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 Formulary Chapter 13: Skin - Full Chapter
13.08.01  Expand sub section  Sunscreen preparations
13.08.01  Expand sub section  Photodamage
Solaraze
(Diclofenac sodium in sodium hyaluronate gel)
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Green

Solaraze®- Diclofenac 3% Gel 50g, 100g

For the treatment of actinic keratosis

Do not prescribe for longer than 3 months. Should not be confused with diclofenac 1% gel which is indicated for pain and inflammation.

 
   
Cytotoxic Drug Efudix (Fluorouracil 5% cream)
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Amber

Efudix®- Fluorouracil 5% cream 40g

For the treatment of actinic keratosis

1st line for superficial basal cell carcinoma

Restriction: Initiation by a consultant dermatologist or GP with a special interest

 

 
   
Aldara (Imiquimod 5% cream)
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Amber

Aldara®- Imiquimod 5% cream 250mg sachets (12 sachets)

2nd line for superficial basal cell carcinoma

Restriction: Initiation by a consultant dermatologist or GP with a special interest

 

 
   
Picato (Ingenol mebutate 150 or 500microgram/g gel)Black Triangle
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Amber

Picato®150microgram/g gel 1.41g
Picato®500microgram/g gel 0.94g

For the treatment of non-hyperkeratotic, non-hypertrophic actinic keratosis in adults

Restriction: Patients with actinic keratosis affecting an area of skin of up to 25cm2

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.

 
   
Aldara (Imiquimod 5% cream)
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Red

Aldara®- Imiquimod 5% cream 250mg sachets (12 sachets)

For Bowen’s Disease [unlicensed indication]

Restriction: To be initiated by a dermatology consultant

 

 

 
   
Actikerall
(Fluorouracil 0.5% and salicylic acid 10% cutaneous solution)
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Red

Actikerall 5mg/g / 100mg/g cutaneous solution

For low or moderately thick hyperkeratotic actinic keratoses

 
   
Metvix (Methyl-5-aminolevulinate cream)
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Red

Metvix 160mg/g cream

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

Traffic Light Status Information

Status Description

Red

Medicines that can only be prescribed within Secondary Care. Examples of medicines which fall into this category are: Certain new medicines and new indications for older medicines where there is at present no experience of use in Primary Care. Medicines or dressings not available or prescribable in Primary Care. Where a medicine has been classified as Amber E, but an approved shared-care guideline is not yet available   

Amber

Medicines which can be prescribed within Secondary Care, but are only suitable for prescribing in Primary Care after specialist referral. There is no need for approved shared care guidelines for medicines in this category. This replaces Amber 2 on the North Staffs Formulary.   

Amber E

Medicines which can be prescribed within Secondary Care, but are only considered suitable for prescribing in Primary Care under an approved shared-care agreement (ESCA) or Rationale for Initiation, Continuation and Discontinuation (RICaD). This replaces Amber 1 on the North Staffs Formulary  

Green

Medicines which can be prescribed in either Primary or Secondary Care.  

Grey

These medicines have been reviewed by the New Medicines Committee and the Area Prescribing Committee and found not to be suitable for inclusion in the Joint Formulary. Inadequate or weak evidence for efficacy No clearly defined local need Lack of long term safety data No perceived benefit over established formulary alternatives Prescribers can consider these medicines where formulary alternatives are unsuitable, ineffective or not tolerated.  

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