointment

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

     

    02.05.05.01 Enalapril  

    Enalapril 2.5mg Tablet
    Enalapril 5mg Tablet
    Enalapril 10mg Tablet
    Enalapril 20mg Tablet


    For existing patients ONLY.

    08.01.05 Encorafenib  Braftovi®

    Restriction: In line with NICE guidance only

     

    02.08.01 Enoxaparin Clexane®

    Important to prescribe as brand
    Continue whichever brand the patient has been initiated on to maintain familiarity with the injection device.  

    Enoxaparin Injection 100mg/ml 0.2ml Pfs
    Enoxaparin Injection 100mg/ml 0.4ml Pfs
    Enoxaparin Injection 100mg/ml 0.6ml Pfs
    Enoxaparin Injection 100mg/ml 0.8ml Pfs
    Enoxaparin Injection 100mg/ml 1ml Pfs

    Enoxaparin Injection 150mg/ml 0.8ml Pfs
    Enoxaparin Injection 150mg/ml 1ml Pfs

    02.01.02 Enoximone 
    09.04 Ensure®Compact 
    09.04 Ensure®Plus  Milkshake style
    09.04 Ensure®Plus Juce 
    09.04 Ensure®Shake 
    09.04 Ensure® Plus Advance 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Ensure® Plus Fibre 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Ensure® TwoCal 

    Initiation by specialist dietician services prior to continuation within primary care.

    04.09.01 Entacapone Comtess® Entacapone Tablet 200mg
    05.03.03 Entecavir Baraclude® Entecavir for the treatment of Chronic Hepatitis B TA153

    This is an NHS England Specialised Commissioning Drug for Hepatitis B
    08.01.05 Entrectinib Rozlytrek®

    Restriction: In line with NICE Guidance only

    08.03.04.02 Enzalutamide 

    This is an NHS England Specialised Commissioning Drug for Cancer

    12.02.02 Ephedrine 7 Day Use ONLY

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

    7 Day Use ONLY

     

     

    02.02.03 Eplerenone 

    Eplerenone 25mg Tablet
    Eplerenone 50mg Tablet

    For patients with left ventricular dysfunction following myocardial infarction (start therapy within 3-14 days of the event, as per BNF).
    Careful monitoring of U&E's is required
    Consider changing to spironolactione once stable.

    Once patient in stabilised prescribing can continue in primary care.  A RICad or prescribing supporting information will be provided

    09.01.03 Epoetin alfa Eprex®

    This is an NHS England Specialised Commissioning Drug for Dialysis-induced anaemia

    09.01.03 Epoetin beta NeoRecormon®

    This is an NHS England Specialised Commissioning Drug for Dialysis-induced anaemia

    02.09 Eptifibatide Integrilin®
    Eptifibatide 20mg/10ml solution for injection vials
    Eptifibatide 75mg/100ml solution for infusion vials
    04.07.04.02 Erenumab Aimovig®

    Restriction: In line with NICE Guidance only

    09.06.04 Ergocalciferol Calfovit D3® Calfovit D3_Pdr Sach 3.1g/800u
    08.01.05 Eribulin Halaven®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    08.01.05 Erlotinib Tarceva®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    08.01.05 Erlotinib Tarceva® Erlotinib for the treatment of non small cell lung cancer TA162
    Erlotinib monotherapy for maintenance treatment of non small cell lung cancer TA227
    Erlotinib for the first line tratment of locally advanced or metastatic egfe-tk mutation positive TA258

    05.01.07 Ertapenem 
    06.01.02.03 Ertugliflozin Steglatro®

    Ertugliflozin Tablets 5mg
    Ertugliflozin Tablets 15mg

    Restriction: In line with NICE Guidance only

    For mono, dual & triple therapy  - should not be initiated in patients with a glomerular filtration rate [GFR] < 60 mL/min and should be discontinued at GFR persistently below 45 mL/min

    MHRA/CHM advice (updated April 2016): Risk of diabetic ketoacidosis with sodium-glucose co-transporter 2 (SGLT2) inhibitors

    MHRA/CHM advice: SGLT2 inhibitors: reports of Fournier’s gangrene (necrotising fasciitis of the genitalia or perineum) (February 2019)

    05.01.05 Erythromycin 

    Erythromycin Tab GR 250mg 
     

    Please note there are other salts and 500mg tablets but are incredibly expensive it is more cost effective to give 2 x250mg GR tablets.
     
    Erythromycin Ethylsuc Susp 125mg/5ml S/F 
    Erythromycin Ethylsuc Susp 250mg/5ml S/F 
    Erythromycin Ethylsuc Susp 500mg/5ml S/F

    Liquid is for children and adults with swallowing difficulties only. Note there is a non sugar free version but this is more expensive
     
    Erythromycin is poorly tolerated (GI) in Adults - Clarithromycin is usually better tolerated

    13.06.01 Erythromycin 40mg with Zinc Acetate 12mg/mL Zineryt® Lotion 30ml and 90ml
    04.03.03 Escitalopram Cipralex®

    Escitalopram Tablet 5mg
    Escitalopram Tablet 10mg
    Escitalopram Tablet 20mg
    Escitalopram Oral Drops 10mg/ml S/F


    See MHRA advice on QT prolongation. Maximum daily dose 20 mg for adults; 10 mg for patients older than 65 years; and 10 mg for those with hepatic impairment.

    04.08.01 Eslicarbazepine Zebinix®

    Eslicarbazepine 200mg tablets
    Eslicarbazepine 800mg tablets

    Restriction: By specialist only
    Unnecessary to maintain patient on specific manufacturer's products.

    01.03.05 Esomeprazole granules 

    Restriction: For use in paediatric patients for gastro-oesophageal reflux disease only

    Third choice (for those unable to use Omeprazole dispersible and Lansoprazole orodispersible preparations; Expensive)

    07.02.01 Estriol 0.01% cream Ovestin® Ovestin_Crm 0.01% + Applic

    Improve the vaginal epithelium in menopausal atrophic vaginitis (short-term use)

    Apply 1 applicatorful daily for 2–3 weeks, then reduced to 1 applicatorful twice weekly, discontinue every 2–3 months for 4 weeks to assess need for further treatment.


    Use in Vaginal surgery for prolapse when there is epithelial atrophy in postmenopausal women (before surgery)


    Apply 1 applicatorful daily for 2 weeks before surgery, resume 2 weeks after surgery.



    10.01.03 Etanercept Enbrel® This is an NHS England Specialised Commissioning Drug for Paediatric indications (where adult T/A available)
    This is an NHS England Specialised Commissioning Drug for Juvenile Arthritis
    13.05.03 Etanercept Enbrel®
    09.05.01.02 Etelcalcetide   This is an NHS Specialist Commissioning drug for treating secondary hyperparathyroidism in adults with chronic kidney disease on haemodialysis
    05.01.09 Ethambutol  
    All drugs for tuberculosis are hospital only
    04.08.01 Ethosuximide 

    Ethosuximide Oral Solution 250mg/5ml
    Ethosuximide Capsule 250mg

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products.

    07.03.02.02 Etonorgestrel (Implanon) Nexplanon®

    Etonogestrel Implant 68mg
    Nexplanon Implant 68mg

    MHRA/CHM advice (June 2016): Nexplanon® (etonogestrel) contraceptive implants: reports of device in vasculature and lung

    FSRH: CEU statement on Nexplanon insertion site (Jan 2020)

    10.01.01 Etoricoxib  MHRA Advice COX-2 NSAIDs have a higher cardiovascular risk profile -LIMIT USE

    Etoricoxib_Tab 30mg
    Etoricoxib_Tab 60mg
    Etoricoxib_Tab 90mg
    Etoricoxib_Tab 120mg


    For Gout ONLY, regular BP monitoring required.
    08.01.05 Everolimus Afinitor®

    This is an NHS England Specialised Commissioning Drug for Cancer
    Hospital only in line with NICE

     

    05.03.01 Eviplera Eviplera® Emtricitabine 200mg, Rilpivirine 25mg and Tenofovir 245mg
    05.03.01 Eviplera 
    02.12 Evolocumab Repatha®

    Restriction: In line with NICE Guidance only

    06.04.01.01 Evorel  Patches
    Estradiol '25' patch (releasing approx. 25micrograms/24 hours
    Estradiol '50' patch (releasing approx. 50micrograms/24 hours
    Estradiol '75' patch (releasing approx. 75micrograms/24 hours
    Estradiol '100' patch (releasing approx. 100micrograms/24 hours

    Unopposed oestrogen only. For hysterectomised women and non-hysterectomised women following individual risk/benefit assessment.
    06.04.01.01 Evorel Conti  Patches
    50mcg/24hours

    06.04.01.01 Evorel Sequi  Combintion Pack

    Sequential combined HRT for women with an intact uterus
    08.03.04.01 Exemestane 
    06.01.02.03 Exenatide Bydureon®

    Bydureon 2 mg powder and solvent for prolonged-release suspension for injection pre-filled pen

    PRODUCT DISCONTINUATION

    Bydureon 2 mg powder and solvent for prolonged-release suspension for injection in pre-filled pen (exenatide once-weekly) will be discontinued from 31/12/2020. Clinicians should note that the old device is being replaced by the Bydureon BCise pen (exenatide 2mg prolonged-release injectable suspension); a once weekly, single use, fixed dose pen with a hidden needle that automatically injects the required dose, allowing for simpler administration compared to the old Bydureon device. Prior to prescribing and administration of this new device, patient and caregivers training must be undertaken by a healthcare professional.

    To be initiated by a diabetes specialist

    Once weekly preparation of exenatide


    Exenatide should only be considered if
    • BMI>= 35mg/m2 in people of European descent and there are problems associated with high weight
    • BMI < 35mg/m2 and insulin is unacceptable because of occupational implications or weight loss would benefit other co-morbities.

    Only continue if reduction in HBA1c of at least 1.0 percentage points and a weight loss of at least 3% is achieved within 6 months of starting treatment

    06.01.02.03 Exenatide Byetta® Exenatide should only be considered if
    • BMI>= 35mg/m2 in people of European descent and there are problems associated with high weight
    • BMI < 35mg/m2 and insulin is unacceptable because of occupational implications or weight loss would benefit other co-morbities.

    Only continue if reduction in HBA1c of at least 1.0 percentage points and a weight loss of at least 3% is achieved within 6 months of starting treatment
    02.12 Ezetimibe Ezetrol®

    Ezetimibe 10mg Tablet

    Very limited indications refer to NICE Guidelines.
    Reserved for non-familial hypercholesterolaemia in patients that are contra-indicated to statins or are statin intolerant

    10.01.04 Febuxostat Adenuric® Febuxostat_Tab 80mg
    Febuxostat_Tab 120mg
    02.06.02 Felodipine  

    Felodipine 2.5mg M/R Tablet
    Felodipine 5mg M/R Tablet
    Felodipine 10mg M/R Tablet

    07.03.01 Femodene Femodene® ED Femodene ED_Tablet
    Femodene_Tablet
    06.04.01.01 Femoston 
    06.04.01.01 Femoston Conti 
    02.12 Fenofibrate 
    Fenofibrate micronised 160mg Tablet
    Fenofibrate micronised 67mg Capsule
    Fenofibrate micronised 200mg Capsule
    Fenofibrate micronised 267mg Capsule



    Healthcare professionals should not prescribe them to newly diagnosed patients as first-line treatment, except for those with severe hypertriglyceridaemia or those who cannot take statins.

    04.07.02 Fentanyl 

    Fencino Transdermal Patch 12mcg/hr
    Fencino Transdermal Patch 25mcg/hr
    Fencino Transdermal Patch 50mcg/hr
    Fencino Transdermal Patch 75mcg/hr
    Fencino Transdermal Patch 100mcg/hr

    Useful if patient cannot swallow tablets
    Prescribe by Brand - Fencino recommended 
    (Applicable in Primary care only). 

    09.01.01.01 Ferrous Fumarate  Ferr Fumar_Liq Spec 140mg/5ml
    Ferr Fumar_Oral Soln 140mg/5ml
    Ferr Fumar_Oral Soln 140mg/5ml S/F
    Ferr Fumar_Tab 210mg

    Significantly less expensive than ferrous sulphate
    09.01.01.01 Ferrous Sulphate  Ferr Sulf_Tab 200mg
    07.04.02 Fesoterodine Toviaz® Fesoterodine Fumar_Tab 4mg M/R
    Fesoterodine Fumar_Tab 8mg M/R

    Very Expensive. NOT commonly used in Practice.

    10.01.03 Filgotinib Jyseleca®

    Restriction: In line with NICE Guidance

    09.01.06 Filgrastim  Nivestim® This is an NHS England Specialised Commissioning Drug for Neutopenia and Bath Syndrome
    06.04.02 Finasteride  Finasteride Tablets 5mg

    Useful for BPH if Alpha-blockers are not tolerated. Only effective in men with large prostates >49ml
    08.02.04 Fingolimod 

    This is an NHS England Specialised Commissioning Drug for Multiple Sclerosis

    MHRA advice (Sep 2019): Fingolimod (Gilenya▼): increased risk of congenital malformations; new contraindication during pregnancy and in women of childbearing potential not using effective contraception

     

    19 Flamazine Silver Sulphadiazine Cream  Sizes
    20g (1)

    Mode of Action - It is an antibacterial cream used to treat bacterial infections in burns and other wounds. (for burns or two week use, or as indicated by TVS).

    Indications - infected/colonised wounds, prophylactically for burns, effective againist all strains of MRSA.

    Method of Use - Should be applied 3.5mm in depth, a secondary dressing should be applied. Each container is for single patient use only.

    Contra-Indications - pregnancy, children in first month of life.

    Caution - significant hepatic or renal impairment, known sensitivities to sulphonamide.

    Frequency of Dressing change - the dressing should be changed every 2 to 3 days. Once opened pots should be disposed of after 24 hours, tubes can be used for up to 7 days. In burns replace dressing after 24 hours.
    19 Flaminal Forte (absorbs) & Flaminal Hydro (hydrates)  Tissue Nurse approval needed
    This product requires and exemption form. Prescribe for two weeks ONLY

    Size 15g (5)

    This product requires an exemption form. Prescribe for two weeks ONLY

    Alginate gel containing two antimicrobial enzymes, glucose oxidase and lactoperoxidase.Provides antimicrobial activity without damaging healing cells.

    Mode of Action - Debrides and maintains moisture balance. Provides a biodegradeable, soft and soothing wound interface reducing pain and trauma.

    Indications - Moderate to heavily exuding wounds. Can be used on a wide range of wound types and at every stage of healing.

    Method of Use - Apply a thick layer (5mm) of either Flaminal Hydro or Flaminal Forte to the wound, do not allow to spill over the wound edge. Flaminal can be re-capped & re-used on the same patient.

    Frequency of Dressing change - Choose Flaminal Hydro for wounds that are dry or have a mild to moderateamounts of exudate. This generally means wounds in which the dressing can stay in place for 3-4 days. Choose Flaminal Forte for wounds that have moderate to heavy amounts of exudate. Flaminal Forte wounds are generally changed every 1-2 days.

    Contra-Indications - Known sensitivity to aliginate dressing of poyethylene glycol. Should not be uded on full thickness burns.

    06.01.06 Flash glucose monitoring system FreeStyle Libre® FreeStyle Libre 2®

    Initiation of patients on FreeStyle Libre® FreeStyle Libre 2® will be done by diabetes specialist teams ONLY using the following criteria:

    - People with Type 1 diabetes* 
    - People with any form of diabetes on hemodialysis AND on insulin* (* who are clinically indicated as requiring intensive monitoring >8 times per day; as demonstrated on a meter download/review over the last 3mths.)
    - People with diabetes associated with cystic fibrosis on insulin treatment. 
    - Pregnant women with type 1 diabetes; for a maximum of 12 months including the post-partum period.
    - People with Type 1 diabetes unable to routinely self-monitor blood glucose levels due to disability that requires carers to support glucose monitoring and insulin management.
    - People with Type 1 diabetes for whom the specialist MDT team determines has occupational or psychosocial circumstances that warrant a 6 month trial of Libre with adjunct support.
    - Previous self-funders of Flash Glucose Monitoring with Type 1 diabetes where those with clinical responsibility for their care are satisfied that their clinical history suggests that they would have satisfied one or more of the criteria prior to them commencing use of Flash Glucose Monitoring AND has shown improvement in HbA1c since self-funding. 
    - For those with Type 1 diabetes and recurrent severe hypoglycaemia or impaired awareness of hypoglycaemia, NICE suggests that Continuous Glucose Monitoring (CGM) with an alarm is the standard. However, if the person with diabetes and their clinician consider that Flash Glucose Monitoring would be more appropriate for the individual’s specific situation, then this can be considered.
    - People with Type 1 diabetes or insulin treated Type 2 diabetes who are living with a learning disability and recorded on their GP Learning Disability register.

    The CCG does not currently commission the prescribing of Freestyle Libre for any other patients other than those identified above.

    Limited to prescribing two sensors per 28 days.

    02.03.02 Flecainide Acetate 

    Flecainide Acetate 50mg Tablet
    Flecainide Acetate 100mg Tablet

    19 Flivasorb  10 x 10cm (10)
    10 x 20cm (10)
    20 x 20cm (10)
    20 x 30cm (10)
    19 Flivasorb Adhesive  12 x 12cm (10)
    15 x 15cm (10)
    05.01.01.02 Flucloxacillin 

    Flucloxacillin Sod Cap 250mg
    Flucloxacillin Sod Cap 500mg

    High Cost MedicineSolution is expensive and should be reserved for those unable to swallow capsules
    Flucloxacillin Sod Oral Soln 125mg/5ml
    Flucloxacillin Sod Oral Soln 125mg/5ml S/F
    Flucloxacillin Sod Oral Soln 250mg/5ml
    Flucloxacillin Sod Oral Soln 250mg/5ml S/F

    05.02 Fluconazole 

    Fluconazole Cap 50mg
    Fluconazole Cap 150mg
    Fluconazole Cap 200mg

    07.02.02 Fluconazole  Fluconazole 150mg for 1 dose


    recurrent vulvovaginal candidiasis

    Initially 150 mg every 72 hours for 3 doses, then 150 mg once weekly for 6 months.
    08.01.03 Fludarabine Phosphate Fludara®

    Guidance on the use of fludarabine for b-cell chronic lymphocytic leukaemia T

     

     

    06.03.01 Fludrocortisone  Florinef Tablets 100mcg
    12.01.01 Flumetasone 0.02% with Clioquinol 1% 

    Flumetasone 0.02% with Clioquinol 1%_Ear Dps

    11.04.01 Fluocinolone intravitreal implant Iluvien®
    11.04.01 Fluorometholone FML FML®
    13.08.01 Fluorouracil Efudix® Superficial malignant and pre-malignant skin lesions.
    Initiation by Dermatologist
    04.03.03 Fluoxetine 

    Treatment in Adolescents

    Fluoxetine HCl Capsule 20mg
    Fluoxetine Liquid 20mg/5ml (Prescribe Liquid for doses less than 20mg)

    See link below for ESCA's. 

    Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

    04.03.03 Fluoxetine  Treatment in Adults

    Fluoxetine HCl Capsule 20mg
    Fluoxetine 20mg orodispersible tablets

    Use the orodispersible tablets where there are swallowing difficulties or patient is on a 10mg dose as the tablet can be divided into equal halves to get the correct dose. This is much more cost effective then the oral solution
    04.02.02 Flupentixol Decanoate  Flupentixol Decanoate Injection 20mg/ml 1ml Amp
    Flupentixol Decanoate Injection 20mg/ml 2ml Amp
    Flupentixol Decanoate Injection 100mg/ml 0.5ml Amp
    Flupentixol Decanoate Injection 100mg/ml 1ml Amp
    Flupentixol Decanoate Injection 200mg/ml 1ml Amp
    04.02.02 Fluphenazine Decanoate 

    Fluphenazine Decanoate Injection 20mg/ml 5ml Amp
    Fluphenazine Decanoate Injection 25mg/ml 0.5ml Amp
    Fluphenazine Decanoate Injection 25mg/ml 1ml Amp
    Fluphenazine Decanoate Injection 25mg/ml 2ml Amp
    Fluphenazine Decanoate Injection 100mg/ml 0.5ml Amp
    Fluphenazine Decanoate Injection 100mg/ml 1ml Amp

    03.02 Fluticasone and formoterol Flutiform® Fluticasone/Formoterol Inhalation 125/5mcg 120D
    Fluticasone/Formoterol Inhalation 250/10mcg 120D
    Fluticasone/Formoterol Inhalation 50/5mcg 120 D
    Flutiform Inhalation 125/5mcg (120 D)
    Flutiform Inhalation 250/10mcg (120 D)
    Flutiform Inhalation 50/5mcg (120 D)
    12.02.01 Fluticasone furoate Avamys®
    03.02 Fluticasone/vilanterol/umeclidinium  Trelegy Ellipta®

    Trelegy Ellipta 92micrograms/dose / 55micrograms/dose / 22micrograms/dose dry powder inhaler

    Contains 3 components Fluticasone, Vilanterol and Umeclidinium

    09.01.02 Folic Acid  Folic Acid_Tab 400mcg
    Folic Acid_Tab 5mg

    Folic Acid (0.4mg) required to prevent neutral tube defects; available OTC
    02.08.01 Fondaparinux 

    Solution for injection pre-filled syringes

    09.04 Foodlink Complete® 
    09.04 Foodlink Complete® with Fibre 

    Initiation by specialist dietician services prior to continuation within primary care.

    13.07 Formaldehyde Veracur®

    Self Care  Self Care Medicine. Available OTC for self care

    03.01.01.01 Formoterol Fumarate  Formoterol Dry Powder Inhaler 12mcg/actuation 120D

    Formoterol Easyhaler 12mcg (120 D)

    Long Acting Beta2 Adrenoreceptor Agonist
    Indicated COPD ONLY.

    03.01.04 Formoterol/Aclidinium Bromide Duaklir Genuair Aclidinium Bromide 396mcg/dose/Formoterol 11.8mcg/dose DPI
    Duaklir 340mcg/dose/ 12mcg/dose Genuair


    Long-Acting Antimuscarinic + Long-Acting Beta2 Adrenorecepter Agonist combination.

    Indicated for COPD ONLY.

    The combination product offers cost & compliance advantages compared to prescribing LAMA and LABA drugs as separate devices.

    03.02 Formoterol/Beclometasone Fostair® Fostair Inhalation 100mcg/6mcg (120D) CFF

    Fostair Inhalation 200mcg/6mcg (120D) CFF (ASTHMA ONLY)

    ONLY USE THE HIGHER STRENGTH 200/6 PREPARATION IN ASTHMA, 100/6 CAN BE USED IN ASTHMA AND COPD
    09.04 Fortisip® 2kcal 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Fortisip® Compact Fibre 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Fortisip® Compact Protein 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Fortisip® Extra 

    Initiation by specialist dietician services prior to continuation within primary care.

    05.01.07 Fosfomycin Sachets 3g Monuril® Specialist Use ONLY- where recommended by a microbiologist

    Please prescribe by Brand Monuril® 3g sachets which is the licensed preparation.

    By mouth , uncomplicated lower urinary-tract infections caused by multiple-antibacterial resistant organisms (when other antibacterials cannot be used), adult over 18 years 3g as a single dose (in men, repeat dose after 3 days)

    For treatment of multi-resistant gram-negative organisms on the advice of microbiologists ONLY & for patients who cannot use any other oral alternative. .

    04.07.04.02 Fremanezumab Ajovy®

    Restriction: In line with NICE Guidance only

    09.04 Fresubin® 2kcal Creme 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Fresubin® 3.2kcal Drink  

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Fresubin® Thickened  Level 2

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Fresubin® Thickened  Level 3

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Fresubin® 5kcal Shot 

    Initiation by specialist dietician services prior to continuation within primary care.

    08.03.04.01 Fulvestrant Faslodex®

    Not recommended by NICE - see NICE TA for guidance

     

    02.02.02 Furosemide 

    Furosemide 20mg/5ml S/F Oral Solution
    Furosemide 40mg/5ml S/F Oral Solution
    Furosemide 20mg Tablet
    Furosemide 40mg Tablet

    Monitor Potassium Levels - Risk of Hypokalaemia

    11.03.01 Fusidic Acid  Fusidic Acid_Viscous Eye Dps 1%

    2nd Line - Useful for Staphylococcal Infections
    13.10.01.01 Fusidic Acid 2% Fucidin® ONLY if indicated on swab report
    01.06.01 Fybogel Fybogel® Mebeverine
    04.07.03 Gabapentin 

    Capsules 100mg
    Capsules 300mg
    Capsules 400mg

    Oral Solution 50mg/ml

    CDAs of the 1st April 2019 Gabapentin is re-classified as a Schedule 3 Controlled Drug

    04.07.04.02 Gabapentin Neurontin®
    04.08.01 Gabapentin 

    Gabapentin Capsule 100mg
    Gabapentin Capsule 300mg
    Gabapentin Capsule 400mg

    CD As of the 1st April 2019 Gabapentin is re-classified as a Schedule 3 Controlled Drug

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products.

    04.11 Galantamine Reminyl®

    Galantamine_Tablet 8mg
    Galantamine_Tablet 12mg

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

    04.11 Galantamine M/R capsules Galzemic XL capsules®

    Galantamine XL 8mg Capsules
    Galamtamine XL 16mg capsules
    Galantamine XL 24mg capsules

    Please prescribe by brand name GALZEMIC XL as this is most cost effective option.

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

    04.07.04.02 Galcanezumab Emgality®

    Restriction: In line with NICE Guidance only

    01.01.02 Gaviscon®Advance 

    Self Care Self Care Medicine -Available OTC for self care

          

    01.01.02 Gaviscon®Infant Oral Powder Sachets

    Each half of the dual-sachet is identified as ‘one dose’.

    To avoid errors prescribe with directions in terms of ‘dose’.

    08.01.05 Gefitinib Iressa®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

     

    12.03.05 Gelclair 
    08.01.03 Gemcitabine Gemzar®

    Guidance on the use of gemcitabine for the treatment of pancreatic cancer 
    Guidance of Gemcitabine for the treatment of metastic breast cancer

     

     

    08.02.03 Gemtuzumab ozogamicin Mylotarg®

    NHS England Commissioned - Hospital Only

     

    05.01.04 Gentamicin 
    08.01.05 Gilteritinib Xospata®

    Restriction: In line with NICE Guidance only

    12.03.05 Glandosane®  Glandosane_A/Spy 50ml (Lem)
    Glandosane_A/Spy 50ml (Peppermint)
    06.01.01.02 Glargine 300units/ml  Toujeo Solostar®

    Ricad no longer needed for continuation in primary care. It only needs to be initiated by diabetes team and then followed up to ensure effectiveness.

    08.02.04 Glatiramer acetate Copaxone®

    Restriction: In line with NICE Guidance only

    05.03.03.02 Glecaprevir - pibrentasvir Maviret®

    NHS England commissioned

    In line with NICE

    06.01.02.01 Gliclazide  Slow release preparations of sulphonylureas should not be used due to increased risk of hypoglycaemia. Start at smaller dose at the time of day when blood glucose levels increase following meals-likely to be with biggest carbohydrate load of the day. Titrate dose until blood glucose levels smooth out then reduce testing.
    06.01.06 Gluco Rx Nexus  

    Alternative meters may be needed for some patient groups e.g in maternity patients or if ketone testing is required.

    06.01.04 Gluco-Juice ®(glucose 15g in 60mL) 

    Only for prescribing to children with diabetes under the age of 18.
    All other patients should be advised to purchase this or other glucose products for the management of hypoglycaemia.

    From March 2019 this item is now known as (Lift Glucose Juice Shot Berry)

    Could prescriptions please be hand written.

    06.01.01.03 GlucoRx Needles  First choice unless a safety needle is advised by the diabetes team

    Finepoint - Pen needles for Insulin
    4mm/31G
    5mm/31G
    6mm/31G
    8mm/31G
    10mm/29G
    12mm/29G

    Finepoint Ultra - Pen needles for Insulin
    4mm/32G
    06.01.01.03 GlucoRx Lancets  Blood Lancets (Pack size 200)
    0.31mm/30G

    Safety Lancets (Pack size 100)
    1.6mm/30G
    1.6mm/32G
    1.8mm/26G
    1.8mm/28G
    2.2mm/23G
    09.04.01 Gluten Free Dietary Products 

    Prescribe in line with ACBS Guidance and endorse prescription ’ACBS’
    Please prescribe in line with current guidelines

    01.06.02 Glycerol (Glycerin) 

    Glycerol 4g Suppositories Adults
    Glycerol 2g Suppositories Children
    Glycerol 1g Suppositories Infants

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

     

     

    02.06.01 Glyceryl Trinitrate 

    Glyceryl Trinitrate 400 mcg/spray (180 dose)
    Glyceryl Trinitrate 400 mcg/spray (200 dose)
    Glyceryl Trinitrate 500microgram S/L Tablet

    For the infrequent user it is more cost effective to have the spray.
    AVOID patches as very expensive, offer a few advantages and should be removed overnight.
    AVOID Suscard Buccal as very expensive.

    01.07.04 Glyceryl Trinitrate 0.4% Rectogesic®

    Rectogesic 0.4% Ointment

    01.02 Glycopyrronium bromide Sialanar® oral solution

    Sialanar® 320mcg/ml glycopyrronium (equivalent to 400mcg/ml glycopyrronium bromide) - 60mL oral solution, 250mL oral solution.

    Restriction: For Initiation and stabilisation by a specialist prior to transferring into primary care

    03.01.02 Glycopyrronium Bromide Seebri breezhaler® Glycopyrronium Bromide Inhalation Capsule 55mcg + Device
    Seebri Breezhaler 44mcg Inhalation Powder Capsules + Device

    Long-Acting Antimuscarinic
    Indication for COPD ONLY.

    01.05.03 Golimumab Simponi®

    Restriction: In line with NICE Guidance only

    10.01.03 Golimumab Simponi®

    Commissioned by CCG's

    Hospital only

    In line with NICE

    08.03.04.02 Goserelin Zoladex®

    Zoladex 3.6 mg Implant - monthly

    Indications:

    • Prostate cancer
    • Breast cancer
    • Endometriosis
    • Endometrial thinning
    • Uterine fibroids
    • Assisted reproduction

     

    08.03.04.02 Goserelin Zoladex® LA

    Zoladex LA 10.8mg implant - 3 monthly

    Indications:

    • Prostate cancer
    04.06 Granisetron 
    13.05.03 Guselkumab Tremfya®

    This is commissioned by CCG'S but is a hospital only drug

    In line with NICE

    04.02.01 Haloperidol 
    Haloperidol 500microgram Tablets
    Haloperidol 1.5mg Tablets
    Haloperidol 5mg Tablets
    Haloperidol 10mg Tablets
    Haloperidol 1mg/5ml Oral Solution (Halkid)
    Haloperidol 5mg/5ml Oral Solution SF 
    Haloperidol 10mg/5ml Oral Solution SF
    04.02.02 Haloperidol Haldol Decanoate® Haloperidol Decanoate Injection 50mg/ml 1ml Amp
    Haloperidol Decanoate Injection 100mg/ml 1ml Amp
    02.08.01 Heparin  Heparin sodium 1000 units/ml injection ampoule
    Heparin sodium 5000 units/5ml injection ampoule
    Heparin sodium 20000 units/20ml injection ampoule
    Heparin sodium 10000 units/10ml injection ampoule

    Heparin 5000 units/ml injection vials
    Heparin sodium 25000 units/ml injection ampoule
    Heparin calcium 5000 units/0.2ml injection ampoule

    All heparin infusion bags

    These are all hospital only prescribing only the heparin flushes listed below are allowed in primary care
    02.08.01 Heparin 
    02.08.01 Heparin unfractionated flushes  heparin sodium 50 units/5ml patency solution ampoules
    heparin sodium 50 units/5ml i.v flush solution ampoules

    heparin sodium 200 units/2ml patency solution ampoules
    heparin sodium 200 units/2ml i.v flush solution ampoules

    These are flushes for maintaining patency of peripheral venous catheters- note there are two strengths so confirm with original specialist which is needed.
    06.03.02 Hydrocortisone  

    Standard release 10mg and 20mg tablets

     

    12.03.01 Hydrocortisone Corlan® Corlan_Pellets 2.5mg
    13.04 Hydrocortisone 0.5%  Mild Potency

    Cream 15g and 30g
    Ointment 15g and 30g

    Please refer to Topical Corticosteroid Potency Ladder for more details
    06.03 Hydrocortisone 1% 
    13.04 Hydrocortisone 1%  

    Mild Potency

    Cream 15g, 30g and 50g
    Ointment 15g, 30g and 50g


    Please refer to Topical Corticosteroid Potency Ladder for more details

    Self Care Self Care Medicine-Available OTC for self care. (Please note exceptions may apply)

     

    13.04.01 Hydrocortisone 1% with Miconazole Nitrate 2% Daktacort® Mild Potency with Antifungal

    Cream 30g
    Ointment 30g

    Please refer to Topical Corticosteroid Potency Ladder for more details
    13.04.01 Hydrocortisone 1%, Clotrimazole 1% Cream  Mild Potency with antifungal.

    Cream 20g and 50g

    DO NOT PRESCRIBE 15g SIZE - MORE EXPENSIVE

    Please refer to Topical Corticosteriod Potency Ladder for more details
    13.04.01 Hydrocortisone Acetate 1% with Fusidic Acid 2% Fucidin H® Mild Potency

    Cream 30g and 60g

    Use ONLY when sensitivity to Fusidic Acid confirmed on Microbiology Report

    Please refer to Topical Corticosteroid Potency Ladder for more details
    12.01.01 Hydrocortisone Acetate 1% with Gentamicin 0.3% Gentisone® HC

    Gentisone HC_Ear Dps

    Note: more expensive

    01.05.02 Hydrocortisone foam enema Colifoam®

    July 2018 - supply problem expected to last until late 2018/early 2019

    Hydrocortisone acetate 100 mg per 1 gram (Colifoam 10% enema)

    Gastroenterologists have advised this is a more cost effective choice then prednisolone enema and that the preparations are interchangeable (Burton, wolverhampton and Heart of England Trust have agreed this)

    13.02.01.01 Hydromol Bath and Shower Emollient 

    Cheapest Bath Additive

    There is no evidence to support the use of bath and shower emollients. Patients should be advised to wash with their normal emollient as a soap substitute(but not 50:50)as this is more cost effective and provides better moisturisation. Bath emollients leave the bath very slippery and there is a risk of falling.

    Please note Hydromol Cream and Ointment Preparations should be prescribed as Zeroderm
     
    Please refer to the Supplementary ’Emollient Guide’ for more detail

    NHS England has identified this product as an item that should not be routinely prescribed in primary care (Ver. 2, June 2019)

    NHS England: Items which should not be routinely prescribed in primary care: Guidance for CCGs

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

     

    13.02.01 Hydrous Ointment  Greasy Preparation

    500g Ointment (Oily Cream)

    This is also called Oily cream

    09.01.02 Hydroxocobalamin  Hydroxocobalamin_Inj 1mg/ml 1ml Amp

    Maintenenace Dose needed once every 3 months
    08.01.05 Hydroxycarbamide 
    09.01.03 Hydroxycarbamide Siklos®
    13.05.03 Hydroxycarbamide 
    10.01.03 Hydroxychloroquine  Hydroxychloroquine Sulf_Tab 200mg
    03.04.01 Hydroxyzine  Hydroxyzine HCl Tablet 10mg
    Hydroxyzine HCl Tablet 25mg
    Hydroxyzine HCl Oral Solution 10mg/5ml


    Pruritus.
    01.02 Hyoscine Butylbromide 

    Hyoscine Butylbromide 10mg Tablet
    Hyoscine Butylbromide 20mg/1ml Amps for palliative care

     

    MHRA/CHM advice: Hyoscine butylbromide (Buscopan®) injection: risk of serious adverse effects in patients with underlying cardiac disease (February 2017).

    Hyoscine butylbromide injection is contra-indicated in patients with tachycardia and should be used with caution in patients with cardiac disease.

    19 Hypafix  Size
    10cm x 5m (1)
    03.07 Hypertonic Sodium Chloride 7% Nebules PulmoClear®
    11.08.01 Hypromellose Evolve®

    0.3% eye drops preservative free

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

     

    11.08.01 Hypromellose 0.5% eye drops 

    Please prescribe generically

             

        Self Care Self Care Medicine-Available OTC for self care

             

    06.06.02 Ibandronic Acid Oral

    Ibandronic acid 50mg tablets

    Ibandronic acid 150mg tablets
     
    Therapeutic indications Ibandronic acid is indicated in adults for prevention of skeletal events (pathological fractures, bone complications requiring radiotherapy or surgery) in patients with breast cancer and bone metastases.

    People at risk of osteoporosis need to maintain an adequate intake of Calcium and Vitamin D; Vitamin D dosage should be 800iu per day .

    06.06.02 Ibandronic Acid  Injection

    Ibandronic acid 3mg/3ml solution for injection pre-filled syringes

    Licensed for osteoporosis for Specialist Initiation

    06.06.02 Ibandronic acid IV infusion Bondronat®
    08.01.05 Ibrutinib Imbruvica ®

    This is an NHS England specialised commissioning drug

     

    04.07 Ibuprofen  Tablets 200 and 400mg
    Oral Suspension SF 100mg/5ml
    Oral Suspension 100mg/5ml



    See also section 10.1.1
    10.01.01 Ibuprofen 
    Ibuprofen_Tab 200mg
    Ibuprofen_Tab 400mg
    Ibuprofen_Oral Susp 100mg/5ml


    First Line Agents - Topical Ibuprofen for patients with OA try prior to oral therapy (NICE CG177)
    10.03.02 Ibuprofen (as Fenbid) 

    Fenbid Fte_Gel 10%
    Fenbid_Gel 5%

     

    note the 10% gel is much more expensive

    08.01.05 Idelalisib Zydelig ®

    This is an NHS England Specialised commissioning drug for Chronic Lymphocytic Leukaemia

    Hospital only in line with NICE

     

     

    08.01.05 Imatinib Glivec®

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Graft versus host disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)
    This drug is NHS specialist commisioning for cancer and would be clasified as a red drug

     

    13.07 Imiquimod Aldara® 5% Imiquimod 5% cream 250mg sachets

    For removal of external genital and perianal warts
    03.01.01.01 Indacaterol Onbrez®Breezhaler

    Indacaterol 150microgram Inhalation Powder, hard capsules with device
    Indacaterol 300microgram Inhalation Powder, hard capsules with device

    Long Acting Beta2 Adrenoreceptor Agonist
    Indicated for COPD ONLY.

    03.01.04 Indacterol/Glycopyrronium Ultibro Breezhaler® Long-Acting Antimuscarinic + Long-Acting Beta2 Adrenorecepter Agonist combination.

    Indicated for COPD ONLY.

    The combination product offers cost & compliance advantages compared to prescribing LAMA and LABA drugs as separate devices.

    02.02.01 Indapamide 

    Indapamide 2.5mg Tablet


    No reason to use MR Indapamide.

    10.01.01 Indometacin  Indometacin_Cap 25mg
    Indometacin_Cap 50mg

    Caution – During prolonged therapy ophthalmic and blood examinations particularly advisable (BNF)
    01.05.03 Infliximab 

    Restriction: In line with NICE Guidance only

    10.01.03 Infliximab Remicade® This is an NHS England Specialised Commissioning Drug for Paediatric Indications (where adult TA available)

    This is an NHS England Specialised Commissioning Drug for Crohn's Disease in Children

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Connective tissue disease - interstital lung disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Graft versus host disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Renal, Sarcoidosis, Uveitis and Hidradenitis Suppurativa. This would go through a South Staffs CCGs Individual Funding Request (IFR)
    13.05.03 Infliximab 
    13.08.01 Ingenol mebutate Picato®

    MHRA advice (Oct 2019): Ingenol mebutate gel (Picato▼)- increased incidence of skin tumours seen in some clinical studies

    MHRA advice (Feb 2020): Ingenol mebutate gel (Picato▼): suspension of the licence due to risk of skin malignancy. Clinicians should stop prescribing Picato and consider other treatment options for actinic keratosis as appropriate. The licence of ingenol mebutate (Picato) has been suspended as a precautionary measure while the European Medicines Agency (EMA) continues to investigate concerns about a possible increased risk of skin malignancy.

    08.02.03 Inotuzumab ozogamicin Besponsa®

    NHS England Commissioned - Hospital Only

     

    27.01 Instillagel* (Lidocaine 2% and chlorohexidine 0.25% gel) Clinimed
  • Disposable syringes of sterile lubricant and/or local anaesthetic for instillation can reduce injury to the urothelium and subsequent risk of possible urethral damage. It can also facilitate pain free instrumentation and help reduce the risk of associated infection.

    6ml F Pack Size 1
    Price per Item £1.41

    11ml M Pack Size 1
    Price per Item £1.58

    * To be used in accordance with the Trust's PGD
  • 06.01.01.01 Insulin Actrapid®
    06.01.01.01 Insulin Humulin® S
    06.01.01.01 Insulin Insuman® Rapid
    06.01.01.01 Insulin Aspart  NovoRapid®
    06.01.01.01 Insulin Aspart Fiasp®
    06.01.01.02 Insulin Degludec 100units/ml  Tresiba® Tresiba Penfill 100units/ml 3ml cartridges
    Tresiba Flextouch 100units/ml 3ml pre-filled pen

    Please check strength as there is a high strength 200units/ml which is only to be initiated by diabetic specialist.
    06.01.01.02 Insulin Degludec 200units/ml  Tresiba®

    Tresiba Flextouch 200units/ml 3ml pre-filled pen
    Please check strength as there is a lower strength 100units/ml also.

    Prescribing by diabetes specialist only.

    Classification will be changed to Amber E when RICad developed.

    06.01.01.02 Insulin Detemir Levemir® In Type 2 Diabetes should only be used in specific circumstances for people who require assistance with their treatment administration, or whose lifestyle is significantly restricted by recurrent symptomatic hypoglycaemic episodes, or for those who would otherwise need twice daily basal insulin injections in combination with oral anti-diabetic drugs
    06.01.01.02 Insulin Glargine Lantus®

    From September 2015 a bio-similar product to insulin glargine will be available in the UK. All insulin preparations should be prescribed by brand name to ensure continuity of supply of the insulin and associated administration devices so if the patient is on Lantus this needs prescribing by brand to avoid confusion.
     
     UHDB will initiate new patients requiring insulin glargine on biosimilar Abasaglar® and may switch non stable patients over to this also but they will be prescribed by brand.

    In Type 2 Diabetes should only be used in specific circumstances for people who require assistance with their treatment administration, or whose lifestyle is significantly restricted by recurrent symptomatic hypoglycaemic episodes, or for those who would otherwise need twice daily basal insulin injections in combination with oral anti-diabetic drugs

    06.01.01.02 Insulin Glargine Abasaglar®

    This is a bio-similar product to insulin- please see document attached below glargine . 
     
     UHDB  will initiate new patients requiring insulin glargine on biosimilar Abasaglar®.
    and may switch non stable patients over to this also.

    All insulin preparations should be prescribed by brand name to ensure continuity of supply of the insulin and associated administration devices so please prescribe as Abasaglar®.

    In Type 2 Diabetes should only be used in specific circumstances for people who require assistance with their treatment administration, or whose lifestyle is significantly restricted by recurrent symptomatic hypoglycaemic episodes, or for those who would otherwise need twice daily basal insulin injections in combination with oral anti-diabetic drugs

    06.01.01.01 Insulin Glulisine Apidra®
    06.01.01.01 Insulin Lispro Humalog®
    08.02.04 Interferon Alfa 

    This is an NHS England Specialised Commissioning Drug for Hepatitis B & C

     

    08.02.04 Interferon Beta 

    Restriction: In line with NICE Guidance only

    07.03.02.03 Intra-uterine Progestogen Only System Mirena®

    Mirena_Intra-Uterine System

    The Prescriber must also be able to fit the Mirena and Assess for STI before fitting the IUD.

    This is included in the service level agreement and should not be prescribed on FP10

    19 Iodoflex Paste  Size
    5g (5)

    Mode of Action - This is a product that releases slow release iodine into a wound and its cadexomer precludes bacterial proliferation particularly in staph aureous or MRSA and can also aid granulation.

    Indications - Moderate/highly exuding, sloughy/infected wounds. Secondary dressing required.

    Method of Use - Apply directly onto wound bed.

    Contra-Indications - Thyroid disease without close monitoring i.e. blood test

    Frequency of Dressing change - Dressing needs to be changed 2 to 3 times a week. Needs at least one week break after 3 months' use. Use up to 50gm per application (max of 150gm per week)
    Loss of brown colour indicates iodine used.
    19 Iodozyme  6.5cm x 5cm (1)
    10cm x 10cm (1)
    08.01.05 Ipilimumab Yervoy®

    Restriction: In line with NICE Guidance only

    03.01.02 Ipratropium Bromide 

    Ipratropium Bromide Inhalation Solution 500mcg/2ml Ud
    Ipratropium Bromide Inhalation 20mcg (200 D) CFF 
     
     

    12.02.01 Ipratropium Bromide Rinatec® Ipratrop Brom_Aq Nsl Spy 21mcg (180D)CFF
    02.05.05.02 Irbesartan 

    Irbesartan 75mg Tablet
    Irbesartan 150mg Tablet
    Irbesartan 300mg Tablet

    08.01.05 Irinotecan Hydrochloride Campto®
    09.01.01.02 Iron Isomaltoside Monofer®

    100mg/mL solution for injection vials

    MHRA advice: Intravenous iron and serious hypersensitivity reactions- strengthened recommendations (Dec 2014)

    19 Irripod  Size
    20ml (25)
    08.02.03 Isatuximab Sarclisa®

    Restriction: In line with NICE Guidance only

    05.01.09 Isoniazid  All drugs for tuberculosis are hospital only
    06.01.01.02 Isophane Insulin Insulatard®
    06.01.01.02 Isophane Insulin Humulin® I
    06.01.01.02 Isophane Insulin Insuman® Basal

    Isophane Insulin should be used first line in Type 2 Diabetes

    DISCONTINUATION (from May 2020)

    Insuman Basal 100IU/mL suspension for injection in a vial (expected end of supply May 2020). Alternative is Humulin I vial, Insuman Basal cartridge/Solostar.

    02.06.01 Isosorbide Mononitrate  Isosorbide Mononitrate Tablet 10mg
    Isosorbide Mononitrate Tablet 20mg
    02.06.01 Isosorbide Mononitrate Monomil® XL Isosorbide Mononitrate Tablet 60mg MR (Monomil)
    13.06.02 Isotretinoin 
    01.06.01 Ispaghula Husk 

    Ispaghula Husk 3.5g Effervescent Granules Sachets GF/SF

    Patients taking bulk-forming laxatives should be advised to increase their fluid intake

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

     

     

    05.02 Itraconazole Sporanox®

    Itraconazole Cap 100mg

    Expensive! Use ONLY for recurent vulvo-vaginal candidosis. Available OTC.

    Prevent reccurent infection using barrier contraception, antifungal cream and attention to Hygiene.

    02.06.03 Ivabradine 

    Ivabradine 5mg Tablet
    Ivabradine 7.5mg Tablet

    08.01.05 Ixazomib Ninlaro®

    This is an NHS England Specialised Commissioning Drug

    In line with NICE

     

    13.05.03 Ixekizumab Taltz®
    09.04.02 Jevity® Abbott Laboritories Ltd

    Less than 1kcal/mL and less than 5g protein/100ml

    Gluten-free
    Residual lactose

    Available in:
    500ml
    1000ml
    1500ml

    09.04.02 Jevity®1.5kcal Abbott Laboritories Ltd

    1.5kcal/mL and 5g (or more) protein/100mL

    Gluten-free
    Residual lactose

    Available in:
    500ml
    1000ml
    1500ml

    09.04.02 Jevity®Plus Abbott Laboritories Ltd

    Less than 1.5kcal/mL and 5g (or more) protein/100mL

    Gluten-free
    Residual lactose

    Available in:
    500ml
    1000ml
    1500ml

    09.04.02 Jevity®Plus HP Abbott Laboritories Ltd

    Less than 1.5kcal/mL and 5g (or more) protein/100mL

    Gluten-free
    Residual lactose


    Available in:
    500ml
    1000ml
    1500ml

    09.04.02 Jevity®Promote Abbott Laboritories Ltd

    Less than 1.5kcal/mL and 5g (or more) protein/100mL

    Gluten-free
    Residual lactose

    Available in:
    1 litre

    19 Kerramax Dressing 
    10cm x 10cm Pack Size 10
    10cm x 22cm Pack Size 5
    20cm x 22cm Pack Size 5
    30cm x 20cm Pack Size 5


    Mode of Action - absorbs exudate and MMP's are absorbed and bound inside the dressing

    Indications - Moderate to heavily exuding wounds. May be used under moderate compression bandaging

    Frequency of Dressing change - requires changing when strikethrough appears.
    13.09 Ketoconazole Shampoo  Prescribe Generically
    Regular maintenance
    Use ONCE a fortnight

    13.10.02 Ketoconazole Shampoo  Regular maintenance
    Use ONCE a fortnight
    10.03.02 Ketoprofen 2.5%  Ketoprofen_Gel 2.5%
    19 K-Lite  Size
    10cm x 4.5m (1)

    Indications - Part of the multi-layer compression

    Light support bandaging system
    Apply with spiral technique
    19 Ko-Flex  Sizes
    10cm x 6m (1)

    Indications - Conditions relating to venous hypertension

    Cohesive compression bandage, spply with spiral technique, 50% overlap, 50% stretch

    Refer to Leg Ulcer Guidelines for further guidance
    19 K-Plus  Size
    10cm x 8.7m (1)

    Indications - Apply with Figure of 8 technique - 50% stretch, 50% overlap Conditions relating to venous hypertension
    Refer to Leg Ulcer Guidelines for further guidance
    19 K-Soft  Size
    10cm x 3.5m (1)

    Mode of Action - Conditions relating to venous hypertension, provides an absorptive layer and assists with shaping to provide graduated compression therapy.
    Apply with spiral technique
    Refer to Leg Ulcer Guidelines for further guidance
    19 K-Three C  Size
    10cm x 3m (1)

    Indications - K-Three C is indicated in the treatment of leg ulcers as part of the K-Four multi-layer compression system for ankles 25-30cm and greater than 30cm
    19 K-Two Bandage Kit  Sizes
    10cm width (for ankle circumference 18cm - 25cm) (1)
    10cm width (for ankle circumberence 25cm - 32cm) (1

    Mode of Action - Irrespective of leg shape, K-Two provides the correct level of pressure due to its specific pressure indicator system.

    Indications - conditions relating to venous hypertension
    Provides grduated, sustained compression
    Both layers are capable of providing 40mmHg together
    Apply both layers using spiral technique
    Has extension indicators
    Refer to Leg Ulcer Guidelines for further guidance

    Contra-Indications - High-level compression is contra-indicated in patients suffering from an arterial conditon (arterial or predominantly arterial ulcer; known or suspected arterial disease)

    K-Two is not recommended when the ankle-brachial pressure index (ABPI), measured by Doppler ultrasound, is below 0.8.
    Patients potentially allergic to any of the components (especially to latex).
    19 K-Two Reduced  Sizes
    10cm width (for ankle circumference 18 - 25cm) (1)
    10cm width (for ankle circumference 25 - 32cm) (1)

    Mode of Action - Irrespective of leg shape, K-two provides the correct level of pressure due to its specific pressure indicator system

    Indications - Conditions relating to venous/mixed artiology disease
  • Provides mild, graduated, sustained compression
  • Both layers are capable of providing 20mmHg together
  • Apply both layers using spiral technique
  • Has extension indicators
  • Refer to Leg Ulcer Guidelines for further guidance

    Contra-Indications - High-level compression is contra-inicated in patients suffering from an arterial condition (arterial or predominantly arterial ulcer; known or suspected arterial disease).
    K-Two is not recommended when the ankle-brachial pressure index (ABPI), measured by Doppler ultrasound, is below 0.8, unless assessed by Tissue Viability Service. Patients potentially allergic to any of the components (especially to latex).
  • 02.04 Labetalol Hydrochloride 

    Labetalol Hydrochloride 50mg Tablet
    Labetalol Hydrochloride 100mg Tablet
    Labetalol Hydrochloride 200mg Tablet
    Labetalol Hydrochloride 400mg Tablet

    04.08.01 Lacosamide  Vimpat ®

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products

    01.06.04 Lactulose 

    Lactulose 3.1g-3.7g/5ml Oral Solution

    Tolerence may develop with continued use
    Better than stimulent laxative in diverticular disease
    Takes 1-2 days to take effect.

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

     

     

    04.08.01 Lamotrigine 

    Lamotrigine Tablet 25mg
    Lamotrigine Tablet 50mg
    Lamotrigine Tablet 100mg
    Lamotrigine Tablet 200mg
    Lamotrigine Tablet Dispersible 5mg S/F
    Lamotrigine Tablet Dispersible 25mg S/F
    Lamotrigine Tablet Dispersible 100mg S/F

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products.

    03.04.03 Lanadelumab Takhzyro®

    Restriction: In line with NICE guidance only

    This is an NHS England Specialised Commissioning Drug for preventing attacks of hereditary angioedema

    08.03.04.03 Lanreotide 
    01.03.05 Lansoprazole 

    Lansoprazole 15mg (G/R Granules) Capsule
    Lansoprazole 30mg (G/R Granules) Capsule
    Lansoprazole 15mg Orodispersible Tablet
    Lansoprazole 30mg Orodispersible Tablet

    (Orodispersible for patients with enteral feeding tubes or swallowing difficulties)

    09.05.02.02 Lanthanum Fosrenol ®

    For the treatment of Hyperphosphataemia

    Lanthanum Carb_Tab Chble 1g S/F
    Lanthanum Carb_Tab Chble 500mg S/F
    Lanthanum Carb_Tab Chble 750mg S/F

    Commissioned by NHS England ONLY when used for adult renal dialysis patients.

    08.02.04 Larotrectinib 

    Restriction: In line with NICE Guidance only

    19 Larvae Therapy 
    11.06 Latanoprost  Latanoprost_Eye Dps 50mcg/ml
    11.06 Latanoprost Monopost

    Latanoprost 50mcg/ml 0.2ml UDV

    for those needing preservative free eye drops

    11.06 Latanoprost with Timolol  

    Latanoprost/Timolol 50mcg/5mg/ml eye drops

    05.03.03.02 Ledipasvir - Sofosbuvir Harvoni®

    NHS England Commissioned

    In line with NICE

    10.01.03 Leflunomide 

    Leflunomide_Tab 10mg
    Leflunomide_Tab 20mg

    GP only to continue prescribing where a shared care agreement is provided


    08.02.04 Lenalidomide Revlimid®

    Restriction: In line with NICE Guidance only

    Patient, prescriber, and supplying pharmacy must comply with a pregnancy prevention programme. Every prescription must be accompanied by a completed Prescription Authorisation Form.

     

    09.01.06 Lenograstim Granocyte® This is an NHS England Specialised Commissioning Drug for Neutropenia

    This is an NHS England Specialised Commissioning Drug for Bath Syndrome
    08.01.05 Lenvatinib Kisplyx®

    This is an NHS England Specialised Commissioning Drug  

    In line with NICE

     

     

     

     

    05.03.02.02 Letermovir Prevymis®

    This is a NHS England Specialised Comissioning Drug

    In line with NICE

     

    08.03.04.01 Letrozole 
    08.03.04.02 Leuprorelin Acetate Prostap® SR

    This is the preferred Injectable LHRH Agonist (or GnRH Analogue)

    Prostap SR 3.75mg - monthly

    Indications:

    • Prostate cancer
    • Endometriosis
    • Endometrial preparation prior to intrauterine surgery
    • Preoperative management of Uterine fibroids
    08.03.04.02 Leuprorelin Acetate Prostap® 3

    This is the preferred Injectable LHRH Agonist (or GnRH Analogue)

    Prostap 3 (11.25mg) - 3 monthly

    Indications:

    • Prostate cancer
    • Endometriosis
    •   Central Precocious Puberty (CPP) in girls under 9 years of age, boys under 10 years of age

     

    04.08.01 Levetiracetam 

    Levetiracetam Tablet 250mg
    Levetiracetam Tablet 500mg
    Levetiracetam Tablet 750mg
    Levetiracetam Tablet 1g
    Levetiracetam Oral Solution 500mcg/5ml S/F

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products.

    05.01.12 Levofloxacin 
    07.03.02.03 Levonorgestrel Levosert®

    Levosert® 20 mcg/24 hours intrauterine delivery system

    For Heavy Menstrual Bleeding (HMB) in women requiring reversible contraception. 

    Used as an alternative to Mirena® where staff have undertaken the necessary training and in-line with the licensed indications.

    The doctor or nurse administering (or removing) the system should be fully trained in the technique and should provide full counselling reinforced by the patient information leaflet.

    MHRA/CHM advice (June 2015) Intra-uterine contraception: uterine perforation—updated information on risk factors

    07.03.04 Levonorgestrel 13.5mg (Jaydess Coil) 

    Levonorgest_Intra-Uterine System 13.5mg

    This device provides contraception for up to 3 years as oppose to mirena which is 5 years.

    PLEASE NOTE: It is not licensed for menorrhagia- use Mirena for this indication

    This is included in the service level agreement and should not be prescribed on FP10.



    07.03.05 Levonorgrestrel  Levonelle_Tab 1.5mg

    First line when lady presents less then 72 hours after coitus

    Do not prescribe Levonelle One Step (more expensive), prescribe as Levonorgestrel 1500mg
    06.02.01 Levothyroxine 

    Patients on long-term thyroid treatment should have annual blood level checks

    Levothyroxine sodium 25microgram Tablets
    Levothyroxine sodium 50microgram Tablets
    Levothyroxine sodium 100microgram Tablets

    Levothyroxine sodium Oral Solution 5mcg/1ml, 10mcg/1ml and 20mcg/1ml - HCD Very expensive 

    15.02 Lidocaine 5% patch Versatis®

    NICE CG173 on neuropathic pain does not recommend the use of lidocaine patches as a treatment option due to limited clinical evidence supporting its use 

    NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017).

    01.06.07 Linaclotide 

    Restriction: To be initiated by Gastroenterologist when conventional treatments are not effective and transferred to Primary Care following review after initial 4 weeks

    06.01.02.03 Linagliptin Trajenta® Glitazones and Gliptins should only be considered if:
    • Substituting for a sulphonylurea in patients on metformin and a sulphonylurea where there is a significant risk of hypoglycaemia (or its consequences) or a sulphonylurea is contra-indicated or not tolerated.
    • Metformin is contraindicated or not tolerated and the patient HBA1c remains above 6.5% on a sulphonylurea.
    As triple therapy if insulin is unacceptable (because of employment, social or recreational or other personal issues, or obesity.
    Only continue if reduction in HBA1c of at least 0.5% in 6 months

    Maximal effect is seen in 3-6 months; if no response to therapy in 6 months in terms of achieving patients target then review
    05.01.07 Linezolid 
    06.02.01 Liothyronine 

    Only to be presribed for clinically appropriate patients after specialist initiation when Levothyroxine not clinically tolerated.

    NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017). Although this drug is clinically effective, there are more cost-effective products are available.

    13.02.01 Liquid and White Soft Paraffin Ointment (50:50) 

    Very Greasy Preparation

    Ointment 250g

    Please refer to the supplementary "Emollient Guide" for more details

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

     

    11.08.01 Liquid Paraffin Xailin Night

    Xailin Night Ointment 5g

    This is the preferred cost effective brand of liquid paraffin eye ointment.

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

     

    11.08.01 Liquid Paraffin HYLO NIGHT

    HYLO NIGHT eye ointment preservative free (formerly known as Vita-POS Paraf Eye Oint P/F)

    This is another preferred cost effective brand of liquid paraffin eye ointment

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

    04.05 Liraglutide Saxenda®

    Restriction: In line with NICE Guidance

     

    The CCG does not currently have a Tier 3 commissioned service to manage overweight and obesity

    06.01.02.03 Liraglutide Victoza®

    THIS IS FOR DIABETES ONLY.

    Exenatide should only be considered if
    • BMI>= 35mg/m2 in people of European descent and there are problems associated with high weight
    • BMI < 35mg/m2 and insulin is unacceptable because of occupational implications or weight loss would benefit other co-morbities.

    Only continue if reduction in HBA1c of at least 1.0 percentage points and a weight loss of at least 3% is achieved within 6 months of starting treatment

    Doses should not exceed 1.2mg

    04.04 Lisdexamfetamine Elvanse®

    Lisdexamfetamine 20mg cap 
    Lisdexamfetamine 30mg cap
    Lisdexamfetamine 40mg cap
    Lisdexamfetamine 50mg cap
    Lisdexamfetamine 60mg cap
    Lisdexamfetamine 70mg cap

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

     

    02.05.05.01 Lisinopril 
    Lisinopril 2.5mg Tablet
    Lisinopril 5mg Tablet
    Lisinopril 10mg Tablet
    Lisinopril 20mg Tablet
    04.02.03 Lithium Carbonate 

    Prescribe by Brand and maintain patient on the same Brand

    Current Brands Available:
    Camcolit, Lithonate, Liskonum and Priadel Tablets


    Note change in bioavailability when changing from Tablets to Liquid. Lithium citrate tetrahydrate 520 mg (liquid) is equivalent to lithium carbonate 204 mg (tablet)

    Preparations vary widely in bioavailability; changing the preparation requires the same precautions as initiation of treatment (Litium Carbonate)

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

    04.02.03 Lithium Citrate 

    Prescribe by Brand and maintain patient on the same Brand

    Current Brands Available:
    Priadel Liquid and Li-liquid

    Note change in bioavailability when changing from Tablets to Liquid. Note Lithium citrate tetrahydrate 520 mg is equivalent to lithium carbonate 204 mg.
    Preparations vary widely in bioavailability; changing the preparation requires the same precautions as initiation of treatment (Lithium Carbonate)

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

    06.01.02.03 Lixisenatide Lyxumia® Exenatide should only be considered if
    • BMI>= 35mg/m2 in people of European descent and there are problems associated with high weight
    • BMI < 35mg/m2 and insulin is unacceptable because of occupational implications or weight loss would benefit other co-morbities.

    Only continue if reduction in HBA1c of at least 1.0 percentage points and a weight loss of at least 3% is achieved within 6 months of starting treatment
    04.03.01 Lofepramine  Lofepramine HCl Tablet 70mg
    01.04.02 Loperamide 

    Loperamide HCI 2mg Capsule
    Loperamide 1mg/5ml S/F Oral Solution

     

    MHRA/CHM advice: reports of serious cardiac adverse reactions with high doses of loperamide associated with abuse or misuse (September 2017)

    A2.07 Loprofin SNO-PRO® 
    A2.07 Loprofin® PKU Drink 
    03.04.01 Loratadine 

    Loratadine Oral Solution 5mg/5ml
    Loratadine Tablet 10mg

    Self Care Self Care Medicine-Available OTC for self care

    Non-sedating.

    04.01.02 Lorazepam  Lorazepam Tablet 1mg
    Lorazepam Tablet 2.5mg
    Lorazepam Tablet 500mcg

    CSM Advice: Hypnotics and Anxiolytics are indicated for the short-term relief of sleep disturbance and/or anxiety. (For continuous use up to a maximum of 14 days).
    08.01.05 Lorlatinib Lorviqua®

    Restriction: In line with NICE Guidance only

    02.05.05.02 Losartan potassium 

    Losartan Potassium 12.5mg Tablet 
    Losartan Potassium 25mg Tablet 
    Losartan Potassium 50mg Tablet 
    Losartan Potassium 100mg Tablet 

    A2.07 L-Tyrosine 
    03.07 Lumacaftor with ivacaftor Orkambi®

    This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis

    09.01.04 Lusutrombopag Mulpleo®

    Restriction: In line with NICE Guidance only

    08.03.04.03 Lutetium (177Lu) oxodotreotide 

    Restriction: In line with NICE Guidance only

    05.01.03 Lymecycline 

    Lymecycline MR Capsules 408mg

    13.06.02 Lymecycline  Once Daily
    01.06.04 Macrogol  Compound Oral Powder Sachet NPF S/F

    Prescribe generically
    01.06.04 Macrogol oral paediatric powder 

    CosmoCol Paediatric oral powder 6.9g sachets is the preferred brand (applies to primary care)




    09.05.01.03 Magnaspartate (Kora) Oral Powder  Please Note: Contains sucrose. Patients with rare hereditary problems of fructose intolerance, glucosegalactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.
    Frequent and long-term use of Magnaspartate 243 mg may be harmful to the teeth (caries).
    If an undesirable effect occurs, such as diarrhoea, the therapy should be temporarily interrupted and can be restarted after improvement and /or elimination of the symptoms with a reduced dosage.
    Magnesium Glycerphosphate tablets (4mmol) are second line preparation.
    09.05.01.03 Magnesium Glycerophosphate  4mmol Tablet
    This is Second Choice

    There is now a licensed preparation called Neomag. As this is in the drug tariff all generic prescriptions should be dispensed as the licensed preparation.
    13.10.04 Malathion 0.5% Derbac-M®

    Derbac-M Liquid 50ml and 200ml

    For dimeticone treatment failure (returning infestation after several weeks not to be confused with "treatment failure")

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

     

    03.07 Mannitol Dry Powder Bronchitol ®

    This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis

    05.05.01 Mebendazole 

    Mebendazole Oral Susp 100mg/5ml 
    Mebendazole Tab 100mg

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

    01.02 Mebeverine Hydrochloride 

    Mebeverine HCI 135mg Tablet


    An alternative in resistant cases is Dicycloverine.

    07.03.02.02 Medroxyprogesterone Acetate Depo-Provera® Medroxyprogesterone Acet_Inj 150mg/ml 1ml Pfs
    Medroxyprogesterone Acet_Inj 150mg/ml 1ml Vl
    10.01.01 Mefenamic Acid  Mefenamic Acid_Cap 250mg
    Mefenamic Acid_Tab 500mg


    Dysmenorrhoea, although Ibuprofen and Naproxen equally effective
    04.01.01 Melatonin  Circadin ®

    See link below for ESCA's. 

    Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

    When a patient cannot swallow, Circadin MR tablets can be crushed (note – this would change it from a modified-release tablet to an immediate-release one) and mixed or dissolved in 15-30mL of water for administration via enteral feeding tubes or easier swallowing.

    10.01.01 Meloxicam  meloxicam 7.5mg tablet
    meloxicam 15mg tablet

    meloxicam 7.5mg orodispersible tablet (swallowing difficulties only)
    meloxicam 15mg orodispersible tablet(swallowing difficulties only)
    04.11 Memantine Ebixa®

    Memantine HCl_Tablet 10mg
    Memantine HCl_Tablet 20mg

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

    09.06.06 Menadiol Sodium Phosphate 

    Reserved for use in cystic fibrosis patients over 7 years. this will be initiated by a specialist

    The main suppliers are likely to be out of stock from mid-January until October 2018. From the middle of February an unlicensed special will be available. 

    03.04.02 Mepolizumab Nucala®

    This is an NHS England Specialised Commissioning Drug for Asthma
    This will be prescribed in secondary care as per NICE TA below

    01.05.03 Mercaptopurine 

    Mercaptopurine 50mg Tablet
    Xaluprine 20mg/1ml Oral Suspension

    BNF States : Mercaptopurine tablets and Xaluprine® oral suspension are not bioequivalent, haematological monitoring is advised when switching formulations.

    05.01.07 Meropenem 
    01.05.01 Mesalazine Foam Enema

    Mesalazine 1g/actuation Foam Enema
     

    01.05.01 Mesalazine  

    Octasa MR Gastro-resistant 400mg and 800mg Tablet - preferred brand
    Pentasa MR 500mg Tablet

    Prescribe by recommended BRAND.

    06.01.02.02 Metformin 
    06.01.02.02 Metformin hydrochloride MR tablets Sukkarto SR® Metformin hydrochloride SR 500mg tablets
    Metformin hydrochloride SR 1000mg tablets

    Please prescribe by preferred brand Sukkarto SR
    06.01.02.02 Metformin Hydrochloride SR Glucophage® SR Metformin SR 500mg tablets
    Metformin SR 750mg tablets
    Metformin SR 1000mg tablets
    04.10.03 Methadone 

    Methadone HCl_Mix 1mg/1ml
     

    From April 1st 2017 there should be no prescribing of medications within primary care for alcohol or substance misuse. New patients should be referred into the One Recovery specialist service.

    One Recovery are working to repatriate patients back into their specialist services but if there any queries related to specific patients it is recommended that these are directed to the service.

    Stafford Tel: 01785- 270080

    Cannock Tel: 01543-468667


     

    01.05.03 Methotrexate 

    Methotrexate 2.5mg Tablet

    ONLY recommended for GP to prescribe if fully conversant with therapy and can reliably provide the necessary review and monitoring requirement within the context of a Shared Care Arrangement


    Prescribe WEEKLY (on the same day each week)as 2.5mg Tablets (Local Agreement)

    MHRA/CHM advice: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing (September 2020)

    10.01.03 Methotrexate 

    Methotrexate_Tab 2.5mg

    ONLY recommended for GP to prescribe if fully conversant with therapy and can reliably provide the necessary review and monitoring requirement within the context of a Shared Care Arrangement

    Prescribe WEEKLY (on the same day each week)as 2.5mg Tablets (Local Agreement)

    MHRA/CHM advice: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing (September 2020)

    13.05.03 Methotrexate 

    Initiation by Dermatologist

    ONLY recommended for GP to continue to prescribe if fully conversant with therapy and can reliably provide the necessary review and monitoring requirement within the context of a Shared Care Arrangement

    Prescribe WEEKLY (on the same day each week)as 2.5mg Tablets (Local Agreement)

    MHRA/CHM advice: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing (September 2020)



    02.05.02 Methyldopa 

    Methyldopa 125mg Tablet - Considerably more costly than others
    Methyldopa 250mg Tablet
    Methyldopa 500mg Tablet

    If methyldopa was used during pregnancy stop within 2 days of birth.NICE CG107

    01.06.06 Methylnaltrexone 

    Restriction: Palliative care use only

    04.04 Methylphenidate hydrochoride 

    Restriction: Initiation and stabilisation by specialist
     
    Note Different versions of modified-release preparations may not have the same clinical effect. To avoid confusion between these different formulations of methylphenidate, prescribers should specify the brand to be dispensed

    See link below for ESCA.  Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

     

    10.01.02.02 Methylprednisolone Acetate Depo-Medrone® Methylpred Acet_Inj 40mg/ml 1ml Vl
    Methylpred Acet_Inj 40mg/ml 2ml Vl
    Methylpred Acet_Inj 40mg/ml 3ml Vl
    10.01.02.02 Methylprednisolone Acetate and Lidocaine Depo-Medrone® with Lidocaine Methylpred Acet/Lidocaine Inj 40/10mg/1ml Vl
    Methylpred Acet/Lidocaine Inj 80/20mg/2ml Vl
    01.02 Metoclopramide 

    Metoclopramide 10mg Tablet
    Metoclopramide 5mg/5ml Oral Solution
    Metoclopramide 5mg/1ml 2ml Amp

     

    MHRA/CHM advice—Metoclopramide: risk of neurological adverse effects—restricted dose and duration of use (August 2013)

    Caution for <20 year olds. MHRA advises that length of treatment should be no longer than 5 days

    04.06 Metoclopramide  Metoclopramide HCl Tablet 10mg

    Avoid SR form as very expensive. Do not use in people <20 years. MHRA recommend use for no more than 5 days.

    04.07.04.01 Metoclopramide (Section 4.6 also)  Please refer to section 4.6

    Metoclopramide HCl Tablet 10mg
    02.02.01 Metolazone 

    Metolazone 2.5mg Tablet
    Metolazone 5mg Tablet
     

    Unlicensed special. Only to be prescribed in primary care following specialist initiation.

    02.04 Metoprolol Tartrate 

    Metoprolol Tartrate 50mg Tablet
    Metoprolol Tartrate 100mg Tablet

    05.01.11 Metronidazole 

    Metronidazole Tab 200mg
    Metronidazole Tab 400mg

    13.10.01.01 Metronidazole 0.75% gel Anabact® There are differences in the licensing of metronidazole preparations so please prescribe by brand.

    Use Anabact gel for malodorous tumours and ulcers.
    13.10.01.01 Metronidazole 0.75% gel Rozex® There are differences in the licensing of metronidazole preparations so please prescribe by brand.

    Use Rozex gel for rosacea.
    02.03.02 Mexiletine  

    Licensed preparation: Namuscla® 167mg hard capsules is reserved for non-dystrophic myotonia and it is not licensed for ventricular arrhythmia. This is an NHS England specialised commissioning medicine.

    unlicensed Unlicensed preparation: Mexiletine 50mg, 100mg and 200mg capsules are unlicensed and only available from ’special-order’ manufacturers or specialist importing companies. For treatment of life-threatening ventricular arrhythmias (using the unlicensed preparations ONLY).

    Restriction: Initiation under direction of cardiologist

    02.03.02 Mexiletine 
    05.02.04 Micafungin 

    This is an NHS England Specialised Commissioning Drug for Fungal Infection

    07.02.02 Miconazole Gyno-Daktarin miconazole_vaginal Cream 2% 78g tube
    miconazole 1200mg vaginal capsule

    second line option where clotrimazole not tolerated or ineffective

    13.10.02 Miconazole 2% Daktarin®

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

    12.03.02 Miconazole Oral Gel Daktarin

    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.

    04.08.02 Midazolam Buccolam Buccolam Pre-filled Syringe 0.5ml(2.5mg)
    Buccolam Pre-filled Syringe 1ml(5mg)
    Buccolam Pre-filled Syringe 1.5ml(7.5mg)
    Buccolam Pre-filled Syringe 2ml(10mg)

    Only Licensed for patients between 3 months and 18 years of age.

    No Licensed Preparation for over 18 year olds. Preferred prescribe Buccolam off label


    20 MIDODRINE hydrochloride Tablets  Bramox tablets® Midodrine hydrochloride 2.5mg tablets
    Midodrine hydrochloride 5mg tablets
    08.01.05 Midostaurin Rydapt®

     This is an NHS England Specialised Commissioning Drug

     In line with NICE

     

    08.02.04 Mifamurtide 
    A2.07 Milupa PKU 3-advanta® 
    07.04.02 Mirabegron Betmiga® Mirabegron_Tab 25mg M/R
    Mirabegron_Tab 50mg M/R

    Mirabegron for treating symptoms of overactive bladder TA290.

    ONLY to be used if at least two anticholinergic drugs have been tried and not tolerated or if anticholinergic drugs are contra-indicated.

    Mirabegron is now contra-indicated in patients with severe uncontrolled hypertension (MHRA October 2015)
    04.03.04 Mirtazapine  Mirtazapine Tablet 15mg
    Mirtazapine Tablet 30mg
    Mirtazapine Tablet 45mg

    Mirtazapine Orodisper Tab 15mg
    Mirtazapine Orodisper Tab 30mg
    Mirtazapine Orodisper Tab 45mg

    01.03.04 Misoprostol 

    Misoprostol 200microgram Tablet

    For specialist initiation only

    12.02.01 Mometasone furoate  

    Mometasone Fur_Aq N/Spy 50mcg (140 D)

    13.04 Mometasone Furoate 0.1% Elocon® Potent Potency

    Ointment 30g and 100g Once a Day

    Prescribe generically

    Please refer to Topical Corticosteroid Potency Ladder for more details

    03.03.02 Montelukast 

    Montelukast 10mg Tablets
    Montelukast 4mg Chewable Tablets SF
    Montelukast 5mg Chewable Tablets SF
    Montelukast 4mg Granules Sachets SF

     

    04.07.02 Morphine Sulfate ZOMORPH CAPSULES

    Zomorph Capsule 10mg M/R
    Zomorph Capsule 30mg M/R 
    Zomorph Capsule 60mg M/R  
    Zomorph Capsule 100mg M/R 
    Zomorph Capsule 200mg M/R 
     
     
    Prescribe M/R Capsules as brand Zomorph in preference to M/R Tablets as more cost effective. Please prescribe by brand to avoid medication errors (Applicable in Primary care only).

    04.07.02 Morphine Sulfate - Oral Solution  Morph Sulfate Oral Solution 10mg/5ml (POM)
    Morph Sulfate Oral Solution 20mg/1ml (Controlled Drug)
    01.06.05 Moviprep® 

    First Choice

    02.05.02 Moxonidine 
    Moxonidine 200microgram Tablet
    Moxonidine 300microgram Tablet
    Moxonidine 400microgram Tablet




    Adjunctive treatment.

    13.10.01.01 Mupirocin (Cream, Ointment and Nasal) Bactroban® MRSA - See Guidelines
    12.02.03 Mupirocin 2% in White Soft Paraffin Bactroban Nasal® Mupirocin_Nsl Oint 2%
    Bactroban_Nsl Oint 2%

    Reserve for MRSA
    08.02.01 Mycophenolate Mofetil 

    This is an NHS England Specialised Commissioning Drug for Transplant Immunosuppression ONLY

    06.01.01.03 Mylife Clickfine AutoProtect Mylife Clickfine AutoProtect® First choice where a safety needle is advised by diabetes team

    Lengths/Gauges available:
    8mm/29g
    Compatible with ALL major devices (including Flextouch)
    03.07 N-acetylcysteine  NACSYS®

    1st Line

    Brand specific prescribing only- as NACSYS®

    Preferred choice of mucolytic liquid. Use in preference to carbocisteine liquid/carbocisteine sachets for patients with swallowing difficulty.

    02.06.04 Naftidrofuryl Oxalate 

    Naftidrofuryl Oxalate 100mg Capsule

    Cilostazol, pentoxifylline and inositol nicotinate are not recommended for the treatment of intermittent claudication in people with peripheral arterial disease. NICE TA 223

    01.06.06 Naldemedine Rizmoic®

    Naldemedine 200microgram Tablet

    Restriction: In line with NICE Guidance only

    04.10.01 Nalmefene 

    Restriction: In line with NICE Guidance only

    Restriction: Initiation by substance abuse unit, no prescribing by General Practice

    Patients with alcohol dependence should be referred using the GP surgeries clinical systems online referral form.

    • Staffordshire CCG’s – Humankind - Staffordshire treatment and recovery service (STARS) – Link to website
    01.06.06 Naloxegol 
    Naloxegol 12.5mg Tablet
    Naloxegol 25mg Tablet

    Restriction: In line with NICE Guidance only

    04.10.03 Naltrexone Nalorex®

    From April 1st 2017 there should be no prescribing of medications within primary care for alcohol or substance misuse. New patients should be referred into the One Recovery specialist service.

    One Recovery are working to repatriate patients back into their specialist services but if there any queries related to specific patients it is recommended that these are directed to the service.

    Stafford Tel: 01785- 270080

    Cannock Tel: 01543-468667

    10.01.01 Naproxen  Naproxen_Tab 250mg
    Naproxen_Tab 500mg

    Topical Ibuprofen for patients with OA try prior to oral therapy (NICE CG177)
    08.02.04 Natalizumab 

    This is an NHS England Specialised Commissioning Drug for Multiple Sclerosis

     

    06.01.02.03 Nateglinide Starlix®
    06.04.02 Nebido  Injection (only), testosterone undecanoate 250mg/ml
    11.04.02 Nedocromil Rapitil®

    Nedocromil Sod_Eye Dps Aq 2%

    DISCONTINUED 2018

    28.02 Neocate Active(r)blackcurrant flavour 

    This is not infant formulae - for over 1 year olds only

    To only be started if recommended by Paediatric Dietician

    28.02 Neocate Advance® banana/vanilla flavour Nutricia

    This is not infant formulae - for over 1 year olds only

    To only be started by Paediatric Dietician

    28.02 Neocate Advance®unflavoured Nutricia

    This is not infant formulae - for over 1 year olds only

    To only be started if recommended by Paediatric Dietician

    28.02 Neocate LCP® Nutricia

    Prescribe in primary care only as recommended by Paediatric Dietician or Paediatrician

    From birth until able to tolerate over the counter products

    If a patient presents with clear anaphylactic reaction to cows milk these fomulae should be commenced in primary care, with immediate onward referral to secondary or specialist care.

    If formulae top-ups are needed for a child who is otherwise breastfed (mother on a a milk free diet) AAF will be required

    28.02 NeocateActive®unflavoured Nutricia

    Prescribe in primary care only as recommended by Paediatric Dietician or Paediatrician

    This is not infant formulae - for over 1 year olds only

    08.03.04.01 Neratinib Nerlynx®

    Restriction: In line with NICE Guidance only

    02.06.03 Nicorandil Ikorel®

    Nicorandil 10mg Tablet
    Nicorandil 20mg Tablet

    04.10.02 Nicotine Replacement Therapy 

    Restriction: As part of a smoking cessation programme or during inpatient stay only.

    Commissioned by Staffordshire County Council. GPs should not routinely prescribe; patients should be directed to a local provider of stop smoking services to access support and treatment.

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

    02.06.02 Nifedipine  

    Different versions of modified-release preparations may not have the same clinical effect. To avoid confusion between these different formulations of nifedipine, prescribers should specify the brand to be dispensed. Modified-release formulations may not be suitable for dose titration in hepatic disease. (As per BNF)

    Drug discontinuations
    Adalat 5mg immediate release capsules* –discontinued from February 2019.
    Adalat 10mg immediate release capsules* – discontinued after March 2019
    Adalat Retard 10mg modified release tablets – discontinued after November 2018
    Adalat Retard 20mg modified release tablets – discontinued August 2018
    Adalat LA 20mg*, 30mg and 60mg prolonged release – discontinued

    *Bayer is the main supplier of these products.

    08.01.05 Nilotinib Tasigna®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

     

    08.01.05 Niraparib Zejula®

       This is an NHS England specialised commissioning drug

       In line with NICE

     

    05.01.13 Nitrofurantoin 

    Nitrofurantoin Cap 50mg
    Nitrofurantoin Tab 100mg
    Nitrofurantoin Cap 100mg
    Nitrofurantoin Cap 100mg M/R
    Nitrofurantoin Oral Susp 25mg/5ml S/F

    We advise prescribing the  100mg MR twice daily  as it is more cost effective, associated with better compliance and less gastric side effects than normal release preparations.
     
    Nitrofurantoin is now recommended over trimethoprim as a first-line choice for uncomplicated urinary tract infections, where clinically appropriate. This is in-line with Public Health England guidance and the planned antibiotic indicators in the national Quality Premium for 2017/18.

    Nitrofurantoin oral suspension is over £400 per 300mL bottle – please ensure all prescribing of this is appropriate and contact the medicines optimisation team if further advice is required.

    08.02.03 Nivolumab Opdivo®

    Restriction: In line with NICE Guidance only

     

    MHRA advice (Oct 2019): Nivolumab (Opdivo): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation

     

    08.02.04 Nivolumab  This is an NHS England Specialised Commissioning Drug for cancer
    19 Non-Woven Fabric Swab  (100 swabs per pack)
    10cm x 10cm (Non Sterile, 4 Ply, Spec 28

    06.04.01.02 Norethisterone  Tablets 5mg
    07.03.02.01 Norethisterone (Noriday)  Noriday® Norethisterone Tablet 350mcg
    Noriday Tablet 350mcg
    04.07.03 Nortriptyline  Allegron Tablets 10mg and 25mg

    Please note the 10mg & 25mg Tablets are VERY EXPENSIVE items
    06.01.01.03 Novofine Autocover  Novofine Autocover® Lengths/Gauges available:
    8mm/30g (Risk assessment states 8mm or less)
    Compatible with all major devices (compatibility with Flextouch not confirmed)
    10.02 Nusinersen® Spinraza

    This is an NHS England Specialised Commissioning drug

    In line with NICE

    A2.05.02 Nutilis Clear powder 

    This is South Staffordshire's preferred thickener

    For thickening of liquids or foods in dysphagia. Not suitable for children under 3 years.
    Formulation: Powder , dried glucose syrup, xanthan gum, guar gum, gluten- and lactose-free.

    Gum based products are generally preferred as they thicken to a more stable end point (unlike starch based products, they do not continue thickening over time) and provide a smoother texture, which improves acceptability and palatability for patients

     

    09.04 Nutilis® Complete Crème Level 3

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Nutilis® Complete Drink  Level 3

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Nutilis® Fruit  Level 4

    Initiation by specialist dietician services prior to continuation within primary care.

    28.01 Nutramigen 1 with LGG® 

    May be a more appropriate first-line feed for children birth to six months

    Lactose and Gluten free

    (previously called Nutramigen Lipil 1®)

    28.01 Nutramigen 2 with LGG® 

    May be a more appropriate first-line feed for children aged 6 months to 2 years

    Lactose and Gluten free

    (Previously called Nutramigen Lipil 2®)

    28.02 Nutramigen®Puramino Mead Johnson

    Prescribe in primary care only as recommended by Paediatric Dietician or Paediatrician

    From birth until able to tolerate over the counter products

    If a patient presents with clear anaphylactic reaction to cows milk these fomulae should be commenced in primary care, with immediate onward referral to secondary or specialist care.

    If formulae top-ups are needed for a child who is otherwise breastfed (mother on a a milk free diet) AAF will be required

    09.04 Nutricrem 

    Initiation by specialist dietician services prior to continuation within primary care.

    12.03.02 Nystatin Oral Suspension Nystan®
    13.10.02 Nystatin with Chlorhexidine cream Nystaform®
    01.09.01 Obeticholic acid 

    NHS England specialist commissioning

    Assess the response to Obeticholic acid after 12 months

    08.02.03 Obinutuzumab  Gazyvaro®

    Restriction: In line with NICE Guidance only

     

    08.02.03 Ocrelizumab  Ocrevus®

    This is an NHS England specialised commissioning drug for MS

    In line with NICE

     

    This can only be prescribed if alemtuzumab is contraindicated or otherwise unsuitable.

     

    11.08.02 Ocriplasmin Jetrea®
    12.02.03 Octenidine Hydrochloride  Octenisan® md nasal gel

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

    08.03.04.03 Octreotide 
    07.02.01 Oestrogens, Topical Vagifem® Vagifem Vaginal Tablet 10mcg

    administered intravaginally as a local oestrogen therapy by use of an applicator.

    Initial dose: One vaginal tablet daily for two weeks.

    Maintenance dose: One vaginal tablet twice a week.
    08.02.03 Ofatumumab Arzerra® This is a Specialised Drug which would not be routinely commissioned by CCGs for Pemphigus vulgaris. This would go through a South Staffs CCGs Individual Funding Request (IFR)
    05.01.12 Ofloxacin 
    Ofloxacin 200mg Tablets
    Ofloxacin 400mg Tablets

     

    Broad spectrum antibiotics are associated with the development of clostridium difficle and use should be limited.

    Please refer to the Staffordshire and Stoke-On-Trent Antimicrobial Prescribing Guidelines for clinical indications and guidance

    04.02.01 Olanzapine Zyprexa®

    Olanzapine Tablet 2.5mg
    Olanzapine Tablet 5mg
    Olanzapine Tablet 7.5mg
    Olanzapine Tablet 10mg
    Olanzapine Tablet 15mg
    Olanzapine Tablet 20mg
    Olanzapine Orodisper Tablet 5mg
    Olanzapine Orodisper Tablet 10mg
    Olanzapine Orodisper Tablet 15mg

    Do not prescribe Oral Lyophilisates preparations Very Expensive-Applicable in Primary care only.

    See link below for ESCA's.  Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

    08.01.05 Olaparib Lynparza®

    Restriction: In line with NICE Guidance only

     

    MHRA/CHM advice: Lynparza® (olaparib): Risk of medication errors with new pharmaceutical form (May 2018)

    08.01.05 Olaratumab Lartruvo®

    This is an NHS England specialist commissioning drug for cancer

     

    MHRA advice (June 2019): Lartruvo▼ (olaratumab)- withdrawal of the EU marketing authorisation due to lack of efficacy; No new patients should be started on olaratumab therapy.

    12.01.03 Olive Oil Ear Drops 

    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.

    03.01.01.01 Olodaterol Striverdi®Respimat

    Hospital only

     

     

     

    11.04.02 Olopatadine Opatanol® Olopatadine_Eye Dps 1mg/ml
    03.04.02 Omalizumab 

    This is an NHS England Specialised Commissioning Drug for Asthma

    This is a Specialised Drug which is commissioned by the CCGs ONLY for Chronic Spontaneous Urticaria.

    05.03.03.02 Ombitasvir with Paritaprevir and Ritonavir Viekirax®

    NHS England commissioned

    In line with NICE

    01.03.05 Omeprazole 

    Omeprazole 10mg G/R Capsule
    Omeprazole 20mg G/R Capsule
    Omeprazole 10mg G/R Tablet Dispersible
    Omeprazole 20mg G/R Tablet Dispersible
     
     
    Omeprazole mups tablets are licensed in patients >1 year old and doses smaller then 10mg can be achieved by dispersing tablets in water and drawing up the correct dose. This method of administration is preferable than the prescribing of unlicensed omeprazole liquids for patients over 1 year.

    04.06 Ondansetron 

    Amber Amber for licensed indications of post operative nausea and vomiting ,and nausea and vomiting related to chemotherapy.

    AmberAmber for the unlicensed indications of pallitative care where recommended by the pallitative care team.

    Red Traffic Light  For all other indications

    Tablets are the preferred formulation.

    If patient has swallowing difficulties the most cost effective option for both 4mg and 8mg strength are the Setofilm® orodisperible films as the liquid and generically prescribed orodispersible tablets and melts are more expensive. These must be prescribed by brand Setofilm.

    Please note these are still considerably more expensive then the normal release tablets.

    MHRA advice: Ondansetron- small increased risk of oral clefts following use in the first 12 weeks of pregnancy (Jan 2020)

    09.02.01.02 Oral Rehydration Salts Dioralyte® Dioralyte Relief® Electrolade® Dioralyte_Tab Eff (Blkcurrant)
    Dioralyte_Tab Eff (Citrus)
    Dioralyte_Tab Eff (Plain)
    Electrolade_Pdr Sach 4g (Banana)
    Electrolade_Pdr Sach 4g (Blkcurrant)
    Electrolade_Pdr Sach 4g (Lem & Lim)
    Electrolade_Pdr Sach 4g (Melon)
    Electrolade_Pdr Sach 4g (Multiflav)
    Electrolade_Pdr Sach 4g (Orange)
    Electrolade_Pdr Sach 4g (Plain)
    04.05.01 Orlistat  Orlistat Capsule 120mg

    Initiated ONLY after trial of weight loss. Should not prescribe outside its limited licensed indication. Treatment with orlistat should be discontinued after 12 weeks if less than 5% of the body weight has been lost since the start of therapy.

    05.03.04 Oseltamivir Tamiflu®
    Oseltamivir Phosphate 30mg Capsules
    Oseltamivir Phosphate 45mg Capsules
    Oseltamivir Phosphate 75mg Capsules
    Oseltamivir Phosphate 6mg/1ml oral Suspension

    Recommended to only prescribe when official notification that influenza is circulating in the Community, to patients in "At Risk" groups, if they present within 36 hours of first symptoms and will be able to administer within 48 hours of first symptoms.

    Please refer to the Staffordshire and Stoke-On-Trent Antimicrobial Prescribing Guidelines for clinical indications and guidance

    08.01.05 Osimertinib  Tagrisso ®

    Restriction: In line with NICE Guidance only

     

    09.04.02 Osmolite® Abbott Laboritories Ltd

    1kcal/mL and less than 5g protein/100ml

    Gluten-free
    Residual lactose

    Available in:
    500ml
    1000ml
    1500ml

    09.04.02 Osmolite®1.5kcal Abbott Laboritories Ltd

    1.5kcal/mL and 5g (or more) protein/100ml

    Gluten-free
    Residual lactose

    Available in:
    500ml
    1000ml
    1500ml

    09.04.02 Osmolite®Plus Abbott Laboritories Ltd

    1.5kcal/mL and 5g (or more) protein/100mL

    Gluten-free
    Residual lactose

    Available in:
    500ml
    1000ml
    1500ml

    09.05.02.02 Osvaren Osvaren® Osvaren Tablet 435mg/235mg
    08.01.05 Oxaliplatin 
    06.04.03 Oxandrolone (Unlicensed) 
    04.08.01 Oxcarbazepine Trileptal®

    Oxcarbazepine Tablet 150mg
    Oxcarbazepine Tablet 300mg
    Oxcarbazepine Tablet 600mg
    Oxcarbazepine Oral Suspension 300mg/5ml

    Restriction: Initiation and stabilisation by specialist
    Maintain patient on specific manufacturer's products.

    07.04.02 Oxybutynin  Oxybutynin HCl_Tab 2.5mg
    Oxybutynin HCl_Tab 5mg
    Oxybutynin 2.5mg/5ml Oral Solution


    First Line treatment as stated in the NICE Guidelines. This applies to immediate release ONLY. 3mg Very Expensive

    Do Not offer immediate release to frail older women.
    04.07.02 Oxycodone 

    Shortec Capsule 5mg 
    Shortec Capsule 10mg 
    Shortec Capsule 20mg

    Longtec HCl Tablet 5mg M/R
    Longtec HCl Tablet 10mg M/R 
    Longtec HCl Tablet 15mg M/R
    Longtec HCl Tablet 20mg M/R 
    Longtec HCl Tablet 30mg M/R
    Longtec HCl Tablet 40mg M/R 
    Longtec HCl Tablet 60mg M/R
    Longtec HCl Tablet 80mg M/R

    Longtec HCl Tablet 120mg M/R

    Oxycodone HCl Oral Solution 10mg/1ml S/F
    Oxycodone HCl Oral Solution 5mg/5ml S/F

     

    Please prescribe the normal release as Shortec® and the modified release as longtec® as this is more cost effective (Applicable in Primary care only).

    05.01.03 Oxytetracycline 

    Oxytetracycline 250mg Tablets

    13.06.02 Oxytetracycline  500mg Twice Daily
    19 Oxyzyme  6.5cm x 5cm (1)
    10cm x 10cm (1)
    08.01.05 Paclitaxel 
    08.01.05 Paclitaxel - Albumin Bound Formulation Abraxane®

    This is an NHS England Specialised Commissioning drug

     

    08.01.05 Palbociclib Ibrance®

    Restriction: In line with NICE Guidance only

     

    04.02.02 Paliperidone Xeplion®

    Paliperidone 50mg/0.5ml suspension for injection pre-filled syringes 
    Paliperidone 75mg/0.75ml suspension for injection pre-filled syringes 
    Paliperidone 100mg/1ml suspension for injection pre-filled syringes 
    Paliperidone 150mg/1.5ml suspension for injection pre-filled syringes

    05.03.05 Palivizumab Synagis® This is an NHS England Specialised Commissioning Drug for RSV Prophylaxis
    01.09.04 Pancreatin Creon® 10000

    Capsules

    Counsel patient on need for adequate hydration

    01.09.04 Pancreatin Creon® Micro

    100 mg granules = one measured scoopful (scoop supplied with product).

    For infants, Creon Micro® granules can be mixed with a small amount of milk on a spoon and administered immediately—granules should not be added to the baby's bottle

    01.09.04 Pancreatin Pancrex®

    Powder

    Counsel patient on need for adequate hydration

    01.09.04 Pancreatin Pancrex® V

    Tablets
    Tablets Forte
    Capsules
    Powder

    Counsel patient on need for adequate hydration
    Pancrex V powder may be administered via nasogastric tube or gastrostomy tube

    01.09.04 Pancreatin Creon® 40000

    DISCONTINUATION

    Mylan confirm discontinuation of this strength from June 2019.

    01.09.04 Pancreatin Pancrease® HL

    Capsules

    Counsel patient on need for adequate hydration
    Should not be used in children aged 15 years or less with cystic fibrosis

    01.09.04 Pancreatin Creon® 25000

    Capsules

    Counsel patient on need for adequate hydration

    01.09.04 Pancreatin Nutrizym® 22

    Gastro-resistant capsules

    Counsel patient on need for adequate hydration
    Should not be used in children aged 15 years or less with cystic fibrosis

    Note: Nutrizym 10 has been discontinued, so can only prescribe Nutrizym 22.

    08.01.05 Panitumumab Vectibix®

    This is an NHS England Specialised Commissioning Drug for Cancer

    Hospital only

     

    08.01.05 Panobinostat Farydak®

    This is an NHS England specialised commissioning drug

     

    04.07 Paracetamol  Paracetamol Tablet 500mg
    Paracetamol Capsule 500mg - More Expensive than Tablets
    Paracetamol Tablet Soluble 500mg - More Expensive than Tablets

    Paracetamol Oral Solution Paediatric 120mg/5ml
    Paracetamol Oral Solution Paediatric 120mg/5ml S/F
    Paracetamol Oral Suspension 250mg/5ml
    Paracetamol Oral Suspension 250mg/5ml S/F
    Paracetamol Syrup 120mg/5ml


    04.07.04.01 Paracetamol See Section 4.7.1
    06.06.01 Parathyroid Hormone 

    This is an NHS England Specialised Commissioning Drug for Specialist Endocrinology conditions

    09.06.07 Paravit-CF® 

    Paravit-CF® is a fat-soluble vitamin supplement specifically designed for patients with Cystic Fibrosis and is available in Liquid and Softgel Capsule form.

    Paravit-CF® should only be used in pregnancy on the advice of a specialist

    04.03.03 Paroxetine  Paroxetine HCl Tablet 20mg
    Paroxetine HCl Tablet 30mg
    Paroxetine Oral Suspension 10mg/5ml SF

    Withdrawal syndrome is more common with paroxetine - Royal College of Psychiatrists
    09.02.01.01 Patiromer calcium Veltassa®

    Restriction: In line with NICE Guidance only

    08.01.05 Pazopanib Votrient®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    03.01.05 Peak Flow Meters  Low Range Peak Flow Meters
    - Medi Low Range
    - Mini Wright Low Range
    - Pocketpeak Low Range

    Standard Range Peak Flow Meters
    - Airzone
    - Medi Standard Range
    - Micropeak
    - Mini-Wright Standard Range
    - Piko-1
    - Pinnacle
    - Pocketpeak Standard Range
    - Vitalograph
    09.01.06 Pegfilgrastim Neulasta® This is a Specialised Drug which would not be routinely commissioned by CCGs for Neutropenia. This would go through a South Staffs CCGs Individual Funding Request (IFR)
    08.02.04 Peginterferon Alfa 

    This is an NHS England Specialised Commissioning Drug for Hepatitis B & C

     

    08.02.04 Peginterferon Beta-1a Plegridy®

    Restriction: In line with NICE Guidance only

    08.02.03 Pembrolizumab Keytruda®

    Restriction: In line with NICE Guidance only
     

     

    08.01.03 Pemetrexed Alimta®

    This is an NHS England Specialised Commissioning Drug for Cancer
     
     

     

     

     

    10.01.03 Penicillamine 

    Penicillamine_Tab 125mg
    Penicillamine_Tab 250mg


    06.01.01.03 Pens (Cartridge pens can be provided by the company) 
    07.04.03 Pentosan polysulfate sodium Elmiron®

    Elmiron 100mg capsules

    Restriction: In line with NICE Guidance only

    01.02 Peppermint Oil  Capsules

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

    01.01.02 Peptac®Liquid 

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

    Na+ content 3.1 mmol/5ml

    28.01 Pepti 1® Milupa Aptamil

    Birth to 6 months

    Contains Lactose

    May be tried if the infant/child is not tolerating first-line products because of taste

    28.01 Pepti 2® Milupa Aptamil

    6 months to 2 years.  Not needed if tolerating suitable milk free OTC products and weaned to appropriate diet as recommended by paediatric dietician.

    Contains Lactose

    28.01 Pepti-Junior® Cow&Gate

    MUST BE RECOMMENDED BY DIETICIAN

    Extensively Hydrolysed Formulae with Medium Chain Triglycerides. 

    Prescribe in primary care only as recommended by Paediatric Dietician or Paediatrician.

    Birth to 2 years.  Not needed if tolerating suitable milk free OTC products and weaned to appropriate diet as recommended by paediatric dietician.

    Used where Cows milk protein allergy is accompanied by malabsorption

    04.08.01 Perampanel Fycompa®

    Perampanel 2mg tablets
    Perampanel 4mg tablets
    Perampanel 6mg tablets
    Perampanel 8mg tablets
    Perampanel 10mg tablets
    Perampanel 12mg tablets

    Restriction: By specialist only
    Unnecessary to maintain patient on specific manufacturer's products.

    09.04.02 Perative ® Abbott Laboritories Ltd

    less than 1.5kcal/mL and 5g (or more) protein/100mL

    Gluten free
    Residual lactose

    Available in:
    500ml
    1000ml

    02.05.05.01 Perindopril erbumine 

    Perindopril Erbumine 2mg Tablet
    Perindopril Erbumine 4mg Tablet
    Perindopril Erbumine 8mg Tablet


    Do not prescribe Perindopril arginine - this is the branded Coversyl version- see NHS england advice below

    NHS England Guidance for CCGs

    • prescribers in primary care should not initiate perindopril arginine for any new patient.
    • prescribers should be supported in deprescribing perindopril arginine in all patients and, where appropriate, ensure the availability of relevant services to facilitate this change.
    13.10.04 Permethrin 5% Lyclear® Dermal Cream

    Permethrin 5% Cream 30g

    For scabies, body lice
    DO NOT use Shampoo Formulation

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

    08.01.05 Pertuzumab Perjeta®

    This is an NHS England Specialised Commissioning drug

     

    03.04.02 Pharmalgen 
    05.01.01.01 Phenoxymethylpenicillin 

    Phenoxymethylpenicillin potassium 250mg Tablets
    Phenoxymethylpenicillin potassium 125mg/5ml oral Solution
    Phenoxymethylpenicillin potassium 125mg/5ml oral Solution SF
    Phenoxymethylpenicillin potassium 250mg/5ml oral Solution
    Phenoxymethylpenicillin potassium 250mg/5ml oral Solution SF

    04.08.01 Phenytoin 

    Phenytoin Sodium Capsule 25mg
    Phenytoin Sodium Capsule 50mg
    Phenytoin Sodium Capsule 50mg
    Phenytoin Sodium Capsule 100mg
    Phenytoin Sodium Capsule 300mg
    Phenytoin Oral Liquid

    Restriction: Initiation and stabilisation by specialist
    Maintain patient on specific manufacturer's products.

    A2.07 Phlexy-10® Exchange System 
    A2.07 Phlexy-Vits® 
    09.05.02.01 Phosphate Sandoz®   Effervescent tablets
    01.06.04 Phosphates  Rectal

    Fleet®Ready-to-use Enema

    09.06.06 Phytomenadione Konakion® MM paediatric Konakion MM Paed_Oral/IM/IV 2mg/0.2ml Am
    licensed for oral use
    01.06.05 Picolax® 
    11.06 Pilocarpine  Piloc HCl_Eye Dps 1%
    Piloc HCl_Eye Dps 2%
    Piloc HCl_Eye Dps 4%
    13.05.03 Pimecrolimus Elidel® 1% Cream 30, 60 and 100g

    Initiation by Dermotologist
    06.01.02.03 Pioglitazone Actos® Glitazones and Gliptins should only be considered if:
    • Substituting for a sulphonylurea in patients on metformin and a sulphonylurea where there is a significant risk of hypoglycaemia (or its consequences) or a sulphonylurea is contra-indicated or not tolerated.
    • Metformin is contraindicated or not tolerated and the patient HBA1c remains above 6.5% on a sulphonylurea.
    As triple therapy if insulin is unacceptable (because of employment, social or recreational or other personal issues, or obesity.
    Only continue if reduction in HBA1c of at least 0.5% in 6 months
    03.11 Pirfenidone 
    • NHS England commissioned
    • In line with NICE

    MHRA/CHM advice: Pirfenidone (Esbriet®): risk of serious liver injury; updated advice on liver function testing (November 2020)

    05.01.01.05 Pivmecillinam 

    Pivmecillinam 200mg Tablets

    Please refer to the Staffordshire and Stoke-On-Trent Antimicrobial Prescribing Guidelines for clinical indications and guidance

     

    08.01.02 Pixantrone Pixuvri®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    04.07.04.02 Pizotifen 

    Pizotifen Malate_Tab 1.5mg
    Pizotifen Malate_Tab 500microgram

    Liquid Preparations are Unlicensed and Expensive

    A2.07 PK Aid-4® 
    A2.07 PKU Anamix® Infant 
    A2.07 PKU Anamix® Junior 
    A2.07 PKU Anamix® Junior LQ 
    A2.07 PKU cooler10® 
    A2.07 PKU cooler15® 
    A2.07 PKU cooler20® 
    A2.07 PKU express 15® 
    A2.07 PKU express 20® 
    A2.07 PKU gel® 
    A2.07 PKU Lophlex® LQ 10 
    A2.07 PKU Lophlex® LQ 20 
    A2.07 PKU Lophlex®sensation 20 
    A2.07 PKU Squeezie® 
    A2.07 PKU Start® 
    08.02.03 Polatuzumab vedotin Polivy®

    Restriction: In line with NICE Guidance only

    13.10.01.01 Polyfax Ointment  This requires Tissue Viability Nurse approval or Microbiology approval
    19 Polymem  8cm x 8cm (5)
    10cm x 10cm (5)
    09.02.01.01 Polystyrene Sulphonate Resins Resonium A®
    09.02.01.01 Polystyrene Sulphonate Resins Calcium Resonium®
    08.02.04 Pomalidomide Imnovid®

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Myelofibrosis. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    This is an NHS England Specialised Commissioning Drug for Cancer
    Hospital only in line with NICE for myeloma previously treated with lenalidomide and bortezomib

     

    08.01.05 Ponatinib Iclusig®

    NHS specialist commissioning for chronic-accelerated or blast-phase chronic myeloid leukemia in adults and Philadelphia-chromosome-positive acute lymphoblastic leukemia

     

    05.02 Posaconazole Noxafil®

    This is an NHS England Specialised Commissioning Drug for Fungal Infection

    09.02.01.01 Potassium Chloride 

    potassium chloride 600mg MR tablets

     

    Slow K has been discontinued and the imported products of potassium chloride tablets are costly

    09.02.01.01 Potassium Chloride Sando-K® Effervescent tablets
    09.02.01.01 Potassium Chloride Kay-Cee-L® Syrup 75mg per 1ml

    Only where initiated by hospital consultant
    04.09.01 Pramipexole  

    pramipexole 0.088 mg tablets
    pramipexole 0.18 mg tablets
    pramipexole0.35 mg tablets
    pramipexole 0.7 mg tablets
     

    04.09.01 Pramipexole modified release tablets Pipexus® Pipexus 0.26 mg prolonged-release tablets
    Pipexus 0.52 mg prolonged-release tablets
    Pipexus 1.05 mg prolonged-release tablets
    Pipexus 1.57 mg prolonged-release tablets
    Pipexus 2.10 mg prolonged-release tablets
    Pipexus 2.62 mg prolonged-release tablets
    Pipexus 3.15 mg prolonged-release tablets

    Please prescribe Pramipexole MR as most cost effective brand in primary care Pipexus ®
    02.09 Prasugrel Efient®

    Prasugrel 5mg Tablet
    Prasugrel 10mg Tablet

    02.12 Pravastatin  
    Pravastatin 10mg Tablet
    Pravastatin 20mg Tablet
    Pravastatin 40mg Tablet
    02.05.04 Prazosin 

    Prazosin Hydrochloride 500microgram Tablet
    Prazosin Hydrochloride 1mg Tablet
    Prazosin Hydrochloride 2mg Tablet (Very Expensive Special)
    Prazosin Hydrochloride 5mg Tablet (Very Expensive Special)

    06.03.02 Prednisolone  Tablets 1mg, 2mg and 5mg

    No evidence to support the use of the EC Preparation - PLEASE DO NOT USE

    If an equivalent of >7.5mg prednisolone daily is prescribed long term (>3 months) assess patient for osteoporosis risk.
    In asthma a two week course of 40mg daily or less does not need stepping down (Ref BNF, Section 6.3.2 Withdrawal of corticosteroids).
    Glucocorticoid equivalent Prednisolone 5mg = Dexamethasone 0.75mg = Hydrocortisone 20mg
    11.04.01 Prednisolone Pred Forte® Prednisolone Sod Phos_Eye Dps 1%
    01.05.02 Prednisolone enema 

    Prednisolone Sodium Phosphate Enema 20mg/100ml
    Predsol Retention Enema 20mg/100ml

    Prednisolone 20mg Application Foam Enema (14D) is now removed from formulary as the generic is very expensive

    Please note significantly more expensive then first choice which is hydrocortisone 10% enema (colifoam). In the absence of colifoam due to stock issues budesonide enema is the second line choice. Gastroenterologists at Burton, wolverhampton and Heart of England Trust have advised they are interchangeable.

    11.04.01 Prednisolone eye drops  Prednisolone Sod Phos_Eye Dps 0.05%
    11.04.01 Prednisolone preservative free eye drops  Prednisolone Sod Phos_Eye Dps 0.5% P/F
    06.03.02 Prednisolone soluble preparation 

    Soluble tablets are expensive, use only where swallowing difficulties are confirmed.
     
    For doses under 5mg the 5mg/5ml oral solution will be more appropriate. 

    Use the 10mg/ml solution only for suitable doses

    Both preparations licensed in children and for all standard steroid indications
    To avoid errors with wrong liquid strength being prescribed please always prescribe the dose in mg rather then mls.

    04.07.03 Pregabalin 

    Pregabalin Capsule 25mg
    Pregabalin Capsule 50mg
    Pregabalin Capsule 75mg
    Pregabalin Capsule 100mg
    Pregabalin Capsule 150mg
    Pregabalin Capsule 200mg
    Pregabalin Capsule 225mg
    Pregabalin Capsule 300mg
    Pregabalin Oral Soln 100mg/5ml S/F - for patients with swallowing difficulties ONLY

    The Capsules are flat priced so dose optimise when increasing Daily Doses, e.g. 1x50mg twice a day is cheaper to prescribe than 2x25mg twice a day.

    CDAs of the 1st April 2019 Pregabalin is re-classified as a Schedule 3 Controlled Drug

    04.08.01 Pregabalin 

    Pregabalin Capsule 25mg
    Pregabalin Capsule 50mg
    Pregabalin Capsule 75mg
    Pregabalin Capsule 100mg
    Pregabalin Capsule 150mg
    Pregabalin Capsule 200mg
    Pregabalin Capsule 225mg
    Pregabalin Capsule 300mg

    Pregabalin Oral Solution 100mg/5ml S/F - for patients with swallowing difficulties ONLY
     
    The Capsules are flat priced so dose optimise when increasing Daily Doses, e.g. 1x50mg twice a day is cheaper to prescribe than 2x25mg twice a day.

    CDAs of the 1st April 2019 Pregabalin is re-classified as a Schedule 3 Controlled Drug

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products.

    09.01.01 Pregaday  Pregaday_Tab

    Contains 100mg Iron, 350mcg Folic Acid
    28.01 Pregestimil Lipil® Mead Johnson

    MUST BE RECOMMENDED BY DIETICIAN

    Extensively hydrolysed formulae with medium chain triglycerides.

    Prescribe in primary care only as recommended by Paediatric Dietician or Paediatrician

    Birth to 2 years.  Not needed if tolerating suitable milk free OTC products and weaned to appropriate diet as recommended by paediatric dietician.

    Used where Cows milk protein allergy is accompanied by malabsorption.

    06.04.01.01 Premarin  Tablets
    300mcg
    625mcg
    1.25mg

    Unopposed oestrogen only. For hysterectomised women and non-hysterectomised women following individual risk/benefit assessment.
    06.04.01.01 Premique  Premique Low Dose Tablets 300mcg
    Premique Tablets 625mcg

    Continuous combined HRT for women with an intact uterus.
    09.04 Pro-Cal® Shot 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 Pro-Cal® Powder 

    Initiation by specialist dietician services prior to continuation within primary care.

    04.06 Prochlorperazine 


     

    04.09.02 Procyclidine  Procyclidine HCl Tablet 5mg
    06.04.01.02 Progesterone Lubion®

    25mg/1.112ml soln for inj

     

    Fertility drugs should not be prescribed in Primary care. They are funded as part of the fertility treatment and will be provided form fertility clinic

    06.04.01.02 Progesterone Utrogestan®

    100mg cap

    Fertility drugs not to be prescribed in primary care

    19 Prontosan   Prontosan Wound Gel 30ml Ampoules (6)
    Prontosan Wound Irrigation Solution 40ml (1)
    02.03.02 Propafenone hydrochloride 

    Propafenone hydrochloride 150mg Tablet
    Propafenone hydrochloride 300mg Tablet

    04.07.04.02 Propranolol  See Section 2.4

    See link for Chapter 2.4.9
    02.04 Propranolol Hydrochloride 

    Propranolol Hydrochloride 10mg Tablet
    Propranolol Hydrochloride 40mg Tablet
    Propranolol Hydrochloride 80mg Tablet
    Propranolol Hydrochloride 160mg Tablet
    Propranolol Hydrochloride MR 80mg Capsule
    Propranolol Hydrochloride MR 160mg Capsule
    Propranolol Hydrochloride 5mg/5ml Oral Solution SF
    Propranolol Hydrochloride 10mg/5ml Oral Solution SF
    Propranolol Hydrochloride 40mg/5ml Oral Solution SF
    Propranolol Hydrochloride 50mg/5ml Oral Solution SF


    Prescribe MR capsules generically as more cost-effective(Applicable in Primary care only)




    06.02.02 Propylthiouracil  Tablets 50mg

    Hepatotoxicity - Severe hepatic reactions have been reported, including fatal cases and cases requiring liver transplant - discontinue if significant liver-enzyme abnormalities develop.

    Carbimazole and Propylthiouracil are associated with rare cases of neutropenia and agranulocytosis due to bone marrow suppression.
    • Patients should be advised to report symptoms suggestive of infection, especially sore throat.
    • Blood Count should be performed if there is clinical evidence of infection.
    • Carbimazole/Propylthiouracil should be stopped if there is clinical or lab evidence of neutropenia.
    09.04 ProSource ® TF  

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 ProSource® Jelly 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 ProSource® Liquid 

    Initiation by specialist dietician services prior to continuation within primary care.

    09.04 ProSource® Plus 

    Initiation by specialist dietician services prior to continuation within primary care.

    01.06.07 Prucalopride Resolor ®

    Prucalopride 1mg Tablet
    Prucalopride 2mg Tablet

    RICAD necessary. Only licensed for women who have failed to respond to two other laxatives at maximum doses. Initiation should be undertaken by a Specialist. See NICE Guidance TA 211.

    05.01.09 Pyrazinamide   All drugs for tuberculosis are hospital only
    10.02.01 Pyridostigmine Bromide 60mg tablets 
    09.06.02 Pyridoxine Hydrochloride  Pyridox HCl_Tab 10mg
    Pyridox HCl_Tab 20mg
    Pyridox HCl_Tab 50mg
    04.02.01 Quetiapine 

    FIRST CHOICE- normal release tablets
    Quetiapine Tablet 25mg
    Quetiapine Tablet 100mg
    Quetiapine Tablet 150mg
    Quetiapine Tablet 200mg
    Quetiapine Tablet 300mg

    SECOND CHOICE - MR where there are compliance issues
    Zaluron XL Tablet 50mg
    Zaluron XL tablet 150mg
    Zaluron XL Tablet 200mg
    zaluron XL Tablet 300mg
    zaluron XL Tablet 400mg

    THIRD CHOICE
    Biquelle XL Tablet 50mg
    Biquelle XL tablet 150mg
    Biquelle XL Tablet 200mg
    Biquelle XL Tablet 300mg
    Biquelle XL Tablet 400mg

    See link below for ESCA's.  Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

     

    Prescribers should choose the most cost-effective option (Applicable in Primary care only)

     

    10.02.02 Quinine sulfate 

    Nocturnal Leg Cramp: Drug Safety Update (June 2010) state that Quinine should only be used when leg cramps regularly disrupt sleep and Healthcare Professionals are advised:
    1. Before use of Quinine for nocturnal leg cramps, the risks should be carefully considered realative to the potential benefits

    2. After a trial of at least 4 weeks, treatment shold be stopped if there is no benefit. If treatment continues the benefits should be assessed around every 3 months

    13.02.01 QV Cream  Lowest Greasy Preparation
    Cream 100g and 500g

    Please refer to the supplementary "Emollient Guide" for more details
    02.05.05.01 Ramipril 

    Ramipril 1.25mg Capsule
    Ramipril 2.5mg Capsule
    Ramipril 5mg Capsule
    Ramipril 10mg Capsule
    Ramipril 1.25mg Tablet
    Ramipril 2.5mg Tablet
    Ramipril 5mg Tablet
    Ramipril 10mg Tablet
    Ramipril 2.5mg/5ml S/F Oral Solution 

    11.08.02 Ranibizumab Lucentis®

    Restriction: In line with NICE Guidance only

    01.03.01 Ranitidine 

    Ranitidine HCI 75mg/5ml S/F Oral Solution 
    Ranitidine HCI 150mg Tablet
    Ranitidine HCI 300mg Tablet

    02.06.03 Ranolazine Ranexa®

    Ranolazine 375mg M/R Tablet
    Ranolazine 500mg M/R Tablet
    Ranolazine 750mg M/R Tablet

    04.09.01 Rasagiline  Rasagiline Mesil_Tablet 1mg
    08.01.05 Regorafenib Stivarga®

    This is an NHS England Specialised Commissioning Drug for Cancer

    06.01.02.03 Repaglinide Prandin®
    03.04.02 Reslizumab Cinqaero® This is an NHS England specialised commissioning drug for the treatment of severe eosinophilic asthma
    06.04.02 Restandol  testosterone undecanoate capsules for oral use
    02.10.02 Reteplase Rapilysin®
    04.08.01 Retigabine 

    Retigabine Tablet 50mg
    Retigabine Tablet 100mg
    Retigabine Tablet 200mg
    Retigabine Tablet 300mg
    Retigabine Tablet 400mg

    Retigabine for the adjunctive treatment of partial onset seizures in epilepsy, see TA232.

    Discontinued June 2017See manufacturer's note

    05.03.05 Ribavirin  This is an NHS England Specialised Commissioning Drug for Hepatitis C

    Peginterferon-Alfa and Ribavirin for the treatment of Chronic Hepatitis C TA200

    Hepatitis C Peginterferon-Alfa and Ribavirin in Children and Young people TA300
    08.01.05 Ribociclib Kisqali®

    This is an NHS England Specialised Commissioning Drug 

     

    05.01.09 Rifabutin Mycobutin® All drugs for tuberculosis are hospital only
    05.01.09 Rifampicin 

    Rifampicin Cap 150mg
    Rifampicin Cap 300mg
    Rifampicin Oral Susp 100mg/5ml


    Rifampicin is used second line in Meningococcal meningitis prophylaxis. Both rifampicin and ciprofloxacin are recommended for chemoprophylaxis, although several factors now favour the use of ciprofloxacin in most individuals. The advantages of ciprofloxacin over rifampicin are that it is given as a single dose, does not interact with oral contraceptives, and is more readily available in community pharmacies. It is now licensed for the indication in adults. However, it is contraindicated in known ciprofloxacin hypersensitivity.

    05.01.09 Rifampicin (infusion)   All drugs for tuberculosis are hospital only
    05.01.09 Rifampicin and Isoniazid and Pyrazinamide (Rifater®)   All drugs for tuberculosis are hospital only
    05.01.07 Rifaximin  Rifaximin 550mg Tablets

    Formulary item for Hepatic Encephalopathy only

    ESCA/RICaD in development

    Please note 200mg strength is not licensed for this use and as such is non-formulary
    07.03.01 Rigevidon  Rigevidon_Tab

    Same constituents as Microgynon.
    05.03.01 Rilpivirine 

    This is an NHS England Specialised Commissioning Drug for HIV in connection with other anti-retrovial drugs

    05.03.01 Rilpivirine hydrochloride Edurant®
    04.09.03 Riluzole Rilutek ® The use of Riluzole for the treatment of Motor Neurone Disease

    Initiated in secondary care then continued with ESCA from the trust initiated in.
    13.05.03 Risankizumab Skyrizi®

    In line with NICE guidance

    06.06.02 Risedronate   People at risk of osteoporosis need to maintain an adequate intake of Calcium and Vitamin D; Vitamin D dosage should be 800iu per day.
    04.02.01 Risperidone 

    Risperidone Tablet 500mcg
    Risperidone Tablet 1mg
    Risperidone Tablet 2mg
    Risperidone Tablet 3mg
    Risperidone Tablet 4mg
    Risperidone Orodisper Tablet 500mcg SF
    Risperidone Orodisper Tablet 1mg SF
    Risperidone Orodisper Tablet 2mg SF
    Risperidone Orodisper Tablet 3mg SF
    Risperidone Orodisper Tablet 4mg SF
    Risperidone Oral Solution 1mg/ml SF

    See link below for ESCA's.  Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

     

    04.02.02 Risperidone Risperdal Consta® Risperidone Powder for reconstitution 25mg vial
    Risperidone Powder for reconstitution 37.5mg vial
    Risperidone Powder for reconstitution 50mg vial
    10.01.03 Rituximab (rheumatology) MabThera® This is an NHS England Specialised Commissioning Drug for ANCA-positive vascullitis

    This is an NHS England Specialised Commissioning Drug for Paediatric indications (where adult TA available

    This is an NHS England Specialised Commissioning Drug for SLE

    This is an NHS England Specialised Commissioning Drug for Neuromyelitis optica

    This is an NHS England Specialised Commissioning Drug for ABO-incompatible kidney transplants

    This is an NHS England Specialised Commissioning Drug for Juvenile arthritis

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Haemophilia. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Phemphigus vulgaris. This would go through a South Staffs CCGs Individual Funding Request (IFR)


    This is a Specialised Drug which would not be routinely commissioned by CCGs for Connective Tissue Disease - interstitial lung disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Graft versus host disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Myositis. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Nephritis. This would go through a South Staffs CCGs Individual Funding Request (IFR)
    08.02.03 Rituximab iv MabThera®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    02.08.02 Rivaroxaban Xarelto®

    Rivaroxaban 10mg Tablet
    Rivaroxaban 15mg Tablet
    Rivaroxaban 20mg Tablet

    02.08.02 Rivaroxaban Xarelto®

    Rivaroxaban 2.5mg Tablet

    • for preventing atherothrombotic events in people with coronary or peripheral artery disease
    • The recommended dosage for rivaroxaban is 2.5 mg taken orally twice daily in combination with a daily dose of 75 to 100 mg aspirin taken orally

    Restriction: In line with NICE Guidance

    MHRA/CHM advice: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome (June 2019)

     


     
     

    04.11 Rivastigmine Alzest®

    Rivastigmine_Cap 1.5mg
    Rivastigmine_Cap 3mg
    Rivastigmine_Cap 4.5mg
    Rivastigmine_Cap 6mg
    Rivastigmine_Oral Soln 2mg/1ml
    Rivastigmine_Oral Soln 2mg/1ml S/F
    Rivastigmine_Skin Patch 4.6mg/24hrs
    Rivastigmine_Skin Patch 9.5mg/24hrs
    Rivastigmine_Skin Patch 13.3mg/24hrs

    Patches should only be used in patients with swallowing difficulties and should be prescribed as Alzest which is more cost effective in primary care.

    See link below for ESCA. Please use the ESCA under the title Agreements - South Staffordshire CCG Locality

    04.07.04.01 Rizatriptan 
    03.03.03 Roflumilast Daxas®

    For use in severe COPD patients only to be prescribed by respiratory specialists. Not for prescribing in primary care.
    Roflumilast 500 microgram tablets


    09.01.04 Romiplostim Nplate®

    Restriction: In line with NICE Guidance only

    04.09.01 Ropinirole 

    Restriction: Initiation and stabilisation by specialist

    Ropinirole HCl Tab 250mcg
    Ropinirole HCl Tab 500mcg
    Ropinirole HCl Tab 1mg
    Ropinirole HCl Tab 2mg
    Ropinirole HCl Tab 5mg

    Ropinirole HCl Tab 2mg M/R 
    Ropinirole HCl Tab 3mg M/R  
    Ropinirole HCl Tab 4mg M/R
    Ropinirole HCl Tab 6mg M/R  
    Ropinirole HCl Tab 8mg M/R
     
    Ipinnia XL or Repinex XL are the preferred cost-effective MR brands (Applicable in primary care).

    02.12 Rosuvastatin 
    Rosuvastatin 5mg Tablet
    Rosuvastatin 10mg Tablet
    Rosuvastatin 20mg Tablet
    Rosuvastatin 40mg Tablet
    08.02.04 Rucaparib Rubraca®

    This is a Cancer Drug Fund Specialised Drug for Cancer

     

    04.08.01 Rufinamide Inovelon®

    Rufinamide Tablet 100mg
    Rufinamide Tablet 200mg
    Rufinamide Tablet 400mg
    Rufinamide Oral Suspension 40mg/1ml S/F

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products

    08.01.05 Ruxolitinib Jakavi®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    02.05.05 Sacubitril with valsartan Entresto®
    Entresto® 24/26mg Tablet
    Entresto® 49/51mg Tablet
    Entresto® 97/103mg Tablet

    This drug requires a RICaD.

    For Burton hospital patients please follow the link below to the RICaD.

    The provision for other hospitals may be different and would need to refer to the respective formulary but this RICaD could be used for clinical information.

    03.01.01.01 Salbutamol Salamol®Easi-Breathe Salbutamol Sulfate 100mcg/ dose Breath actuated CFC Free Inhaler (200D)


    Short Acting Beta2 Adrenoreceptor Agonist
    Indicated for Asthma and COPD.

    03.01.01.01 Salbutamol (as sulfate) Easyhaler  Salbutomol Dry powder for inhalation,100mcg(200D)

    Short Acting Beta2 Adrenoreceptor Agonist
    Indicated for Asthma and COPD.

    03.01.01.01 Salbutamol CFC Free  Salbutamol Inhalation 100mcg (200 D) CFF
    Salbutamol Inhalation Solution 2.5mg/2.5ml Ud
    Salbutamol Inhalation Solution 5mg/2.5ml Ud

    Short Acting Beta2 Adrenoreceptor Agonist
    Indicated for Asthma and COPD.

    13.07 Salicylic Acid 16.7% with Lactic Acid 16.7% Salactol®

    Self Care  Self Care Medicine. Available OTC for self care

    09.05.01.01 Sandocal-1000® 

    For patients with swallowing difficulties only

    10.01.03 Sarilumab Kevzara®

     For use in specialist settings only. Commissioned by CCG's

    09.04 Scandishake® Mix 

    Initiation by specialist dietician services prior to continuation within primary care.

    19 Scanpor  Size
    2.5cm x 5m (1)
    01.07.02 Scheriproct  Scheriproct Suppository
    Scheriproct Ointment
    13.05.02 Sebco Ointment  40g and 100g

    Coal Tar Solution 12%, Salicylic Acid 2%, Precipitated Sulfar 4% in a Coconut Oil Emollient Base
    13.09 Sebco Ointment  Scalp Ointment
    13.05.03 Secukinumab  Cosentyx®
    04.09.01 Selegiline Hydrochloride  Selegiline HCl Tablet 5mg
    Selegiline HCl Tablet 10mg
    06.01.02.03 Semaglutide Ozempic®

    To be initiated by a diabetes specialist

    Once weekly GLP1 injection

    Ozempic 0.25mg, 0.5mg and 1mg solution for injection pre-filled pens

    Only continue if reduction in HBA1c of at least 1.0 percentage points and a weight loss of at least 3% is achieved within 6 months of starting treatment

    01.06.02 Senna 

    Senna 7.5mg/5ml Oral Solution
    Senna 7.5mg Tablet

    Available OTC and more expensive than Bisacodyl

    04.03.03 Sertraline  Sertraline HCl Tablet 50mg
    Sertraline HCl Tablet 100mg
    09.05.02.02 Sevelamer  

    For Adult Renal Dialysis ONLY. This is an NHS England Specialised Commissioning Drug  and for this indication should be prescribed in secondary care.

    Prescribe generically

    09.05.02.02 Sevelamer Carbonate tablets

    For the treatment of hyperphosphataemia 

    Sevelamer_Tab 800mg - prescribe generically
    Sevelamer_Oral Pdr Sach 2.4g S/F - (Renvela®)

     

    07.04.05 Sildenafil GENERIC

    Sildenafil_Tab 50mg
    Sildenafil_Tab 100mg

    Please note that restriction to Sildenafil NHS prescribing has been lifted, healthcare professionals should no longer offer generic Sildenafil on Private Prescription. The NHS health circular has noted that generic Sildenafil has "street value".

    A local decision has been made that the usual monthly quantity on the NHS should start at 4 tablets a month and should not usually exceed 8 tablets a month, except where a patient has been seen by a specialist in erectile dysfunction who is recommending a more frequent usage where advice should then be sought from the medicines management team

     

    VIAGRA IS NON FORMUALRY AND SLS CRITERIA WOULD STILL APPLY

    13.10.01.01 Silver Sulfadiazine Flamazine® This product is licensed for prophylaxis and treatment of Burn wounds.

    Also licensed for short-term treatment of infection in Pressure sores and Leg ulcers
    05.03.03.02 Simeprevir Olysio®

    NHS England commissioned

    In line with NICE

    Simeprevir Discontinued

    01.01.01 Simeticone Infacol®

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

    02.12 Simvastatin 

    Simvastatin 10mg Tablet
    Simvastatin 20mg Tablet
    Simvastatin 40mg Tablet
    Simvastatin 80mg Tablet

    08.02.04 Siponimod Mayzent®

    Restriction: In line with NICE Guidance only

    08.02.02 Sirolimus Rapamune®

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Lymphangioleiomyomatosis (LAM). This would go through a South Staffs CCGs Individual Funding Request (IFR)

    This is an NHS England Specialised Commissioning Drug for Transplant immunosuppression ONLY

    06.01.02.03 Sitagliptin Januvia® Glitazones and Gliptins should only be considered if:
    • Substituting for a sulphonylurea in patients on metformin and a sulphonylurea where there is a significant risk of hypoglycaemia (or its consequences) or a sulphonylurea is contra-indicated or not tolerated.
    • Metformin is contraindicated or not tolerated and the patient HBA1c remains above 6.5% on a sulphonylurea.
    As triple therapy if insulin is unacceptable (because of employment, social or recreational or other personal issues, or obesity.
    Only continue if reduction in HBA1c of at least 0.5% in 6 months

    Maximal effect is seen in 3-6 months; if no response to therapy in 6 months in terms of achieving patients target then review.
    10.01.03 Sodium Aurothiomalate Myocrisin®

    Sod Aurothiomalate_Inj 100mg/ml 0.5ml Amp
    Sod Aurothiomalate_Inj 20mg/ml 0.5ml Amp

    Prescribe in line with shared care agreement

    DISCONTINUATION

    Sanofi has confirmed the discontinuation of 10mg, 20mg and 50mg ampoules of Myocrisin from 30th June 2019 (being 3 months from the shortest expiry date). There are supplies within the supply chain, and will continue until current stock is depleted.

    09.02.01.03 Sodium Bicarbonate  Sod Bicarb_Cap 500mg
    12.01.03 Sodium Bicarbonate 5% 

    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

    09.02.01.02 Sodium Chloride Slow Sodium® 600mg MR tablets
    09.02.01.02 Sodium chloride oral solution  1mmol/mL and 5mmol oral solution

    Note - the strengths of solution listed are licensed preparations and should be used in preference to other strengths which would be unlicenced
    01.06.04 Sodium citrate Rectal

    Micro-enema
    Microlette®, Relaxit® and Micralax® 

    06.06.02 Sodium Clodronate 
    11.04.02 Sodium Cromoglicate  Sod Cromoglicate_Eye Dps 2%
    09.01.01.01 Sodium Feredetate Sytron® Sod Feredate_Elix 190mg/5ml S/F
    11.08.01 Sodium hyaluronate Artelac Rebalance®

    0.15% eye drops preservative free

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

     


     

    11.08.01 Sodium hyaluronate Evolve HA®

    0.2% eye drops preservative free

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

     

    04.08.01 Sodium Valproate 

    Sodium Valproate Tablet 100mg
    Sodium Valproate Tablet 300mg M/R
    Sodium Valproate Tablet 500mg M/R
    Sodium Valproate Tablet E/C 200mg
    Sodium Valproate Tablet E/C 500mg
    Sodium Valproate Oral Solution 200mg/5ml S/F

    Restriction: Initiation and stabilisation by specialist
    Maintain patient on specific manufacturer's products.

    Please see the following links to materials to support the new Valproate Pregnancy Prevention Programme:

    Patient Card – to be given by pharmacists to all female patients who are dispensed valproate medicines to inform them of the risks
    Patient Guide – to be provided to girls (of any age) and women of childbearing potential (or their parent/caregiver/responsible person) taking any medicine containing valproate
    Guide for healthcare professionals – for all prescribers, pharmacists, and other healthcare providers involved in the care of women and girls of childbearing potential using valproate medicines
    • Risk Acknowledgment form – for the specialist and patient (or their parent/caregiver/responsible person) to sign at initiation and at treatment reviews at least every year. The patient should receive a copy of the form; one copy should be filed in the specialist notes, and one copy sent to the patient’s GP

    09.02.01.01 Sodium zirconium cyclosilicate Lokelma®

    Restriction: In line with NICE Guidance only

    05.03.03.02 Sofosbuvir-velpatasvir-voxilaprevir 

    NHS England commissioned

    In line with NICE

    05.03.03.02 Sofosubvir-velpatasvir Epclusa®

    This is an NHS England Specialised Commissioning Drug for Hepatitis C
     

    19.01 Softpore 
    Sizes
    6cm x 7cm (60)
    10cm x 10cm (50)
    10cm x 15cm (50)
    10cm x 25cm (30)

    Water repellent, soft and conforming, breathable adhesive surgical dressing
    07.04.02 Solifenacin Vesicare® Solifenacin_Tab 5mg
    Solifenacin_Tab 10mg

    Very expensive not a recommended choice
    06.05.01 Somatropin 

    Follow the shared care guideline from the original trust (Derby and NorthStaffs in links below), Note in wolverhampton and Birmingham there is no shared care agreement. Prescribe by brand as licensing differnces as below

    All somatropin products are licensed for the treatment of short stature due to an inadequate secretion of growth hormone, for use in Turner Syndrome, chronic renal insufficiency and growth disturbance in short children born SGA , except Zomacton® which is unlicensed for use in chronic renal insufficiency and SGA and Nutropin Aq® which is unlicensed for use in SGA.

    Genotropin® and Omnitrope® are also licensed for use in Prader-Willi syndrome.

    Humatrope® is the only product licensed for use in SHOX deficiency.

     

    08.01.05 Sorafenib Nexavar®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

    19.05 Sorbaderm  Sizes
    28ml (1)
    1ml (5)
    3ml (5)

    No sting barrier film, which is colourless and transparent to allow monitoring of the skin. It can provide up to 72 hours' protection and is available in a spray bottle or foam applicator.

    Mode of Action - Forms a long lasting waterproof barrier, which acts as a protective interface between the skin and bodily fluids.

    Indications - Helps to protect intact and damaged skin from irritation from wound exudate, urine/and or faecal incontinence, adhesives friction and shear.

    Method of Use - Skin should be clean prior to application. Foam applicator: Apply a uniform coating over the treatment area.
    Spay: Hold the applicator 10 to 15cm from the skin and apply a uniform coating while moving the spray in a sweeping motion. When used under adhesive tapes, allow to dry.

    Frequency of Dressing change - Re-application is necessary each time dressing is changed. Whe used as a protectant from bodily fluids it can last up to 48-72 hours. If desired, the film can be removed by using most medical adhesive removers as directed.

    Contra-Indications - Not to be used on infected area.
    13.02.02 Sorbaderm®  Cream 2g, 28g and 92g

    19 Sorbsan Plus Carbon  Tissue Nurse approval needed
    This product requires and exemption form. Prescribe for two weeks ONLY

    Sizes
    7.5cm x 10cm (1)
    10cm x 15cm (1)

    The calcium alginate fibres of Sorbsan Plus Carbon swell and form a sodium-calcium alginate gel in contact with wound exudate.

    Mode of Action - Absorbs excess exudate wicks 'laterally', allowing greater abosorption capacity. Holds the exudate away from the wound, to minimise maceration. Negates the need for a separate, absorbant secondary dressing. The carbon within the dressing absorbs odour from the wound/wound exudate.

    Indications - Sorbasan Plus Carbon may be used on wounds where there is a high level of exudate, suitable for the management of: partial thickness and full thickness wounds, arterial, venous and diabetic leg ulcers, pressure sores, post-operative wounds, fungating lesions.

    Method of Use - Ensure a 5mm overlap around the wound edge to allow for the dressing gelling and conforming. do not cut.
    Position Sorbsan Plus Carbon with the alginate layer facing downwards, and the blue side facing away from the wound.

    Frequency of Use - Change Sorbsan Plus Carbon when clinically indicated. If exudate strikethrough is visible at the edge of the dressing, or if odour is no longer being absorbed, the dressing has reached saturation and should be changed.

    Contra-Indications - Do not use on patients with a known sensitivity, or who exhibit sensitivity to Sorbsan Plus Carbon dressing or any of its components.
    02.03.02 Sotalol Hydrochloride 

    Sotalol Hydrochloride 40mg Tablet
    Sotalol Hydrochloride 80mg Tablet
    Sotalol Hydrochloride 160mg Tablet

    Offer either a standard beta-blocker (that is, a beta-blocker other than sotalol) or a rate-limiting calcium-channel blocker as initial monotherapy to people with atrial fibrillation who need drug treatment as part of a rate control strategy - NICE CG180.

    03.01.05 Spacer Devices  Volumatic
    Volumatic Peadiatric
    AeroChamber Plus

    Please check COPD and Asthma Guidelines for Spacer compatibilities with Inhalers
    02.02.03 Spironolactone 

    Spironolactone 25mg Tablet
    Spironolactone 50mg Tablet
    Spironolactone 100mg Tablet

    Spironolactone has been shown to reduce symptoms and mortality in patients with Grade III or Grade IV heart failure. Careful monitoring of U&E's is required.

    19 Stericlens  Sizes
    240ml spray
    110ml spray

    Its norrow spray is designed to help remove debris and bacterial matter without touching the wound. Unique spraying technology allows it to spray when held in any position - even upside down.
    12.02.03 Sterimar 
    19 Steripaste  Size
    7.5cm x 6m (1)

    Mode of Action - Paste bandages act as a buffer between fragile, inflammed skin and the turns of a compression bandage. They provide a moist healing environment and can absorb exudate.

    Indications - Skin conditions associated with leg ulceration, venous dermatitis and weeping atopic eczema.

    Contra-Indications - Does not provide compression. Contra-indicated in acute eczematous lesions/grossly macerated skin.

    Method of Use - Apply from base of toes to knee with foot at right angles. Bandage should be pleated and never completely encircling the leg; allows for expansion should the leg swell. It should be applied without tension. Ensure patient is aware to report any signs of irritation or skin reaction.

    Frequency of Dressing change - wear time 7 days, or changed every 2 to 3 days in the treatment of skin conditions.

    02.10.02 Streptokinase Streptase®
    05.01.09 Streptomycin Sulphate  All drugs for tuberculosis are hospital only
    06.06.02 Strontium Ranelate Protelos®
    01.03.03 Sucralfate 

    Sucralfate 1g Tablet
    Sucralfate 1g/5mL S/F Oral Suspension 

    For Specialist Initiation Only

    01.05.01 Sulfasalazine 

    Sulfasalazine 500mg Tablets (Plain)
    Sulfasalzine 500mg enteric coated Tablet
    Sulfasalazine 500mg Suppository
    Sulfasalazine 250mg/5ml S/F Oral Suspension (ONLY for patients with swallowing difficulties)


    Please note the plain tablets are more cost effective then the enteric coated.

    Prescribe primary care only where in line with Esca 

    10.01.03 Sulfasalazine enteric coated Salazopyrin EN

    Salazopyrin EN-Tabs 500mg
    Salazopyrin 500mg Suppositories
    Sulfasalazine 25mg/5ml Suspension (ONLY for patients with swallowing difficulties)


    Please note - occasionally prescribed for Osteoarthritis, this is unlicensed. The plain tablets are also unlicensed.

    Prescribe primary care only where in line with Esca 

    04.02.01 Sulpiride  Sulpiride Tablets 200mg
    Sulpiride Tablets 400mg
    04.07.04.01 Sumatriptan  Sumatriptan Tablet 100mg
    Sumatriptan Tablet 50mg
    Sumatriptan Aq Nasal Spray 20mg/0.1ml Ud
    08.01.05 Sunitinib Sutent®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

     

    13.08.01 Sunsense Ultra Lotion 50+ 

    Preparations marked'ACBS' are regarded as drugs when prescribed for skin protection against ultraviolet radiation in abnormal cutaneous photosensitivity resulting from genetic disorders or photodematoses, including vitiligo and those resulting from radiotherapy; chronic or recurrent herpes simplex labialis. Preparations with SPF less than 30 should not normally be prescribed.

    50ml and 125ml bottle with roll-on applicator
    500ml Pump pack

     

    Self Care Self Care Medicine. Available OTC for self care

    19 Suprasorb X+PHMB  Tissue Nurse approval needed
    This product requires and exemption form. Prescribe for two weeks ONLY

    Sizes
    5cm x 5cm (5)
    9cm x 9cm (5)

    Suprasorb X+PHMB is a biocellulose dressing which combines a broad spectrum of antimicrobial activity and low cytotoxicity.

    Mode of Action - The dressing absorbs and releases moisture to maintain an optimum, moist wound healing environment. It can reduce wound pain during treatment and provides an alternative option to silver or honey when treating patients with an infected wound or patients who are at risk of infection.

    Indications - Light to moderately exuding wounds
  • Critically colonised and infected wounds
  • Suitable for long term use
  • Useful in patients who have pain with other antimicrobials

    Method of Use - Can be cut and folded to size. Film is recommended as a secondary dressing. When removing Suprasorb X+PHMB sheet dressing, lift one edge and gently peel the dressing from the wound. Should the dressing dry out, rehydrate the dressing with saline 30 minutes before removal.

    Frequency of Use - Can remain in situ for up to 2 to 7 days

    Contra-Indications - 3rd degree burns and fistulae
  • 06.01.01.03 Syringes 0.3ml, 0.5ml, 1ml in 8mm with 8mm needle size 
    08.02.02 Tacrolimus 
    13.05.03 Tacrolimus Ointment 0.03% and 0.10% Protopic® Initiation by Dermotologist

    Ointment
    0.03% 30g
    0.03% 60g
    0.1% 30g
    0.1% 60g
    07.04.05 Tadalafil tablets GENERIC
    • Tadalafil 10mg tablets
    • Tadalafil 20mg tablets

    Prescribe generically

    A local decision has been made that the usual monthly quantity on the NHS should start at 4 tablets a month and should not usually exceed 8 tablets a month, except where a patient has been seen by a specialist in erectile dysfunction who is recommending a more frequent usage where advice advice should then be sought from the medicines management team.

    Please note: 2.5mg and 5mg Tadalafil once-daily use is not supported locally in accordance with the Prescibing Commissioning Policy

    SLS CRITERIA WOULD STILL APPLY- Prescriptions must be endorsed 'SLS' by the prescriber.

    08.01.05 Talimogene laherparepvec Imlygic®

    This is an NHS England Specialised Commissioning Drug    

    In line with NICE

     

    07.04.01 Tamsulosin  Tamsulosin HCl_Cap 400mcg M/R

    Treatment depends on cause and therefore rule out urinary tract infections.

    Prescribe as capsule formulation as more cost effective then tablets
    05.01.01.04 Tazocin 
    08.01.03 Tegafur with Uracil Uftoral®

    In line with NICE guidance

    Uftoral was discontinued by manufacturer (March 2013)

     

    05.01.07 Teicoplanin Targocid®
    05.03.03 Telaprevir Incivo®

    This is an NHS England Specialised Commissioning Drug for Hepatitis C
     

    Telaprevir no longer has a marketing authorisation in the UK 

    04.01.01 Temazepam Tablets  Temazepam Tablet 10mg
    Temazepam Tablet 20mg

    CSM Advice: Hypnotics and Anxiolytics are indicated for the short-term relief of sleep disturbance and/or anxiety. (For continuous use up to a maximum of 14 days).

    This is second choice due to its higher cost acquisition compared to Z Drugs
    08.01.05 Temozolomide Temodal®

    Guidance on the use of temozolomide for the treatment of recurrent malignant glioma brain cancer
     
     
    This is a Specialised Drug which would not be routinely commissioned by CCGs for Endocrinology: non-malignant conditions. This would go through a South Staffs CCGs Individual Funding Request (IFR)

     

     

    08.01.05 Temsirolimus Torisel®

    This is an NHS England Specialised Commissioning Drug for Cancer

     

     

    02.10.02 Tenecteplase Metalyse®
    05.03.01 Tenofovir Disoproxil  This is an NHS England Specialised Commissioning Drug for HIV in combination with other anti-retrovial drugs. Hepatitis B +/- other anti-retrovial drugs
    05.03.01 Tenofovir Disproxil Viread®
    05.02 Terbinafine 

    Terbinafine HCl 250mg Tablets

    Fingernail and Toenail infections. Initiate ONLY after mycological confirmation from nail clippings and for clear medical reasons (not cosmetic)

    Use for 6 weeks for Fingernails; 12 weeks for Toenails.

    Please refer to the Staffordshire and Stoke-On-Trent Antimicrobial Prescribing Guidelines for clinical indications and guidance

    13.10.02 Terbinafine Cream and Oral  ONLY use with microbiology confirmation of skin and/or nail dermatophyte infection
    03.01.01.01 Terbutaline  Terbutaline Sulfate B/A Inhalation 500mcg (100 D)
    Terbutaline turbohaler

    Short Acting Beta2 Adrenoreceptor Agonist
    Indicated for Asthma and COPD.

    08.02.04 Teriflunomide Aubagio®

    This is an NHS England Specialised Commissioning Drug for Multiple Sclerosis

     

    06.06.01 Teriparatide Forsteo®

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Male and Juvenile Osteoporosis. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    06.04.02 Testosterone and Esters Testogel®

    •Gel, testosterone 50mg/5g sachet

    One sachet of 5 g contains 50 mg of testosterone

    Apply 50 mg once daily; increased in steps of 25 mg, adjusted according to response; maximum 100 mg per day

     

    • Gel, 16.2mg/g gel pump, 88g

    Apply 2 actuations Once daily in the Morning, adjusting according to response; maximum of 4 actuations daily

    06.04.02 Testosterone and Esters 2 % gel Tostran® Gel, testosterone 2% gel

    10mg testosterone per 0.5g metered application

    Apply 60 mg (3g) once daily, subsequent application adjusted according to response; maximum 80 mg (4g) per day.
    06.04.02 Testosterone injection Sustanon 250®

    Injection (oily), testosterone propionate 30mg, testosterone phenylpropionate 60mg, testosterone isocaporate 60mg and testosterone decanoate 100mg/ml

    08.02.04 Thalidomide Pharmion®
    08.02.04 Thalidomide Celgene®

    Restriction: In line with NICE Guidance only

    Patient, prescriber, and supplying pharmacy must comply with a pregnancy prevention programme. Every prescription must be accompanied by a complete Prescription Authorisation Form.

    03.01.03 Theophylline 

    Note: The rate of absorption from modified-release preparations can vary between brands. Additionally, it is essential that a patient discharged from hospital should be maintained on the brand on which that patient was stabilised as an in-patient. (As per BNF)

    PSNC: Slo-phyllin brand discontinued. Alternative preparations can be used (Nov 2019)

    09.06.02 Thiamine  Thiamine HCl_Tab 50mg
    04.08.01 Tiagabine Gabitril®

    Tiagabine Tablet 5mg
    Tiagabine Tablet 10mg
    Tiagabine Tablet 15mg

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products.

    06.04.01.01 Tibolone Livial® Livial Tablets 2.5mg

    Unsuitable for use in the premenopause (unless being treated with gonadotrophin-releasing hormone analogue) and as (or with) an oral contraceptive; also unsuitable for use within 12 months of last menstrual period (may cause irregular bleeding). If transferring from cyclical HRT, start at end of regimen; if transferring from continuous-combined HRT, start at any time.
    02.09 Ticagrelor Brilique®

    Ticagrelor 90mg Tablet

    Ticagrelor can now be used up to a maximum of 3 years as per NICE TA420.
    Duration needs to be specified by initiating specialist.

    05.01.03 Tigecycline Tygacil®
    13.05.03 Tildrakizumab Ilumetri®

    In line with NICE guidance

    13.04.01 Timodine Cream (Hydrocortisone 0.5% nystatin 100 000 units  Mild Potency with Antifungal

    Cream 30g

    Barrier properties in moist areas

    Please refer to Topical Corticosteroid Potency Ladder for more details
    11.06 Timolol 

    Timolol_Eye Dps 0.25%
    Timolol_Eye Dps 0.5%

    Timolol PF Eye drops 0.25% & 0.5% - prescribe as Eysano brand as more cost effective

    05.01.11 Tinidazole Fasigyn®
    03.01.02 Tiotropium Spiriva Respimat®

    Spiriva Respimat® 2.5microgam/dose inhalation solution device 
     
    Long-Acting Antimuscarinic 
     
    Green Traffic Light  COPD ONLY


    Amber E  FOR ASTHMA must be initiated by specialist then transferred to primary care using the RICaD within the asthma guidlelines
     

    03.01.02 Tiotropium with olodaterol Spiolto Respimat®

    Olodaterol (as Olodaterol hydrochloride 2.5microgram per 1 dose, Tiotropium (as Tiotropium bromide) 2.5 microgram per 1 dose, solution for inhalation cartridge with device (60 dose).

    02.09 Tirofiban Aggrastat®
    Tirofiban 12.5mg/250ml infusion bags
    Aggrastat®12.5mg/50ml concentrate for solution for infusion vials
    08.01.05 Tisagenlecleucel Kymriah®

    In line with NICE

     

     

    08.01.05 Tivozanib Fotivda®

    This is an NHS England specialised commissioning drug

     

    05.01.04 Tobramycin  This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis
    05.01.04 Tobramycin inhaler TOBI Podhaler®
    10.01.03 Tocilizumab RoActemra®

    This is an NHS England Specialised Commissioning Drug for Paediatric indications (where Adult TA available)

    This is an NHS England Specialised Commissioning Drug for Juvenile Arthritis

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Large Vessel Vaculitis. This would go through a South Staffs CCGs Individual Funding Request (IFR)

     

    MHRA advice(July 2019): Rare risk of serious liver injury including cases requiring transplantation.

    01.05.03 Tofacitinib Xeljanz®

    Restriction: In line with NICE Guidance only

    10.01.03 Tofacitinib  Xeljanz ®

    Restriction: In line with NICE Guidance

    07.04.02 Tolterodine  Tolterodine_Tab 1mg
    Tolterodine_Tab 2mg
    Tolterodine_Cap 4mg M/R (Prescribed as Neditol XL)

    First Line treatment as stated in the NICE Guidelines. This applies to immediate release only.
    06.05.02 Tolvaptan Jinarc®

    The treatment (including tolvaptan) of people with stage 2 and 3 CKD is commissioned by clinical commissioning groups. NHS England is the commissioner of dialysis and kidney transplants.

    06.05.02 Tolvaptan Jinarc NSH England Specialist Initialisation for treating dominant polycystic kidney disease
    06.05.02 Tolvaptan Samsca

    This is a Specialised Drug which would not be routinely commissioned by CCGs for Hyponatraemia and other Endocrine uses. This would go through a South Staffs CCGs Individual Funding Request (IFR)

    19 Topical Negative Pressure 
    04.08.01 Topiramate 

    Topiramate Tablet 25mg
    Topiramate Tablet 50mg
    Topiramate Tablet 100mg
    Topiramate Tablet 200mg

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products.

    04.07.04.02 Topiramate Tablets  Topiramate Tabs 25mg
    Topiramate Tabs 50mg
    Topiramate Tabs 100mg
    Topiramate Tabs 200mg

    08.01.05 Topotecan Hycamtin®
    08.01.05 Trabectedin Yondelis®
    04.07.02 Tramadol  Tramadol HCl Capsule 50mg

    Tramulief SR 100 mg tablets
    Tramulief SR 150 mg tablets
    Tramulief SR 200 mg tablets

    ONLY use M/R Preparation if compliance really is a problem
    08.01.05 Trametinib Mekinist®

    Restriction: In line with NICE Guidance only

     

     

    02.11 Tranexamic Acid  Tranexamic Acid Tablet 500mg
    08.01.05 Trastuzumab 

    Restriction: In line with NICE Guidance only

     

    08.01.05 Trastuzumab emtansine 

    Restriction: In line with NICE Guidance only

     

    08.01.01 Treosulfan Trecondi®

    Restriction: In line with NICE Guidance only

    19 Tricotex  Size
    9.5cm x 9.5cm (10)

    Mode of Action - Sterile, knitted viscose low adherent wound contact layer.

    Indications - For granulating/epithelialising wounds which are dry or lightly exuding.

    Method of Use - Apply directly to the wound surface with a secondary dressing.

    Frequency of Use - Effective for up to 7 days, changed due to the nature and conditions of the wound. Can be removed with saline or water.
    08.01.03 Trifluridine tipiracil Lonsurf®

    Hospital only - commissioned by NHS England

    In line with NICE

     

    05.01.08 Trimethoprim 

    Trimethoprim Tab 100mg
    Trimethoprim Tab 200mg
    Trimethoprim Oral Susp 50mg/5ml S/F

    Nitrofurantoin is now recommended over trimethoprim as a first-line choice for uncomplicated urinary tract infections, where clinically appropriate. This is in-line with Public Health England guidance and the planned antibiotic indicators in the national Quality Premium for 2017/18.

    08.03.04.02 Triptorelin- Decapeptyl® SR 

    Decapeptyl SR 3mg - monthly

    Indications:

    • Prostate cancer
    • Endometriosis & uterine fibroids
    • Breast cancer

    Decapeptyl SR 11.25mg - 3 monthly

    Indications:

    • Prostate cancer
    • Central Precocious puberty (CPP) onset before 8 years in girls and 10 years in boys.

    Decapeptyl SR 22.5mg - 6 monthly

    Indications:

    • Prostate cancer
    • Endometriosis
    • Central Precocious puberty (CPP) in children 2 years and older with an onset of CPP before 8 years in girls and 10 years in boys).
    07.04.02 Trospium 

    Trospium Chlor_Tab 20mg

    09.04.02 TwoCal® Abbott Laboritories Ltd

    More than 1.5kcal/mL and 5g (or more) protein/100mL

    Gluten free
    Residual lactose

    Available in:
    1 litre

    A2.07 Tyrosine Amino Acid Supplement 
    07.03.05 Ulipristal EllaOne® Ulipristal Acet_Tab 30mg

    Second Line when lady presents more than 72 hours but before 120 hours after coitus.

    06.04.01.02 Ulipristal Acetate (Esmya) 

    Tablets 5mg

    MHRA/CHM advice: Esmya® (ulipristal acetate) for symptoms of uterine fibroids: restrictions to use and requirement to check liver function before, during and after treatment (August 2018)

    18/03/2020: MHRA Central alerting system

    Esmya: Urgent patient level recall

    All unexpired stock of Ulipristal acetate (Esmya) from patients, pharmacies and wholesalers are hereby recalled following a new case of liver failure requiring liver transplant in a patient taking the medicine.

    • To protect patients while a safety review is conducted, the European Medicines Agency's safety committee, Pharmacovigilance Risk Assessment Committee, (PRAC) has recommended that women stop taking 5mg ulipristal acetate (Esmya and generic medicines) for uterine fibroids.
    • Clinicians must contact patients who have been supplied Esmya and ask them to stop taking their medication as soon as possible and return any unused medicine to their pharmacy.
    • All patients currently being treated with Esmya/ulipristal acetate for uterine fibroids should be provided advice about other possible treatments for uterine fibroids.
    • Further information can be accessed via the hyperlink on the MHRA website: EL (20)A 16 Final.pdf
    03.01.02 Umeclidinium Bromide Incruse Ellipta Umeclidinium Bromide 65mcg/dose DPI
    Incruse Ellipta 55mcg/dose DPI

    Long-Acting Antimuscarinic
    Indication for COPD ONLY.


    03.01.04 Umeclidinium Bromide/Vilanterol Anoro Ellipta Umeclidinium Bromide 65mcg/dose/Vilanterol 22mcg/dose DPI
    Anoro Ellipta® 55mcg/22mcg DPI

    Long-Acting Antimuscarinic + Long-Acting Beta2 Adrenorecepter Agonist combination.

    Indicated for COPD ONLY.

    The combination product offers cost & compliance advantages compared to prescribing LAMA and LABA drugs as separate devices.

    06.01.01.03 Unifine pentips Plus Unifine pentips Plus® Lengths/Gauges available:
    5mm/31g
    6mm/31g
    8mm/31g
    12mm/29g
    Risk assessment states 8mm or less
    Compatible with all major devices(compatibility with Flextouch not confirmed)

    May be suitable for health professional/carer use but not as safe for patient use (FIT4Safety)
    01.07.02 Uniroid HC  Uniroid HC Ointment
    Uniroid HC Suppository

    Uniroid HC same formulation as Proctosedyl and considerably less expensive
    10.01.03 Upadacitinib Rinvoq®

    Restriction: In line with NICE Guidance

    MHRA/CHM advice: Baricitinib (Olumiant®): risk of venous thromboembolism (March 2020) (Upadacitinib)

    19 Urgotul Contact  5cm x 7cm (1)
    11cm x 11cm (1)
    19 Urgotul Start  6m x 6cm (1)
    10cm x 10cm (1)
    01.09.01 Ursodeoxycholic acid 

    Ursodeoxycholic Acid 250mg Tablet- preferred option

    Ursodeoxycholic Acid 250mg Capsule
    Ursodeoxycholic Acid 250mg/5ml S/F Oral Suspension
    Ursodeoxycholic Acid 150mg Tablet
    Ursodeoxycholic Acid 300mg Tablet

    500mg tablets are VERY EXPENSIVE - 250mg tablets are the preferred option as more cost effective.

     

    01.05.03 Ustekinumab Stelara®

    Restriction: In line with NICE Guidance only

    13.05.03 Ustekinumab 

    In line with NICE Guidance

    04.02.03 Valproic Acid Semisodium

    Valproic Acid Tablet EC 250mg (As Semisodium Valproate)
    Valproic Acid Tablet EC 500mg (As Semisodium Valproate)

    Please see the following links to materials to support the new Valproate Pregnancy Prevention Programme:

    Patient Card – to be given by pharmacists to all female patients who are dispensed valproate medicines to inform them of the risks
    Patient Guide – to be provided to girls (of any age) and women of childbearing potential (or their parent/caregiver/responsible person) taking any medicine containing valproate
    Guide for healthcare professionals – for all prescribers, pharmacists, and other healthcare providers involved in the care of women and girls of childbearing potential using valproate medicines
    Risk Acknowledgement Form – for the specialist and patient (or their parent/caregiver/responsible person) to sign at initiation and at treatment reviews at least every year. The patient should receive a copy of the form; one copy should be filed in the specialist notes, and one copy sent to the patient’s GP

    02.05.05.02 Valsartan 

    Valsartan 40mg Capsule
    Valsartan 80mg Capsule
    Valsartan 160mg Capsule
    Valsartan 40mg Tablet
    Valsartan 80mg Tablet
    Valsartan 160mg Tablet
    Valsartan 320mg Tablet

    05.01.07 Vancomycin Vancocin

    Vancocin Matrigel capsules 125mg
    Vancomycin capsules 250mg

    Please dose optimise to most appropriate strength as cost per capsule for each strength is very similar.

    For the lower strength it is significantly more cost effective to prescribe as Vancocin Matrigel 125mg capsules.

    05.01.07 Vancomycin  Intravenous
    04.10.02 Varenicline Champix®

    Varenicline Tart Tablet 0.5mg
    Varenicline Tart Tablet 1mg

    Varenicline Starter Pack (11 x 500mcg Tabs + 14 x 1mg Tabs)

    Restriction: As part of a smoking cessation programme only.

    01.05.03 Vedolizumab Entyvio®

    Restriction: In line with NICE Guidance only

    08.01.05 Vemurafenib Zelboraf®

    This is an NHS England Specialised Commissioning Drug for Melanoma

     

     

    08.01.05 Venetoclax Venclyxto®

    This is an NHS England Specialised commissioning drug for cancer

     

     

    04.03.04 Venlafaxine M/R capsules  Venlafaxine Capsules 75mg M/R
    Venlafaxine Capsules 150mg M/R
    Venlafaxine Capsules 225mg M/R (prescribe 225mg strength as Vensir)

    Drug tariff price for 75mg and 150mg capsules now based on Vensir so can be prescribed generically

    Please note licensed in depression and not anxiety
    04.03.04 Venlafaxine M/R Tablets  Venlafaxine tablets 75mg M/R
    Venlafaxine tablets 150mg M/R
    Venlafaxine tablets 225mg M/R

    Prescribe generically.

    Please note first line is Vensir mr caspules for depression
    However the tablets are licensed in anxiety.
    04.03.04 Venlafaxine Tablets  Venlafaxine Capsules 75mg
    02.03.02 Verapamil Hydrochloride 

    Verapamil Hydrochloride 40mg Tablet
    Verapamil Hydrochloride 80mg Tablet
    Verapamil Hydrochloride 120mg Tablet
    Verapamil Hydrochloride 120mg M/R Tablet - Prescribe brand
    Verapamil Hydrochloride 160mg Tablet
    Verapamil Hydrochloride 240mg M/R Tablet - Prescribe brand
    Verapamil Hydrochloride 40mg/5ml oral solution SF


    Use Post M.I. if beta blockers contraindicated.

    19 Videne Povidone (iodine 10% aqueos solution)  500ml (1)
    04.08.01 Vigabatrin Sabril®

    Vigabatrin Tablet 500mg
    Vigabatrin Powder Sachet 500mg S/F

    Supported by ESCA only where agreed from initiating trust (see links below)

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products

    03.02 Vilanterol/Fluticasone furoate Relvar Ellipta® Relvar Ellipta 184mcg/dose / 22mcg/dose DPI
    Relvar Ellipta 92mcg/dose / 22mcg/dose DPI


    Note: For use in Asthma at STEP 4

    For use in COPD
    08.01.04 Vinorelbine 

    Advanced Breast cancer

     

    08.01.05 Vismodegib Erivedge®

    This is an NHS England Specialised Commissioning Drug for cancer

     

    09.04.02 Vital 1.5kcal Abbott Laboritories Ltd

    1.5kcal/mL and 5g (or more) protein/100mL

    Gluten free
    Residual lactose

    Available in:
    200ml
    1000ml

    09.06.02 Vitamin B Tablets, Compound Strong 

    Vit B Co Strong_Tab

    NICE CG 100: NICE no longer recommends this drug for patients with alcohol use disorders. Clinicians should review use accordingly.

    09.04 Vitasavoury® Soup 

    Initiation by specialist dietician services prior to continuation within primary care.

    05.02 Voriconazole Vfend®

    This is an NHS England Specialised Commissioning Drug for Fungal Infection

    This is an NHS England Specialised Commissioning Drug for Chronic Pulmonary Aspergillosis

    04.03.03 Vortioxetine Brintellix

    5mg Tablets
    10mg Tablets
    20mg Tablets

     

    Vortioxetine is recommended as an option for treating major depressive

    episodes in adults whose condition has responded inadequately to

    2 antidepressants within the current episode.

     

    02.08.02 Warfarin sodium 

    Warfarin Sodium 1mg Tablet
    Warfarin Sodium 3mg Tablet
    Warfarin Sodium 5mg Tablet

    A2.07 XP Maxamaid® 
    A2.07 XP Maxamum® 
    12.02.02 Xylometazoline 0.05% (Paediatric) Otrivine®

    Xylomet HCl_Nsl Dps Paed 0.05%

    7 Day Use ONLY

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

     

     

     

    01.07.02 Xyloproct ® 

    Xyloproct Ointment

    05.03.04 Zanamivir inhalation Relenza®

    Zanamivir 5mg Inhalation powder blisters with Diskhaler

    Recommended to only prescribe when official notification that influenza is circualating in the Community, to patients in "At Risk" groups, if they present within 36 hours of first symptoms and will be able to administer within 48 hours of first symptoms.

     

    Please refer to the Staffordshire and Stoke-On-Trent Antimicrobial Prescribing Guidelines for clinical indications and guidance

     

    13.02.01 ZeroAQS Cream ZeroAQS® Lowest Greasy Preparation

    100g and 500g Cream

    Cheaper than Aqueous Cream

    Aqueous cream is currently more expensive than other emollients so is not recommended for prescribing

    Please refer to the supplementary "Emollient Guide" for more details
    13.02.01 Zerobase  Moderately Greasy Preparation

    Zerobase 50g and 500g
    Cheaper and equivalent to Diprobase


    13.02.01 Zerocream®  Lowest Greasy Preparation

    Cream 50g
    Pump pack 500g

    Cheaper and equivalent to E45

    Please refer to the supplementary "Emollient Guide" for more details
    13.02.01 Zeroderm Ointment  Greasy Preparation

    125g and 500g Ointment

    Cheaper and Equivalent to Epaderm and Hydromol


    Please refer to the Supplementary ’Emollient Guide’ for more detail
    13.02.01 ZeroDouble Gel  Moderately Greasy Preparation


    Gel 100g and 500g


    Equivalent to Doublebase Gel


    Please refer to the Supplementary ’Emollient Guide’ for more detail
    13.02.01 Zeroguent  Greasy Preparation
    Cheaper and equivalent to Unguentum M

    19 Zetuvit E - Sterile  Size
    10cm x 10cm (25)
    10cm x 20cm (25)
    20cm x 20cm (15)

    Indications - Low to moderately exuding wounds. Also for cushioning and protecting wounds.

    Frequency of Dressing change - requires changing when strikethrough appears.
    19 Zetuvit Plus Dressing  Sizes
    10cm x 10cm (10)
    10cm x 20cm (10)

    Mode of Action - Superabsorbent dressing which is water repellent, air premeable and has a non-woven layer which protects against contamination. It also has a cushioning effect.

    Indications - Superficial, heavily exuding acute and chronic wounds

    Frequency of Dressing change - requires changing when strikethrough appears.
    09.05.04 Zinc Sulphate 125mg Solvazinc® Please note Valupak Zinc tablets 10mg are available as a food supplement and they are more cost effective but a much lower dose. These can be purchased OTC for a low cost.
    19 ZipZoc  Size
    7.5cm x 6m (1)

    Indications - Treatment of chronic leg ulcers and venous insufficiency. Can be used as a primary contact layer

    Contra-Indications - hypersensitivity to ingrediants, arterial leg ulcers
    06.06.02 Zoledronic Acid 
    04.07.04.01 Zolmitriptan 

    NICE Recommend this for Menstrual-related Migraine. If this is not tolerated then consider Frovatriptan 2.5mg tablets instead for menstrual related migraine. (Unlicensed indication)

    04.08.01 Zonisamide 

    Zonisamide 25mg capsules
    Zonisamide 50mg capsules
    Zonisamide 100mg capsules

    Should be initiated by a specialist and suitable for continuation in primary care with ESCA - see link below

    Restriction: Initiation and stabilisation by specialist
    Unnecessary to maintain patient on specific manufacturer's products

    04.01.01 Zopiclone 

    Zopiclone Tablet 3.75mg
    Zopiclone Tablet 7.5mg


    CSM Advice: Hypnotics and Anxiolytics are indicated for the short-term relief of sleep disturbance and/or anxiety. (For continuous use up to a maximum of 14 days).

    Zaleplon, zolpidem and zopiclone for the short-term management of insomnia (April 2004)
    Zaleplon, zolpidem and zopiclone are recommended for the short-term management of severe insomnia that interferes with normal daily life, and should be prescribed for short periods of time only. www.nice.org.uk/TA77

    NB: Zaleplon is discontinued and Zolpidem is non-formulary

    04.02.02 Zuclopenthixol Decanoate  Zuclopenthixol Decanoate Injection 200mg/ml 1ml Amp
    Zuclopenthixol Decanoate Injection 500mg/ml 1ml Amp
    South Staffordshire Joint Formulary