Prescribe by brand name

HIV infection only

Infusion and subcutaneous injection

NICE TA563: Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer

Maintaining abstinence in alcohol dependence - refer to shared care guidelines

Tablets can be swallowed whole or broken in half

Tablets

SR capsules

Paracetamol overdose

This product will be discontinued. GSK anticipate supplies to be available until June 2019.

A suitable alternative is ganciclovir eye gel

 Information on restriction - Mixed dyslipidaemia unresponsive to statins and intolerant of fibrates

LAMA in multidose dry powder inhaler device. Refer to COPD guidelines

Cohesive short stretch bandage for single use and adapted according to ankle circumference. can be worn for up to 7 day. Recommended in patients with an ABPI of > 0.8

10cm width for routine below knee leg ulcer bandaging.

8cm Actico bandages are for use in patients with chronic oedema. 8 cm banadge should be applied to the foot.

Medium compression hosiery for moderate to severe chronic oedema and lymphoedema where resistant oedema occurs and shape disfunction.

Available in Below knee and above knee. Wide or regular band. Closed toe and open toe. Various colours and sizes.

Available as small, medium, large , XL, XXL. Useful for active ulceration to apply full compression for patients who can't tolerate bandaging. Assessing and measuring as per single hosiery product.

Light (mild) compression Hosiery

Available in Below knee and thigh length, closed toe and open toe. Various colours and sizes.

Strong support compression hosiery for recurring leg ulceration and gross varices.

Available in Below knee and thigh length, closed toe and open toe. Various colours and sizes.

Prescribe by brand name

Crohns Disease in line with NICE TA 187, moderately to severely active ulcerative colitis NICE TA 329

For patients requiring a soluble preparation

Calcium carbonate 1500mg equivalent to 600mg of elemental calcium, Colecalciferol 400iu equivalent to 10μg vitamin D₃ 

Chronic hepatitis B in line with NICE TA 96

RED for Renal transplant patients

RED for Renal transplant patients

Refer to mental health provider guidelines

Only as an option for use in paediatric patients requiring sedation for procedures

NOTE 10mg and 30mg capsules are the SAME PRICE (£411) per pack of 30 capsules.

Do not dispense 3 x 10mg capsules if a patient is on 30mg (standard) dose.

Hyper-absorbent. For use on high exudating wounds where a wear time 5 - 7 days is required.

First choice DPP-4 inhibitor for new initiations

SLS endorsement required in primary care

Training on use must be given in secondary care

SLS endorsement required in primary care

Submacular haemorrhage - unlicensed

Aluminimum chloride hexahydrate 20% in an alcoholic basis

NHS England low value medication

A prescription for high strength antiperspirants for the treatment of mild to moderate hyperhidrosis should not routinely be offered in primary care as the condition is appropriate for self-care

NHS England low value medication

A prescription for mild infrequent indegestion and heatburn should not routinely be offered in primary care as the condtion is appropriate for self-care

On microbiology advice only

100mg in 2ml injection

NHS England low value medication

A prescription for the treatment of mild to moderate hay fever should not routinely be offered in primary care as the condition is appropriate for self-care

Includes ointment and suppositories

NHS England low value medicine

A prescription for treatment of haemorrhoids should not routinely be offered in primary care as the condition is self-limiting and will clear up on its own without the need for treatment

Consultant only - requires specialist initiation and supervision

Cost effective alternative to Aveeno cream

Pepti 1 and 2 - for Cows Milk Protein Allergy

Extensively Hydrolysed Formula

First line agent

Can be used as a soap substitute

First line if hyperprolactinaemia caused by other agents.  Schizophrenia in 15-17 year olds (second line) NICE TA 213.  Manic episodes in bipolar disorder in adolescents over 13 NICE TA 292

Falciparum malaria - refer to PHT Adult Antimicrobial Guide

NHS England low value medication

A prescription for the treatment of minor conditions associated with pain, discomfort and mild fever should not routinely be offered in primary care as the condition is appropriate for self-care. (e.g aches and sprains, headache, period pain, back pain).

HIV infection only

Prescribe generically, avoid chewable tablets

May not be suitable for patients with sensitivities to conconut or its derivatives. Consider Tricotex for patients with coconut allergy.

May not be suitable for patients with sensitivities to conconut or its derivatives. Consider Tricotex for patients with coconut allergy.

Secondary Care only Except for Emergency use

Second line for erectile dysfuntion

SLS endorsement required in primary care

First choice if food fortification is not sufficient

Use Aymes powder for care home patients and those with carers

USe Aymes complete for patients with no-one to make up the shake

unlicensed

Allergic Rhinitis, not first-line.

Only for patients requiring combination treatment with both agents to control symptoms.

Restricted prescribing as per Microguide or NICE prescribing guidance

For cystic fibrosis only in accordance with NHSE policy A01/P/b

Contains 5% urea - for dry skin conditions

Only for patients intolerant of all mesalazine products.  Initiation by consultant gastroenterologist only

For use in at risk groups only (newborn infants of parents from high risk areas and those resident in or originating from high incidence areas)

None of the local CCGs meet the criterion for a high incidence area.

Prescribe by BRAND name

Cost effective alternative to QVAR inhaler - only available as MDI

Prescribe by BRAND NAME - CFC-free beclometasone inhalers are NOT interchangeable

Dry powder

NHS England low value medication

A prescription for the treatment of mild to moderate hay fever should not routinely be offered in primary care as the condition is appropriate for self-care

Scabies - not first choice

Unlicensed special - Ophthalmology Only

Prescribe generically

A soft, absorbent polyurethane foam pad with a vapour-permeable film backing and a silicone adhesive border.

A soft, absorbent polyurethane foam pad with a vapour-permeable film backing and a silicone adhesive border.

Second line after latanoprost.

0.1mg per ml (100mcg per ml) available in 3ml bottles

0.3mg per ml (300mcg per ml) available in single dose containers only

Comb 15 - 3ml cartridges

Comb 25 - 5ml vials, 3ml cartridges & Solostar pen

Comb 50 - 3ml cartridges

Includes tablets and suppositories

NHS England low value medication

A prescription for infrequent constipation should not routinely be offered in primary care as the condtion is appropriate for self-care

Anal fissure - approved off-licence indication

Refer to list of approved indications

Consultant neurologist only to initiate for patients with refractory epilepsy and where other antiepileptics are contraindicated, ineffective or not tolerated.

Specialist to establish benefit and stabilise dose before request is made to GP to provide ongoing prescriptions.

Secondary Care initiated

MDI / Turbohaler / nebuliser solution

When used for relapses of small bowel Crohn's disease - full course to be supplied by hospital.

Amber Initiated when prescribed for autoimmune hepatitis - course may be continued in primary care.

Alternative to Symbicort for new initiations. Adults only (over 18). Prescribe by brand name

Bupicvacaine 0.25% and 0.5%

Moderate to severe pain

Substance Misuse services only

Moderate to severe chronic pain including cancer pain requiring an opioid analgesic where oral morphine is unsuitable or not tolerated.  Palliative care.    

Change patch every 4 days. 

Prescribe by brand name. In primary care the cost effective brand is Bupeaze

For use by Southern Health as per the anxiety treatment guidelines only

Acute Treatment or Short-term prophylaxis prior to planned procedures for Hereditary Angioedema and Acquired Angioedema in accordance with NHS England commissioning policy.

Prophylactic treatment of hereditary angioedema (HAE) types I and II in accordance with NHS England commissioning policy - specialist centres only (UHS)

For treating medullary thyroid cancer

Neonatal unit only. Peyona can be used for intravenous infusion and oral administration.

Calcium carbonate 1.25 g (calcium 500 mg), colecalciferol 10 micrograms (400 units) per tablet

Calcium carbonate 1.25 g (calcium 500 mg) colecalciferol 10 micrograms (400 units) per tablet 

Gel can be used on the scalp and body

Secondary Care only

For flexures and vulval psoriasis

Folinic acid rescue. Adjunct to 5-fluorouracil.

Red for renal dialysis patients

Contains 10% urea

Coal tar 1%, coconut oil 1%, salicyclic acid 0.5%

Prophylaxis and treatment of oral mucositis in patients with head and neck cancer receiving radiotherapy with or without chemotherapy

Option for localised neuropathic pain including diabetic neuropathy

Paediatrics only

Includes tablets, MR tablets, liquid and suppositories. (Chewtabs discontinued)

Suppositories are HIGH COST in primary care (£120.00 for 5)

MHRA/CHM Advice on switching:

Category 1: ensure patient is maintained on a specific manufacturer's product. 

Capsules 375mg and syrup 250mg in 5ml

Oral solution 750mg in 10ml sachets are a cost-effective option if liquid is required.

Optive Plus contains castor oil in addition to carmellose and glycerol

Optive Fusion contains hyaluronic acid in addition to carmellose and glycerol

NHS England low value medication

A prescription for treatment of dry or sore eyes should not routinely be offered in primary care as the condition is appropriate for self-care.

Second line agent for heart failure after bisoprolol

Unlicensed special - Ophthalmology only

Resistant pseudomonal infections  - microbiologist recommendation only

Cream, Ointment, Lotion

For use in pregnancy.

Note HIGH COST in primary care.

NHS England low value medicine

A prescription for treatment of conjunctivitis should not be routinely offered in primary care as the condition is sel-limiting and will clear up on its own without the need for treatment

Paediatrics only

For adults travelling to at risk areas

For severe keratoconjuctivitis in children from four years of age and adolescents

Includes tablets and oral solution

NHS England low value medication

A prescription for mild infrequent indegestion and heatburn should not routinely be offered in primary care as the condtion is appropriate for self-care

NHS England low value medication

A prescription for the treatment of travel sickness should not routinely be offered in primary care as the condition is appropriate for self-care.

Intravenous infusion

Unlicensed special listed in Drug Tariff

Paediatrics only

Available in 1m, 3m and 5m lengths.

Sterile activated charcoal cloth. Apply as a secondary dressing over an appropriate primary dressing. Exudate will reduce the dressings effectiveness. Can be cut to size. Can be used in the management of malodourous wounds such as fungating wounds, pressure ulcers, leg ulcers and diabetic foot ulcers.

Sterile activated charcoal cloth. Apply as a secondary dressing over an appropriate primary dressing. Exudate will reduce the dressings effectiveness. Can be cut to size. Can be used in the management of malodourous wounds such as fungating wounds, pressure ulcers, leg ulcers and diabetic foot ulcers.

Psychiatry only: refer to anxiety treatment guidelines

Prescribe generically

10% vaginal cream

200mg pessaries

500mg pessary

NHSE low value medication

A prescription for the treatment of ringworm or athlets foot should not routinely be offered in primary care as the condition is appropriate for self-care

Included on BAD specials list 2014

2.5mg/25mg and 5mg/50mg tablets

Multi-layer compression bandage kit. Bandages of choice for lymphoedema/coedema management.

Coban 2 system is second-line for patients requiring full compression where Actico is considered inappropriate, known latex allergies or slippage may be a concern.

The Coban 2 lite comfort 15cm width bandage should be used for applying reduced compression to the knee and thigh of patients with chronic oedema.

15cm width bandage should be used for applying reduced compression to the knee and thigh of patients with chronic oedema.

Specialist use in line with NHSE Commissioning Policy D04/P/e

Includes capsules and suspension.  Only for treatment of terminally ill patients.

Moderate to severe pain

Symptomatic bile salt salt malabsorption with severe diarrhoea - second line after cholestyramine. Consultant gastroenterologist only.

Sugar-free

Patches only are formulary

Secondary care initiated

Absorbant hydrocolldoid dressing with added alginate for absorption, a vapour-permeable film backing and bevelled edge.

Absorbant hydrocolldoid dressing with added alginate for absorption, a vapour-permeable film backing and bevelled edge.

Category 1 acceptable

Restricted use - refer to BNF

Category 2

DACC-coated, hydrophobic, antimicrobial wound contact layer. Primary dressing for contaminated, colonised or infected superficial or deep wounds including superficial wounds. traumatic, post-operative or dehisced wounds, ulcers and fungal infections in the groin, skin folds or between digits.

0.5 % and 1% drops and preservative-free unit dose drops (Minims)

For SSRI overdose

Secondary Care initiated

On microbiologist advice only

Hereditary angioedema - unlicensed indication

Neuroleptic malignant syndrome

 For use in type 2 diabetics

 For use in type 1 diabetics

Consultant microbiologist only

HIV infection only

Commisioned by NHS England for iron chelation in thalassaemia, sickle cell and rare inherited anaemias (Policy 16070/P)

Vitamin and mineral supplements for use when recommended by a specialist in patients with cystic fibrosis 

May be initiated in primary care or first injection in secondary care

Prescribe by brand name (Prolia)

Dermatology only. Other brands (Covermark, Keromask, Veil) may be prescribed on specialist advice - all ACBS.)

Contains 25% urea

500 Lotion and Cream

Commissioned by NHS England for iron chelation in thalassaemia, sickle cell and rare inherited anaemias (Policy 16070/P)

NHS England low value medication

A prescription for the treatment of mild to moderate hay fever should not routinely be offered in primary care as the condition is appropriate for self-care

Use generic in primary care or Cerelle in peanut/soya allergy

For the treatment of anthracycline extravasation in accordance with PHT guidelines.

Contact oncology pharmacist.

Severe pain

Short term use only

Unlicensed special listed in Drug Tariff

Paediatrics only

EC tablets, SR capsules, suppositories, injection

Dispersible tablets only if necessary

IM injection only in primary care.

Only for patients with high risk of GI bleed

High cost in primary care

Digoxin overdose

Only for chronic anal fissures unresponsive to GTN.

Unlicensed in the UK.

Adizem XL, Dilzem XL, Viazem XL, Zemtard XL Tildiem LA (once daily dosage).

Different versions of modified-release preparations containing more than 60mg diltiazem hydrochloride may not have the same clinical effect. To avoid confusion between these different formulations of diltiazem, prescribers should specify the brand to be dispensed.

NICE TA 538: Dinutuximab beta for treating neuroblastoma

Zerobase is a lower cost alternative for primary care prescribing

Substance Misuse Service only

Strengths 0.1%. 0.5%, 1%, 2%, 4%, 10%, 15%

Unlicensed  special on BAD list

HIV infection only

Cystic fibrosis  -  commissioned by NHS England

Zerodouble is the lower cost alternative for prescribing in primary care.

Modified release tablets are NON-FORMULARY

Second line on dermatology recommendation only

Travel Prophylaxis - Private Prescription

NHS England low value medication

A prescription for the treatment of nappy rash should not routinely be offered in primary care as the condition is appropriate for self-care

Prevention and treatment of post-operative nausea and vomting in paediatrics.

Mental Health specialists only to initiate for depression/GAD.

Stress incontinence in women

To aid debriding, promote granulation, occlusive barrier.

For light to medium exuding wounds ONLY. Ensure correct size is applied; overlap the wound by at least 2 cm . odour from dressing constituents can be a concern to patients.

Not suitable for infected wounds unless oberved frequently. Not indicated routinely on diabetic foot wounds - contact local diabetic/foot protection team for advice.

NICE TA 534: Dupilumab for treating moderate to severe atopic dermatitis

A highly absorbent, non-woven, sliver gelling fibre dressing. Use as a primary dressing for moderately to high exuding wounds where there is infection.

A highly absorbent, non-woven, sliver gelling fibre dressing. Use as a primary dressing for moderately to high exuding wounds where there is infection.

A highly absorbent, non-woven, sliver gelling fibre dressing. Use as a primary dressing for moderately to high exuding wounds where there is infection.

Contains 1% chlorhexidine. Can also be used as a soap substitute

HIV infection only

50:50 liquid paraffin/white soft paraffin aerosol spray

HIV infection only

HIV infection only

HIV infection only

Prescribe by BRAND name

Chronic hepatitis B in line with NICE TA 153

Second-line for the renal transplant (when other preparations have unacceptable side effects).  Used under the advice of renal transplant specialists ONLY.

Included in BAD specials list 2014

NHS England low value medicine

A prescription for coughs, colds and nasal congestion should not routinely be offered in primary care as the condition is self-limiting and will clear up on its own without the need for treatment.

Epimax is a cost effective alternative to Diprobase cream

Left ventricular dysfunction (LVEF <40%) and clinical evidence of heart failure after recent myocardial infarction. NYHA class II CHF and left ventricular systolic dysfunction (LVEF <30%) in addition to standard optimal therapy.

Microbiology recommendation only

GUM only

Refer to MHRA and local advice concerning QT prolongation and  dose restrictions

Includes tablets and capsules

Prescribe by brand name

Prescribe by brand name

Oncology use only. High cost in primary care.

Consilient brand = Gedarel 30/150

Consilient brand = Rigevidon

Capsules are HIGH COST in primary care

MHRA advice on switching:

Category 3: usually unnecessary to ensure that patients are maintained on a specific manufacturer's product unless there are specific concerns, such as patient anxiety and risk of confusion or dosing errors.

HIV infection only

Cost effective alternative to Cetraben cream

Twice daily injection - type 2 diabetes

For infected/heavily exudating wounds. Do NOT use on dry or low exudating wounds. Requires a secondary dressing.

Apply in a cavity wound or on shallow wounds. Should overlap the wound margins.

Apply in a cavity wound or on shallow wounds. Should overlap the wound margins.

For infected/heavily exudating wounds. Do NOT use on dry or low exudating wounds. Requires a secondary dressing.

Option if allopurinol contraindicated or not tolerated.  Refer to local guidance on management of gout.

Mixed dyslipidaemia unresponsive to statins

Restricted to use in patients unable to receive Monofer® e.g. renal patients requiring doses of up to 1g to be given by an IV bolus and paediatrics

NHS England low value medication

A prescription for the treatment of mild to moderate hay fever should not routinely be offered in primary care as the condition is appropriate for self-care

Under advice of microbiology only.

Liquid for use in infants and children unable to swallow tablets

Contains 25% urea

Resistant candida, with specialist advice

Previously Locorten-Vioform

First line agent in general population

20mg capsules are the most cost-effective presentation for doses of 20mg, 40mg and 60mg.

Oral solution 20mg in 5ml can be used for patients with swallowing difficulties or if a 10mg dose is required.

Psychiatry only

Modecate is going to be discontinued and will no longer be available after the end of 2018.

New patients should not be initiated on Modecate and existing patients will need to be identified and an alternative treament prescribed.

Second-line corticosteroid for allergic rhinitis.

Second Line - Dermatology and Paediatrics only

At high doses of Seretide, Accuhalers are significantly cheaper than MDIs and should be prescribed in preference to MDIs where possible.

Sirdupla and Sereflo - alternative combination inhaler for asthma only – prescribe by brand name. Note, only licensed for patients >18 years

For use in patients with a previous history of heparin induced thrombocytopenia (HIT) for thromboprophylaxis

Under advice of haematology for use in treatment of HIT (off-label use)

HIV infection only

CMV retinitis

Community multi-resistant Extended-spectrum Beta-lactamase (ESBL) E. coli UTI - on advice from microbiology. 

Restricted prescribing as per Microguide or NICE prescribing guidance

Category 2

For those patients who cant tolerate milk based Aymes shakes

Moderate to severe psoriasis- unlicensed

Second line

Refer to chronic pain guidelines

Used to absorb large amounts of exudate. Not to be used as primary dressing. If used in leg management always pad OUTSIDE the bandage to maintain adequate pressures (if compression to the leg).

Can be cut to size.

via nebuliser for non-CF bronchiectasis - refer to shared care agreement

ACBS

Category 2

Category 1 acceptable

5%,10%,, 20%, 50%

NHS England low value medication

A prescription for infrequent constipation should not routinely be offered in primary care as the condtion is appropriate for self-care

Prescribe as brand 'Nitromin'

LABA+LAMA. Refer to COPD guidelines

For hypersalivation

Unlicensed special listed in Drug Tariff

Paediatrics only

for iontophoresis

Unlicensed special on BAD list and in Drug Tariff

Secondary care only

Pain Clinic only

Psychiatry only

 for use in paediatric patients only where being administered by community nurses

Twinrix, Ambirix

For people travelling to at risk areas

Engerix B, HbvaxPRO, Fendrix

For people at increased risk of exposure to hepatitis B virus, at increased risk of complications of hepatitis B or post potential exposure to hepatitis B virus (including infants born to mothers carrying hepatitis B). 

Ex vivo expanded autologous human corneal cells containing stem cells

Gynaecology - for perineal pain/scarring

Paediatric use only

Secondary Care Initiated

Unlicensed special

Paediatrics only

Dry, non infected wounds; retention of lines; fixation of secondary dressings. NB: Management of IV sites - refer to local guidlines

Dry, non infected wounds; retention of lines; fixation of secondary dressings. NB: Management of IV sites - refer to local guidlines

Dry, non infected wounds; retention of lines; fixation of secondary dressings. NB: Management of IV sites - refer to local guidlines

Superficial bacterial skin infection

Hydroquinone 5% w/w, hydrocortisone 1% w/w and tretinoin 0.1% w/w

Unlicensed in the UK. On BAD specials list for melasma (maximum 6 months treatment).