netFormulary
 Report : A-Z of formulary items 15/08/2020 11:17:05
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Section Name Details
03.04.02 Omalizumab Xolair®

75mg/0.5mL solution for injection pre-filled syringes
150mg/1mL solution for injection pre-filled syringes

Restriction: In line with NICE Guidance only and NHS England prescribing policy

This is an NHS England Specialised Commissioning Drug for Asthma

This is a Specialised Drug which is commissioned by the North Staffs and Stoke CCGs ONLY for Chronic Spontaneous Urticaria.

Blueteq form NICE TA339 - CCG

13.05.02 5-Methoxypsoralen 20mg tablets

Unlicensed preparation

Restriction: To be initiated by a dermatology consultant

13.05.02 8-Methoxypsoralen 10mg tablets, capsules

Unlicensed preparation

Restriction: To be initiated by a dermatology consultant

13.05.02 8-Methoxypsoralen 

Unlicensed preparation

Restriction: To be initiated by a dermatology consultant

10.01.03 Abatacept Orencia®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

02.09 Abciximab ReoPro®

IV Infusion

Restriction: Cardiology only

DISCONTINUED

08.01.05 Abemaciclib Verzenios®

Restriction: In line with NICE guidance only

08.03.04.02 Abiraterone acetate Zytiga®

Zytiga®(abiterone acetate) 500mg tablets

Restriction: In line with NICE Guidance only

 

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
  • Stoke-on-Trent CCG – North Staffordshire Combined Healthcare – Community drug and alcohol service (CDAS) - Link to website

 

06.01.02.03 Acarbose Glucobay®

Acarbose Tablets 50mg
Acarbose Tablets 100mg

09.06.04 Accrete D3® Colecalciferol and calcium carbonate

Maintenance dose (with calcium)

Colecalciferol 10microgram (equivalent to 400unit of vitamin D3) plus Calcium carbonate 1500mg (equivalent to 600mg of elemental calcium) tablets

 

Reserve for patients that cannot tolerate chewable tablets

11.06 Acetazolamide 

Acetazolamide 250mg tablets
Acetazolamide SR 250mg capsules

 

11.03.03 Aciclovir  Zovirax®

Aciclovir 3% opthalmic ointment

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 

Aciclovir 5% cream 2g,10g

Cold sores resolve after 7–10days without treatment.

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

02.12 Acipimox Olbetam®

Acipimox 250mg capsules

13.05.02 Acitretin 

Acitretin 10mg capsules
Acitretin 25mg capsules

Restriction: Initiation on specialist dermatological advice

 

 

03.01.04 Aclidinium & formoterol 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.

For use in COPD with end of day deterioration.

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

03.01.02 Aclidinium Bromide Eklira Genuair®

Aclidinium Bromide 375mcg/dose Dry Powder Inhaler
Eklira 322mcg/dose Genuair Inhalation Powder

Long Acting Antimuscarinic
For use in COPD with end of day deterioration

NOTE: This is a twice daily preparation therefore not suitable for all patients.

13.08.01 Actikerall® Fluorouracil 0.5% and salicylic acid 10% cutaneous solution

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

For low or moderately thick hyperkeratotic actinic keratoses

01.05.03 Adalimumab Hyrimoz®, Amgevita®, Imraldi®, Hulio®, Humira®

Restriction: In line with NICE Guidance only

Clinicians must ensure the biosimilar brand for their region is prescribed first-line.
(Hyrimoz is the first line biosimilar in West Midlands region; Amgevita is used in patients intolerant to citrate content i.e injection site reactions)

10.01.03 Adalimumab Hyrimoz®, Amgevita®, Imraldi®, Hulio®, Humira®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

Clinicians must ensure the biosimilar brand for their region is prescribed first-line.
(Hyrimoz is the first line biosimilar in West Midlands region; Amgevita is used in patients intolerant to citrate content i.e injection site reactions)

11.04.01 Adalimumab  Hyrimoz®, Amgevita®, Imraldi®, Hulio®, Humira®

Restriction: In line with NICE Guidance only

Clinicians must ensure the biosimilar brand for their region is prescribed first-line.
(Hyrimoz is the first line biosimilar in West Midlands region; Amgevita is used in patients intolerant to citrate content i.e injection site reactions)

13.05.03 Adalimumab Hyrimoz®, Amgevita®, Imraldi®, Hulio®, Humira®

Restriction: In line with NICE Guidance only

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 where commissioned.

Clinicians must ensure the biosimilar brand for their region is prescribed first-line.
(Hyrimoz is the first line biosimilar in West Midlands region; Amgevita is used in patients intolerant to citrate content i.e injection site reactions)

 

13.06 Adalimumab Hyrimoz®, Amgevita®, Imraldi®, Hulio®, Humira®

For Acne inversa

Restriction: In line with NICE Guidance

Clinicians must ensure the biosimilar brand for their region is prescribed first-line.
(Hyrimoz is the first line biosimilar in West Midlands region; Amgevita is used in patients intolerant to citrate content i.e injection site reactions)

 

13.06.01 Adapalene Differin®

Differin®Adapalene 0.1% cream 45g
Differin®Adapalene 0.1% gel 45g

13.06.01 Adapalene with benzoyl peroxide Epiduo®

Topical retinoids and related preparations with benzoyl peroxide

Epiduo®- Adapalene 0.1% and benzoyl peroxide 2.5% gel 45g

09.06.04 Adcal-D3® Colecalciferol and calcium carbonate

Maintenance dose (with calcium)

Colecalciferol 10microgram (equivalent to 400unit of vitamin D3) plus Calcium carbonate 1500mg (equivalent to 600mg of elemental calcium) chewable tablets

09.06.04 Adcal-D3® Colecalciferol and calcium carbonate

Maintenance dose (with calcium)

Colecalciferol 5microgram (equivalent to 200unit of vitamin D3) plus Calcium carbonate 750mg (equivalent to 300mg of elemental calcium) caplets

05.03.03.01 Adefovir Dipivoxil Hepsera®

Adefovir Dipivoxil Tablets 10mg

Restriction: In line with NICE Guidance

This is a Specialised Drug which would not be routinely commissioned by CCGs for Hepatitis B. This would go through the CCGs Individual Funding Request (IFR).

02.03.02 Adenosine 

6mg/2mL Solution for Injection vials
30mg/10mL Solution for Infusion vials

Restriction: Anaesthetics and cardiology only

03.04.03 Adrenaline / epinephrine 

Solution for injection auto-injectors
Solution for injection pre-filled syringes

17th October 2018 - 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

08.01.05 Afatinib dimaleate Giotrif®

Restriction: In line with NICE Guidance only

11.08.02 Aflibercept Eylea®

Eylea 2mg/50microlitres solution for injection vials

Restriction: In line with NICE Guidance only

13.08.01 Aldara® Imiquimod 5% cream

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

For Bowen’s Disease [unlicensed indication]

Restriction: To be initiated by a dermatology consultant

 

 

13.08.01 Aldara® Imiquimod 5% cream

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

 

08.01.05 Alectinib hydrochloride Alecensa®

Restriction: In line with NICE Guidance only

08.02.03 Alemtuzumab Lemtrada®

Restriction: In line with NICE Guidance only

 

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 

Alendronic acid Tablets 10mg
Alendronic acid Tablets 70mg 
Alendronic acid Oral Solution 70mg/100ml SF
Alendronic acid Effervescent Tablets 70mg

1st line for Osteoporosis

If a liquid formulation is required, the effervescent tablets are preferred over the oral solution. (Applicable in Primary care)

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

09.06.04 Alfacalcidol 

One-Alpha® - Alfacalcidol 2mcg/1ml solution for injection ampoules (0.5ml and 1ml)
One-Alpha® - Alfacalcidol 2mcg/1ml oral drops
Alfacalcidol 250nanogram capsules
Alfacalcidol 500nanogram capsules
Alfacalcidol 1microgram capsules

One drop of alfacalcidol 2 microgram/mL oral drops contains approximately 100 nanograms alfacalcidol.

 

 

07.04.01 Alfuzosin hydrochloride 

Alfuzosin MR 10mg tablets

Modified release preparations only

02.12 Alirocumab Praluent®

Solution for injection pre-filled pen

Restriction: In line with NICE Guidance only

02.05.05.03 Aliskiren 

 

Not approved for inclusion in the North Staffordshire Joint Formulary

 

 

 

 

 

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

 

13.05.01 Alitretinoin Toctino®

Restriction: In line with NICE Guidance

Alitretinoin is teratogenic and must not be given to women of child-bearing potential unless they practise effective contraception and then only after detailed assessment and explanation by the physician.

10.01.04 Allopurinol 

Allopurinol 100mg tablets
Allopurinol 300mg tablets

04.07.04.01 Almotriptan Almogran®

Almotriptan (as Almotriptan hydrogen malate) Tablets 12.5mg

3rd line triptan
(As per Anti-Migraine Prescribing Guide)

06.01.02.03 Alogliptin Vipidia®

Alogliptin Tablets 6.25mg
Alogliptin Tablets 12.5mg
Alogliptin Tablets 25mg

Preferred DPP-4 inhibitor

Reduce dose to 12.5 mg once daily if eGFR 30–50 mL/minute/1.73 m2.
Reduce dose to 6.25 mg once daily if eGFR less than 30 mL/minute/1.73 m2.

09.06.05 Alpha tocopheryl acetate Vitamin E

Alpha tocopheryl acetate 75unit capsules
Alpha tocopheryl acetate 100unit capsules
Alpha tocopheryl acetate 200unit capsules
Alpha tocopheryl acetate 250unit capsules
Alpha tocopheryl acetate 400unit capsules
Alpha tocopheryl acetate 600unit capsules
Alpha tocopheryl acetate 1000unit capsules
Alpha tocopheryl acetate 500mg per 5ml oral suspension

(HCD- Oral suspension reserved for patients with swallowing difficulties as expensive) (Applicable in Primary care only)

 

 

 

13.09 Alphosyl 2 in 1® Coal Tar Extract 5% alcoholic

Alphosyl 2 in 1®- Coal Tar Extract 5% alcoholic shampoo 250ml

Self Care Self Care Medicine. Available OTC for self care

07.04.05 Alprostadil Caverject®

There are differences in the delivery devices so prescribe by brand 

Caverject®- Alprostadil 10microgram powder and solvent for solution for injection vials
Caverject®- Alprostadil 20microgram powder and solvent for solution for injection vials
Caverject®- Alprostadil 40microgram powder and solvent for solution for injection vials

Caverject®Dual Chamber - Alprostadil 10microgram powder and solvent for solution pre-filled disposable injection
Caverject®Dual Chamber - Alprostadil 20microgram powder and solvent for solution pre-filled disposable injection
Caverject®Dual Chamber - Alprostadil 40microgram powder and solvent for solution pre-filled disposable injection

The prescription must be endorsed 'SLS'. 

07.04.05 Alprostadil MUSE®

There are differences in the delivery devices so prescribe by brand 

Muse®- Alprostadil 250microgram urethral sticks
Muse®- Alprostadil 500microgram urethral sticks
Muse®- Alprostadil 1000microgram urethral sticks

The prescription must be endorsed 'SLS'.

02.10.02 Alteplase Actilyse®

Injection

Restriction: In line with NICE Guidance only

09.04 Altraplen Compact 
09.04 Altrashot 

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

12.01.01 Aluminium acetate 

Available as 8% and 13% ear drops for treatment of inflammation in otitis externa.

For the 8% preparation, dilute 8 parts aluminium acetate ear drops (13%) with 5 parts purified water. Must be freshly prepared.

An alternative astringent is EarCalm® spray (Acetic acid 2%),

 

 

 

13.12 Aluminium chloride hexahydrate  antiperspirant

Anhydrol Forte® 20% solution, 60ml
Driclor® 20% solution 20ml,75ml

Self Care Self Care Medicine. Available to purchase over the counter for hyperhidrosis

01.01.01 Aluminium Hydroxide 

Alu-Cap 475mg capsules

DISCONTINUED (May 2004)

In renal impairment, there is a risk of accumulation and aluminium toxicity.

09.05.02.02 Aluminium hydroxide Alu-Cap®

Alu-Cap®Aluminium hydroxide 475mg capsules

DISCONTINUED (May 2004)

04.09.01 Amantadine 

Amantadine Capsules 100mg

Restriction: Initiation by specialist

02.05.01 Ambrisentan Volibris®

Ambrisentan 5mg tablet
Ambrisentan 10mg tablet

Restriction: In accordance with NHS England prescribing policy.
To be initiated by Specialist Only (for pulmonary arterial hypertension).

10.02.01 Amifampridine Firdapse®

Amifampridine phosphate 10mg tablets

Restriction: In accordance with NHS England prescribing policy

 

Not routinely commissioned by NHS England for Lambert-Eaton myasthenic syndrome (LEMS) except by prior IFR approval.

02.02.03 Amiloride Hydrochloride 

Amiloride Tablet 5mg

03.01.03 Aminophylline 

Brand must be stated

Aminophylline has a narrow therapeutic index and bioavailability differs between brands. Patients should be maintained on the same brand.

02.03.02 Amiodarone Hydrochloride 

Amiodarone Hydrochloride Tablet 100mg
Amiodarone Hydrochloride Tablet 200mg

Restriction: Initiation under direction of cardiologist

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

MHRA/CHM advice: Sofosbuvir with daclatasvir; sofosbuvir and ledipasvir (May 2015); simeprevir with sofosbuvir (August 2015): risk of severe bradycardia and heart block when taken with amiodarone

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

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

04.02.01 Amisulpride 

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

04.03.01 Amitriptyline Hydrochloride 

Amitriptyline Hydrochloride Tablet 10mg 
Amitriptyline Hydrochloride Tablet 25mg 
Amitriptyline Hydrochloride Tablet 50mg 
Amitriptyline Hydrochloride Oral Solution 25mg/5ml S/F 
Amitriptyline Hydrochloride Oral Solution 50mg/5ml S/F

Standard release preparations only

04.07.03 Amitriptyline Hydrochloride 

Amitriptyline Hydrochloride Tablets 10mg
Amitriptyline Hydrochloride Tablets 25mg
Amitriptyline Hydrochloride Tablets 50mg
Amitriptyline Hydrochloride Oral Solution 25mg/5ml S/F 
Amitriptyline Hydrochloride Oral Solution 50mg/5ml S/F

Restriction: 1st line therapy in line with the Non-Malignant Chronic Pain Guide

04.07.04.02 Amitriptyline Hydrochloride 

Amitriptyline Hydrochloride Tablet 10mg 
Amitriptyline Hydrochloride Tablet 25mg 
Amitriptyline Hydrochloride Tablet 50mg 
Amitriptyline Hydrochloride Oral Solution 25mg/5ml S/F 
Amitriptyline Hydrochloride Oral Solution 50mg/5ml S/F

For patients already established
(As per Anti-Migraine Prescribing Guide)

02.06.02 Amlodipine 

Amlodipine Tablet 5mg 
Amlodipine Tablet 10mg 

12.03.02 Amphotericin Lozenges Fungilin®

DISCONTINUED

Consider alternatives within the drug class i.e. Nystatin or Miconazole oral gel.

09.01.04 Anagrelide hydrochloride 

Anagrelide hydrochloride 500microgram capsules

Link to ESCA

10.01.03 Anakinra Kineret®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

Not routinely commissioned by NHS England for adult and paediatric indications except by prior IFR approval. Commissioned by NHS England for cryopyrin associated periodic syndrome -highly specialised criteria only.

08.03.04.01 Anastrozole 

Anastrozole 1mg tablets

01.07.02 Anusol 

Haemorrhoid relief ointment
Haemorrhoid relief suppositories

 


Self Care Self Care Medicine-Available OTC for self care

01.07.02 Anusol-HC 

Ointment
Suppositories

 Self Care Self Care Medicine-Available OTC for self care

02.08.02 Apixaban Eliquis®

Apixaban Tablet 2.5mg 

Restriction: In line with NICE Guidance only. Orthopaedic consultant use only.

Complete course to be supplied by the hospital

02.08.02 Apixaban Eliquis®

Apixaban Tablet 2.5mg 
Apixaban Tablet 5mg 

  • Prevention of stroke and systemic embolism in people with non-valvular AF
  • Treatment and secondary prevention of DVT and/or PE

Restriction: In line with NICE guidance and locally agreed guidelines

MHRA/CHM advice: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome (June 2019)

04.09.01 Apomorphine 

APO-go PEN 30mg/3ml Solution for Injection
APO-go 50mg/5ml Solution for Injection Amps
APO-go PFS 50mg/10ml Solution for Infusion pre-filled syringes

Link to ESCA

11.08.02 Apraclonidine Iopidine®

Apraclonidine 5mg/ml eye drops
Apraclonidine 1% eye drops (0.25ml unit dose)

Used to control or prevent post surgical elevations in intraocular pressure that occur in patients after anterior segment laser surgery.

10.01.03 Apremilast Otezla®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

13.05.03 Apremilast Otezla®

Restriction: In line with NICE Guidance only

02.11 Aprotinin Trasylol®

Injection

Restriction: Cardiology and Anaesthetics only

13.02.01 Aquadrate®cream Urea 10%

Creamy with Urea Content

Pack size 100g

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

 

 

13.02.01.01 Aqueous cream  

1st Line

Use only as a soap substitute

Pack size 100g, 500g

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

01.06.03 Arachis Oil enema 

Arachis Oil 130ml enema

02.08.01 Argatroban Exembol®

50mg/50mL solution for infusion vials
250mg/2.5mL concentrate for solution for infusion vials

Restriction: For use when danaparoid is not available.

Anticoagulation in patients with heparin induced thrombocytopenia
1st line for Renal & Critical Care patients

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 due to higher costs (Applicable in Primary care only)

Prescribe generically.

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®

Restriction: In line with NICE Guidance only

09.06.03 Ascorbic acid Vitamin C

Ascorbic acid 50mg tablets
Ascorbic acid 100mg tablets
Ascorbic acid 200mg tablets
Ascorbic acid 500mg tablets

 

04.07.04.01 Aspirin  

Aspirin Dispersible Tablets 300mg

900mg dose effective in the treatment of acute migraine as per Anti-Migraine Prescribing Guide.

 

02.09 Aspirin (AcetylsalicylicAcid) 

Aspirin Dispersible Tablet 75mg 

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).

02.04 Atenolol 

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

1st line beta-blocker

08.01.05 Atezolizumab Tecentriq®

Restriction: In line with NICE Guidance only

04.04 Atomoxetine Strattera®

Atomoxetine (as Atomoxetine hydrochloride) Capsule 10mg 
Atomoxetine (as Atomoxetine hydrochloride) Capsule 18mg 
Atomoxetine (as Atomoxetine hydrochloride) Capsule 25mg 
Atomoxetine (as Atomoxetine hydrochloride) Capsule 40mg 
Atomoxetine (as Atomoxetine hydrochloride) Capsule 60mg 
Atomoxetine (as Atomoxetine hydrochloride) Capsule 80mg 
Atomoxetine (as Atomoxetine hydrochloride) Capsule 100mg

Restriction: Initiation and stabilisation by specialist

Medicines for Children Leaflet: Atomoxetine for ADHD

Link to ESCA

02.12 Atorvastatin 

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

1st line agent. Use in accordance with locally agreed hyperlipidaemia guidelines

11.05 Atropine sulfate 

Atropine sulfate 1% eye drops 10ml (£131.92)
Minims Atropine sulfate 1% eye drops 0.5ml unit dose x 20 (£15.10)

 

Atropine Minims are more cost-effective ( Applicable in Primary care only)

07.04.05 Avanafil Spedra®

Spedra®- Avanafil 50mg tablet
Spedra®- Avanafil 100mg tablet
Spedra®- Avanafil 200mg tablet

2nd line for patients not responding to Sildenafil

The prescription must be endorsed 'SLS'.

08.01.05 Avelumab Bavencio®

Restriction: In line with NICE Guidance only

08.02.04 Axicabtagene ciloleucel Yescarta®

Restriction: In line with NICE Guidance only

08.01.05 Axitinib Inlyta®

Restriction: In line with NICE Guidance only

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®

Restriction: In line with NICE Guidance only

11.06 Azarga® Brinzolamide 1% & timolol 0.5%

Azarga®- Brinzolamide 1% & timolol 0.5% eye drops

Restriction: Initiation by Consultant Ophthalmologist only

 

01.05.03 Azathioprine 

Tablets 25mg and 50mg

For the treatment of Inflammatory Bowel Disease [unlicensed indication]

Link to ESCA

08.02.01 Azathioprine 

All post-transplant immunosuppressants are RED for patients newly prescribed these medicines from April 2013

Azathioprine 25mg tablets
Azathioprine 50mg tablets

08.02.01 Azathioprine 

Azathioprine 25mg tablets
Azathioprine 50mg tablets

Link to ESCA

10.01.03 Azathioprine 

Azathioprine 25mg tablets
Azathioprine 50mg tablets

Link to ESCA

13.05.03 Azathioprine 

For the treatment of Inflammatory Skin Disease [unlicensed indication]

Azathioprine 25mg tablets
Azathioprine 50mg tablets

Link to ESCA

13.06.01 Azelaic acid Skinoren®

Skinoren®- Azelaic acid 20% cream 30g

Do not confuse with Azelaic Acid 15% (Finacea) which is licensed for rosacea

12.02.01 Azelastine hydrochloride Rhinolast®

Rhinolast®- Azelastine hydrochloride 140microgram/dose nasal spray.

05.01.02.03 Aztreonam lysine powder nebuliser solution Cayston®

75 mg powder and solvent for nebuliser solution (with Altera Nebuliser Handset)

Restriction: In accordance with NHS England prescribing policy.

This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis

10.02.02 Baclofen 

Baclofen 10mg tablets
Baclofen 5mg/5ml oral solution SF

 

Red Intrathecal Injection (Hospital only):
Baclofen 50mcg/ml solution for injection ampoules 
Baclofen 10mg/5ml solution for infusion ampoules
Baclofen 10mg/20ml solution for infusion ampoules

 

 

12.02.03 Bactroban®nasal Mupirocin calcium

Bactroban®- Mupirocin calcium 2% nasal ointment

Restriction: For the eradication (in both patients and staff) of nasal carriage of MRSA, in accordance with hospital or local guidelines.

Restriction: For the suppression of S. aureus prior to elective high risk surgery, on request of the consultant surgeon

 

13.02.01 Balneum®cream Urea 5%

Creamy with Urea Content

Pack size 50g, 500g

13.02.01 Balneum®Plus cream Urea 5% + lauromacrogol 3%

Creamy with Urea Content

Restricted for pruritus

Pack size 100g, 500g

01.05.01 Balsalazide Colazide®

Balsalazide 750mg capsules

Restriction: For acute relapses of ulcerative colitis

10.01.03 Baricitinib Olumiant®

Restriction: In line with NICE Guidance

08.02.02 Basiliximab Simulect®

Restriction: In line with NICE Guidance only

08.02.04 BCG bladder instillation 

Powder for instillation fluid for intravesical use containing 2-8 x 108 CFU Tice BCG.

03.02 Beclometasone Clenil®

Clenil Modulite Inhalation 100mcg (200D) 
Clenil Modulite Inhalation 200mcg (200D) 
Clenil Modulite Inhalation 250mcg (200D) 
Clenil Modulite Inhalation 50mcg (200D)

For use in Asthma only.
Restriction:
See APC Advice

APC advice -
CFC-free beclomethasone inhalers should be prescribed by brand, not generically.
Clenil modulite requires no dose adjustment from CFC-BDP inhalers. Prescribing of this brand will minimise potential errors associated with changing doses and will reduce patient confusion.

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. 

For use in Asthma only.

Restriction: See APC Advice

APC advice -
CFC-free beclomethasone inhalers should be prescribed by brand, not generically.
Clenil modulite requires no dose adjustment from CFC-BDP inhalers. Prescribing of this brand will minimise potential errors associated with changing doses and will reduce patient confusion.

03.02 Beclometasone & formoterol Fostair®

Fostair Inhalation 100mcg/6mcg (120D) 
Fostair Inhalation 200mcg/6mcg (120D) (ASTHMA ONLY)

For use in both Asthma and COPD - high strength is for Asthma only

12.02.01 Beclometasone dipropionate nasal spray

Beclometasone dipropionate 50microgram/dose nasal spray

1st line for the treatment and prophylaxis of allergic perennial rhinitis

Self Care Self Care Medicine- Available OTC for self-care for adults over 18s

 

03.02 Beclometasone dipropionate, formoterol fumarate, & glycopyrronium bromide Trimbow®

Trimbow 87mcg/dose / 5mcg/dose /9mcg/dose
Contains three components Beclometasone/fomoterol/glycopyronnium

For use in COPD only

See APC Advice
The NMC acknowledged that locally approved guidelines reflect the GOLD guidelines for management of COPD whereas the licensed indication for Trimbow® and Trelegy® places its use after ICS and LABA. The APC considered this and supported the use of Trimbow® and Trelegy® in line with GOLD and local guidelines; prescribers need to be aware of this.

10.01.03 Belimumab Benlysta®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

 

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

08.01.01 Bendamustine hydrochloride 

Restriction: In line with NICE Guidance only

MHRA/CHM advice: Bendamustine (Levact®): increased mortality observed in recent clinical studies in off-label use; monitor for opportunistic infections, hepatitis B reactivation (July 2017)

02.02.01 Bendroflumethiazide 

Bendroflumethiazide Tablet 2.5mg

Not to be prescribed for patients newly diagnosed with hypertension
(doses higher than 2.5mg are not indicated in hypertension)

03.04.02 Benralizumab Fasenra®

30 mg solution for injection in pre-filled syringe

Restriction: In line with NICE Guidance only

This is an NHS England specialised commissioning drug for the treatment of severe eosinophilic asthma in adults.

04.09.02 Benzatropine 

Benzatropine Injection 1mg/ml Amp

Discontinued

13.06.01 Benzoyl peroxide 

Acnecide® - Benzoyl peroxide 5% gel 30g,60g
Acnecide®Wash - Benzoyl peroxide 5% gel wash 50g

Panoxyl Aquagel® - Benzoyl peroxide 2.5%, 5% or 10% gel, 40g

 

 

13.06.01 Benzoyl peroxide with clindamycin  Duac® Once Daily

Benzoyl peroxide with Antibacterial

Duac®Once Daily gel (3% and 1%) 30g,60g
Duac®Once Daily gel (5% and 1%) 30g,60g

For mild papular/pustular acne where an antimicrobial is indicated.

12.03.01 Benzydamine hydrochloride 

Benzydamine hydrochloride 0.15% oromucosal spray sugar free
Benzydamine hydrochloride 0.15% mouthwash sugar free

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

 

 

03.05.02 Beractant Survanta®

Restriction: Neonatal use only

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised commissioning drug for RESPIRATORY DISTRESS SYNDROME.

04.06 Betahistine Dihydrochloride 

Betahistine Dihydrochloride  Tablet 8mg 
Betahistine Dihydrochloride  Tablet 16mg 

11.04.01 Betamethasone  

Betamethasone sodium phosphate 0.1% eye/ear/nose drops
Betamethasone (Betnesol) 0.1% eye ointment

13.04 Betamethasone (as dipropionate) 0.05% with salicylic acid 2% scalp application Diprosalic®

Scalp applications

Potent

Diprosalic®scalp application 100ml

13.04 Betamethasone (as dipropionate) 0.05% with salicylic acid 3% Diprosalic®

Topical corticosteroids with salicylic acid

Potent

Diprosalic®ointment 30g, 100g

13.04 Betamethasone (as valerate) 0.025% Betnovate-RD®

Moderate potency

Betnovate-RD®cream 100g
Betnovate-RD®ointment 100g

13.04 Betamethasone (as valerate) 0.1% 

Potent

Betamethasone valerate 0.1% cream 30g, 100g
Betamethasone valerate 0.1% ointment 30g, 100g

13.04 Betamethasone (as valerate) 0.1% with clioquinol 3% 

Topical corticosteroids with antimicrobials

Potent

Betamethasone valerate 0.1% & clioquinol 3% cream 30g
Betamethasone valerate 0.1% & clioquinol 3% ointment 30g

Limit duration of treatment with steroid/antimicrobial combinations; usually twice daily for 1 week.

 

13.04 Betamethasone (as Valerate) 0.1% with fucidic acid 2% Fucibet®

Topical corticosteroids with antimicrobials

Potent

Fucibet®cream 30g

Limit duration of treatment with steroid/antimicrobial combinations; usually twice daily for 1 week.

12.01.01 Betamethasone sodium phosphate 

Betamethasone sodium phosphate 0.1% eye/ear/nose drops

12.01.01 Betamethasone sodium phosphate with neomycin sulfate  Betnesol N®

Betnesol N® - Betamethasone 0.1% with Neomycin 0.5% ear/eye/nose drops

13.04 Betamethasone valerate 0.1% scalp application Betacap®

Scalp applications

Potent

Betacap®scalp application 100ml

11.06 Betaxolol hydrochloride Betoptic®

Betoptic®- Betaxolol hydrochloride 0.25% eye drops
Betoptic®- Betaxolol hydrochloride 0.25 % eye drops (0.25ml Unit Doses) - P/free
Betoptic®- Betaxolol hydrochloride 0.5% eye drops

02.12 Bezafibrate 

Bezafibrate 200mg Tablet
Bezafibrate 400mg MR Tablet

Fibrates should not be offered routinely for the primary or secondary prevention of cardiovascular disease alone or in combination with a statin, including for those with chronic kidney disease or Type 1 or 2 Diabetes Mellitus. This does not apply to those diagnosed with familial hypercholesterolaemia (NICE CG181). 

 

08.03.04.02 Bicalutamide 

Bicalutamide 50mg tablets
Bicalutamide 150mg tablets

11.06 Bimatoprost 

Lumigan®- Bimatoprost 100microgam/ml eye drops
Bimatoprost 300microgam/ml eye drops
Bimatoprost 300 micrograms/ml eye drops (0.4ml unit dose) - P/free

2nd line prostaglandin analogue after Latanoprost

 

11.06 Bimatoprost with timolol Ganfort®

2nd line after latanoprost & timolol eye drops

Ganfort®- Bimatoprost 300microgram/ml & Timolol 5mg/ml eye drops

11.06 Bimatoprost with timolol Ganfort®

Ganfort®- Bimatoprost 300microgram/ml & Timolol 5mg/ml eye drops (0.4ml unit dose) - P/free

06.01.01.02 Biphasic Insulin Aspart NovoMix® 30

100 units/ml solution for injection cartridges (Penfill)
100 units/ml solution for injection prefilled pen (FlexPen)

06.01.01.02 Biphasic Insulin Lispro Humalog® Mix25

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled pen (KwikPen)

06.01.01.02 Biphasic Insulin Lispro Humalog® Mix50

100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled pen (KwikPen)

06.01.01.02 Biphasic Isophane Insulin Humulin® M3

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled pen (KwikPen)

06.01.01.02 Biphasic Isophane Insulin Hypurin® Porcine 30/70 Mix

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges

06.01.01.02 Biphasic Isophane Insulin Insuman® Comb

Insuman Comb 15 100 units/ml solution for injection cartridges

Insuman Comb 25 100 units/ml solution for injection vials
Insuman Comb 25 100 units/ml solution for injection cartridges
Insuman Comb 25 100 units/ml solution for injection prefilled pen (SoloStar Pen)

Insuman Comb 50 100 units/ml solution for injection cartridges

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 

Tablet E/C 5mg, Suppository 10mg

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

02.04 Bisoprolol Fumarate 

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

02.08.01 Bivalirudin Angiox®

250mg powder for concentrate for solution for infusion vials

Restriction: Initiation by Cardiology consultants only and should only be used during percutaneous coronary intervention (PCI) procedure

08.02.03 Blinatumomab Blincyto®

Restriction: In line with NICE Guidance only

05.03.03.02 Boceprevir Victrelis®

Boceprevir Capsules 200mg

Restriction: In line with NICE Guidance
This is an NHS England Specialised Commissioning Drug for Hepatitis C

Boceprevir is no longer available in the UK 

08.01.05 Bortezomib Velcade®

Restriction: In line with NICE Guidance only

08.01.05 Bosutinib Bosulif®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice (May 2016): Risk of hepatitis B virus reactivation with BCR-ABL tyrosine kinase inhibitors

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

Commissioned by the CCG for chronic migraine and other agreed indications.

04.09.03 Botulinum Toxin Type A 

Restriction: Initiation by specialist only where alternative funding is secured

08.01.05 Brentuximab vedotin Adcetris®

Restriction: In line with NICE Guidance only

07.03.01 Brevinor® 

Monophasic

 

08.01.05 Brigatinib Alunbrig®

Restriction: In line with NICE guidance only

11.06 Brimonidine tartrate 

Brimonidine tartrate 0.2% eye drops

11.06 Brinzolamide 

Brinzolamide 10mg/ml eye drops

04.08.01 Brivaracetam Briviact®

Brivaracetam Tablets 10mg
Brivaracetam Tablets 25mg
Brivaracetam Tablets 50mg
Brivaracetam Tablets 75mg
Brivaracetam Tablets 100mg
Brivaracetam Oral Solution 10mg/ml
Brivaracetam Solution for Injection 50mg/5ml vials

3rd line agent.

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 warranting 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 third line agents; and
  3. Is currently on a 3rd line agent which would be replaced by Brivaracetam; or
  4. Has tried 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
13.05.03 Brodalumab Kyntheum®

Restriction: In line with NICE Guidance only

06.07.01 Bromocriptine 

Bromocriptine Tablets 1mg
Bromocriptine Tablets 2.5mg
Bromocriptine Capsules 5mg (Parlodel)
Bromocriptine Capsules 10mg (Parlodel)

MHRA advice: Ergot-derived dopamine agonists: risk of fibrotic reactions (Oct 2008).

Not recommended in post partum lactation suppression. Caution with antihypertensive therapy and avoid other ergot alkaloids. Discontinue immediately if hypertension, unremitting headache, or signs of CNS toxicity develop.

 

01.05.02 Budesonide Budenofalk®

Budenofalk 3mg gastro-resistant capsules

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

 

03.02 Budesonide 

Budesonide 500mcg/2ml nebuliser liquid Udv
Budesonide 1mg/2ml nebuliser liquid Udv

Restriction: Nebuliser use only

12.02.01 Budesonide Rhinocort Aqua®

Budesonide 64microgram/dose nasal spray

Recommendation: Licensed for the treatment of nasal polyps

Rhinocort Aqua® is not licensed for use in children (but generic products are).

03.02 Budesonide & formoterol Symbicort®

Symbicort Turbohaler 100mcg/6mcg (120 D) 
Symbicort Turbohaler 200mcg/6mcg (120 D) 
Symbicort Turbohaler 400mcg/12mcg (60 D) 

For paediatric use only

Restriction: For use in Asthma only

03.02 Budesonide & formoterol DuoResp®Spiromax

DuoResp Spiromax 160mcg/dose / 4.5mcg/dose DPI

In asthma, the 160/4.5 inhaler may be used both as regular maintenance treatment and as needed in response to symptoms


DuoResp Spiromax 320mcg/dose / 9mcg/dose DPI

The 320/9 inhaler must be used with a separate reliever.

For use in both Asthma and COPD

NOT to be used for anyone under the age of 18.


02.02.02 Bumetanide 

Bumetanide Tablet 1mg
Bumetanide Tablet 5mg
Bumetanide Oral Liquid 1mg/5ml Expensive Item SPECIAL

Monitor Potassium Levels - Risk of Hypokalaemia 

2nd line if furosemide ineffective

04.07.02 Buprenorphine Temgesic®

Buprenorphine sublingual Tablets 200mcg
Buprenorphine sublingual Tablets 400mcg 

Tablets only. Prescribe by brand

04.07.02 Buprenorphine 

For the 5, 10, 20 microgram/hour transdermal patch [7 day patch], Butec® (equivalent to Butrans®) is more cost effective (Applicable in Primary care only)

For the 35 and 70 microgram/hour transdermal patch [72 hourly patch], Hapoctasin® is 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

Restriction: Only to be used in line with the Non-Malignant Chronic Pain Guide.

Buprenorphine patches are available as 72-hourly, 96-hourly (non-formulary) and 7-day formulations

04.07.02 Buprenorphine Transtec®

 

Not approved for inclusion in the North Staffordshire Joint Formulary

This includes the 35, 52.5 and 70 microgram/hour transdermal patch [96 hourly patch]. Brands include Transtec®, Relevtec®, Buplast® and Bupeaze®  

 

 

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 

Restriction: Initiation by substance abuse specialist only

04.10.02 Bupropion hydrochloride Zyban®

Bupropion HCl Tablet 150mg M/R

2nd line for smoking cessation.

Restriction: As part of a smoking cessation programme only.

APC Advice: Varenicline (Champix®), revised May 2008.

  • Nicotine Replacement Therapy remains the pharmacological agent of choice for smoking cessation.
  • Consider varenicline or bupropion if NRT ineffective, not tolerated or inappropriate.
  • Only use as a component of a smoking cessation programme. 
  • Current evidence is insufficient to recommend an additional treatment course in those who have stopped smoking after the initial 12 weeks of therapy
03.04.03 C1 esterase inhibitor 

500unit powder and solvent for solution for injection vials
1500unit powder and solvent for solution for injection vials (Berinert only)

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised Commissioning Drug for HEREDITARY ANGIOEDEMA - ACUTE TREATMENT, PROPHYLACTIC TREATMENT and for PROPHYLACTIC TREATMENT IN CHILDREN (CINRYZE ONLY)

Brands include BERINERT and CINRYZE.

08.01.05 Cabazitaxel Jevtana®

Restriction: In line with NICE Guidance only

06.07.01 Cabergoline Dostinex®

Cabergoline Tablets 500mcg

Restriction: Initiation under direction of a specialist

BNF 62 - Suppression of lactation. Although bromocriptine and cabergoline are licensed to suppress lactation, they are not recommended for routine suppression (or for the relief of symptoms of postpartum pain and engorgement) that can be adequately treated with simple analgesics and breast support. If a dopamine-receptor agonist is required, cabergoline is preferred.

MHRA advice: Ergot-derived dopamine agonists: risk of fibrotic reactions (Oct 2008).

08.01.05 Cabozantinib Cabometyx®

Restriction: In line with NICE Guidance only

09.06.04 Calceos® Colecalciferol and calcium carbonate

Maintenance dose (with calcium)

Colecalciferol 10microgram (equivalent to 400unit of vitamin D3) plus Calcium carbonate 1250mg (equivalent to 500mg of elemental calcium) chewable tablets

09.05.01.01 Calcichew ® 

Calcichew ®Calcium carbonate 1.25g (500mg) tablets (12.6mmol Ca2+)

13.05.02 Calcipotriol 

Calcipotriol 50microgram/g ointment 30g, 60g, 120g

13.05.02 Calcipotriol 50micrograms/g with Betamethasone 0.05% Dovobet®

Restriction: See APC/NMC Advice

Dovobet®ointment 30g,60g,120g
Dovobet®gel 60g,120g

Dovobet gel: Usual duration of therapy for scalp psoriasis is 4 weeks and for mild to moderate plaque psoriasis for 8 weeks; may be continued or repeated on the advice of a specialist

Dovobet ointment: Indicated for once daily treatment of stable plaque psoriasis for 4 weeks; if necessary treatment may be continued beyond 4 weeks or repeated on the advice of a specialist. 

 

APC/NMC Advice: Betamethasone 0.05% / calcipotriol 50micrograms per gram (May 2017).
Dovobet® & Enstilar® are included in the NSJF as a second line agent for the treatment of psoriasis when patients are unable to comply with the individual preparations i.e. betamethasone applied mane and calcipotriol applied nocte. (Green status on the NSJF)

13.05.02 Calcipotriol 50micrograms/g with Betamethasone 0.05% Enstilar®

Restriction: See APC/NMC Advice

Enstilar®cutaneous foam 60g, 120g

The foam presentation may be preferred to the gel or ointment presentations, depending on the site of the psoriasis and patient preference. The recommended duration of therapy is 4 weeks.

 

APC/NMC Advice: Betamethasone 0.05% / calcipotriol 50micrograms per gram (May 2017).
Dovobet® & Enstilar® are included in the NSJF as a second line agent for the treatment of psoriasis when patients are unable to comply with the individual preparations i.e. betamethasone applied mane and calcipotriol applied nocte. (Green status on the NSJF)

06.06.01 Calcitonin (salmon) / Salcatonin 

50units/ml Solution for Injection Amps
100units/ml Solution for Injection Amps
400units/2ml Solution for Injection Vials

09.06.04 Calcitriol 

Calcitriol 250nanogram capsules
Calcitriol 500nanogram capsules

 

09.05.01.01 Calcium gluconate 

Calcium gluconate 100mg/1ml (10%) solution for injection ampoules
(1 g contains calcium 89 mg or Ca2+ 2.23 mmol.)

 

The MHRA has advised that repeated or prolonged administration of calcium gluconate injection packaged in 10 mL glass containers is contra-indicated in children under 18 years and in patients with renal impairment owing to the risk of aluminium accumulation; in these patients the use of calcium gluconate injection packaged in plastic containers is recommended.

09.05.02.02 Calcium Salts 

Calcichew ®Calcium carbonate 1.25g (500mg) tablets (12.6mmol Ca2+)
Phosphex®Calcium acetate 1gram tablets (equivalent to 250mg calcium; 6.2 mmol Ca2+)

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®

Canagliflozin Tablets 100mg
Canagliflozin Tablets 300mg

Restriction: In line with NICE Guidance only

For mono, dual & triple therapy -  should not be initiated in patients with an eGFR < 60 mL/min/1.73 m2 or CrCl < 60 mL/min. In patients tolerating canagliflozin whose eGFR falls persistently below 60 mL/min/1.73 m2 or CrCl 60 mL/min, the dose of canagliflozin should be adjusted to or maintained at 100 mg once daily. Canagliflozin should be discontinued when eGFR is persistently below 45 mL/min/1.73 m2 or CrCl persistently below 45 mL/min 

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

MHRA/CHM advice (updated March 2017): Increased risk of lower-limb amputation (mainly toes)

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

02.05.05.02 Candesartan Cilexetil 

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

1st line angiotensin II antagonist

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

 

08.01.03 Capecitabine Xeloda®

Restriction: In line with NICE Guidance only

02.05.05.01 Captopril 

Captopril 12.5mg tablets
Captopril 25mg tablets
Captopril 50mg tablets

Restriction: Initiation by a Paediatrician

04.02.03 Carbamazepine 

Carbamazepine Tablets 100mg
Carbamazepine Tablets 200mg
Carbamazepine Tablets 400mg
Carbamazepine MR Tablets 200mg
Carbamazepine MR Tablets 400mg
Carbamazepine Suppositories 125mg
Carbamazepine Suppositories 250mg
Carbamazepine Oral Solution 100mg/5ml

Restriction: Initiation by psychiatrist

Suppositories of 125 mg may be considered to be approximately equivalent in therapeutic effect to tablets of 100 mg but final adjustment should always depend on clinical response (plasma concentration monitoring recommended).

04.07.03 Carbamazepine 

Carbamazepine Tablets 100mg
Carbamazepine Tablets 200mg
Carbamazepine Tablets 400mg

04.08.01 Carbamazepine MR 

Carbagen SR Tablets 200mg
Carbagen SR Tablets 400mg
Tegretol MR Tablets 200mg
Tegretol MR Tablets 400mg

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

Additional Information July 2006

  • Carbamazepine suppositories are licensed for short-term treatment (maximum 7 days) only when oral therapy is temporarily not possible.
  • Carbamazepine 125mg suppositories should be considered equivalent to 100mg tablets but plasma monitoring is recommended.

06.02.02 Carbimazole Neo-Mercazole®

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.

Feb 2018: Women of childbearing potential should use effective contraception during treatment with carbimazole. If carbimazole is used during pregnancy, close maternal, foetal and neonatal monitoring is recommended.

MHRA advice: Carbimazole- increased risk of congenital malformations; strengthened advice on contraception (Feb 2019)

MHRA advice: Carbimazole- risk of acute pancreatitis (Feb 2019)

03.07 Carbocisteine 

2nd line

Prescribe generically.

Restriction within secondary care:
Paediatrics & Respiratory initiation only

07.01.01 Carboprost Hemabate®

Carboprost trometamol 250microgram/1ml solution for injection ampoules

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

12.03.01 Carmellose Sodium Gelatin mouth Preps

Protective paste 30g. 

Orabase is formulated to adhere to mucous membranes and raw weeping areas. It can be used in the mouth , around wounds or ostomies that need protection.

Self Care Self Care Medicine - Available OTC for self-care this product can be purchased online.

 

08.01.01 Carmustine Gliadel®

Restriction: In line with NICE Guidance only

 

11.06 Carteolol Teoptic®

Carteolol 1% eye drops
Carteolol 2% eye drops

DISCONTINUED 2017

10.01.01 Celecoxib 

Celecoxib 100mg capsules
Celecoxib 200mg capsules

 

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less)

MHRA Advice: COX-2 NSAIDs have a higher cardiovascular risk profile

08.01.05 Cemiplimab Libtayo®

Restriction: In line with NICE Guidance only

08.01.05 Ceritinib Zykadia®

Restriction: In line with NICE Guidance only

10.01.03 Certolizumab Pegol Cimzia®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

03.04.01 Cetirizine Hydrochloride 

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

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

 

 

 

13.02.01 Cetraben®cream 

Creamy (equivalent to Epaderm® Cream)

2nd Line

Pack size 150g, 500g 

Self Care Self Care Medicine-Avilable OTC self care.

 

13.02.01 Cetraben®ointment 

Greasy (equivalent to Epaderm® Ointment)

2nd Line

Pack size 125g, 450g

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

 

 

08.01.05 Cetuximab Erbitux®

Restriction: In line with NICE Guidance only

11.03.01 Chloramphenicol 

Chloramphenicol 0.5% eye drops
Chloramphenicol 1% eye ointment

1st line

Self Care  Self Care Medicine-Available OTC for self care and patients should be advised to purchase a suitable product over the counter. First line for bacterial conjunctivitis.(Please note exceptions may apply)

 

04.01.02 Chlordiazepoxide Hydrochloride 

Chlordiazepoxide Hydrochloride Capsule 5mg 
Chlordiazepoxide Hydrochloride Capsule 10mg 

Restriction: To be used only in community detoxification clinics or GPs with special interest

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)

12.03.04 Chlorhexidine gluconate 

Chlorhexidine gluconate 0.2% mouthwash
Chlorhexidine gluconate 0.2% oral spray
Chlorhexidine gluconate 1% dental gel

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

 

13.11.02 Chlorhexidine gluconate  preparations

Chlorhexidine gluconate 0.05% Sachets 25mL
Chlorhexidine gluconate 0.05% Sachets 100mL (Brands include Unisept®)

Chlorhexidine 0.015% with Cetrimide 0.15% (Tisept®) 

Chlorhexidine 4% solution (Brands include Hydrex® surgical scrub and Hibiscrub® cleansing solution). Can be purchased over the counter.

10.01.03 Chloroquine Avloclor®

Avloclor® - Chloroquine phosphate 250mg tablets

 

03.04.01 Chlorphenamine Maleate 

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

 

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

 

03.04.03 Chlorphenamine maleate 

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

 

 

 

 

04.02.01 Chlorpromazine Hydrochloride 

Chlorpromazine Hydrochloride Oral Solution 100mg/5ml 
Chlorpromazine Hydrochloride Oral Solution 25mg/5ml 
Chlorpromazine Hydrochloride Tablet 25mg 
Chlorpromazine Hydrochloride Tablet 50mg 
Chlorpromazine Hydrochloride Tablet 100mg 

11.03.01 Chlortetracycline 

Eye ointment

Discontinued in the UK 2004, but may be available as an import. 

 

12.03.01 Choline salicylate Bonjela®

Bonjela® Original gel

Self Care Self Care Medicine. Available to purchase over the counter for oral ulceration and inflammation.

Not to be used in children and adolescents under the age of 16. Bonjela Junior® gel could be used instead for children from 5 months and above.

06.05.01 Chorionic Gonadotrophin Pregnyl®

1500 unit powder and solvent for solution for injection ampoules
5000 unit powder and solvent for solution for injection ampoules

Restriction: Specialist use only

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.

03.02 Ciclesonide Alvesco®

Not approved for inclusion in the North Staffordshire Joint Formulary

 

 

 

08.02.02 Ciclosporin 

Brand must be stated

MHRA/CHM advice: ciclosporin must be prescribed and dispensed by brand name (December 2009)

Link to ESCA

08.02.02 Ciclosporin Cyclosporin

All post-transplant immunosuppressants are RED for patients newly prescribed these medicines from April 2013

Brand must be stated

MHRA/CHM advice: ciclosporin must be prescribed and dispensed by brand name (December 2009)

10.01.03 Ciclosporin Prescribe by brand

Ciclosporin 10mg capsules (only available as Neoral®)
Ciclosporin 25mg capsules
Ciclosporin 50mg capsules
Ciclosporin 100mg capsules

MHRA/CHM advice: ciclosporin must be prescribed and dispensed by brand name (December 2009)

Link to ESCA

11.08.01 Ciclosporin Ikervis®

Ikervis®- Ciclosporin 0.1% eye drops (0.3ml unit dose) - P/free

Restriction: In line with NICE Guidance only

 

13.05.03 Ciclosporin 

Restriction: Initiation on specialist dermatological advice

Brand must be stated

MHRA/CHM advice: ciclosporin must be prescribed and dispensed by brand name (December 2009)

07.03.01 Cilest® 

Monophasic

DISCONTINUED (July 2019)

Two alternative products are currently available in the UK with the same active ingredients - Cilique® and Lizinna®

09.05.01.02 Cinacalcet hydrochloride Mimpara®

Cinacalcet 30mg Tablet
Cinacalcet 60mg Tablet
Cinacalcet 90mg Tablet

Restriction: In line with NICE Guidance

04.06 Cinnarizine 

Cinnarizine Tablet 15mg 

04.03.03 Citalopram 

Citalopram Hydrobromide Tablet 10mg 
Citalopram Hydrobromide Tablet 20mg 
Citalopram Hydrobromide Tablet 40mg 
Citalopram (as Citalopram Hydrochloride) 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

 

 

13.06.02 Clarithromycin 

Clarithromycin 250mg tablets
Clarithromycin 500mg tablets

07.02.02 Clindamycin Dalacin®

Clindamycin cream 2%

04.08.01 Clobazam 

Clobazam Oral Suspension 5mg/5ml - For patients with swallowing difficulty 
Clobazam Oral Suspension 10mg/5ml - For patients with swallowing difficulty 
Clobazam Tablets 10mg

Not NHS except on specialist recommendation for epilepsy and endorsed 'SLS'.

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

HCD - Liquid Suspension

13.04 Clobetasol propionate 0.05% Dermovate®

Very potent

Dermovate®cream 30g, 100g
Dermovate®ointment 30g, 100g

13.04 Clobetasol propionate 0.05% scalp application Dermovate®

Scalp applications

Very potent

Dermovate®scalp application 30ml, 100ml

13.04 Clobetasol propionate 500microgram/neomycin sulfate 5mg/ and nystatin 100,000unit/g 

Topical corticosteroids with antimicrobials

Very potent

Clobetasol propionate 500microgram/neomycin sulfate 5mg/ and nystatin 100,000unit/g cream 30g
Clobetasol propionate 500microgram/neomycin sulfate 5mg/ and nystatin 100,000unit/g ointment 30g

HCDGeneric expensive. Dermovate NN is no longer available as the brand

 

13.04 Clobetasone butyrate 0.05% Eumovate®

Moderate potency

Eumovate®cream 30g, 100g
Eumovate®ointment 30g, 100g

 

13.04 Clobetasone butyrate 0.05% with oxytetracycline 3% and nystatin 100,000 units/g Trimovate®

Topical corticosteroids with antimicrobials

Moderate potency

Trimovate®cream 25g, 30g

Limit duration of treatment with steroid/antimicrobial combinations; usually twice daily for 1 week.

04.01.01 Clomethiazole Heminevrin®

Clomethiazole 192mg capsules

06.05.01 Clomifene citrate 

Clomifene citrate Tablets 50mg

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.

The CSM has recommended that clomifene should not normally be used for longer than 6 cycles (possibly increased risk of ovarian cancer).

04.03.01 Clomipramine Hydrochloride 

Clomipramine Hydrochloride Capsule 10mg 
Clomipramine Hydrochloride Capsule 25mg 
Clomipramine Hydrochloride Capsule 50mg

Standard release preparations only

04.08.01 Clonazepam 

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

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

04.08.02 Clonazepam 

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

02.05.02 Clonidine Hydrochloride Catapres®

Clonidine Hydrochloride 100 microgram tablets

Restriction: Anaesthetics and Cardiology only

 

02.09 Clopidogrel 

Clopidogrel Tablet 75mg

Restriction: For patients post cardiac stent and for NICE approved indications* only


NICE approved indications:

  • Acute Coronary Syndrome without ST-segment elevation
  • Patients intolerant of low-dose aspirin who have experienced a recent MI or Ischemic stroke or who have symptomatic peripheral arterial disease.

 

 

07.02.02 Clotrimazole 

Clotrimazole Combi/Pack (500mg pessary/2% cream)
Clotrimazole cream 1%
Clotrimazole cream 2%
Clotrimazole cream 10% (intravaginal stat treatment)
Clotrimazole pessary 100mg, 200mg and 500mg

13.10.02 Clotrimazole Canesten®

Clotrimazole 1% (cream, powder, solution)

Self Care Self Care Medicine. Available OTC for self care

12.01.01 Clotrimazole 1% ear solution Canesten®

Note this is called '1% solution' rather than 'ear drops'. Prescribe as Canestan solution 1% otherwise pharmacies can not find it on their computers.

04.02.01 Clozapine Clozaril®

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

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  

As per skin department formulary

Coal tar bath emulsion (Psoriderm 40% bath additive) 200ml
Coal tar cream (Psoriderm cream) 225ml
Coal tar emollient (Polytar 2.5% solution) 500ml
Coal tar lotion (Exorex 5%) 100ml, 250ml
Coal tar scalp ointment (Sebco 12%, Cocois) 40g, 100g

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

MHRA/CHM advice (updated December 2018): Emollients: new information about risk of severe and fatal burns with paraffin-containing and paraffin-free emollients

 

02.02.04 Co-amilofruse  

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

For patients on multiple tablets only. 

Careful monitoring of U&Es is required.

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

Restriction: Initiation by specialist

04.09.01 Co-Careldopa Sinemet®

Co-careldopa Tablets 12.5/50mg (Sinemet 62.5)
Co-careldopa Tablets 10/100mg (Sinemet-110)
Co-careldopa Tablets 25/100mg (Sinemet Plus)
Co-careldopa Tablets 25/100mg MR (Half-Sinemet CR)
Co-careldopa Tablets 25/250mg (Sinemet-275)
Co-careldopa Tablets 50/200mg (Sinemet CR)

Restriction: Initiation by specialist

13.09 Cocois® 

Cocois®ointment 40g, 100g

Self Care  Self Care Medicine. Available OTC for self care

13.06.02 Co-Cyprindiol (cyproterone acetate 2mg with ethinylestradiol 35micrograms) Dianette®

2nd line

Prescribe generically.

CSM Advice: Co-cyprindiol is licensed for use in women with severe acne which has not responded to oral antibacterials and for moderately severe hirsutism; it should not be used solely for contraception. It is contra-indicated in those with a personal or close family history of venous thromboembolism. Women with severe acne or hirsutism may have an inherently increased risk of cardiovascular disease.

01.06.02 Co-danthramer 

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

Suspension for Swallowing difficulties.

Restriction: Terminally ill patients only

01.06.02 Co-danthrusate 

Co-danthrusate 50mg/60mg/5mL Oral Suspension SF

Restriction: Terminally ill patients only

01.04.02 Codeine phosphate 

Codeine phosphate 15mg Tablets
Codeine phosphate 30mg Tablets
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 investigated further.

04.07.02 Codeine phosphate 

Codeine Phosphate Tablet 15mg 
Codeine Phosphate Tablet 30mg 
Codeine Phosphate Tablet 60mg 
Codeine Phosphate Linctus 15mg/5ml S/F 

10.01.04 Colchicine 

Colchicine 500microgram tablets

02.12 Colestyramine 

Colestyramine 4gram oral powder sachets

01.05.02 Colifoam®  

Hydrocortisone foam 10% aerosol

1st line rectal preparation

05.01.07 Colistimethate Promixin®

Promixin 1,000,000u powder for nebuliser solution UDV
Promixin 1,000,000u powder for solution for injection vials
 

Restriction: Non-CF Bronchiectasis. 2nd Line only at the recommendation of respiratory consultant

05.01.07 Colistimethate dry powder for nebuliser Colobreathe®

Colobreathe 1,662,500u inhalation powder capsules.

Restriction:

  • CF - In line with NICE Guidance & in accordance with NHS England prescribing policy. This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis.

 

  • Non-CF Bronchiectasis. 3rd line only. Prior approval is required from CCG. Respiratory consultant prescription only.
05.01.07 Colistimethate injection for nebuliser Colomycin®

Colistimethate Sodium Injection 500,000u Vl (Dry)
Colistimethate Sodium Injection 1,000,000u Vl (Dry) 
Colistimethate Sodium Injection 2,000,000u Vl (Dry) 

Restriction: Non-CF Bronchiectasis. 1st line

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.

10.03.01 Collagenase Xiapex®

Collagenase 0.9mg powder and solvent for solution for injection ampoules

Restriction: In line with NICE Guidance

 

10/2/2020 - NICE have withdrawn the TA459 guidance because collagenase clostridium histolyticum (Xiapex) is no longer available in the UK.

13.06.02 Combined Oral Contraceptive 

1st line

03.04.03 Conestat Alfa Ruconest®

2100unit powder for solution for injection vials

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised Commissioning Drug for HEREDITARY ANGIOEDEMA - ACUTE TREATMENT ONLY

13.02.02 Conotrane®cream 

Pack size 100g, 500g

08.01.05 Crizotinib Xalkori®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice (November 2015): Risk of cardiac failure

04.06 Cyclizine 

Cyclizine Hydrochloride Tablet 50mg

11.05 Cyclopentolate hydrochloride 

Mydrilate®- Cyclopentolate hydrochloride 0.5% solution eye drops
Mydrilate®- Cyclopentolate hydrochloride 1% solution eye drops
Minims Cyclopentolate hydrochloride 0.5% eye drops 0.5ml unit dose
Minims Cyclopentolate hydrochloride 1% eye drops 0.5ml unit dose

06.04.02 Cyproterone acetate 

Cyproterone Acetate Tablets 50mg
Cyproterone Acetate Tablets 100mg

Restriction: Initiation under direction of a specialist

08.03.04.02 Cyproterone acetate 

Cyproterone acetate 50mg tablets
Cyproterone acetate 100mg tablets

13.06.02 Cyproterone acetate 

Cyproterone acetate 50mg tablets
Cyproterone acetate 100mg tablets

Restriction: Initiation on specialist dermatological advice

 

08.01.03 Cytarabine–daunorubicin liposomal  Vyxeos®

Restriction: In line with NICE Guidance only

02.08.02 Dabigatran Pradaxa®

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

  • Prevention of stroke and systemic embolism in AF 
  • Treatment and secondary prevention of DVT and/or PE

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

Restriction: In line with NICE Guidance and locally agreed guidelines

MHRA/CHM advice: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome (June 2019)

02.08.02 Dabigatran Pradaxa®

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

Restriction: In line with NICE Guidance only. Orthopaedic consultant use only.

Complete course to be supplied by the hospital

08.01.05 Dabrafenib mesilate Tafinlar®

Restriction: In line with NICE Guidance only

05.03.03.02 Daclatasvir  Daklinza®

Daclatasvir Tablets 30mg
Daclatasvir Tablets 60mg

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policy
This is an NHS England Specialised Commissioning Drug for Hepatitis C

 

MHRA/CHM advice: Direct-acting antivirals to treat chronic hepatitis C: risk of interaction with vitamin K antagonists and changes in INR (January 2017)

MHRA/CHM advice: Direct-acting antiviral interferon-free regimens to treat chronic hepatitis C: risk of hepatitis B reactivation (January 2017)

MHRA/CHM advice: Direct-acting antivirals for chronic hepatitis C: risk of hypoglycaemia in patients with diabetes (December 2018)

Bristol-Myers Squibb has discontinued daclatasvir (Daklinza)

08.02.04 Daclizumab Zinbryta®

Restriction: In line with NICE Guidance only

WITHDRAWN FROM MARKET

MHRA advice: Daclizumab (Zinbryta▼): suspension and recall for safety reasons; review patients as soon as possible and start alternative therapy (March 2018).

08.01.05 Dacomitinib Vizimpro®

Restriction: In line with NICE Guidance only

09.06.07 Dalivit®drops 

Dalivit® oral drops

Not licensed for use in children under 6 weeks.

Contains Vitamins A, B's, C, D. See SPC for full details.
(0.6ml= 14 drops = 5000 units vitamin A)

02.08.01 Dalteparin Sodium  

Solution for injection ampoules/ pre-filled syringes

In Obstetrics

Link to ESCA

02.08.01 Dalteparin Sodium  

Solution for injection ampoules/ pre-filled syringes

Treatment of DVT and PE in adult cancer patients

Link to ESCA

02.08.01 Dalteparin Sodium  

Solution for injection ampoules/ pre-filled syringes

Treatment of DVT and PE in medical patients

 

02.08.01 Danaparoid 

750units/ 0.6mL solution for injection ampoules

Restriction: For heparin induced thrombocytopenia only

06.07.02 Danazol 

Danazol Capsules 100mg
Danazol Capsules 200mg

 

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 sodium  Dantrium®

Dantrium®- Dantrolene sodium 25mg capsules
Dantrium®- Dantrolene sodium 100mg capsules

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

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 (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
Dapagliflozin Tablets 10mg

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 (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®

Restriction: In line with NICE Guidance only

 

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

09.01.03 Darbepoetin Alfa Aranesp®

Restriction: In line with NICE Guidance only

Restriction: In accordance with NHS England prescribing policy

MHRA/CHM advice: Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (updated January 2018)

MHRA/CHM advice (December 2007) Erythropoietins—haemoglobin concentration

MHRA/CHM advice (December 2007 and July 2008) Erythropoietins—tumour progression and survival in patients with cancer

05.03.03.02 Dasabuvir Sodium Monohydrate Exviera®

Dasabuvir Tablets 250mg

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policy
This is an NHS England Specialised Commissioning Drug for Hepatitis C

 

MHRA/CHM advice: Direct-acting antivirals to treat chronic hepatitis C: risk of interaction with vitamin K antagonists and changes in INR (January 2017)

MHRA/CHM advice: Direct-acting antiviral interferon-free regimens to treat chronic hepatitis C: risk of hepatitis B reactivation (January 2017)

MHRA/CHM advice: Direct-acting antivirals for chronic hepatitis C: risk of hypoglycaemia in patients with diabetes (December 2018)

08.01.05 Dasatinib Sprycel®

Restriction: In line with NICE Guidance only

08.03.04.02 Degarelix acetate Firmagon®

Firmagon (degarelix axetate) 80mg powder and solvent for solution for injection vials
Firmagon (degarelix axetate) 120mg powder and solvent for solution for injection vials

Restriction: In line with NICE Guidance only

 

06.05.02 Demeclocycline hydrochloride Ledermycin®

Demeclocycline hydrochloride 150mg Capsules 

Link to ESCA

06.06.02 Denosumab 

Xgeva, 70mg/ml 1.7ml Vial
Prolia, 60mg/ml Prefilled Syringe

Restriction: In line with NICE Guidance only

  • Prolia: Use in accordance with NICE TA204 [Oct 2010] when oral bisphosphonates cannot be used. 
  • Xgeva: This presentation is indicated for reduction of bone damage in patients with bone metastases from breast and solid tumours (other than prostate cancer) in line with NICE TA265 [Oct 2012].

Supplementation of at least calcium 500 mg and Vitamin D 400 units daily should also be taken unless hypercalcaemia is present.

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)

13.02.01.01 Dermalo®bath emollient 

2nd Line

Pack size 500ml

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

 

13.02.01 Dermol®500 lotion 

Light with Antimicrobial Effect

Pack size 500ml

Self Care Self Care Medicine-Available OTC self care.

 

13.02.01.01 Dermol®600 bath emollient 

Emollient bath and shower preparations with antimicrobial effect

4th Line

Pack size 600ml

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

 

13.02.01 Dermol®cream 

Creamy with Antimicrobial Effect

Pack size 100g, 500g

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

 

09.01.03 Desferrioxamine mesilate 

500mg powder for solution for injection vials

06.05.02 Desmopressin 

Tablets 100mcg
Tablets 200mcg
DDAVP 4mcg/ml Solution for Injection
Nasal Spray 10mcg/dose
Desmomelt Oral Lyophilisates 120mcg
Desmomelt Oral Lyophilisates 240mcg
DDAVP Intranasal Solution 100mcg/ml drops

For Licensed Indications, please refer to individual formulations as per BNF

Generic tablets now cover all indications. Children requiring an intranasal dose of less than 10 micrograms should be given DDAVP® intranasal solution.

07.04.02 Desmopressin acetate 

Desmopressin acetate 100mcg tablets
Desmopressin acetate 200mcg tablets

Noqdirna - Desmopressin acetate 25mcg oral lyophilisate tablets
Noqdirna - Desmopressin acetate 50mcg oral lyophilisate tablets

DDAVP Melt - Desmopressin acetate 60mcg oral lyophilisate tablets
DDAVP Melt - Desmopressin acetate 120mcg oral lyophilisate tablets
DDAVP Melt - Desmopressin acetate 240mcg oral lyophilisate tablets

DesmoMelt - Desmopressin acetate 120mcg oral lyophilisate tablets
DesmoMelt - Desmopressin acetate 240mcg oral lyophilisate tablets

DDAVP® and Desmotabs ® tablets may be crushed.

07.03.02 Desogestrel 

Desogestrel 75mcg tablets

Administration can be delayed for 12 hours without loss of contraceptive effect.

09.06.04 Desunin® Colecalciferol

Maintenance dose (without calcium)

Desunin®Colecalciferol 400unit tablets

06.03.02 Dexamethasone 

Dexamethasone Tablets 500mcg
Dexamethasone Tablets 2mg

Dexamethasone Soluble tablets 2mg, 4mg and 8mg

Oral Solution 400mcg/1ml, 2mg/1ml and 4mg/1ml - HCD Very expensive(Applicable in Primary care only)

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

11.04.01 Dexamethasone  Maxidex®

Dexamethasone 0.1% eye drops 
Minims Dexamethasone sodium phosphate 0.1% eye drops (0.5ml unit dose)

11.04.01 Dexamethasone  Ozurdex®

Ozurdex® 700micrograms intravitreal implant

Restriction: In line with NICE Guidance only

HCD

12.01.01 Dexamethasone with framycetin & gramicidin Sofradex®

Sofradex®- Dexamethasone 0.05%, Framycetin Sulphate 0.5%, Gramicidin 0.005% ear/eye drops

12.01.01 Dexamethasone with neomycin and glacial acetic acid Otomize®

Otomize®spray - Dexamethasone 0.1%, Neomycin Sulphate (3250 units per mL) and Glacial Acetic Acid 2% ear spray

04.04 Dexamfetamine Sulfate 

Dexamfetamine Sulfate Tablet 5mg

Restriction: Initiation and stabilisation by specialist

Link to ESCA

04.07.02 Diamorphine Hydrochloride 

Diamorphine Hydrochloride 10mg Tablets

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

Diamorphine Hydrochloride 500mg Powder for Soln for Injection Ampoules

04.01.02 Diazepam 

Diazepam Tablet 2mg 
Diazepam Tablet 5mg 
Diazepam Tablet 10mg
Diazepam 2mg/5ml Oral Solution SF

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).

04.08.02 Diazepam 

Diazepam Solution 5mg/2.5ml Rectal Tube 
Diazepam Solution 10mg/2.5ml Rectal Tube
Diazepam Injection 10mg/2ml Amps

Use IV and Rectal solution for Status Epilepticus

10.02.02 Diazepam 

Diazepam 2mg tablets
Diazepam 5mg tablets
Diazepam 10mg tablets
Diazepam 2mg/5ml oral suspension
Diazepam 2mg/5ml oral solution SF

 

 

10.01.01 Diclofenac 

Diclofenac 25mg E/C tablet
Diclofenac 50mg E/C tablet
Diclofenac 50mg tablet
Diclofenac 75mg MR tablet and capsule
Diclofenac 100mg MR tablet and capsule
Diclofenac 12.5mg suppositories
Diclofenac 25mg suppositories
Diclofenac 50mg suppositories
Diclofenac 100mg suppositories
Diclofenac 75mg/3ml solution for injection ampoules

 

Paediatrics only

10.01.01 Diclofenac 

Diclofenac 25mg E/C tablet
Diclofenac 50mg E/C tablet
Diclofenac 50mg tablet
Diclofenac 75mg MR tablet and capsule
Diclofenac 100mg MR tablet and capsule
Diclofenac 12.5mg suppositories
Diclofenac 25mg suppositories
Diclofenac 50mg suppositories
Diclofenac 100mg suppositories
Diclofenac 75mg/3ml solution for injection ampoules

Diclofenac is now contraindicated in those with: ischaemic heart disease; peripheral arterial disease; cerebrovascular disease; or established congestive heart failure (New York Heart Association [NYHA] classification II-IV). Naproxen and ibuprofen are preferred when NSAIDs are indicated. 

01.02 Dicycloverine Hydrochloride 

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

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

08.03.01 Diethylstilbestrol 

Diethylstilbestrol 1mg tablets
Diethylstilbestrol 5mg tablets

 

13.04 Diflucortolone valerate 0.3% Nerisone®Forte

Very potent

Nerisone®Forte ointment 15g
Nerisone®Forte oily cream 15g

02.01.01 Digibind® 

Restriction: Consultant use only

02.01.01 Digifab® 

Restriction: Consultant use only

02.01.01 Digoxin 

Digoxin Tablet 125mcg
Digoxin Tablet 250mcg
Digoxin Tablet 62.5mcg
Digoxin Elixir 50mcg/mL

For plasma-digoxin concentration assay, blood should be taken at least 6 hours after a dose. Toxicity increased by electrolyte disturbances.

02.03.02 Digoxin also 02.01.01

Digoxin Tablet 125mcg
Digoxin Tablet 250mcg
Digoxin Tablet 62.5mcg
Digoxin Elixir 50mcg/mL

For plasma-digoxin concentration assay, blood should be taken at least 6 hours after a dose. Toxicity increased by electrolyte disturbances.

04.07.02 Dihydrocodeine Tartrate 

Dihydrocodeine Tartrate Tablet 30mg 

Standard release preparations only

02.06.02 Diltiazem Hydrochloride 

Diltiazem Hydrochloride 60mg tablets - FIRST LINE. For administration three times a day. No requirement for brand name prescribing.

Modified- release formulations should be prescribed by brand name.

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®

Restriction: In line with NICE Guidance only

13.05.03 Dimethyl Fumarate  Skilarence®

Skilarence® 30mg G/R tablets
Skilarence® 120mg G/R tablets

Restriction: In line with NICE Guidance only

07.04.04 Dimethyl sulphoxide bladder instillation 50% 

Restriction: Named patient supply; requires consultant letter.

Unlicensed medicine
HCD 

07.01.01 Dinoprostone 

Prostin E2 - Dinoprostone 3mg vaginal tablet
Prostin E2 - 1mg Dinoprostone 400microgram/1ml vaginal gel
Prostin E2 - 2mg Dinoprostone 800microgram/1ml vaginal gel
Propess - Dinoprostone 10mg vaginal delivery system

Note: Prostin E2 Vaginal tablets and Vaginal Gel are not bioequivalent.

08.01.05 Dinutuximab beta Qarziba®

Restriction: In line with NICE Guidance only

13.02.01 Diprobase ®cream 

Creamy (equivalent to Epaderm® Cream)

3rd Line

Pack size 50g, 500g

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

 

02.09 Dipyridamole 

Dipyridamole M/R Capsule 200mg
Dipyridamole Oral Suspension 50mg/5ml SF (This is an Unlicensed Special Liquid)

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 

15mg/1ml Solution for Infusion Amps
30mg/2ml Solution for Infusion Amps
60mg/4ml Solution for Infusion Amps
90mg/6ml Solution for Infusion Amps

For Osteolytic lesions and bone pain in bone metastases associated with breast cancer or multiple myeloma, and hypercalcemia of malignancy.

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

02.03.02 Disopyramide 

Disopyramide Capsule 100mg
Disopyramide Capsule 150mg 

Restriction: Initiation by cardiologist only

04.10.01 Disulfiram 

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
  • Stoke-on-Trent CCG – North Staffordshire Combined Healthcare – Community drug and alcohol service (CDAS) - Link to website

 

13.05.02 Dithranol Dithrocream®

Dithrocream®0.1% cream 50g
Dithrocream®0.25% cream 50g
Dithrocream®0.5% cream 50g
Dithrocream®1% cream 50g
Dithrocream®2% cream 50g

Dithranol should not be used in people with acute or pustular psoriasis or inflamed psoriasis. Avoid using dithranol on the face.

Self Care Prescription only medicine if dithranol content more than 1%, otherwise may be sold to the public. 

02.07.01 Dobutamine 

5mg/mL solution for infusion vials
12.5mg/mL concentrate for solution for infusion ampoules

08.01.05 Docetaxel 

Restriction: In line with NICE Guidance only

01.06.02 Docusate Sodium 

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

- Time to effect is approximately 24 to 48 hours 

01.02 Domperidone 

Domperidone 10mg Tablets 
Domperidone 5mg/5ml SF Suspension 200ml

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 Oral Solution 1mg/ml

Babies and children up to 18 years

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 (as Domperidone maleate) 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. 

04.11 Donepezil 

Donepezil HCl Tablet 5mg
Donepezil HCl Tablet 10mg 
Donepezil HCl Orodispersible Tablet 5mg 
Donepezil HCl Orodispersible Tablet 10mg

 

02.07.01 Dopamine 

40mg/mL solution for infusion ampoules
160mg/mL solution for infusion ampoules

02.07.01 Dopexamine Dopacard®

50mg/5mL concentrate for solution for infusion

03.07 Dornase Alfa Pulmozyme®

Dornase alfa 2.5mg/2.5mL nebuliser liquid

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis ONLY

FORMULARY CLASSIFICATION:

  • Red - for patients commencing treatment after April 2013
  • Amber - for patients commencing treatment before April 2013
11.06 Dorzolomide hydrochloride 

Dorzolomide hydrochloride 20mg/ml eye drops
Trusopt®- Dorzolomide hydrochloride 20mg/ml eye drops (0.2ml unit dose) P/free

03.05.01 Doxapram Dopram®

IV infusion or injection

02.05.04 Doxazosin 

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


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

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

08.01.05 Doxorubicin hydrochloride Caelyx®

Restriction: In line with NICE Guidance only

13.06.02 Doxycycline 

Doxycycline 50mg capsules
Doxycycline 100mg capsules
Doxycycline 100mg dispersible tablets
Efracea® - Doxycycline 40mg MR capsules (for papulopustular facial rosacea, without ocular involvement)

1st line choice. Counsel on need to minimise sun exposure due to photosensitivity

02.03.02 Dronedarone Multaq®

Dronedarone 400mg tablet

Restriction: Initiation by cardiologist only

Link to ESCA

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

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)

04.03.04 Duloxetine Cymbalta®

Not approved for inclusion in the North Staffordshire Joint Formulary 

 

 

04.07.03 Duloxetine Cymbalta®

Duloxetine (as Duloxetine hydrochloride) Capsule G/R 30mg 
Duloxetine (as Duloxetine hydrochloride) Capsule G/R 60mg 

Restriction: 3rd line for diabetic neuropathy in line with the Non-Malignant Chronic Pain Guide

13.05.03 Dupilumab Dupixent®

Restriction: In line with NICE Guidance only

08.01.05 Durvalumab Imfinzi®

Restriction: In line with NICE Guidance only

06.04.01.02 Dydrogesterone Duphaston

Dydrogesterone Tablets 10mg

13.02.01 E45®cream Hospital only

Light (low paraffin)

Pack size 50g, 125g, 500g

09.01.03 Eculizumab Soliris®

Restriction: In line with NICE Guidance only

Restriction: In accordance with NHS England prescribing policy

02.08.02 Edoxaban Lixiana®

Edoxaban 15mg tablets
Edoxaban 30mg tablets
Edoxaban 60mg tablets

  • Treatment and prevention of DVT and/or PE
  • Prevention of stroke and systemic embolism in people with non-valvular AF

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


Restriction: In line with NICE Guidance and locally agreed guidelines

MHRA/CHM advice: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome (June 2019)

13.08.01 Efudix® Fluorouracil 5% cream

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

 

05.03.03.02 Elbasvir & Grazoprevir Zepatier®

Elbasvir & Grazoprevir Tablets 50/100mg

Restriction: In line with NICE Guidance
This is an NHS England Specialised Commissioning Drug for Hepatitis C

09.08.01 Elosulfase alfa Vimizim®

Elosulfase alfa 5mg/5ml concentrate for solution for infusion vials

 

Restriction: In line with NICE Guidance only

Restriction: In accordance with NHS England prescribing policy

09.01.04 Eltrombopag olamine Revolade®

Restriction: In line with NICE Guidance

 

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

01.04.02 Eluxadoline Truberzi®

Restriction: In line with NICE Guidance only.

Initiation and stabilisation in secondary care with referral to primary care after the 1 month follow up in secondary care has taken place.

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)

13.02.01 Emollin®spray 

Very Greasy

Restriction: Under specialist advice only

Pack size 150ml, 240ml

06.01.02.03 Empagliflozin Jardiance▼®

Empagliflozin Tablets 10mg
Empagliflozin Tablets 25mg

Restriction: In line with NICE Guidance only

For mono, dual & triple therapy  - should not be initiated in patients with an eGFR 2 or CrCl 2 or CrCl below 60 ml/min, the dose of empagliflozin should be adjusted to or maintained at 10 mg once daily. Empagliflozin should be discontinued when eGFR is persistently below 45 ml/min/1.73 m2 or CrCl persistently below 45 ml/min

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 Encorafenib  Braftovi®

Restriction: In line with NICE guidance only

02.01.02 Enoximone 

Restriction: Anaesthetics and CICU only

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 

Entacapone Tablet 200mg

Restriction: Initiation by specialist

05.03.03.01 Entecavir Monohydrate Baraclude®

Entecavir Monohydrate Tablets 500mcg
Entecavir Monohydrate Tablets 1mg

Restriction: In line with NICE Guidance

This is an NHS England Specialised Commissioning Drug for Hepatitis B

02.05.05 Entresto® Sacubitril valsartan

24/26mg tablets
49/51mg tablets
97/103mg tablets

The proportions are expressed in the form x/y where x and y are the strength in milligrams of sacubitril and valsartan respectively. Valsartan, in this formulation, is more bioavailable than other tablet formulations—26 mg, 51 mg, and 103 mg valsartan is equivalent to 40 mg, 80 mg and 160 mg, respectively.

Restriction: In line with NICE Guidance

To be initiated by heart failure specialists ONLY (APC decision Nov 2019).

 

08.03.04.02 Enzalutamide Xtandi®

Restriction: In line with NICE Guidance only

 

02.07.02 Ephedrine 

30mg/10mL solution for injection (ampoules or pre-filled syringes)

12.02.02 Ephedrine hydrochloride 

Ephedrine hydrochloride 0.5% nasal drops
Ephedrine hydrochloride 1% nasal drops

CHM/MHRA advice: With intranasal use in children

The CHM/MHRA has stated that non-prescription cough and cold medicines containing ephedrine can be considered for up to 5 days’ treatment in children aged 6–12 years after basic principles of best care have been tried; these medicines should not be used in children under 6 years of age.

Maximum duration of 7 days to avoid rebound congestion.

13.02.01 Epimax ®Original Cream 

Creamy (equivalent to Epaderm® Cream)

1st line

Pack size 100g, 500g

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

 

13.02.01 Epimax®Isomol Gel 

Rich Cream (equivalent to Doublebase®)

1st line

Pack size 100g, 500g

02.02.03 Eplerenone 

Restriction: Initiation by Consultant Cardiologists only for patients who have had an acute myocardial infarction (MI) and who have symptoms and/or signs of heart failure and left ventricular systolic dysfunction

09.01.03 Epoetin Alfa  Eprex®

Restriction: In line with NICE Guidance only

Restriction: In accordance with NHS England prescribing policy

MHRA/CHM advice: Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (updated January 2018)

MHRA/CHM advice (December 2007) Erythropoietins—haemoglobin concentration

MHRA/CHM advice (December 2007 and July 2008) Erythropoietins—tumour progression and survival in patients with cancer

 

09.01.03 Epoetin Beta NeoRecormon®

Restriction: In line with NICE Guidance only

Restriction: In accordance with NHS England prescribing policy

MHRA/CHM advice: Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (updated January 2018)

MHRA/CHM advice (December 2007) Erythropoietins—haemoglobin concentration

MHRA/CHM advice (December 2007 and July 2008) Erythropoietins—tumour progression and survival in patients with cancer

 

09.01.03 Epoetin Zeta Retacrit®

Restriction: In line with NICE Guidance only

Restriction: In accordance with NHS England prescribing policy

MHRA/CHM advice: Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (updated January 2018)

MHRA/CHM advice (December 2007) Erythropoietins—haemoglobin concentration

MHRA/CHM advice (December 2007 and July 2008) Erythropoietins—tumour progression and survival in patients with cancer

 

02.08.01 Epoprostenol Flolan®

500mcg powder for solution for infusion vials
1.5mg powder for solution for infusion vials

Restriction: Consultant use only

Restriction: In accordance with NHS England prescribing policy

MHRA advice: Veletri (epoprostenol) powder for solution for infusion: incompatibilities with some models of administration devices (December 2014)

03.07 Erdosteine Erdotin®

Not approved for inclusion in the North Staffordshire Joint Formulary 

 

 

07.01.01 Ergometrine maleate Syntometrine®

Syntometrine® contains Oxytocin 5units/ml and Ergometrine maleate 500mcg/ml solution for injection ampoules

 

 

08.01.05 Eribulin Halaven®

Restriction: In line with NICE Guidance only

08.01.05 Erlotinib hydrochloride Tarceva®

Restriction: In line with NICE Guidance only

 

Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis (May 2012)

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)

13.06.02 Erythromycin 

Erythromycin GR 250mg tablets
Erythromycin stearate 500mg tablets
Erythormycin ethyl succinate 125mg/5ml oral suspension
Erythormycin ethyl succinate 250mg/5ml oral suspension
Erythormycin ethyl succinate 500mg/5ml oral suspension

For use in pregnancy, under 12’s and patients with contraindications/intolerance to tetracyclines.

04.01.02 Escitalopram 

Escitalopram 5mg tablets
Escitalopram 10mg tablets
Escitalopram 20mg tablets
Escitalopram 20mg/ml Oral drops

Restriction: For the treatment of Generalised Anxiety Disorder (GAD) only

04.03.03 Escitalopram 

Not approved for inclusion in the North Staffordshire Joint Formulary

 

 

 

04.08.01 Eslicarbazepine Zebinix®

Eslicarbazepine Tablets 200mg
Eslicarbazepine Tablets 800mg 

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

01.03.05 Esomeprazole granules 

Esomeprazole 10mg gastro-resistant granules sachets

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

02.11 Etamsylate Dicynene®

Etamsylate 500mg tablets

Unlicensed preparation. Available from special-order manufacturers.

10.01.03 Etanercept Enbrel®, Benepali®, Erelzi®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

 

 

13.05.03 Etanercept Enbrel®, Benepali®, Erelzi®

Restriction: In line with NICE Guidance only

 

09.05.01.02 Etelcalcetide hydrochloride Parsabiv®

2.5mg/0.5ml solution for injection vials
5mg/1ml solution for injection vials
10mg/2ml solution for injection vials

Restriction: In line with NICE Guidance

04.08.01 Ethosuximide 

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

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

07.03.02.02 Etonorgestrel Nexplanon®

Nexplanon Implant 68mg

It is strongly recommended that Nexplanon be inserted and removed only by healthcare professionals (HCPs) who have completed training for the use of the Nexplanon applicator and techniques for insertion and removal of the Nexplanon implant, and, where appropriate, that supervision be requested prior to inserting or removing the implant.

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)

13.03 Eurax®cream Crotamiton 10%

Pack size 30g, 100g

 

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

08.01.05 Everolimus 

Restriction: In line with NICE Guidance only

02.12 Evolocumab Repatha®

Solution for injection pre-filled pen

Restriction: In line with NICE Guidance only

08.03.04.01 Exemestane 

Exemestane 25mg tablets

 

 

06.01.02.03 Exenatide  Bydureon®

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

Restriction: Only for patients who cannot tolerate twice daily exenatide (Byetta® )

Restriction: Treatment should be initiated by secondary care endocrinologists and transferred to primary care after six months as long as the patient has had a beneficial metabolic process, i.e. at least a 1% HbA1c reduction AND at least a 3% reduction in weight.

For modified-release injection, avoid if eGFR less than 50 mL/minute/1.73 m2.

 

06.01.02.03 Exenatide  Byetta®

Byetta 5micrograms/0.02mL solution for injection 1.2mL pre-filled pen
Byetta 10micrograms/0.04mL solution for injection 2.4mL pre-filled pen

Restriction: Treatment should be initiated by secondary care endocrinologists and transferred to primary care after six months as long as the patient has had a beneficial metabolic process, i.e. at least a 1% HbA1c reduction AND at least a 3% reduction in weight.

For standard-release injection, avoid if eGFR less than 30 mL/minute/1.73 m2.

13.02.01 Exocream® 

Light (low paraffin)

Pack size 50g, 500g

02.12 Ezetimibe Ezetrol®

Ezetimibe Tablet 10mg

Combined preparation with simvastatin (Inegy®) non-formulary

Use in accordance with locally agreed hyperlipidaemia guidelines

In line with NICE Guidance

10.02.01 Fampridine Fampyra®

Fampridine 10mg MR tablets

Restriction: In accordance with NHS England prescribing policy

 

Not routinely commissioned by NHS England for multiple sclerosis except by prior IFR approval

10.01.04 Febuxostat Adenuric®

Febuxostat 80mg tablets
Febuxostat 120mg tablets

Restriction: In line with NICE Guidance

MHRA/CHM advice: Serious hypersensitivity reactions (June 2012)

02.06.02 Felodipine 

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

07.03.01 Femodene ED® 

Monophasic

Recommendation: - Second Line due to increased risk of thromboembolism

07.03.01 Femodene® 

Monophasic

Recommendation: - Second Line due to increased risk of thromboembolism

07.03.01 Femodette® 

Monophasic

Low strength ethinylestradiol pill

Recommendation: - Second Line due to increased risk of thromboembolism

07.03.02 Femulen® Etynodiol diacetate

DISCONTINUED 

Administration can be delayed for 3 hours without loss of contraceptive effect.

04.07.02 Fentanyl 

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

Restriction: Patches only.

Prescribe by brand. Cost effective brands include Fencino®, Matrifen® and Mezolar® (Applicable in Primary care only).

NMC/APC Advice (Feb 2006)

Fentanyl patches are an established alternative to oral opioid analgesics & may be useful in:

  • Patients with stable/controlled pain unable to swallow medicines, where the subcutaneous route via a syringe driver is not appropriate, and
  • Patients with stable/controlled pain unable to remember to take medicines regularly.

Fentanyl patches should only be initiated on the advice of the palliative care team, the UHNM chronic pain team, or via the UHNM pain clinic.

04.07.02 Fentanyl citrate nasal spray PecFent®

PecFent 100 micrograms/spray nasal spray, solution
PecFent 400 micrograms/spray nasal spray, solution

Restriction: For breakthrough pain in head and neck cancer patients during/post radiotherapy

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

04.07.02 Fentanyl lozenges Actiq®
Not approved for inclusion in the North Staffordshire Joint Formulary

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

 

 

04.07.02 Fentanyl sublingual tablets Abstral®

Abstral 100 microgram sublingual tablets
Abstral 200 microgram sublingual tablets
Abstral 300 microgram sublingual tablets
Abstral 400 microgram sublingual tablets
Abstral 600 microgram sublingual tablets
Abstral 800 microgram sublingual tablets

Restriction: Consultant recommendation in palliative, haematology and oncology patients only.

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

09.01.01.02 Ferric carboxymaltose Ferinject®

100mg/2ml solution for injection vials

Restriction: For use in renal patients.

Also for use in haematology, gastroenterology & surgery outpatients and day case patients

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

09.01.01.01 Ferrous fumarate Galfer®

Galfer®(ferrous fumarate) 140mg per 5ml syrup
(5ml ≡ 45mg of elemental iron)

09.01.01.01 Ferrous gluconate 

Ferrous gluconate 300mg tablets
(300 mg contains 35 mg iron)

09.01.01.01 Ferrous sulfate 

Ferrous sulfate 200mg tablets
(200 mg is equivalent to 65 mg iron)

Standard release preparations only. 
Modified-release preparations of iron are licensed for once-daily dosage, but have no therapeutic advantage and should not be used.

03.04.01 Fexofenadine Hydrochloride 

Fexofenadine Hydrochloride 120mg tablets
Fexofenadine Hydrochloride 180mg tablets

06.04.02 Finasteride 

Finasteride Tablets 5mg

MHRA/CHM advice: rare reports of depression and suicidal thoughts (May 2017)

Not NHS Not NHS: Finasteride is not prescribable in NHS primary care for the treatment of androgenetic alopecia in men i.e. using 1mg tablets

08.02.04 Fingolimod Gilenya®

Restriction: In line with NICE Guidance only

MHRA/CHM advice: Multiple sclerosis therapies: signal of rebound effect after stopping or switching therapy (April 2017)

MHRA/CHM advice: Fingolimod—not recommended for patients at known risk of cardiovascular events. Advice for extended monitoring for those with significant bradycardia or heart block after the first dose and following treatment interruption (January 2013)

MHRA/CHM advice: Fingolimod: new contra-indications in relation to cardiac risk (December 2017)

MHRA/CHM advice: Fingolimod: updated advice about risk of cancers and serious infections (December 2017)

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

02.03.02 Flecainide Acetate 

Flecainide Acetate Tablet 50mg
Flecainide Acetate Tablet 100mg

Restriction: Initiation under direction of cardiologist

13.02.01 Flexitol ®heel balm Urea 25%

Creamy with Urea Content

For severe hyperkeratosis

Pack size 40g, 75g

08.01.03 Fludarabine phosphate 

Restriction: In line with NICE Guidance only

06.03.01 Fludrocortisone acetate 

Fludrocortisone acetate Tablets 100mcg 

13.04 Fludroxycortide 4micrograms/square cm tape 7.5cm Haelan®tape

Moderate potency

Pack size 20cm

For chronic localised recalcitrant dermatoses (but not acute or weeping)

12.01.01 Flumetasone pivalate with Clioquinol 

Flumetasone pivalate 0.02%/clioquinol 1% ear drops

 

Locorten-vioform discontinued, thus generic prescribing please

11.04.01 Fluocinolone acetonide Iluvien®

Iluvien® 190micrograms intravitreal implant

Restriction: In line with NICE Guidance only

 

13.04 Fluocinolone acetonide 0.0025%  Synalar®1 in 10 Dilution cream

Mild potency

Pack size 30g, 100g

13.04 Fluocinolone acetonide 0.00625% Synalar®1 in 4 Dilution

Moderate potency

Synalar®1 in 4 Dilution cream 50g
Synalar®1 in 4 Dilution ointment 50g

13.04 Fluocinolone acetonide 0.025% Synalar®

Potent

Synalar®cream 50g
Synalar®ointment 50g

13.04 Fluocinolone acetonide 0.025% gel Synalar®

Scalp applications

Potent

Synalar®gel 30g

13.04 Fluocinolone acetonide 0.025% with clioquinol 3% Synalar®C

Topical corticosteroids with antimicrobials

Potent

Synalar®C cream 15g
Synalar®C ointment 15g

13.04 Fluocinolone acetonide 0.025% with neomycin sulfate 0.5% Synalar®N

Topical corticosteroids with antimicrobials

Potent

Synalar®N cream 30g
Synalar®N ointment 30g

11.08.02 Fluorescein sodium Minims®

Minims Fluorescein sodium 1% eye drops (0.5ml unit dose)
Minims Fluorescein sodium 2% eye drops (0.5ml unit dose)

11.04.01 Fluorometholone FML®

Fluorometholone 0.1% opthalmic suspension

04.03.03 Fluoxetine 

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

1st line SSRI for depression

04.02.01 Flupentixol 

Flupentixol Tablets 500mcg
Flupentixol Tablets 1mg
Flupentixol Tablets 3mg

04.02.02 Flupentixol decanoate Depixol®

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 

Restriction: Initiation under direction of a psychiatrist

04.02.02 Fluphenazine decanoate Modecate®

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 

Restriction: Initiation under direction of a psychiatrist

(Discontinued by manufacturer by the end of 2018)

08.03.04.02 Flutamide 

Flutamide 250mg tablets

12.02.01 Fluticasone furoate Avamys®

Avamys®- Fluticasone furoate 27.5microgram/dose nasal spray

2nd line for the treatment and prophylaxis of allergic perennial rhinitis

 

03.02 Fluticasone furoate & vilanterol Relvar®Ellipta

Relvar Ellipta 184mcg/dose / 22mcg/dose DPI (ASTHMA only)
Relvar Ellipta 92mcg/dose / 22mcg/dose DPI (ASTHMA and COPD)

For use in both Asthma and COPD

03.02 Fluticasone furoate, vilanterol & umeclidinium Trelegy®Ellipta

Trelegy Ellipta 92micrograms/dose / 55micrograms/dose / 22micrograms/dose dry powder inhaler
Contains three components Fluticasone/Vilanterol/Umeclidinium

For use in COPD only

See APC Advice:
The New Medicines Committee acknowledged that locally approved guidelines reflect the GOLD guidelines for management of COPD whereas the licensed indication for Trimbow® and Trelegy® places its use after ICS and LABA. The APC considered this and supported the use of Trimbow® and Trelegy® in line with GOLD and local guidelines; prescribers need to be aware of this.

03.02 Fluticasone propionate & formoterol Flutiform®

Fluticasone/Formoterol Inhalation 125/5mcg 120D 
Fluticasone/Formoterol Inhalation 250/10mcg 120D 
Fluticasone/Formoterol Inhalation 50/5mcg 120 D 

For use in Asthma only

03.02 Fluticasone propionate & salmeterol Seretide®

Fluticasone/Salmeterol Inhalation 50/25mcg 120D 
Fluticasone/Salmeterol Inhalation 125/25mcg 120D 
Fluticasone/Salmeterol Inhalation 250/25mcg 120 D 

For paediatric use only

Restriction: For use in Asthma only

12.02.01 Fluticasone with azelastine Dymista®

Dymista®- Fluticasone propionate 50microgram/dose & azelastine hydrochloride 137microgram/dose nasal spray.

2nd line for moderate to severe seasonal and perennial allergic rhinitis if monotherapy with either intranasal antihistamine or intranasal glucocorticoid is insufficient.

 

09.01.02 Folic acid 

Folic acid 400microgram tablets
Folic acid 5mg tablets
Folic acid 2.5mg/5ml oral solution SF 

06.05.01 Follitropin alfa Gonal-F®

75 units (powdered vial)
300 units (in 0.5ml pre-filled pen)
450 units (in 0.75ml pre-filled pen)

Restriction: Specialist use only

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.

 

Bemfola is an approved biosimilar to the reference product Gonal-F®

02.08.01 Fondaparinux Arixtra®

Solution for injection pre-filled syringes

Restriction: For patients with unstable angina and non-ST elevation myocardial infarction

02.08.01 Fondaparinux 

Not approved for inclusion in the North Staffordshire Joint Formulary for the prevention and treatment of venous thromboembolic events 

 

 

09.04 Foodlink Complete® 


 

09.04 Foodlink Complete® with Fibre 

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

09.06.07 Forceval® 

Forceval®capsules

Restriction: Only for use in patients who have undergone bariatric surgery

 

13.07 Formaldehyde Veracur®

Formaldehyde (as formaldehyde solution BP) 0.75% w/w gel, 15g

Self Care  Self Care Medicine. Available OTC for self care

03.01.01.01 Formoterol Fumarate 

Formoterol Dry Powder Inhaler 12mcg/actuation (120 dose)
Formoterol Easyhaler 12mcg/dose dry powder inhaler (120 dose)

Long Acting Beta2 Adrenoreceptor Agonist
Indicated for COPD ONLY.

MHRA/CHM advice: Pressurised metered dose inhalers (pMDI): risk of airway obstruction from aspiration of loose objects (July 2018)

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.

05.01.13 Fosfomycin Monuril®

Fosfomycin 3g granules sachets.

Restriction: At the recommendation of microbiologist in line with proforma

 

 

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.

04.07.04.01 Frovatriptan 

Frovatriptan (as Frovatriptan succinate monohydrate) Tablets 2.5mg

Restriction: For menstrual-related migraine not responding to standard treatment. (As per Anti-Migraine Prescribing Guide)

NICE (CG150) Recommend this for Menstrual-related Migraine. If this is not tolerated then consider Zolmitriptan 2.5mg tablets instead (Unlicensed indication).

09.06.04 Fultium D3® Colecalciferol

Maintenance dose (without calcium)

Fultium D3®Colecalciferol 800unit capsules

09.06.04 Fultium D3® Colecalciferol

HIGH DOSE BOOST

Fultium D3®Colecalciferol 20,000unit capsules

08.03.04.01 Fulvestrant Faslodex®

Not approved for inclusion in the North Staffordshire Joint Formulary

 

 

 

02.02.02 Furosemide 

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

1st line loop diuretic

Monitor Potassium Levels - Risk of Hypokalaemia 

11.03.01 Fusidic acid 

Fusidic acid 1% modified-release eye drops

Restriction: 2nd line to chloramphenicol
Only covers staphylococcal infections

13.10.01.02 Fusidic acid (sodium fusidate) Fucidin®

Fusidic acid cream 15g
Fusidic acid ointment 15g

Restriction: For acute impetigo, minor infections only

 

04.07.03 Gabapentin 

Gabapentin Capsules 100mg
Gabapentin Capsules 300mg
Gabapentin Capsules 400mg
Gabapentin Tablets 600mg
Gabapentin Oral Solution 50mg/ml

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

Restriction: 2nd line in line with the Non-Malignant Chronic Pain Guide

Reserve liquid preparation for patients with swallowing difficulties as expensive. For cost effective prescribing choose generic in non-epileptic indications.(Applicable in Primary care only)

 

MHRA/CHM advice: Gabapentin (Neurontin®): risk of severe respiratory depression (October 2017)

 

04.07.04.02 Gabapentin 

Gabapentin Capsules 100mg
Gabapentin Capsules 300mg
Gabapentin Capsules 400mg
Gabapentin Tablets 600mg
Gabapentin Oral Solution 50mg/ml

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

2nd line
(As per Anti-Migraine Prescribing Guide)

MHRA/CHM advice: Gabapentin (Neurontin®): risk of severe respiratory depression (October 2017)

04.08.01 Gabapentin 

Gabapentin Capsules 100mg
Gabapentin Capsules 300mg
Gabapentin Capsules 400mg
Gabapentin Tablets 600mg
Gabapentin Oral Solution 50mg/ml

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 

Galantamine Tablet 8mg 
Galantamine Tablet 12mg
Galantamine Tablet 8mg MR
Galantamine Tablet 16mg MR
Galantamine Tablet 24mg MR

Gatalin XL®, Gazylan XL are preferred cost-effective MR Brands (Applicable in primary care only).

01.01.02 Gastrocote® 

Na+ content 1 mmol/tablet, 1.8 mmol/5ml

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®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice: Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis (May 2012)

08.01.03 Gemcitabine 

Restriction: In line with NICE Guidance only

 

07.01.01 Gemeprost 

Gemeprost 1mg pessaries

08.01.05 Gemtuzumab ozogamicin Mylotarg®

Restriction: In line with NICE Guidance only

05.01.04 Gentamicin (nebulised) 

80mg/2ml Solution for Injection Amps

Restriction: Non-CF Bronchiectasis. 3rd line only in patients who do not tolerate colistimethate and tobramycin nebules due to bronchospasm and side effect.

11.03.01 Gentamicin 0.3% 

Gentamicin 0.3% ear/eye drops

12.01.01 Gentamicin sulfate Genticin®

Gentamicin sulfate 0.3% ear/eye drops

12.03.05 Glandosane®spray 

Glandosane®synthetic saliva spray (natural, peppermint or lemon)

May be prescribed under ACBS for patients suffering from dry mouth as a result of having (or having undergone) radiotherapy, or sicca syndrome. 

Spray onto oral and pharyngeal mucosa as required.

08.02.04 Glatiramer acetate Copaxone®

Restriction: In line with DH drug treatments for multiple sclerosis: risk-sharing scheme (HSC 2002/004) briefing note November 2006

Restriction: In line with NICE Guidance only

05.03.03.02 Glecaprevir & Pibrentasvir Maviret®

Glecaprevir & Pibrentasvir Tablets 100/40mg

Restriction: In line with NICE Guidance
NHS England Commissioned

06.01.02.01 Gliclazide 

Gliclazide Tablets 40mg
Gliclazide Tablets 80mg

1st line sulphonylurea

Standard release preparations only

06.01.04 Glucagon GlucaGen® HypoKit

GlucaGen®HypoKit 1mg powder and solvent for solution for injection

10.01.05 Glucosamine 

 

Not approved for inclusion in the North Staffordshire Joint Formulary

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

06.01.04 Glucose 

40% gel (25g triple pack)

A2.07 Glucose 
01.06.02 Glycerol Glycerin

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

 

 

 

01.07.04 Glyceryl Trinitrate 0.4% Rectogesic®

Rectogesic Ointment 0.4%

02.06.01 Glyceryl Trinitrate buccal 

Restriction: Only for regular use in place of IV

02.06.01 Glyceryl Trinitrate patches 

5mg/24hours patch
10mg/24hours patch

More expensive than Isosorbide mononitrate tablets.

02.06.01 Glyceryl Trinitrate spray 

400 mcg/spray (180 dose)
400 mcg/spray (200 dose)

For the infrequent user it is more cost effective to have the spray.

02.06.01 Glyceryl Trinitrate sublingual tablets 

300 mcg S/L tablets
500 mcg S/L tablets
600 mcg S/L tablets

AVOID Suscard Buccal tablets as very expensive.

01.02 Glycopyrronium bromide  Sialanar®oral solution

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 
For use in COPD ONLY.

03.01.04 Glycopyrronium bromide & Indacaterol  Ultibro®Breezhaler

Ultibro Breezhaler 85microgram/43microgram inhalation powder capsules with device

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

For use in COPD only

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

01.05.03 Golimumab Simponi®

Restriction: In line with NICE Guidance only

10.01.03 Golimumab Simponi®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

06.05.01 Gonadorelin HRF®

100mcg powder for solution for injection

Restriction: Specialist use only

(Assessment of pituitary function)

06.07.02 Goserelin Zoladex®

Goserelin 3.8mg Implant SafeSystem pre-filled syringes
Goserelin LA 10.8mg Implant SafeSystem pre-filled syringes

Restriction: Initiation under direction of a specialist

08.03.04.02 Goserelin acetate Zoladex®

Zoladex (goserelin acetate) 3.6mg implant SafeSystem pre-filled syringes - monthly
Zoladex LA (goserelin acetate) 10.8mg implant SafeSystem pre-filled syringes -three monthly

04.06 Granisetron 

Not approved for inclusion in the North Staffordshire Joint Formulary

 

03.04.02 Grass pollen extract Grazax®
 

Not approved for inclusion in the North Staffordshire Joint Formulary

 

 

13.05.03 Guselkumab Tremfya®

Restriction: In line with NICE Guidance only

04.02.01 Haloperidol 

Haloperidol Capsule 500mcg 
Haloperidol Tablet 1.5mg 
Haloperidol Tablet 5mg 
Haloperidol Tablet 10mg 
Haloperidol Tablet 20mg 
Haloperidol Oral Solution 5mg/5ml SF 
Haloperidol Oral Solution 10mg/5ml SF

04.09.03 Haloperidol 

Haloperidol Tablets 0.5mg
Haloperidol Tablets 1.5mg
Haloperidol Tablets 5mg
Haloperidol Tablets 10mg
Haloperidol Tablets 20mg
Haloperidol Oral Solution 5mg/5ml SF
Haloperidol Oral Solution 10mg/5ml SF

Restriction: Initiation by specialist

04.02.02 Haloperidol decanoate Haldol®

Haloperidol Decanoate Injection 50mg/ml 1ml Amp 
Haloperidol Decanoate Injection 100mg/ml 1ml Amp 

Restriction: Initiation under direction of a psychiatrist

02.08.01 Heparin 

Solution for injection ampoules/ vials
All Heparin Infusion bags

These are all hospital only prescribing only. The heparin flushes listed below may be prescribed in primary care.

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.

13.13 Heparinoid  Hirudoid®

Hirudoid® 0.3% cream 50g
Hirudoid® 0.3% gel, 50g

11.08.02 Holoclar® 

 

Restriction: In line with NICE Guidance only

Not approved for inclusion in the North Staffordshire Joint Formulary:

UHNM is not commissioned to provide this treatment. All appropriate patients should be referred to a tertiary specialist commissioned centre.

 

10.03.01 Hyaluronidase 

Hyaluronidase 1,500unit powder for solution for injection ampoules

02.05.01 Hydralazine Hydrochloride 

Hydralazine Hydrochloride 25mg tablet
Hydralazine Hydrochloride 50mg tablet

Can be used for hypertensive emergencies (including in pregnancy)

01.05.02 Hydrocortisone 

Standard release

Hydrocortisone 10mg tablets

Hydrocortisone 20mg tablets

03.04.03 Hydrocortisone 

Solution for injection

06.03.02 Hydrocortisone 

Hydrocortisone Standard release 10mg and 20mg tablets
Hydrocortisone Sodium Succinate Injection 100mg vial (Solu-Cortef)
Hydrocortisone Sodium Phosphate Injection 100mg/ml Amps
Hydrocortisone Acetate Suspension for Injection 25mg/ml Amps (Hydrocortistab)

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

13.04 Hydrocortisone  0.5% & 1%

Mild potency

Hydrocortisone 0.5% cream 15g, 30g
Hydrocortisone 0.5% ointment 15g, 30g
Hydrocortisone 1% cream 15g, 30g
Hydrocortisone 1% ointment 15g, 30g

Hydrocortisone 1% cream Self Care Self Care Medicine-Available OTC for self care (Please note exceptions may apply)

13.04 Hydrocortisone 1% with clotrimazole 1% Canesten®HC

Topical corticosteroids with antimicrobials

Mild potency

Canesten HC®cream 30g

Limit duration of treatment with steroid/antimicrobial combinations; usually twice daily for 1 week.

13.04 Hydrocortisone 1% with miconazole nitrate 2% Daktacort®

Topical corticosteroids with antimicrobials

Mild potency

Daktacort®cream 30g
Daktacort®ointment 30g

Limit duration of treatment with steroid/antimicrobial combinations; usually twice daily for 1 week.

10.01.02.02 Hydrocortisone acetate Hydrocortistab®

Hydrocortistab® - Hydrocortisone acetate 25mg/1ml suspension for injection ampoules

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

13.04 Hydrocortisone acetate 1% with fusidic acid 2% Fucidin®H

Topical corticosteroids with antimicrobials

Mild potency

Fucidin®H cream 30g
Fucidin®H ointment 30g

Limit duration of treatment with steroid/antimicrobial combinations; usually twice daily for 1 week.

12.01.01 Hydrocortisone acetate with gentamicin sulfate Gentisone HC®

Hydrocortisone acetate 1% & Gentamicin sulfate 0.3% ear drops

13.04 Hydrocortisone butyrate 0.1% Locoid®

Potent

Locoid®cream 30g, 100g
Locoid®ointment 30g, 100g

 

12.03.01 Hydrocortisone sodium succinate Corlan®

Hydrocortisone sodium succinate 2.5mg muco-adhesive buccal tablets sugar free

12.03.04 Hydrogen peroxide Peroxyl®

Hydrogen peroxide 1.5% mouthwash (in primary care as Peroxyl®)
Hydrogen peroxide 6% solution (in secondary care)

 

 

13.11.06 Hydrogen peroxide  

Hydrogen peroxide 3% solution (10vols) 200ml
Hydrogen peroxide 6% solution (20vols) 200ml

Restriction: On specialist advice only

 

13.02.01.01 Hydromol ® bath and shower 

3rd Line

Pack size 350ml, 500ml

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 Hydromol ®ointment 

Greasy (equivalent to Epaderm® Ointment)

1st line

Pack size 125g, 500g

09.01.02 Hydroxocobalamin 

Hydroxocobalamin 1mg/1ml solution for injection ampoules

 

08.01.05 Hydroxycarbamide 
10.01.03 Hydroxychloroquine sulfate 

Hydroxychloroquine sulfate 200mg tablets

(Rheumatology)

Link to ESCA

03.04.01 Hydroxyzine Hydrochloride 

Hydroxyzine Hydrochloride Tablet 10mg 
Hydroxyzine Hydrochloride Tablet 25mg 
Hydroxyzine Hydrochloride Oral Solution 10mg/5ml 

MHRA advice: Risk of QT-interval prolongation and torsade de pointes (April 2015)

01.02 Hyoscine Butylbromide 

Hyoscine Butylbromide Tablet 10mg
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.

04.06 Hyoscine hydrobromide Scopolamine hydrobromide

Hyoscine hydrobromide Patch 1mg/72 hour
Hyoscine hydrobromide Tablets 150mcg
Hyoscine hydrobromide Tablets 300mcg

Hyoscine hydrobromide injection is not formulary

06.06.02 Ibandronic acid 

Ibandronic acid Tablets 150mg

Restriction: In line with NICE Guidance only

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

 

06.06.02 Ibandronic acid  Bondronat®

3mg/3ml Solution for Injection Pre-filled Syringes
2mg/2ml Concentrate for Solution for Infusion Vials
6mg/6ml Concentrate for Solution for Infusion Vials

Restriction: In line with NICE Guidance only

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

06.06.02 Ibandronic acid 

Ibandronic acid Tablets 50mg

Restriction: For the prevention of skeletal events in breast cancer and metastatic bone disease only

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

08.01.05 Ibrutinib Imbruvica®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice: Ibrutinib (Imbruvica®): reports of ventricular tachyarrhythmia; risk of hepatitis B reactivation and of opportunistic infections (August 2017)

10.01.01 Ibuprofen 

1st line NSAID

Ibuprofen 200mg tablets
Ibuprofen 400mg tablets
Ibuprofen 100mg/5ml oral suspension
Ibuprofen 100mg/5ml oral suspension SF

10.03.02 Ibuprofen gel 

Ibuprofen 5% gel

03.04.03 Icatibant Firazyr®

30mg/3ml solution for injection pre-filled syringes

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised Commissioning Drug for HEREDITARY ANGIOEDEMA - ACUTE TREATMENT ONLY

08.01.05 Idelalisib Zydelig®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice: Idelalisib (Zydelig®): Updated indications and advice on minimising the risk of infection (September 2016)

08.01.05 Imatinib mesilate 

Restriction: In line with NICE Guidance only

 

 

13.07 Imiquimod  

Aldara® 5% cream 250mg sachets (12 sachets)
Bascellex® 50mg/g cream 250mg sachets (12 sachets)

Restriction: Initiation by specialist for anogenital warts


Should be rubbed in and allowed to stay on the treated area for 6–10 hours for warts, then washed off with mild soap and water (uncircumcised males treating warts under foreskin should wash the area daily). The cream should be washed off before sexual contact. Maximum 16 weeks course length. 

 

03.01.01.01 Indacaterol Onbrez®Breezhaler

Not approved for inclusion in the North Staffordshire Joint Formulary

 

 

02.02.01 Indapamide 

Indapamide Tablet 2.5mg

1st line thiazide-like diuretic for hypertension

Indapamide MR is non-formulary

07.01.01.01 Indometacin Indocid PDA®

Indomethacin 1mg vial

Discontinued - Replaced by Ibuprofen Pedea® 10mg/2ml Injection (Unlicensed use for treatment of PDAs in neonates only)

10.01.01 Indometacin 

Indometacin 25mg capsules
Indometacin 50mg capsules

 

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less)

 

 

01.05.03 Infliximab Flixabi®, Inflectra®, Remicade®, Remsima®

Restriction: In line with NICE Guidance only

10.01.03 Infliximab Flixabi®, Inflectra®, Remicade®, Remsima®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

 

Not routinely commissioned by NHS England for Connective tissue disease, interstital lung disease, renal or sarcoidosis except by prior IFR approval.

13.05.03 Infliximab Flixabi®, Inflectra®, Remicade®, Remsima®

Restriction: In line with NICE Guidance only

08.01.05 Inotuzumab ozogamicin Besponsa®

Restriction: In line with NICE Guidance only

06.01.01.01 Insulin Humulin®S

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges

06.01.01.01 Insulin Actrapid®

100 units/ml solution for injection vials

06.01.01.01 Insulin Aspart  NovoRapid®

100 units/ml solution for injection vials
100 units/ml solution for injection pre-filled pen (Flexpen)
100 units/ml solution for injection pre-filled pen (FlexTouch)
100 units/ml solution for injection cartridges (Penfill)
100 units/ml solution for injection cartridges (PumpCart)

Restriction: For use only by practitioners experienced in the use of insulins

06.01.01.01 Insulin Aspart Fiasp®

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges (Fiasp Penfill)
100 units/ml solution for pre-filled pen (Fiasp Flextouch)

Restriction: For use only by practitioners experienced in the use of insulins

06.01.01.02 Insulin degludec  Tresiba®

HIGH STRENGTH

Tresiba Flextouch 200units/ml 3ml pre-filled pen

(Long-acting insulin)

06.01.01.02 Insulin degludec Tresiba®

Tresiba Penfill 100units/ml 3ml cartridges
Tresiba Flextouch 100units/ml 3ml pre-filled pen

(Long-acting insulin)

06.01.01.02 Insulin Detemir Levemir®

100 units/ml solution for injection prefilled pen (FlexPen)
100 units/ml solution for injection prefilled pen (InnoLet)
100 units/ml solution for injection cartridges (Penfill)

(Long-acting Insulin)

06.01.01.02 Insulin Glargine Toujeo®

HIGH STRENGTH

Toujeo 300 units/ml solution for injection 1.5ml pre-filled pen (SoloStar)

(Long-acting insulin)

06.01.01.02 Insulin Glargine  

100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled pen (KwikPen)

This is a bio-similar product to insulin glargine. Prescribe by brand name.

Restriction: For use only by practitioners experienced in the use of insulins

(Long-acting insulin)

06.01.01.02 Insulin Glargine Lantus®

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled pen (SoloStar Pen)

Restriction: For use only by practitioners experienced in the use of insulins

(Long-acting insulin)

06.01.01.01 Insulin Glulisine Apidra®

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled Solostar pen

Restriction: For use only by practitioners experiencxed in the use of insulins

06.01.01.01 Insulin Lispro  Humalog®

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled pen (Junior KwikPen/ KwikPen)

Restriction: For use only by practitioners experienced in the use of insulins

06.01.01.01 Insulin Lispro  Humalog®kwikpen

HIGH STRENGTH

200 units/ml solution for injection prefilled pen (KwikPen)

Not approved for inclusion in the North Staffordshire Joint Formulary

 

06.01.01.02 Insulin Zinc suspension Hypurin®Bovine Lente

100 units/ml solution for injection vials

(Long-acting insulin)

DISCONTINUED (July 2017)

08.02.04 Interferon Alfa 
08.02.04 Interferon Beta 

Restriction: In line with DH drug treatments for multiple sclerosis: risk-sharing scheme (HSC 2002/004) briefing note November 2006

Restriction: In line with NICE Guidance only

09.06.04 Invita D3®  Colecalciferol

HIGH DOSE BOOST

Invita D3®Colecalciferol 25,000unit per 1ml oral solution 
Invita D3®Colecalciferol 50,000unit per 1ml oral solution 

06.02.02 Iodine  

Aqueous iodine oral (Lugol's) solution BP

13.11.04 Iodine 

Weak iodine solution and povidone-iodine

Povidone-Iodine 10% antiseptic solution, 500ml
Povidone-Iodine 2.5% dry powder spray, 100ml

Alternative for patients with chlorhexidine intolerance/allergy 

08.01.05 Ipilimumab Yervoy®

Restriction: In line with NICE Guidance only

 

 

03.01.02 Ipratropium Bromide 

Ipratropium Bromide Inhalation Solution 500mcg/2ml Unit Dose Vials
Ipratropium Bromide Inhalation 20mcg/dose (200 D) CFC Free 
Ipratropium Bromide 500mcg/2ml nebs Unit Dose Vials

 

12.02.02 Ipratropium bromide Rinatec®

Rinatec®- Ipratropium bromide 21microgram/dose nasal spray

02.05.05.02 Irbesartan 

Irbesartan Tablets 75mg 
Irbesartan Tablets 150mg 
Irbesartan Tablets 300mg 

Restriction: For use by renal physicians or as a second-line angiotensin II antagonist

09.01.01.02 Iron dextran CosmoFer®

100mg/2ml solution for injection Amps

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

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)

09.01.01.02 Iron sucrose Venofer®

100mg/5ml solution for injection vials

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

 

06.01.01.02 Isophane Insulin Hypurin® Bovine Isophane

DISCONTINUED

06.01.01.02 Isophane Insulin Hypurin® Porcine Isophane

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges

(Intermediate-acting insulin)

06.01.01.02 Isophane Insulin Insulatard®

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges (Penfill)
100 units/ml solution for injection prefilled pen (InnoLet)

(Intermediate-acting insulin)

06.01.01.02 Isophane Insulin Humulin® I

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled pen (KwikPen)

(Intermediate-acting insulin)

06.01.01.02 Isophane Insulin Insuman® Basal

100 units/ml solution for injection vials
100 units/ml solution for injection cartridges
100 units/ml solution for injection prefilled pen (SoloStar Pen)

(Intermediate-acting insulin)

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.

 

02.07.01 Isoprenaline 

0.2mg/mL solution for injection ampoule

02.06.01 Isosorbide Mononitrate 

Isosorbide Mononitrate Tablet 10mg 
Isosorbide Mononitrate Tablet 20mg 

13.06.01 Isotretinoin Isotrex®

Isotrex®- Isotretinoin 0.05% gel 

Discontinued 

Prescribers to consider alternative topical preparations within the drug class.

13.06.02 Isotretinoin Roaccutane®

Restriction: Initiation on specialist dermatological advice

Contraindicated in pregnancy.

Each prescription for isotretinoin should be limited to a supply of up to 30 days’ treatment and dispensed within 7 days of the date stated on the prescription; repeat prescriptions or faxed prescriptions are not acceptable.

MHRA/CHM advice: Isotretinoin (Roaccutane®): rare reports of erectile dysfunction and decreased libido (October 2017)

13.06.01 Isotretinoin with erythromycin Isotrexin®

Topical retinoids and related preparations with antibacterial

Isotrexin®- Isotretinoin 0.05% and erythromycin 2.0% gel 30g

01.06.01 Ispaghula Husk  Fybogel®or Ispagel®

Ispaghula Husk 3.5g Effervescent Granules Sachets GF/SF

- Adequate fluid intake is important to prevent obstruction (6 – 8 cups per day) and should not to be taken immediately before bed
- Time to effect is approximately 48 – 72 hours

 

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

 

02.06.03 Ivabradine Procoralan®

Ivabradine Tablet 5mg 
Ivabradine Tablet 7.5mg 

Restriction: In line with NICE Guidance only

MHRA advice on Ivabradine: risk of cardiac side-effects (December 2014)

03.07 Ivacaftor Kalydeco®

Ivacaftor 150mg tablets 

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis ONLY

HCDHCDHCD

13.06 Ivermectin  Soolantra®

Soolantra®10mg/g cream

Restriction: 2nd line treatment for papulopustular rosacea if treatment with topical metronidazole has failed

Provide a 4 month course initially and review after 3 months. The course may be repeated if required.

08.01.05 Ixazomib Ninlaro®

Restriction: In line with NICE Guidance only

10.01.03 Ixekizumab Taltz®

Restriction: In line with NICE Guidance

13.05.03 Ixekizumab Taltz®

Restriction: In line with NICE Guidance only

07.03.01 Katya 30/75® 

Monophasic

Recommendation: - Second Line due to increased risk of thromboembolism

13.09 Ketoconazole 

Ketoconazole 2% shampoo 120ml

Self Care  Self Care Medicine. Available OTC for self care

13.10.02 Ketoconazole Nizoral®

Nizoral® - Ketoconazole 2% cream 30g

Restriction: For treatment of seborrhoeic dermatitis and pityriasis versicolor only (primary care prescriptions should be endorsed ‘SLS’ i.e Nizoral® cream)

 

 

11.08.02 Ketorolac trometamol Acular®

Ketorolac trometamol 0.5% eye drops

02.04 Labetalol Hydrochloride 

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

Also licensed for Hypertension in Pregnancy

04.08.01 Lacosamide  Vimpat ®

Vimpat 50 mg film-coated tablets
Vimpat 100 mg film-coated tablets
Vimpat 150 mg film-coated tablets
Vimpat 200 mg film-coated tablets
Vimpat Syrup 10mg/ml

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

01.06.04 Lactulose 

Lactulose Solution 3.1g-3.7g/5ml

- Tolerence may develop with continued use
- Better than stimulant laxative in diverticular disease
- Time to effect is approximately 24 to 48 hours.

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®

300mg/2mL solution for injection vial

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 acetate 

Restriction: In accordance with NHS England prescribing policy

  • Acromegaly
  • Cancer indication
  • Congenital hyperinsulism

Somatuline® LA (lanreotide acetate) 30mg powder and solvent for suspension for injection vials 

Somatuline® Autogel (lanreotide acetate) 120mg per 1ml solution for injection pre-filled syringes with safety system 

Somatuline® Autogel (lanreotide acetate) 180mg per 1ml solution for injection pre-filled syringes with safety system 

Somatuline® Autogel (lanreotide acetate) 240mg per 1ml solution for injection pre-filled syringes with safety system

 

08.03.04.03 Lanreotide acetate 
  • Non NHS England indications i.e. palliative care

Somatuline® LA (lanreotide acetate) 30mg powder and solvent for suspension for injection vials 

Somatuline® Autogel (lanreotide acetate) 120mg per 1ml solution for injection pre-filled syringes with safety system 

Somatuline® Autogel (lanreotide acetate) 180mg per 1ml solution for injection pre-filled syringes with safety system 

Somatuline® Autogel (lanreotide acetate) 240mg per 1ml solution for injection pre-filled syringes with safety system

 

01.03.05 Lansoprazole 

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

2nd line PPI

(Orodispersible 1st line in patients with enteral feeding tubes or swallowing difficulties)

09.05.02.02 Lanthanum carbonate Fosrenol®

For the treatment of Hyperphosphataemia

Fosrenol®Lanthanum carbonate 500mg chewable tablets
Fosrenol®Lanthanum carbonate 750mg chewable tablets
Fosrenol®Lanthanum carbonate 1gram chewable tablets
Fosrenol®Lanthanum carbonate 750mg oral powder sachets
Fosrenol®Lanthanum carbonate 1gram oral powder sachets

Commissioned by NHS England when used for adult renal dialysis

Link to ESCA

11.06 Latanoprost 

Latanoprost 50microgram/ml eye drops

1st line Prostaglandin analogue

 

11.06 Latanoprost with timolol  

Latanoprost 50microgram/ml & Timolol 5mg/ml eye drops

05.03.03.02 Ledipasvir & Sofosbuvir Harvoni®

Ledipasvir & Sofosbuvir Tablets 90/400mg

Restriction: In line with NICE Guidance
This is an NHS England Specialised Commissioning Drug for Hepatitis C

10.01.03 Leflunomide 

Leflunomide 10mg tablets
Leflunomide 20mg tablets

Link to ESCA

 

 

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®

13.4 mega unit vial and pre-filled syringe
33.6 mega unit vial and pre-filled syringe.

Restriction: Specialist use only

Granocyte® solution for injection contains 105 micrograms of lenograstim per 13.4 mega unit vial and 263 micrograms lenograstim per 33.6 mega unit vial.

08.01.05 Lenvatinib 

Restriction: In line with NICE Guidance only

05.03.02.02 Letermovir Prevymis®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policy

08.03.04.01 Letrozole 

Letrozole 2.5mg tablets

08.03.04.02 Leuprorelin acetate 

Prostap SR DCS (leuprorelin acetate) 3.75mg powder and solvent for suspension for injection pre-filled syringes - monthly

Prostap 3 DCS (leuprorelin acetate) 11.25mg powder and solvent for suspension for injection pre-filled syringes - three monthly

 

04.08.01 Levetiracetam 

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

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

04.09.01 Levodopa and carbidopa with entacapone 

Stanek 50 mg/12.5 mg/200 mg
Stanek 75 mg/18.75 mg/200 
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

Stanek® (equivalent to Stalevo®) is the preferred cost-effective brand (Applicable in primary care).

11.03.01 Levofloxacin Oftaquix®

Levofloxacin 5mg/ml eye drops

Restriction: Initiation by Consultant Ophthalmologist only

05.01.12 Levofloxacin nebuliser solution Quinsair®

240mg Nebuliser Solution Amps

Restriction: CF - In line with NHSE Commissioning Policy

This is a Specialised Drug which would not be routinely commissioned by CCGs for Cystic Fibrosis. This would go through the CCGs Individual Funding Request (IFR).

MHRA advice- Fluoroquinolones (March 2019):

  • systemic (by mouth, injection, or inhalation) fluoroquinolones can very rarely cause long-lasting (up to months or years), disabling, and potentially irreversible side effects, sometimes affecting multiple systems, organ classes, and senses
  • advise patients to stop treatment at the first signs of a serious adverse reaction, such as tendinitis or tendon rupture, muscle pain, muscle weakness, joint pain, joint swelling, peripheral neuropathy, and central nervous system effects, and to contact their doctor immediately for further advice.
04.02.01 Levomepromazine Methotrimipramine

Levomepromazine Tablets 25mg
Levomepromazine solution for injection ampoules 25mg/ml


Restriction: For use in Palliative Care

07.03.05 Levonogrestrel 

Levonelle 1500microgram tablets

Do not prescribe Levonelle One Step as more expensive and it is an OTC preparation. Prescribe as Levonorgestrel 1.5mg tablets.

See APC/NMC recommendation

07.03.02.03 Levonorgestrel Levosert®

Levosert® 20 mcg/24 hours intrauterine delivery system

1st line for Heavy Menstrual Bleeding (HMB) in women requiring reversible contraception. Not to be used for Contraception.

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

07.03.02.03 Levonorgestrel Mirena®

Mirena® 20 mcg/24 hours intrauterine delivery system

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

06.02.01 Levothyroxine sodium 

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 (Applicable in primary care only).

04.07.03 Lidocaine 5% plasters Versatis®

Not approved for inclusion in the North Staffordshire Joint Formulary

 

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

02.03.02 Lidocaine Hydrochloride 

Solution for Injection vials

Restriction: Initiation under direction of cardiologist

01.06.07 Linaclotide Constella®

Linaclotide 290 microgram capsules

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®

Linagliptin Tablets 5mg

06.02.01 Liothyronine 

Liothyronine Tablets 20microgram

Liothyronine Tablets 5microgram (Unlicensed)

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

20–25 micrograms of liothyronine sodium is equivalent to approximately 100 micrograms of levothyroxine sodium.

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

Pack size 250g, 500g

Self Care Self Care Medicine-Available OTC self care.

06.01.02.03 Liraglutide Victoza®

Liraglutide 6 mg/ml 3ml prefilled pen

Restriction: Liraglutide should be used second line to exenatide in patients where exenatide is not tolerated or not effective (i.e. exenatide twice daily (Byetta® ) was not effective OR exenatide twice daily (Byetta® ) was not tolerated and exenatide once weekly (Bydureon® ) was not effective).

Patients should receive at least 3 months of exenatide before liraglutide is prescribed. Treatment should be initiated by secondary care endocrinologists and transferred to primary care after 6 months treatment with liraglutide as long as the patient has had a beneficial metabolic process, i.e. at least a 1% HbA1c reduction AND at least a 3% reduction in weight

04.02.03 Lithium Carbonate Prescribe by brand

Prescribe by Brand and maintain patient on the same Brand

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

Restriction: Initiation by psychiatrist

Note change in bioavailability when changing from Tablets to Liquid. Note 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 (Lithium Carbonate)

Link to ESCA

04.02.03 Lithium Citrate 

Prescribe by Brand and maintain patient on the same Brand

Current Brands Available:
Priadel Liquid and Li-liquid

Restriction: Initiation by psychiatrist

Note change in bioavailability when changing from Tablets to Liquid. Note 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 (Lithium Carbonate).

Link to ESCA

07.03.01 Loestrin 20® 

Monophasic

Low Strength ethinylestradiol pill

DISCONTINUED

07.03.01 Loestrin 30® 

Monophasic

DISCONTINUED

04.03.01 Lofepramine  

Lofepramine Hydrochloride Tablet 70mg 

1st line TCA for depression

04.10.03 Lofexidine BritLofex®

Lofexidine Tablets 200mcg

Restriction: Initiation by substance abuse specialist only

07.03.01 Logynon ED® 

Triphasic

07.03.01 Logynon® 

Triphasic

01.04.02 Loperamide Hydrochloride 

Loperamide Hydrochloride Capsule 2mg
Loperamide Hydrochloride Oral Solution SF 1mg/5ml

 

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

03.04.01 Loratadine 

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

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

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).

04.08.02 Lorazepam 

Lorazepam Injection 4mg/ml Amp
Lorazepam Oral Solution 1mg/ml SF
Lorazepam Tablets 1mg
Lorazepam Tablets 2.5mg

 

08.01.05 Lorlatinib 

Restriction: In line with NICE Guidance only

 

02.05.05.02 Losartan Potassium 

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

Restriction: For hypertension in line with NICE Guidance CG127

01.06.07 Lubiprostone Amitiza®

Lubiprostone 24microgram capsules

Restriction: In line with NICE Guidance only

DISCONTINUED (Dec 2018)

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

Lutathera 370 MBq/mL solution for infusion

13.06.02 Lymecycline 

Lymecycline 408mg capsules

Alternative choice to patients experiencing side-effects with doxycycline.

01.01.01 Maalox® 

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.

01.06.04 Macrogol oral powder Laxido®or Movicol®

Compound Oral Powder Sachet NPF S/F

 

Prescribe generically

09.05.01.03 Magnesium aspartate Magnaspartate®

Magnesium aspartate 243mg (magnesium 5mmol) oral powder 5g sachets
(contains magnesium aspartate 6.5 g (10 mmol Mg2+)/sachet)

For the acute treatment of mild to moderate hypomagnesaemia. 
For chronic hypomagnesaemia and for maintenance therapy, specialist advice should be sought.

 

09.05.01.03 Magnesium sulfate 

Magnesium sulfate 50% (magnesium 2mmol/ml) solution for injection ampoules

01.06.04 Magnesium Sulphate 

Dried 1mg per 1mg 

 

 Self Care Self Care Medicine - Available OTC as Epsom Salts

01.01.01 Magnesium Trisilicate 

Magnesium Trisilicate Oral Suspension 200mL
Magnesium Trisilicate (Compound) 250 mg / 120mg / tab

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

13.10.04 Malathion Derbac-M®

Derbac-M® - Malathion 0.5% liquid 50ml,100ml

Self Care Self Care Medicine. Available OTC for self care

 

02.02.05 Mannitol 

10% infusion
15% infusion
20% infusion

For mannitol 20%, an in-line filter is recommended (15-micron filters have been used).

03.07 Mannitol inhalation Bronchitol ®

Inhalation powder capsules with device

Restriction: In line with NICE Guidance only

This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis.

07.03.01 Marvelon® 

Monophasic

Recommendation: - Second Line due to increased risk of thromboembolism

 

01.02 Mebeverine Hydrochloride 

Mebeverine Hydrochloride Tablet 135mg

Standard release preparations only

06.07.04 Mecasermin Increlex®

Mecasermin 40mg/4ml Solution for Injection Vials

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised Commissioning Drug for Growth Failure.

MHRA advice: Mecasermin- risk of benign and malignant neoplasia (Jan 2020)

06.04.01.02 Medroxyprogesterone  Provera®

Medroxyprogesterone Acetate Tablets 5mg (Climanor®)
Medroxyprogesterone Acetate Tablets 2.5mg, 5mg, 10mg, 100mg, 200mg, 400mg (Provera®)

07.03.02.02 Medroxyprogesterone acetate Depo-Provera®

Medroxyprogesterone Acetate Injection 150mg/ml pre-filled syringe 
Medroxyprogesterone Acetate Injection 150mg/ml vial

08.03.02 Medroxyprogesterone acetate 

Medroxyprogesterone acetate 2.5mg tablets
Medroxyprogesterone acetate 5mg tablets
Medroxyprogesterone acetate 10mg tablets
Medroxyprogesterone acetate 100mg tablets
Medroxyprogesterone acetate 200mg tablets
Medroxyprogesterone acetate 400mg tablets

08.03.02 Megestrol Acetate 

Imported - Megestrol acetate 40mg tablets (unlicensed)
Megace® - Megestrol acetate 160mg tablets

 

Megace® tablets are scored, and can be split to make required doses.

04.01.01 Melatonin  Circadin®

Not approved for inclusion in the North Staffordshire Joint Formulary 

 

10.01.01 Meloxicam 

Meloxicam 7.5mg tablets
Meloxicam 15mg tablets

 

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less)

04.11 Memantine Ebixa®

Memantine HCl Tablet 10mg 
Memantine HCl Tablet 20mg

09.06.06 Menadiol sodium phosphate 

Menadiol Diphosphate 10mg Tablets

Special order

03.08 Menthol crystals 

Limited clincial value for these products and patients may rather purchase these as OTC products.

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

 

03.04.02 Mepolizumab Nucala®

Restriction: In line with NICE Guidance only

Not approved for inclusion in the North Staffordshire Joint Formulary:

UHNM is not commissioned to provide this treatment. All appropriate patients should be referred to a tertiary specialist commissioned centre.

 

 

01.05.03 Mercaptopurine 

Mercaptopurine 50mg Tablets
Xaluprine® 20mg/1ml Oral Suspension

For the treatment of Inflammatory Bowel Disease [unlicensed indication]

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

Link to ESCA

07.03.01 Mercilon® 

Monophasic

Low strength ethinylestradiol pill

Recommendation: - Second Line due to increased risk of thromboembolism

01.05.01 Mesalazine 

Octasa MR gastro-resistant 400mg and 800mg tabs
Pentasa MR 500mg tabs
Mesalazine Foam Enema 1g/Dose 14g (Asacol®)

Prescribe by recommended BRAND.

 

Other brands – Pentasa, Asacol, Asacol MR, Salofalk (granules/enema), Mezavant XL.

06.01.02.02 Metformin hydrochloride 

Metformin hydrochloride Tablets 500mg
Metformin hydrochloride Tablets 850mg
Metformin hydrochloride Oral Solution 500mg/5ml SF

1st line

06.01.02.02 Metformin hydrochloride 

Metformin hydrochloride SR 500mg tablets
Metformin hydrochloride SR 750mg tablets
Metformin hydrochloride SR 1000mg tablets

2nd line in-line with NICE Guidance

Patients taking up to 2 g daily of the standard-release metformin may start with the same daily dose of metformin modified release; not suitable if dose of standard-release tablets more than 2 g daily.

04.10.03 Methadone 

Methadone HCl Mix 1mg/1ml

Restriction: Initiation by substance abuse specialist only

03.09.01 Methadone Hydrochloride Methadone linctus®

Methadone Linctus 2mg/5mL

Restriction: Palliative Care only

Note: Methadone oral solution 1 mg/mL is 2½ times the strength of Methadone Linctus (2 mg/5mL). 

04.07.02 Methadone Hydrochloride 

Methadone Hydrochloride Oral Solution 1mg/ml
Methadone Hydrochloride Oral Solution 1mg/ml SF

Restriction: Use in palliative care and substance misuse only

05.01.13 Methenamine Hippurate Hiprex®

Methenamine Tablets 1gram

1st line therapy for patients presenting with recurrent UTIs to minimise the risk of antibiotic resistance and C. diff infection.

 

BNF (Less suitable for prescribing):
Methenamine (hexamine) hippurate should not generally be used because it requires an acidic urine for its antimicrobial activity and it is ineffective for upper urinary-tract infections; it may, however, have a role in the prophylaxis and treatment of chronic or recurrent uncomplicated lower urinary-tract infections

01.05.03 Methotrexate 

Methotrexate 2.5mg Tablets

For the treatment of Inflammatory Bowel Disease [unlicensed indication]

Prescribe WEEKLY on the same day each week, as 2.5mg strength tabs.

Link to ESCA

10.01.03 Methotrexate 

Methotrexate 2.5mg tablets
Methotrexate injection (as pre-filled syringes/ pens/ injectors)- brands include Nordimet®, Zlatal®, Methofill® and Metoject PEN®

Prescribe WEEKLY (on the same day each week); orally as multiples of 2.5mg strength tablets.

Link to ESCA

13.05.03 Methotrexate 

For the treatment of Inflammatory Skin Disease

Methotrexate 2.5mg tablets

Prescribe WEEKLY (on the same day each week); orally as multiples of 2.5mg strength tablets.

Link to ESCA

13.05.03 Methotrexate injection 

Methotrexate injection (as pre-filled syringes/ pens/ injectors)- brands include Nordimet®, Zlatal®, Methofill® and Metoject PEN®

Prescribe WEEKLY (on the same day each week)

Restriction: Initiation on specialist dermatological advice

 

01.04.01 Methylcellulose Celevac®

Methylcellulose 500mg tablets

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

 

 

02.05.02 Methyldopa 

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

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

01.06.06 Methylnaltrexone 

12mg/0.6ml solution for injection vials

Restriction: Palliative care use only

04.04 Methylphenidate hydrochloride 

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.

Medicines for children leaflet: Methylphenidate for ADHD

Link to ESCA

06.03.02 Methylprednisolone 

Methylprednisolone Tablets 2mg (Medrone)
Methylprednisolone Tablets 4mg (Medrone)
Methylprednisolone Tablets 16mg (Medrone)
Methylprednisolone Tablets 100mg (Medrone)

Methylprednisolone Sodium Succinate Injection 40mg/ml Vial (Solu-Medrone)
Methylprednisolone Sodium Succinate Injection 500mg/8ml Vial (Solu-Medrone)
Methylprednisolone Sodium Succinate Injection 1g/16ml Vial (Solu-Medrone)

Methylprednisolone Acetate Susp for Injection 40mg/ml Vial (Depo-Medrone)
Methylprednisolone Acetate Susp for Injection 80mg/2ml Vial (Depo-Medrone)

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

MHRA/CHM advice: Methylprednisolone injectable medicine containing lactose (Solu-Medrone® 40 mg): do not use in patients with cows’ milk allergy (October 2017)

10.01.02.02 Methylprednisolone acetate Depo-Medrone®

Depo-Medrone®- Methylprednisolone acetate 40mg/1ml suspension for injection vials (1ml, 2ml AND 3ml vial)

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

01.02 Metoclopramide 

Metoclopramide 10mg Tablets 
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 Hydrochloride 

Metoclopramide Hydrochloride Tablet 10mg
Metoclopramide Hydrochloride Injection 10mg/2ml Amps

Standard release preparations only

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

02.02.01 Metolazone 

Metolazone Tablet 2.5mg
Metolazone Tablet 5mg

Restriction: Initiation under direction of secondary care

Available from "special-order" manufacturers or specialist-importing companies.

02.04 Metoprolol Tartrate 

Metoprolol Tartrate Tablet 50mg 
Metoprolol Tartrate Tablet 100mg 

13.06 Metronidazole  Rozex®

1st line treatment for papulopustular rosacea

Metronidazole 0.75% cream or gel 

Acea®, Anabact®, Rozex® brands are more cost-effective. 

13.10.01.02 Metronidazole gel/ cream

Metronidazole 0.75% gel
Metronidazole 0.75% cream (more cost effective)

Acea®, Anabact®, Rozex® brands are more cost-effective. 

 

 

13.08.01 Metvix® Methyl-5-aminolevulinate cream

Metvix 160mg/g cream

06.07.03 Metyrapone Metopirone®

Metyrapone Capsules 250mg

  • Cushing's syndrome
  • Resistant oedema due to increased aldosterone secretion in cirrhosis, nephrotic syndrome, and congestive heart failure (with glucocorticoid replacement therapy) 
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 for VT

APC decision (August 2019): RAG rating change- reclassified as a Red drug (secondary care prescribing only).

12.03.02 Miconazole Daktarin®

Daktarin®miconazole 20mg/g oromucosal gel

MHRA advice: Topical miconazole, including oral gel: reminder of potential for serious interactions with warfarin.

Self Care 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.

13.10.02 Miconazole Daktarin®

Daktarin®- Miconazole 2% cream 30g

Self Care Self Care Medicine. Generic product is available to purchase from the pharmacy.

07.02.02 Miconazole nitrate Gyno-Daktarin®

Miconazole vaginal cream 2% 
Miconazole vaginal capsule 1200mg

Second line option where clotrimazole not tolerated or ineffective

07.03.01 Microgynon 30 ED® 

Monophasic

07.03.01 Microgynon 30® 

Monophasic

07.03.02 Micronor® Norethisterone

DISCONTINUED

Administration can be delayed for 3 hours without loss of contraceptive effect.

04.08.02 Midazolam buccal 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. For patients over 18 years of age, Buccolam may be used off-label.

08.01.05 Midostaurin Rydapt ®

Restriction: In line with NICE Guidance only

08.02.04 Mifamurtide Mepact®

Restriction: In line with NICE Guidance only

07.01.02 Mifepristone Mifegyne®

Mifepristone 200mg tablets

02.01.02 Milrinone 

Restriction: Anaesthetics and CICU only

07.03.04 Mini TT 380®Slimline 

Banded coil (Copper sleeves).

For minimum uterine length 5cm; replacement every 5 years.

07.04.02 Mirabegron Betmiga®

Mirabegron MR 25mg tablets 
Mirabegron MR 50mg tablets 

1st line where there is established cognitive impairment/risk factors for dementia, and 3rd line due to unacceptable anticholinergic side effects.

Restriction: In line with NICE Guidance only

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 Orodispersible Tablet 15mg 
Mirtazapine Orodispersible Tablet 30mg 
Mirtazapine Orodispersible Tablet 45mg 

01.03.04 Misoprostol 

Misoprostol 200mg tablet


For specialist initiation only

07.01.01 Misoprostol 

Mysodelle - Misprostol 200microgram vaginal delivery system (7mcg/hr)
Misoprostol 200microgram vaginal tablets
Topogyne - Misoprostol 400microgram tablets

MHRA/CHM advice: Misoprostol vaginal delivery system (Mysodelle®): reports of excessive uterine contractions (tachysystole) unresponsive to tocolytic treatment (February 2018)

04.04 Modafinil Provigil®

Modafinil Tablet 100mg
Modafinil Tablet 200mg

Restriction: Initiation by specialist

12.02.01 Mometasone furoate 

Mometasone furoate 50microgram/dose nasal spray

2nd line for the treatment and prophylaxis of allergic perennial rhinitis.
Recommendation: Licensed for the treatment of nasal polyps

 

03.03.02 Montelukast Singulair®

Montelukast 10mg Tablets
Montelukast 4mg Chewable Tablets SF
Montelukast 5mg Chewable Tablets SF
Montelukast 4mg Granules Sachets SF

 

MHRA advice (Sep 2019): Montelukast (Singulair): reminder of the risk of neuropsychiatric reactions

04.07.02 Morphine 

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 by brand to avoid medication errors. Zomorph is the preferred cost-effective brand of MR Morphine [12 hourly formulation] (Applicable in Primary care only).

03.09.01 Morphine Hydrochloride 

Restriction: Palliative Care only

04.07.02 Morphine Sulfate - Oral Solution 

Morphine Sulfate Oral Solution 10mg/5ml (POM)
Morphine Sulfate Oral Solution 20mg/1ml (Controlled Drug)

01.06.05 Moviprep® 

Macrogol oral powder sachet

2nd line

13.10.01.01 Mupirocin 2% Bactroban®

Bactroban®- Mupirocin 2% cream 15g
Bactroban®- Mupirocin 2% ointment 15g

Restriction: On specialist advice for the treatment of MRSA minor skin infection

 

08.02.01 Mycophenolate Mofetil 

Mycophenolate mofetil 250mg capsules
Mycophenolate mofetil 500mg tablets
Mycophenolate mofetil 200mg per 1ml oral suspension

MHRA/CHM advice: Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients (February 2018)

Link to ESCA (for renal transplant pts)

08.02.01 Mycophenolate Mofetil 

All post-transplant immunosuppressants are RED for patients newly prescribed these medicines from April 2013

Mycophenolate mofetil 250mg capsules
Mycophenolate mofetil 500mg tablets
Mycophenolate mofetil 200mg per 1ml oral suspension

MHRA/CHM advice: Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients (February 2018)

 

 

10.01.03 Mycophenolate mofetil 

Mycophenolate mofetil 250mg capsules
Mycophenolate mofetil 500mg tablets
Mycophenolate mofetil 200mg per 1ml oral suspension

MHRA/CHM advice: Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients (February 2018)

Link to ESCA (for rheumatology pts)

13.02.01 Myribase®gel 

Rich Cream (equivalent to Doublebase®)

2nd Line

Pack size 100g, 500g

10.01.01 Nabumetone 

Nabumetone 500mg tablets

 

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less).

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.

06.07.02 Nafarelin Synarel®

Nafarelin Nasal Spray 200mcg/dose 

Restriction: Initiation under direction of a specialist

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

02.06.04 Naftidrofuryl Oxalate 

Naftidrofuryl Oxalate Capsule 100mg

Restriction: In line with NICE Guidance

Cilostazol, pentoxifylline and inositol nicotinate are not recommended for the treatment of intermittent claudication in people with peripheral arterial disease. NICE TA 223 

04.10.01 Nalmefene 

Restriction: In line with NICE Guidance only

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

Note: Not to be prescribed in hospital

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
  • Stoke-on-Trent CCG – North Staffordshire Combined Healthcare – Community drug and alcohol service (CDAS) - Link to website
01.06.06 Naloxegol Moventig®

12.5mg tablets
25mg tablets

For treating opioid-induced constipation.

Restriction: In line with NICE Guidance only

04.10.03 Naltrexone Nalorex®

Naltrexone Tablets 50mg

Restriction: Initiation by substance abuse unit only

10.01.01 Naproxen 

Naproxen 250mg tablets
Naproxen 500mg tablets

Standard release preparations only

 

12.02.03 Naseptin® Chlorhexidine hydrochloride with neomycin sulfate

Naseptin®- Chlorhexidine hydrochloride 0.1%/neomycin sulfate 0.5% nasal cream

Restriction: For eradication or suppression of nasal carriage of staphylococci, if staphylococcus is resistant to mupirocin or patient allergic to mupirocin

Contains arachis (peanut) oil so should not be used in patients with a peanut allergy. Patients with soya allergy should also avoid Naseptin®

08.02.04 Natalizumab Tysabri®

Restriction: In line with NICE Guidance only

02.04 Nebivolol 

Nebivolol 2.5mg tablet (more cost-effective to use half a 5mg tablet)
Nebivolol 5mg tablet

Restriction: For patients who cannot tolerate Bisoprolol for heart failure

Does not offer any additional benefit over established beta blockers that are available at a lower aquisition cost.

04.07.01 Nefopam Hydrochloride  Acupan®

Nefopam Hydrochloride Tablets 30mg 

Restriction: Initiation only if recommended by specialist

11.03.01 Neomycin  As Neosporin®

Neosporin® contains gramicidin and polymyxin B

(Neomycin Sulfate, (equivalent to 1.75 mg neomycin base), Polymyxin B Sulfate equal to 10,000 Polymyxin B units, Gramicidin, 0.025 mg)

10.02.01 Neostigmine  

Neostigmine bromide 15mg tablets 
Neostigmine metilsulfate 2.5mg/1ml solution for injection ampoules (Hospital only)

11.08.02 Nepafenac  Nevanac®

Nepafenac 1mg/ml eye drops
Nepafenac 3mg/ml eye drops

Restriction: Reduction of postoperative macular oedema associated with cataract surgery in diabetic patients, previous uveitis, vein occlusions and complicated surgery

08.03.04.01 Neratinib Nerlynx®

Restriction: In line with NICE Guidance only

02.06.03 Nicorandil 

Nicorandil Tablet 10mg 
Nicorandil Tablet 20mg 

MHRA advice on Nicorandil (Ikorel): now second-line treatment for angina- risk of ulcer complications (January 2016)

09.06.02 Nicotinamide 

Nicotinamide 500mg Tablets (unlicensed)

04.10.02 Nicotine replacement therapy 

1st line for smoking cessation.

Restriction: As part of a smoking cessation programme or during inpatient stay only.

Nicotine replacement therapy is funded by Public Health. 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 – out of stock until 2021.

*Bayer is the main supplier of these products. 

See UKMI memo below on treatment alternatives.

08.01.05 Nilotinib Tasigna®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice (May 2016): Risk of hepatitis B virus reactivation with tyrosine kinase inhibitors

02.06.02 Nimodipine Nimotop®

Nimodipine 30mg tablets

Restriction: For subarachnoid haemorrhage

08.01.05 Nintedanib esilate 

Restriction: In line with NICE Guidance only

08.01.05 Niraparib Zejula®

Restriction: In line with NICE Guidance only

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- HCD Significantly expensive item (Applicable in Primary care only)

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 (NICE NG109, Oct 2018). 

08.01.05 Nivolumab Opdivo®

Restriction: In line with NICE Guidance only

 

MHRA advice (Oct 2019): Nivolumab (Opdivo): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation

02.07.02 Noradrenaline / Norepinephrine 

Solution for infusion ampoules/ vials

06.04.01.02 Norethisterone 

Norethisterone Tablets 5mg 

07.03.02 Norgeston® Levonorgestrel 30 microgam

Administration can be delayed for 3 hours without loss of contraceptive effect.

07.03.02 Noriday® Norethisterone 350 microgram

Administration can be delayed for 3 hours without loss of contraceptive effect

Suitable alternative to discontinued Micronor

07.03.01 Norimin® 

Monophasic

 

07.03.01 Norinyl-1® 

Monophasic

High strength oestrogen pill - suitable for women taking liver enzyme-inducing drugs.

Recommendation: - Second Line due to increased risk of thromboembolism.

 

07.03.04 Nova-T® 380 

Not banded (copper in stem only) coil.

For uterine length 6.5-9cm; replacement every 5 years.

04.07.04.01 NSAIDs 

Ibuprofen Tablets 200mg
Ibuprofen Tablets 400mg
Ibuprofen Tablets 600mg
Ibuprofen 100mg/5ml Oral Solution SF

Naproxen Tablets 250mg
Naproxen Tablets 500mg

Recommendation for NSAIDs: As per Anti-Migraine Prescribing Guide

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less). Use lowest effective dose and the shortest duration of treatment necessary to control symptoms.


Self Care Self Care Medicine- Available OTC for Self-care (Ibuprofen only)

10.02 Nusinersen Spinraza ®

Restriction: In line with NICE Guidance only

 

A2.05.02 Nutilis Clear Nutilis®

175g tin (ACBS)

This is the North Staffordshire's preferred thickener of choice.


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.

09.04 Nutricrem 

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

07.02.02 Nystatin 

CREAM DISCONTINUED

Currently available in combination as Nystatin 100,000 units/g with Chlorhexidine Hydrochloride 1% cream

12.03.02 Nystatin oral suspension

Nystatin 100,000unit/ml oral suspension

13.10.02 Nystatin cream

Nystatin cream discontinued in UK 2008

An alternative product is Nystatin 100,000 units/g with Chlorhexidine Hydrochloride 1%, 30g or a similar product within the drug class.

01.09.01 Obeticholic acid 

Restriction: In line with NICE Guidance only Not approved for inclusion in the North Staffordshire Joint Formulary: UHNM is not commissioned to provide this treatment. All appropriate patients should be referred to a tertiary specialist commissioned centre. 

 

 

08.02.03 Obinutuzumab Gazyvaro®

Restriction: In line with NICE Guidance only

08.02.03 Ocrelizumab Ocrevus®

Restriction: In line with NICE Guidance only

11.08.02 Ocriplasmin Jetrea®

Restriction: In line with NICE Guidance only

08.03.04.03 Octreotide acetate 
  • Non NHS England indications i.e. palliative care

Octreotide acetate 50microgram per 1ml solution for injection ampoules
Octreotide acetate 50microgram per 1ml solution for injection pre-filled syringes

Octreotide acetate 100microgram per 1ml solution for injection ampoules
Octreotide acetate 100microgram per 1ml solution for injection pre-filled syringes

Octreotide acetate 500microgram per 1ml solution for injection ampoules
Octreotide acetate 500microgram per 1ml solution for injection pre-filled syringes

Octreotide acetate 1mg per 5ml solution for injection vials

Sandostatin® LAR 10mg powder and solvent for injection vials
Sandostatin® LAR 20mg powder and solvent for injection vials
Sandostatin® LAR 30mg powder and solvent for injection vials

08.03.04.03 Octreotide acetate 

Restriction: In accordance with NHS England prescribing policy

  • Acromegaly
  • Cancer indication
  • Congenital hyperinsulism

Octreotide acetate 50microgram per 1ml solution for injection ampoules

Octreotide acetate 50microgram per 1ml solution for injection ampoules
Octreotide acetate 50microgram per 1ml solution for injection pre-filled syringes

Octreotide acetate 100microgram per 1ml solution for injection ampoules
Octreotide acetate 100microgram per 1ml solution for injection pre-filled syringes

Octreotide acetate 500microgram per 1ml solution for injection ampoules
Octreotide acetate 500microgram per 1ml solution for injection pre-filled syringes

Octreotide acetate 1mg per 5ml solution for injection vials

Sandostatin® LAR 10mg powder and solvent for injection vials
Sandostatin® LAR 20mg powder and solvent for injection vials
Sandostatin® LAR 30mg powder and solvent for injection vials

07.02.01 Oestrogens, Topical 

Ovestin® cream (Estriol 1mg/g) is the preferred choice.
Estriol 0.01% cream
Vagifem®- Estradiol Vaginal Tablet 10mcg

08.02.03 Ofatumumab Arzerra®

Restriction: In line with NICE Guidance only

11.03.01 Ofloxacin  Exocin®

Ofloxacin 0.3% eye drops

04.02.01 Olanzapine 

Olanzapine Tablet 2.5mg 
Olanzapine Tablet 5mg 
Olanzapine Tablet 7.5mg
Olanzapine Tablet 10mg 
Olanzapine Tablet 15mg 
Olanzapine Tablet 20mg 
Olanzapine Orodispersible Tablet 5mg 
Olanzapine Orodispersible Tablet 10mg 
Olanzapine Orodispersible Tablet 15mg

Do not prescribe Oral Lyophilisates preparations -  Very Expensive-(Applicable in Primary care only)

04.02.02 Olanzapine embonate ZypAdhera®

Not approved for inclusion in the North Staffordshire Joint Formulary 

 

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®

Restriction: In line with NICE Guidance only

 

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 Drops

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

02.12 Omacor® 

Not approved for inclusion in the North Staffordshire Joint Formulary 

 
NHS England Guidance for CCGs:

 prescribers in primary care should not initiate omega-3 Fatty Acids for any new patient.
 prescribers should be supported in deprescribing omega-3 Fatty Acids in all patients and, where appropriate, ensure the availability of relevant services to facilitate this change.

05.03.03.02 Ombitasvir, paritaprevir & ritonavir Viekirax®

Ombitasvir, paritaprevir & ritonavir Tablets 12.5/75/50mg

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policy
This is an NHS England Specialised Commissioning Drug for Hepatitis C

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

1st line PPI (except for MUPs)

04.06 Ondansetron 

Ondansetron (as Ondansetron hydrochloride) Tablets 4mg
Ondansetron (as Ondansetron hydrochloride) Tablets 8mg
Ondansetron (as Ondansetron hydrochloride) Injection 4mg/2ml Amps
Ondansetron Orodispersible film 4mg (Prescribe as Setofilm®)
Ondansetron Orodispersible film 8mg (Prescribe as Setofilm®)

1st Line in secondary care

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®.

MHRA advice: Ondansetron- small increased risk of oral clefts following use in the first 12 weeks of pregnancy (Jan 2020)

04.09.01 Opicapone Ongentys®

Opicapone Capsules 50mg

Restriction: To be used where entacapone is contraindicated, poorly tolerated or poorly effective.

To be initiated only by a Consultant Neurologist or Parkinson’s Disease Nurse.

09.02.01.02 Oral Rehydration Salts Dioralyte®

Dioralyte®oral powder sachets blackcurrant
Dioralyte®oral powder sachets citrus
Dioralyte®oral powder sachets plain

 

Reconstitute 1 sachet with 200mL of water (freshly boiled and cooled for infants); 5 sachets reconstituted with 1 litre of water provide Na+ 60 mmol, K+ 20 mmol, Cl60 mmol, citrate 10 mmol, and glucose 90 mmol.

04.05.01 Orlistat 

Orlistat Capsule 120mg

Restriction: As part of weight reduction programme only

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

04.09.02 Orphenadrine 

Orphenadrine Oral Solution 50mg/5ml SF

05.03.04 Oseltamivir Tamiflu®

Oseltamivir Phosphate Capsules 30mg 
Oseltamivir Phosphate Capsules 45mg 
Oseltamivir Phosphate Capsules 75mg
Oseltamivir Phosphate Oral Suspension 6mg/ml

Only to be prescribed on the recommendation of Public Health England

Restriction: In line with NICE Guidance

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 who can start treatment within 48 hours of the onset of symptoms.

08.01.05 Osimertinib Tagrisso®

Restriction: In line with NICE Guidance only

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

Otrivine-Antistin®eye drops

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

07.03.01 Ovranette® 

Monophasic

07.03.01 Ovysmen® 

Monophasic

08.01.05 Oxaliplatin 

Restriction: In line with NICE Guidance only

04.08.01 Oxcarbazepine Trileptal®

Oxcarbazepine 150mg Film-coated Tablets
Oxcarbazepine 300mg Film-coated Tablets
Oxcarbazepine 600mg Film-coated Tablets
Oxcarbazepine Oral Solution 60mg/ml

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

11.07 Oxybuprocaine hydrochloride Minims®

Minims Oxybuprocaine hydrochloride 0.4% eye drops (0.5ml unit doses)

 

07.04.02 Oxybutynin hydrochloride Immediate release

Oxybutynin hydrochloride Tablet 2.5mg
Oxybutynin hydrochloride Tablet 5mg

Oxybutynin hydrochloride 2.5mg/5ml oral solution sugar free
Oxybutynin hydrochloride 5mg/5ml oral solution sugar free

HCD Reserve liquid preparation for patients with swallowing difficulty as expensive.(Applicable in Priamry care)

07.04.02 Oxybutynin Hydrochloride Kentera®

Oxybutynin 3.9mg/24hours patch

Restriction: For women unable to tolerate oral medication

07.04.02 Oxybutynin Hydrochloride Lyrinel XL®

Lyrinel XL®5mg Tablet
Lyrinel XL®10mg Tablet

04.07.02 Oxycodone Hydrochloride Prescribe by brand

Shortec Capsule 5mg 
Shortec Capsule 10mg 
Shortec Capsule 20mg

Longtec Tablet 5mg M/R 
Longtec Tablet 10mg M/R 
Longtec Tablet 15mg M/R 
Longtec Tablet 20mg M/R 
Longtec Tablet 30mg M/R 
Longtec Tablet 40mg M/R 
Longtec Tablet 60mg M/R 
Longtec Tablet 80mg M/R
Longtec Tablet 120mg M/R

Oxycodone Hydrochloride Oral Solution 10mg/1ml S/F 
Oxycodone Hydrochloride 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).

Restriction: See NMC/APC Advice

APC/NMC Advice: Oxycodone February 2006
The NMC agreed that in patients who develop marked cognitive side effects from morphine, oxycodone is a useful alternative, and appears to be comparable in efficacy to morphine. Oxycodone should only be prescribed on the advice of the palliative care team, the chronic pain team, or via the UHNM Pain Clinic.

13.06.02 Oxytetracycline 

Oxytetracycline 250mg tablets

Alternative to doxycycline.

07.01.01 Oxytocin Syntocinon®

Oxytocin 5units/1ml solution for injection ampoules
Oxytocin 10units/1ml solution for injection ampoules

08.01.05 Paclitaxel 

Restriction: In line with NICE Guidance only

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

Restriction: For use in secondary care or by community CPN teams under direction of a psychiatrist.

N.B: Xeplion is the monthly depot injection; Trevicta is the three monthly depot injection. 

04.06 Palonosetron & netupitant Akynzeo®

Netupitant/ Palonosetron Capsules 300mg/0.5mg 

Restriction: For the prevention of nausea and vomiting in highly emetogenic chemotherapy regimens

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

Capsules

Counsel patient on need for adequate hydration

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® 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 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.

01.09.04 Pancreatin Creon® 10000

Capsules

Counsel patient on need for adequate hydration

08.01.05 Panitumumab Vectibix®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice: Severe skin reactions

MHRA/CHM advice: Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis (May 2012)

08.01.05 Panobinostat Farydak®

Restriction: In line with NICE Guidance only

04.07.01 Paracetamol 

Paracetamol Tablet 500mg 
Paracetamol Capsule 500mg - More Expensive than Tablets (Applicable in Primary care only)
Paracetamol Tablet Soluble 500mg - More Expensive than Tablets ( Applicable in Primary care only)
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

Oral & rectal preparations

04.07.04.01 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

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

04.07.01 Paracetamol & codeine Co-codamol 30/500

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 more cost-effective (Applicable in Primary care only).

Avoid effervescent tablets in patients needing salt-restricted diet. Reserve for patients with swallowing difficulties.

04.07.01 Paracetamol & codeine Co-codamol 8/500

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

Please note over the counter (OTC) sale is limited to MAX three days only. 

04.07.01 Paracetamol IV 

Paracetamol Solution for Infusion 1g/100ml vials

Restriction: Post-operative pain relief, paediatrics and ITU only

04.08.02 Paraldehyde 

Paraldehyde Injection 5ml - May be given rectally, not for parenteral use.
Paraldehyde Rectal solution (Pre-mixed 50:50 - 50% paraldehyde and 50% olive oil).

Unlicensed product.

 

09.06.07 Paravit-CF® 

Restriction: Supplementation of Vitamins A, D, E and K for paediatric and adult patients with cystic fibrosis.

Prescribing in primary care to commence once a letter from secondary care is received by the GP recommending that Paravit CF® is commenced, and also detailing which supplements Paravit CF® will be replacing.

Capsules or liquid available

04.03.03 Paroxetine 

Paroxetine (as Paroxetine Hydrochloride) Tablet 20mg 
Paroxetine (as Paroxetine Hydrochloride) Tablet 30mg 
Paroxetine (as Paroxetine Hydrochloride) Oral Suspension 10mg/5ml SF

Concern noted due to problems with discontinuation- Associated with a higher risk of withdrawal reactions

 

09.02.01.01 Patiromer calcium Veltassa®

Restriction: In line with NICE Guidance only

08.01.05 Pazopanib Votrient®

Restriction: In line with NICE Guidance only

08.01.05 Pegaspargase Oncaspar®

Restriction: In line with NICE Guidance only

08.02.04 Peginterferon Alfa Pegasys®

Restriction: In line with NICE Guidance only

08.02.04 Peginterferon Beta-1a Plegridy®

Restriction: In line with NICE Guidance only

08.01.05 Pembrolizumab Keytruda®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice: Pembrolizumab (Keytruda®): reports of organ transplant rejection (July 2017)

08.01.03 Pemetrexed disodium Alimta®

Restriction: In line with NICE Guidance only

09.08.01 Penicillamine 

Penicillamine 125mg tablets
Penicillamine 250mg tablets

Amber For Wilson's disease only (see seperate entry for rheumatoid arthritis)

10.01.03 Penicillamine 

Penicillamine 125mg tablets
Penicillamine 250mg tablets

Amber E For autoimmune rheumatic diseases

Link to ESCA

07.04.03 Pentosan polysulfate sodium Elmiron®

Elmiron 100mg capsules

Restriction: In line with NICE Guidance only

01.01.02 Peptac®Liquid Alternative to Gaviscon

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

Na+ content 3.1 mmol/5ml

 

 

04.08.01 Perampanel Fycompa®

Perampanel 2mg tablets
Perampanel 4mg tablets
Perampanel 6mg tablets
Perampanel 8mg tablets
Perampanel 10mg tablets
Perampanel 12mg tablets

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

All strengths priced the same so optimise dose for cost effective prescribing.(Applicable in Primary care only)

02.05.05.01 Perindopril erbumine  

Perindopril Erbumine Tablet 2mg 
Perindopril Erbumine Tablet 4mg 
Perindopril Erbumine Tablet 8mg 


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.

2nd line ACE inhibitor

13.10.04 Permethrin 

Permethrin 5% cream 30g

BNF designates Lyclear®1% creme rinse as less suitable for prescribing, thus do not prescribe.

Self Care Self Care Medicine. Available OTC for self care

 

08.01.05 Pertuzumab Perjeta®

Restriction: In line with NICE Guidance only

04.07.02 Pethidine Hydrochloride 

Pethidine Hydrochloride Tablets 50mg
Pethidine Hydrochloride Injection 50mg/1ml Amps
Pethidine Hydrochloride Injection 100mg/2ml Amps

04.03.02 Phenelzine Nardil®

Phenelzine Tablets 15mg

Restriction: Initiation by psychiatrist or GP with a special interest in Mental Health

02.08.02 Phenindione 

Phenindione 10mg tablets
Phenindione 25mg tablets
Phenindione 50mg tablets

For patients intolerant of warfarin 

MHRA/CHM advice: Direct-acting antivirals to treat chronic hepatitis C: risk of interaction with vitamin K antagonists and changes in INR (January 2017)

HCDHCD

04.08.01 Phenobarbital 

Phenobarbital Tablets 15mg
Phenobarbital Tablets 30mg
Phenobarbital Tablets 60mg
Phenobarbital Elixir 15mg/5ml

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

01.07.03 Phenol, Oily 

5% solution for injection

13.10.04 Phenothrin 

Full Marks® - Phenothrin 0.2% lotion (alcohol)
Full Marks® - Phenothrin 0.5% liquid (aqueous)
Full Marks® - Phenothrin 0.5% mousse (alcohol)

 

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

 

 

02.07.02 Phenylephrine 

Solution for injection ampoules/ pre-filled syringes

11.05 Phenylephrine hydrochloride Minims ®

Minims Phenylephrine hydrochloride 2.5% eye drops 0.5ml unit dose
Minims Phenylephrine hydrochloride 10% eye drops 0.5ml unit dose

04.08.01 Phenytoin 

Phenytoin Sodium Capsule 25mg 
Phenytoin Sodium Capsule 50mg  
Phenytoin Sodium Capsule 100mg
Phenytoin Sodium Capsule 300mg 
Phenytoin Sodium Chewable Tablets 50mg
Phenytoin Sodium Tablets 100mg
Phenytoin Oral Liquid 30mg/5ml

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

Additional Information June 2006:
Phenytoin 90mg in 15mL suspension may be considered approximately equivalent to capsules containing phenytoin sodium 100mg.

Phenytoin interacts significantly with NG feeds- please contact pharmacy for more information where necessary.

04.08.02 Phenytoin 

Phenytoin Injection 250mg/5ml Amps

NHS Improvement Patient Safety Alert: Risk of death and severe harm from error with injectable phenytoin (November 2016)

Use of injectable phenytoin is error-prone throughout the prescribing, preparation, administration and monitoring processes; all relevant staff should be made aware of appropriate guidance on the safe use of injectable phenytoin to reduce the risk of error.

 

03.09.01 Pholcodine Linctus, BP 

Limited clincial value for these products and patients may rather purchase these as OTC products.

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

01.06.04 Phosphates (Rectal) 

Fleet Ready-to-use Enema

09.05.02.01 Phosphate-Sandoz® 

Phosphate-Sandoz® Sodium dihydrogen phosphate anydrous 1.936gram effervescent tablets (phosphate 16.1mmol/tablet)

09.06.06 Phytomenadione Konakion®MM

Konakion®MM Phytomenadione 10mg per 1ml solution for injection ampoules (10mg/1ml)

Konakion®MM Paediatric phytomenadione 10mg per 1ml solution for injection ampoules (2mg/0.2ml). This strength is also licensed for oral use.

 

Oral use: For oral administration, oral dispensers are provided in the Konakion MM® paediatric pack. After breaking the ampoule open, 0.2 ml of solution should be withdrawn into the oral dispenser until it reaches the mark on the dispenser (0.2 ml = 2 mg vitamin K). Drop the contents of the dispenser directly into the patient's mouth by pressing the plunger.

13.08.01 Picato® Ingenol mebutate 150 or 500microgram/g gel

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.

01.06.05 Picolax ® 

Oral powder

1st line

12.03.05 Pilocarpine hydrochloride Salagen®

Pilocarpine hydrochloride 5mg tablets

Restriction: Consultant use only following irradiation for head and neck cancer.

Licensed for treatment of xerostomia following irradiation for head and neck cancer; dry mouth and dry eyes in Sjögren's syndrome. Discontinue if no improvement after 2–3 months.

11.06 Pilocarpine hydrochoride 

Pilocarpine hydrochoride 1% eye drops
Pilocarpine hydrochoride 2% eye drops
Pilocarpine hydrochoride 4% eye drops

13.05.03 Pimecrolimus Elidel®

Elidel®1% cream 30g, 60g, 100g

Restriction: Initiation only by physicians with a special interest and experience in dermatology

 

06.01.02.03 Pioglitazone Actos®

Pioglitazone Tablets 15mg
Pioglitazone Tablets 30mg
Pioglitazone Tablets 45mg

1st line thiazolidinedione

MHRA/CHM advice: Pioglitazone cardiovascular safety (December 2007 and January 2011)

EMA: Pioglitazone: risk of bladder cancer (July 2011)

03.11 Pirfenidone Esbriet®

Pirfenidone 267mg capsules, tablets
Pirfenidone 801mg tablets

Restriction: In line with NICE Guidance only

This is an NHS England Specialised Commissioning Drug for IDIOPATHIC PULMONARY FIBROSIS

08.01.02 Pixantrone dimaleate Pixuvri®

Restriction: In line with NICE Guidance only

09.06.04 Plenachol® Colecalciferol

HIGH DOSE BOOST

Plenachol®Colecalciferol 20,000unit capsules

09.01.07 Plerixafor Mozobil®

24mg/1.2ml solution for injection vials

Restriction: In accordance with NHS England prescribing policy

13.07 Podophyllotoxin 

Warticon® 0.15% cream 5g
Condyline® 0.5% solution 3.5ml
Warticon® 0.15% solution 3ml

A total of four 3-day treatment courses for Warticon® cream and solution, or five 3-day treatment courses for Condyline®. Direct medical supervision is required for lesions greater than 4 cm2.

 

09.02.01.01 Polystyrene Sulphonate Resins Calcium Resonium®

Calcium polystyrene sulfonate 999.34 mg per 1 gram

13.09 Polytar® 

Polytar®scalp shampoo 150ml

Contains peanut oil.

Self Care Self Care Medicine. Available OTC for self care

08.02.04 Pomalidomide Imnovid®

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.

MHRA/CHM advice (May 2016): Risk of hepatitis B reactivation

08.01.05 Ponatinib Iclusig®

Restriction: In line with NICE Guidance only

 

MHRA/CHM advice: Ponatinib: risk of vascular occlusive events—updated advice on possible dose reduction (updated April 2017)

MHRA/CHM advice: Risk of hepatitis B virus reactivation with BCR-ABL tyrosine kinase inhibitors (May 2016)

MHRA/CHM advice: Ponatinib (Iclusig®): reports of posterior reversible encephalopathy syndrome (October 2018)

03.05.02 Poractant Alfa Curosurf®

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised commissioning drug for RESPIRATORY DISTRESS SYNDROME.

09.02.01.01 Potassium chloride 

Sando-K® (potassium chloride 600mg and potassium bicarbonate 400mg) effervescent tablets

Kay-Cee-L® (potassium chloride) 75mg per 1ml syrup

Potassium chloride MR 600mg tablets (Slow K has been discontinued and the imported products of potassium chloride are costly)

 

07.04.03 Potassium citrate 

Effercitrate® tablets - equivalent to 5ml Potassium Citrate Mixture BP

Self Care Self Care Medicine-Available OTC for self care

(Please note exceptions may apply)

13.11.06 Potassium permanganate  Permitabs®

Potassium permanganate 400mg tablets for cutaneous solution 30 tablets

Caution - Not for Oral use and can be fatal if ingested orally.

1 tablet dissolved in 4 litres of water provides a 0.01% (1 in 10,000) solution for external use only.

11.08.02 Povidone iodine Minims®

Minims Povidone iodine 5% eye drops (0.4ml unit dose)

04.09.01 Pramipexole Prescribe MR prep by brand

Pramipexole 0.088 mg tablets
Pramipexole 0.18 mg tablets
Pramipexole 0.35 mg tablets
Pramipexole 0.70 mg tablets

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

Restriction: Initiation by specialist

Pipexus© is the preferred cost-effective MR Brand (Applicable in primary care). 

07.02.01 Prasterone (intravaginal) Intrarosa®
 Not approved for inclusion in the North Staffordshire Joint Formulary

 

02.09 Prasugrel Efient®

Prasugrel Tablet 5mg 
Prasugrel Tablet 10mg 

Restriction: For consultant cardiologist initiation only.

MHRA advice - Prasugrel (Efient): increased risk of bleeding (December 2014)

01.05.02 Prednisolone 

Prednisolone 1mg tablets

Prednisolone 5mg tablets

Where possible, please refrain from prescribing E/C tablets

06.03.02 Prednisolone 

Plain Tablets 1mg, 2.5mg and 5mg
Soluble Tablets 5mg
Oral Solution 5mg/5ml

Plain tablets preferable over E/C tablets. Reserve Oral solution for patients unable to swallow prednisolone tablets e.g. young children. Lower cost alternative to soluble tablets.

Glucocorticoid equivalent Prednisolone 5mg = Dexamethasone 0.75mg = Hydrocortisone 20mg

08.02.02 Prednisolone 

All post-transplant immunosuppressants are RED for patients newly prescribed these medicines from April 2013

Prednisolone 1mg tablets
Prednisolone 5mg tablets

10.01.02.01 Prednisolone 

Prednisolone 1mg tablets
Prednisolone 5mg tablets

11.04.01 Prednisolone  

Predsol®- Prednisolone sodium phosphate 0.5% ear/eye drops
Pred Forte®- Prednisolone acetate 1% eye drops
Minims Prednisolone sodium phosphate 0.5% ear/eye drops (0.5ml unit dose)

01.05.02 Prednisolone foam enema 

Restriction: For patients that cannot tolerate Colifoam®

Please note that is significantly more expensive than Colifoam® enema.
HCD 

 

12.01.01 Prednisolone sodium phosphate Predsol®

Predsol®- Prednisolone sodium phosphate 0.5% ear/eye drops

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

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

Restriction: 3rd line for neuropathic pain in line with the Non-Malignant Chronic Pain Guide

Restriction: 4th line for diabetic neuropathy in line with the Non-Malignant Chronic Pain Guide

For cost effective prescribing choose generic in non epileptic indications. Reserve the oral solution (100mg/5ml SF) for patients with swallowing difficulties ONLY as very expensive.(Applicable in Primary care only)

09.01.01.01 Pregaday® 

Ferrous fumarate 322mg/folic acid 350microgram tablets

04.08.01 Primidone 

Primidone Tablets 50mg 
Primidone Tablets 250mg

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

04.09.03 Primidone 

Primidone Tablets 50mg
Primidone Tablets 250mg

Restriction: Initiation by specialist

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 Tablets 5mg
Procyclidine Oral Solution 5mg/5ml SF

06.04.01.02 Progesterone 

Progesterone Capsule 100mg (For use in HRT)

 

Red Other Progesterone presentations are Specialist Use Only for fertility treatments, and will be provided in Fertility Clinics i.e.

  • Crinone 8% vaginal gel
  • Cyclogest 200mg and 400mg pessaries
  • Gestone 50mg/ml and 100mg/2ml solution for injection Amps
  • Lutigest 100mg vaginal tablets
  • Lubion 25mg/1.112ml solution for injection vials
  • Utrogestan 200mg vaginal capsules
04.02.01 Promazine Hydrochloride 

Promazine tablet 25mg
Promazine tablet 50mg
Promazine Oral solution 25mg/5ml 
Promazine Oral solution 50mg/5ml

03.04.01 Promethazine Hydrochloride Phenergan®

Promethazine Hydrochloride 10mg tablet
Promethazine Hydrochloride 25mg tablet
Promethazine Hydrochloride 5mg/5ml Oral solution SF

 

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

       

04.01.01 Promethazine Hydrochloride 

Promethazine Hydrochloride 10mg tablets
Promethazine Hydrochloride 25mg tablets
Promethazine Hydrochloride 5mg/5ml Elixir

04.06 Promethazine hydrochloride 

Promethazine Hydrochloride Tablets 10mg
Promethazine Hydrochloride Tablets 25mg
Promethazine Hydrochloride Elixir 5mg/5ml 
Promethazine Hydrochloride Injection 25mg/ml 1ml Amp

02.03.02 Propafenone Hydrochloride 

Propafenone Hydrochloride Tablet 150mg 
Propafenone Hydrochloride Tablet 300mg

Restriction: Initiation under direction of cardiologist

04.09.03 Propranolol 

Propranolol HCl Tablet 10mg 
Propranolol HCl Tablet 40mg
Propranolol HCl Tablet 80mg 
Propranolol HCl Tablet 160mg 
Propranolol MR Capsule 80mg
Propranolol MR Capsule 160mg
Propranolol Oral Solution 5mg/5ml
Propranolol Oral Solution 10mg/5ml
Propranolol Oral Solution 40mg/5ml
Propranolol Oral Solution 50mg/5ml

02.04 Propranolol Hydrochloride 

Propranolol Hydrochloride Tablet 10mg 
Propranolol Hydrochloride Tablet 40mg
Propranolol Hydrochloride Tablet 80mg 
Propranolol Hydrochloride Tablet 160mg 
Propranolol Hydrochloride MR Capsule 80mg
Propranolol Hydrochloride MR Capsule 160mg
Propranolol Hydrochloride Oral Solution 5mg/5ml
Propranolol Hydrochloride Oral Solution 10mg/5ml
Propranolol Hydrochloride Oral Solution 40mg/5ml
Propranolol Hydrochloride Oral Solution 50mg/5ml

Prescribe MR capsules generically as more cost-effective(Applicable in Primary care only)

04.01.02 Propranolol Hydrochloride 

Propranolol Hydrochloride 10mg tablets
Propranolol Hydrochloride 40mg tablets
Propranolol Hydrochloride 80mg tablets
Propranolol Hydrochloride 160mg tablets
Propranolol Hydrochloride Oral solution SF

04.07.04.02 Propranolol Hydrochloride 

Propranolol Hydrochloride Tablet 10mg 
Propranolol Hydrochloride Tablet 40mg
Propranolol Hydrochloride Tablet 80mg 
Propranolol Hydrochloride Tablet 160mg 
Propranolol Hydrochloride MR Capsule 80mg
Propranolol Hydrochloride MR Capsule 160mg
Propranolol Hydrochloride Oral Solution 5mg/5ml
Propranolol Hydrochloride Oral Solution 10mg/5ml
Propranolol Hydrochloride Oral Solution 40mg/5ml
Propranolol Hydrochloride Oral Solution 50mg/5ml

1st line
(As per Anti-Migraine Prescribing Guide)

06.02.02 Propylthiouracil 

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.

02.08.03 Protamine sulfate 

Protamine sulfate 50mg/5mL solution for injection ampoules

11.07 Proxymetacaine hydrochloride Minims®

Minims Proxymetacaine hydrochloride 0.5% eye drops (0.5ml unit doses)

01.06.07 Prucalopride Resolor®

Prucalopride Tablet 1mg
Prucalopride Tablet 2mg

Restriction: In line with NICE guidance only

Review 4 weeks after initiation to assess efficacy and discontinue if ineffective

10.02.01 Pyridostigmine bromide 

Pyridostigmine bromide 60mg tablets

09.06.02 Pyridoxine hydrochloride 

Pyridoxine hydrochloride 10mg tablets
Pyridoxine hydrochloride 20mg tablets
Pyridoxine hydrochloride 50mg tablets

 

Prolonged use of pyridoxine in a dose of 10 mg daily is considered safe but the long-term use of pyridoxine in a dose of 200  mg or more daily has been associated with neuropathy. The safety of long-term pyridoxine supplementation with doses above 10 mg daily has not been established.

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
Sondate XL Tablet 50mg 
Sondate XL tablet 150mg 
Sondate XL Tablet 200mg 
Sondate XL Tablet 300mg 
Sondate XL Tablet 400mg

THIRD CHOICE - If Sondate XL is unavailable
Biquelle XL Tablet 50mg 
Biquelle XL tablet 150mg 
Biquelle XL Tablet 200mg 
Biquelle XL Tablet 300mg 
Biquelle XL Tablet 400mg

Prescribers should choose the most cost-effective option (Applicable in Primary care only)

 

02.03.02 Quinidine 

Quinidine 200mg tablets
Quinidine 300mg tablets
Quinidine 250mg SR tablets

Restriction: Initiation under direction of cardiologist

10.02.02 Quinine sulfate 

Quinine sulfate 200mg tablets

In hospital, ONLY Quinine sulfate 300mg strength tablets is available

MHRA/CHM advice: reminder of dose-dependent QT-prolonging effects (November 2017)

06.06 Raloxifene hydrochloride Evista®

Raloxifene hydrochloride 60mg Tablets

3rd line for secondary prevention of osteoporotic fractures in postmenopausal women (Bisphosphonates are first line for osteoporosis).

02.05.05.01 Ramipril 

Ramipril Capsules 1.25mg 
Ramipril Capsules 2.5mg 
Ramipril Capsules  5mg 
Ramipril Capsules 10mg 
Ramipril Tablets 1.25mg 
Ramipril Tablets 2.5mg 
Ramipril Tablets 5mg 
Ramipril Tablets 10mg 
Ramipril Oral Solution 2.5mg/5ml 

1st line ACE inhibitor

11.08.02 Ranibizumab Lucentis®

Lucentis 1.65mg/0.165ml solution for injection pre-filled syringes
Lucentis 2.3mg/0.23ml solution for injection vials

Restriction: In line with NICE Guidance only

01.03.01 Ranitidine 

Ranitidine Hydrochloride Oral Solution 75mg/5ml S/F
Ranitidine Hydrochloride Tablet 150mg
Ranitidine Hydrochloride Tablet 300mg 

02.06.03 Ranolazine Ranexa®

Ranolazine Tablet 375mg M/R 
Ranolazine Tablet 500mg M/R 
Ranolazine Tablet 750mg M/R 

Restriction: To be initiated, titrated, and stabilised by cardiologists only

04.09.01 Rasagiline 

Rasagiline Tablets 1mg

Restriction: Initiation by specialist

08.01.05 Regorafenib Stivarga®

Restriction: In line with NICE Guidance only

09.06.07 Renavit® 

Renavit®tablets

Restriction: Only for use in renal failure patients undergoing dialysis

ACBS indication:
Dietary management of water-soluble vitamin deficiency in adults with renal failure on dialysis

06.01.02.03 Repaglinide Prandin®

Repaglinide Tablets 0.5mg
Repaglinide Tablets 1mg
Repaglinide Tablets 2mg

Alternative to a sulphonylurea when it is not tolerated or is inappropriate

03.04.02 Reslizumab Cinquil®

10mg/mL Solution for infusion vials

Restriction: In line with NICE Guidance only

This is an NHS England specialised commissioning drug for the treatment of severe eosinophilic asthma 

02.10.02 Reteplase Rapilysin®

Injection

Restriction: Cardiology and Anaesthetics only

04.08.01 Retigabine 

Retigabine Tablet 50mg
Retigabine Tablet 100mg
Retigabine Tablet 200mg 
Retigabine Tablet 300mg 
Retigabine Tablet 400mg

Discontinued June 2017. See manufacturer's note

Restriction: In line with NICE Guidance only

05.03.03.02 Ribavirin 

Ribavirin Tablets 200mg
Ribavirin Tablets 400mg
Ribavirin Capsules 200mg
Ribavirin Oral Solution 40mg/ml
Ribavirin Injection 1.2g/12ml vials

Restriction: In line with NICE Guidance
This is an NHS England Specialised Commissioning Drug for Hepatitis C

08.01.05 Ribociclib succinate Kisqali®

Restriction: In line with NICE Guidance only

05.01.07 Rifaximin Targaxan®

Rifaximin Tablets 550mg

Restriction: In line with NICE Guidance. To be initiated by a gastroenterologist only

Specialist use only for reduction in recurrence of hepatic encephalopathy

04.09.03 Riluzole Rilutek®

Riluzole Tablets 50mg

Restriction: Initiation by specialist

Neutropenia requires discontinuation of riluzole.

There is currently no ESCA developed for this drug

11.04.01 Rimexolone Vexol®

Rimexolone 1% opthalmic suspension

Restriction: 2nd line treatment when other topical corticosteroids have failed

Discontinued in 2016.
Opthalmology to consider Lotoprednol 0.5% eyedrops post-op in patients who have previously developed a disproportionate increase in intra ocular pressure when treated with traditional corticosteroids 

13.05.03 Risankizumab Skyrizi®

Restriction: In line with NICE guidance only

06.06.02 Risedronate 

Risedronate Tablets 5mg
Risedronate Tablets 30mg
Risedronate Tablets 35mg

2nd line for Osteoporosis and Paget’s disease

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

04.02.01 Risperidone 

Risperidone Tablet 500mcg
Risperidone Tablet 1mg 
Risperidone Tablet 2mg 
Risperidone Tablet 3mg 
Risperidone Tablet 4mg 
Risperidone Orodispersible Tablet 500mcg SF 
Risperidone Orodispersible Tablet 1mg SF 
Risperidone Orodispersible Tablet 2mg SF 
Risperidone Orodispersible Tablet 3mg SF 
Risperidone Orodispersible Tablet 4mg SF 
Risperidone Oral Solution 1mg/ml SF

Prescribe generically

See APC advice above (March 2010)

04.02.02 Risperidone Risperdal Consta®

Risperdal Consta® - Risperidone Powder for reconstitution 25mg vial
Risperdal Consta® - Risperidone Powder for reconstitution 37.5mg vial
Risperdal Consta® - Risperidone Powder for reconstitution 50mg vial 

Restriction: Initiation under direction of a psychiatrist

Risperidone depot preparation should not be confused with oral preparations (which is 'Amber' on the formulary).

08.02.03 Rituximab MabThera®, Rixathon®, Truxima®

Restriction: In line with NICE Guidance only

10.01.03 Rituximab MabThera®, Rixathon®, Truxima®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

 

Not routinely commissioned by NHS England for connective tissue disease (interstitial lung disease), primary Sjorgren's disease or chronic inflammatory demyelinating polyneuropathy except by prior IFR approval.

02.08.02 Rivaroxaban Xarelto®

Rivaroxaban Tablet 10mg 
Rivaroxaban Tablet 15mg 
Rivaroxaban Tablet 20mg

  • Prevention of stroke and systemic embolism in AF 
  • Treatment of DVT and prevention of recurrent DVT & PE 
  • Treatment of PE and prevention of recurrent VTE

Restriction: In line with NICE Guidance and locally agreed guidelines

MHRA/CHM advice: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome (June 2019)

MHRA/CHM advice: Rivaroxaban (Xarelto®): reminder that 15 mg and 20 mg tablets should be taken with food (July 2019)

02.08.02 Rivaroxaban Xarelto®

Rivaroxaban Tablet 2.5mg 

  • 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)

 

02.08.02 Rivaroxaban Xarelto®

Rivaroxaban Tablet 2.5mg 

  • Prevention of adverse outcomes after acute management of acute coronary   syndrome

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)

MHRA/CHM advice: Rivaroxaban (Xarelto®): reminder that 15 mg and 20 mg tablets should be taken with food (July 2019)

02.08.02 Rivaroxaban Xarelto®

Rivaroxaban Tablet 10mg 

Restriction: In line with NICE Guidance only. Orthopaedic consultant use only.

Complete course to be supplied by the hospital

04.11 Rivastigmine 

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.

04.07.04.01 Rizatriptan Maxalt®

Rizatriptan (as Rizatriptan benzoate) Orodispersible Tablets 10mg
Rizatriptan (as Rizatriptan benzoate) Tablets 5mg
Rizatriptan (as Rizatriptan benzoate) Tablets 10mg
Rizatriptan (as Rizatriptan benzoate) Oral Lyophilisates 10mg

4th line triptan
(As per Anti-Migraine Prescribing Guide)

13.08.01 RoC Sante Soleil® UVB

Prescriptions in primary care must be endorsed ‘ACBS’

RoC Sante Soleil®sun lotion SPF50 125ml

Not recommended for prescribing as not listed in the ACBS section of NHS Drug Tariff.

Self Care Self Care Medicine. Available OTC for self care

03.03.03 Roflumilast Daxas®

Roflumilast 250microgram tablets
Roflumilast 500microgram tablets

Restriction: Initiation and stabilisation by specialist in Respiratory Medicine in line with NICE Guidance

09.01.04 Romiplostim Nplate®

Restriction: In line with NICE Guidance only

04.09.01 Ropinirole 

Ropinirole Hydrochloride Tab 250mcg 
Ropinirole Hydrochloride Tab 500mcg
Ropinirole Hydrochloride Tab 1mg 
Ropinirole Hydrochloride Tab 2mg
Ropinirole Hydrochloride Tab 5mg

Ropinirole Hydrochloride Tab 2mg M/R 
Ropinirole Hydrochloride Tab 3mg M/R 
Ropinirole Hydrochloride Tab 4mg M/R 
Ropinirole Hydrochloride Tab 6mg M/R 
Ropinirole Hydrochloride Tab 8mg M/R  

Restriction: Initiation and stabilisation by specialist

Ippinia XL, Repinex XL or Spiroco XL are the preferred cost-effective MR brands (Applicable in primary care).

 

04.09.01 Rotigotine Neupro®

Neupro Patch 1mg/24hours
Neupro Patch 2mg/24hours
Neupro Patch 3mg/24hours
Neupro Patch 4mg/24hours
Neupro Patch 6mg/24hours
Neupro Patch 8mg/24hours

Restriction: Patients that are NBM or have swallowing difficulties.

Prescribing should be reviewed on discharge from secondary care

08.02.04 Rucaparib Rubraca®

Restriction: In line with NICE guidance only

08.01.05 Ruxolitinib phosphate Jakavi®

Restriction: In line with NICE Guidance only

03.01.01.01 Salbutamol 

1st line: Generic Pressurised Metered Dose Inhaler (pMDI)
2nd line: Easyhaler Dry Powder Inhaler 
Salbutamol Inhalation Solution 2.5mg/2.5ml Unit Dose Vial
Salbutamol Inhalation Solution 5mg/2.5ml Unit Dose Vial 

Short Acting Beta2 Adrenoreceptor Agonist
Indicated for Asthma and COPD.

13.05.02 Salicylic acid  

Salicylic acid 2% ointment BP

For the treatment of hyperkeratotic and scaling conditions such as psoriasis.

13.07 Salicylic acid 

Salatac® - Salicylic Acid 12% Gel
Salactol® - Salicylic Acid 16.7% with Lactic Acid 16.7% 
Verrugon® complete - Salicylic Acid Ointment 50% ointment 6g
Occlusal® - Salicylic Acid 26% solution 10ml

Self Care  Self Care Medicine. Available OTC for self care

 

 

12.03.05 Salivix ®Pastilles 

Salivix®pastilles

May be prescribed under ACBS for patients suffering from dry mouth as a result of having (or having undergone) radiotherapy, or sicca syndrome. 

Only useful in patients who have residual salivary gland function.

 

 

09.05.01.01 Sandocal®1000  

Calcium carbonate 1.75gram/calcium lactate gluconate 2.263gram effervescent tablets (Each tablet contains 1 g calcium (Ca2+ 25 mmol))

10.01.03 Sarilumab Kevzara®

Restriction: In line with NICE Guidance

09.04 Scandishake® Mix 

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

10.01.03 Secukinumab Cosentyx®

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

 

Not routinely commissioned by NHS England for paediatric indications except by prior IFR approval.

13.05.03 Secukinumab Cosentyx®

Restriction: In line with NICE Guidance only

04.09.01 Selegiline Hydrochloride 

Selegiline Tablets 5mg
Selegiline Tablets 10mg
Selegiline Oral Lyophilisates 1.25mg

Restriction: Initiation by specialist

Note: 1.25-mg oral lyophilisate is equivalent to 10-mg tablet.

13.09 Selsun® Selenium sulfide 2.5%

Selsun®- Selenium sulfide 2.5% shampoo 50ml,100ml,150ml

Self Care  Self Care Medicine. Available OTC for self care

06.01.02.03 Semaglutide Ozempic®

Ozempic 0.25mg/0.19mL Solution for injection 1.5mL pre-filled pens
Ozempic 0.5mg/0.37mL Solution for injection 1.5mL pre-filled pens
Ozempic 1mg/0.74mL Solution for injection 3mL pre-filled pens

Restriction: Treatment should be initiated by secondary care endocrinologists and transferred to primary care after six months as long as the patient has had a beneficial metabolic process, i.e. at least a 1% HbA1c reduction AND at least a 3% reduction in weight.

01.06.02 Senna 

Senna Oral Solution 7.5mg/5ml
Senna Tablet 7.5mg

- Syrup is currently more cost effective than tablets
- Time to effect approximately 8 to 12 hours

Available OTC and more expensive than Bisacodyl (Applicable in Primary care only)

04.03.03 Sertraline 

Sertraline (as Sertraline hydrochloride) Tablet 50mg
Sertraline (as Sertraline hydrochloride) Tablet 100mg 

09.05.02.02 Sevelamer  

For the treatment of Hyperphosphataemia

Sevelamer 800mg tablets
Sevelamer 2.4g oral sachets - HCD (reserve for patients with swallowing difficulties)

Commissioned by NHS England when used for adult renal dialysis

Link to ESCA

 

07.04.05 Sildenafil citrate 

Sildenafil citrate 25mg tablet
Sildenafil citrate 50mg tablet
Sildenafil citrate 100mg tablet

1st line for erectile dysfunction.

Generic sildenafil is no longer listed on the SLS restrictions list
Please note that restriction to Sildenafil NHS prescribing has been lifted for generic form (does not apply to branded Viagra® which is non-formulary). Healthcare professionals should no longer offer generic Sildenafil on a private prescription. 

13.07 Silver nitrate  Avoca®

Avoca®Silver nitrate 40% pencils
Avoca®Silver nitrate 75% applicators
Avoca®Silver nitrate 95% pencils
Avoca®Silver nitrate 95% applicators

13.10.01.01 Silver sulfadiazine Flamazine®

Flamazine®1% cream 20g,50g,250g,500g

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

11.06 Simbrinza® Brinzolamide 10mg/ml & brimonidine 2mg/ml

Simbrinza®- Brinzolamide 10mg/ml & brimonidine 2mg/ml eye drops

05.03.03.02 Simeprevir Olysio®

Simeprevir Capsules 150mg

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policy
NHS England commissioned

Simeprevir Discontinued

01.01.01 Simeticone Infacol®

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

03.09.02 Simple Linctus, BP 

Limited clincial value for these products and patients may rather purchase these as OTC products.

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

Use in accordance with locally agreed hyperlipidaemia guidelines

06.01.02.03 Sitagliptin Januvia®

Sitagliptin Tablets 25mg
Sitagliptin Tablets 50mg
Sitagliptin Tablets 100mg

10.01.03 Sodium aurothiomalate Myocrisin®

Myocrisin®Sodium aurothiomalate 20mg/1ml solution for injection ampoules
Myocrisin®Sodium aurothiomalate 100mg/1ml solution for injection ampoules 

 

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 

Sodium bicarbonate 500mg capsules

12.01.03 Sodium bicarbonate ear drops 

Sodium bicarbonate 5% ear drops

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

 

07.04.04 Sodium chloride  

Sodium chloride 0.9% Irrigation solution

09.02.01.02 Sodium chloride Slow Sodium®

Slow Sodium® (sodium chloride) MR 600mg tablets

Each Slow Sodium® tablet contains approximately 10 mmol each of Na+and Cl-; tablets can be crushed before administration.

13.11.01 Sodium chloride 0.9% 

Sodium chloride 0.9% 10mL Ampoules
Sodium chloride 0.9% 20mL Ampoules
Sodium chloride 0.9% 25mL Sachet (Normasol®)
Sodium chloride 0.9% 100mL Sachet (Normasol®)
Sodium chloride 0.9% Irrigation 1L

 

03.07 Sodium Chloride 3% and 6% nebuliser solution (Hypertonic) PulmoClear®

Not approved for inclusion in the North Staffordshire Joint Formulary

 

 

03.07 Sodium chloride 7% (Hypertonic) PulmoClear®

Nebulised solution

Restriction: For use in CF patients only, not in COPD.

01.06.04 Sodium Citrate (rectal) 

Micro-enema
Microlette®, Relaxit® and Micralax® 

06.06.02 Sodium Clodronate 

Sodium Clodronate Tablets 520mg
Sodium Clodronate Tablets 800mg 

Restriction: Initiation under direction of oncology/haematology only

For osteolytic lesions, hypercalcaemia and bone pain associated with skeletal metastases in breast cancer multiple myeloma.

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

 

11.04.02 Sodium cromoglicate 

Sodium cromoglicate 2% eye drops 

Self Care  Self Care Medicine - Available OTC for self-care, Patients should be advised to purchase a suitable product over the counter. First line for allergy symptoms.

12.02.01 Sodium cromoglicate Rynacrom®

Sodium cromoglicate 4% nasal spray (Unlicensed product)

 

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

 

 

09.05.03 Sodium fluoride 

Colgate Duraphat® 2800ppm Flouride toothpaste
Colgate Duraphat® 5000ppm Flouride toothpaste
Endekay® Sodium Fluoride Mouthwash 0.05% SF

 

Prescribing responsibility should be retained by dentists for most indications.

Rarely, prescription only tooth preparations may be prescribed in general practice on the recommendation of hospital specialists (e.g as part of a package of care for head and neck cancer) or following diagnosis of an oral condition that would benefit from this treatment

 

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

 

 

 

 

 

 

 

07.04.04 Sodium hyaluronate,Chondroitin in water with Calcium Chloride iAluRil®
Restriction: Not approved for inclusion in the North Staffordshire Joint Formulary.

 

 

02.05.01 Sodium nitroprusside 

Sodium nitroprusside 50mg powder and solvent for solution for infusion vials

Seek specialist advice prior to initiation.

02.13 Sodium tetradecyl sulfate 

Solution for Injection

04.07.04.02 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

2nd line
(As per Anti-Migraine Prescribing Guide)

Contraindicated in women of childbearing potential unless part of the Pregnancy Prevention Programme (MHRA, March 2018).

Women of Childbearing Potential: Educational Risk Minimisation Materials

Patient Card – to be given by pharmacists to all female patients who are dispensed valproate medicines to inform them of the risks

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.

 

Contraindicated in women of childbearing potential unless part of the Pregnancy Prevention Programme (MHRA, March 2018).

Women of Childbearing Potential: Educational Risk Minimisation Materials

Patient Card – to be given by pharmacists to all female patients who are dispensed valproate medicines to inform them of the risks

 

09.02.01.01 Sodium zirconium cyclosilicate Lokelma®

Restriction: In line with NICE Guidance only

05.03.03.02 Sofosbuvir Sovaldi®

Sofosbuvir Tablets 400mg

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policy
NHS England commissioned

05.03.03.02 Sofosbuvir & Velpatasvir Epclusa®

Sofosbuvir & Velpatasvir Tablets 400/100mg

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policy
This is an NHS England Specialised Commissioning Drug for Hepatitis C

 

05.03.03.02 Sofosbuvir, velpatasvir & voxilaprevir Vosevi®

Sofosbuvir, velpatasvir & voxilaprevir Tablets 400/100/100mg

Restriction: In line with NICE Guidance
NHS England commissioned

 

13.08.01 Solaraze® Diclofenac sodium in sodium hyaluronate gel

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.

07.04.02 Solifenacin Vesicare®

Solifenacin 5mg tablet
Solifenacin 10mg tablet

Very expensive choice

06.05.01 Somatropin 

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 small for gestational age (SGA).

The exception is Zomacton® which is unlicensed for use in chronic renal insufficiency and SGA. Also 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.

See BNF or manufacturer's SPC for appropriate device to be used with each preparation.

Restriction: Specialist use only. NICE approved patients only

Link to ESCA

08.01.05 Sorafenib tosylate Nexavar®

Restriction: In line with NICE Guidance only

02.03.02 Sotalol Hydrochloride 

Sotalol Hydrochloride Tablet 40mg
Sotalol Hydrochloride Tablet 80mg
Sotalol Hydrochloride Tablet 160mg

Restriction: Initiation under direction of cardiologist

13.08.01 SpectraBan® UVB

Prescriptions in primary care must be endorsed ‘ACBS’

SpectraBan®sunscreen 20g

Not recommended for prescribing as not listed in the ACBS section of NHS Drug Tariff.

Self Care Self Care Medicine. Available OTC for self care

02.02.03 Spironolactone 

Spironolactone Tablet 25mg
Spironolactone Tablet 50mg
Spironolactone Tablet 100mg

Monitor electrolytes—discontinue if hyperkalaemia occurs

09.06.04 Stexerol D3®  Colecalciferol

HIGH DOSE BOOST

Stexerol D3®Colecalciferol 25,000unit tablets 

02.10.02 Streptokinase Streptase®

Injection

01.03.03 Sucralfate 

Sucralfate 1g tablets

For Specialist Initiation Only

01.05.01 Sulfasalazine 

Sulfasalazine 500mg tablets (plain tablets)
Sufasalzine enteric coated tablets
Sulfasalazine 500mg Suppositories 
Sulfasalazine 250mg/5ml Suspension SF (ONLY for patients with swallowing difficulties)


Please note the plain tablets are more cost effective than enteric coated ones- (Applicable in Primary care only)

Link to ESCA

 

10.01.03 Sulfasalazine Salazopyrin EN-Tabs

Sulfasalazine gastro resistant 500mg tablets

Please note only the gastro resistant tablets are licensed for treatment of active rheumatoid arthritis.

Link to ESCA

 

04.02.01 Sulpiride Sulpor®

Sulpiride Tablets 200mg
Sulpiride Tablets 400mg  

04.07.04.01 Sumatriptan 

Sumatriptan (as Sumatriptan succinate) Tablet 100mg 
Sumatriptan (as Sumatriptan succinate)  Tablet 50mg 

1st line triptan.
(As per Anti-Migraine Prescribing Guide)

04.07.04.01 Sumatriptan nasal spray 

Sumatriptan Aq Nasal Spray 10mg/0.1ml Unit dose
Sumatriptan Aq Nasal Spray 20mg/0.1ml Unit dose

1st line triptan for young people 12-17 years 
(As per Anti-Migraine Prescribing Guide)

08.01.05 Sunitinib Sutent®

Restriction: In line with NICE Guidance only

07.03.01 Sunya 20/75® 

Monophasic

Low strength ethinylestradiol pill

Recommendation: - Second Line due to increased risk of thromboembolism

08.02.02 Tacrolimus 

All post-transplant immunosuppressants are RED for patients newly prescribed these medicines from April 2013

  • Prograf ®: immediate release capsule, twice daily dosage
  • Modigraf ®: immediate release formulation, twice daily dosage
  • Advagraf ®: prolonged release capsule, once daily dosage

Brands of other immediate release capsules taken twice daily include Adoport®, Capexion®, Tacni® and Vivadex®.

Switching between tacrolimus brands requires careful supervision and therapeutic monitoring by an appropriate specialist. Envarsus® is not interchangable with other oral Tacrolimus containing products.

 

MHRA/CHM advice: Oral tacrolimus products: prescribe and dispense by brand name only, to minimise the risk of inadvertent switching between products, which has been associated with reports of toxicity and graft rejection (June 2012)

08.02.02 Tacrolimus 
  • Prograf ®: immediate release capsule, twice daily dosage
  • Modigraf ®: immediate release formulation, twice daily dosage
  • Advagraf ®: prolonged release capsule, once daily dosage

Brands of other immediate release capsules taken twice daily include Adoport®, Capexion®, Tacni® and Vivadex®. 

Switching between tacrolimus brands requires careful supervision and therapeutic monitoring by an appropriate specialist. Envarsus® is not interchangable with other oral Tacrolimus containing products.

MHRA/CHM advice: Oral tacrolimus products: prescribe and dispense by brand name only, to minimise the risk of inadvertent switching between products, which has been associated with reports of toxicity and graft rejection (June 2012)

Link to ESCA

13.05.03 Tacrolimus Protopic®

Protopic®0.03% ointment 30g,60g
Protopic®0.1% ointment 30g,60g

Restriction: Initiation only by physicians with a special interest and experience in dermatology

 

11.06 Tafluprost with timolol Taptiqom®

1st line in patients who cannot tolerate a preservative-containing prostaglandin analogue/beta-blocker combination product

Taptiqom®- Tafluprost 15microgram/ml & Timolol 5mg/ml eye drops (0.3ml unit dose) - P/free

08.01.05 Talimogene laherparepvac Imlygic®

Restriction: In line with NICE Guidance only

08.03.04.01 Tamoxifen citrate 

Tamoxifen citrate 10mg tablets (rarely required and more expensive)
Tamoxifen citrate 20mg tablets
Tamoxifen citrate 10mg/5ml oral solution SF (reserve for patients with swallowing difficulties)

 

 

 

07.04.01 Tamsulosin hydrochoride 

Tamsulosin Hydrochloride MR 400microgram capsules

Prescribe as capsule formulation as more cost effective than tablets 

04.07.02 Tapentadol Palexia®

PALEXIA® SR 50 mg prolonged-release tablets
PALEXIA® SR 100 mg prolonged-release tablets
PALEXIA® SR 150 mg prolonged-release tablets
PALEXIA® SR 200 mg prolonged-release tablets
PALEXIA® SR 250 mg prolonged-release tablets

Restriction: Only to be used in line with the Non-Malignant Chronic Pain Guide

MHRA advice: Tapentadol (Palexia)- risk of seizures and reports of serotonin syndrome when co-administered with other medicines (Jan 2019)

08.01.03 Tegafur with Uracil Uftoral®

Restriction: In line with NICE Guidance only

 

Uftoral was discontinued by manufacturer (March 2013)

05.03.03.02 Telaprevir Incivo®

Telaprevir Tablets 375mg

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policy
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 

Temazepam 10mg tablets
Temazepam 20mg tablets

1st line benzodiazepine for short term treatment of insomnia

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 Temozolomide 

Restriction: In line with NICE Guidance only

 

This is a Specialised Drug which would not be routinely commissioned by CCGs for Endocrinology: non-malignant conditions. This would go through CCGs Individual Funding Request (IFR).

05.03.03.01 Tenofovir Disproxil Viread®

Tenofovir Disproxil Tablets 123mg
Tenofovir Disproxil Tablets 163mg
Tenofovir Disproxil Tablets 204mg
Tenofovir Disproxil Tablets 245mg
Tenofovir Disproxil Granules 33mg/g

Restriction: In line with NICE Guidance
This is an NHS England Specialised Commissioning Drug for Hepatitis B +/- other anti-retroviral drugs.

7.5 scoops of granules contains approx. 245 mg tenofovir disoproxil (as fumarate).

 

05.03.01 Tenofovir, cobicistat, elvitegravir & emtricitabine Stribild®

Stribild Tablets 150mg/150mg/200mg/245mg

Restriction: In accordance with NHS England prescribing policy

This is an NHS England Specialised Commissioning Drug for HIV in combination with other anti-retroviral drugs.

03.01.01.01 Terbutaline Sulfate 

Terbutaline Sulfate breath actuated Inhalation 500 micrograms/dose (100 dose)
Terbutaline turbohaler

Short Acting Beta2 Adrenoreceptor Agonist
Indicated for Asthma and COPD.

08.02.04 Teriflunomide Aubagio®

Restriction: In line with NICE Guidance only

06.06.01 Teriparatide Forsteo®

20mcg/80microlitres Solution for Injection 2.4ml pre-filled pen

Restriction: In line with NICE Guidance only

This is a Specialised Drug which would not be routinely commissioned by CCGs for Male and Juvenile Osteoporosis. This would go through the CCGs Individual Funding Request (IFR)

06.05.02 Terlipressin Glypressin®

1mg/8.5ml Solution for Injection Amps
1mg Powder and solvent for solution for injection vials

06.04.02 Testosterone  

Testosterone Implant 100mg (Organon) - unlicensed
Testosterone Undecanoate Injection 1g/4ml vial (Nebido)
Testosterone Injection 250mg/1ml Amp (Sustanon 250)

Restriction: Initiation under direction of a specialist (Injection and implants only)

04.09.03 Tetrabenazine Xenazine® 25

Tetrabenazine Tablets 12.5mg
Tetrabenazine Tablets 25mg

Restriction: Initiation by specialist

11.07 Tetracaine hydrochloride Minims®

Minims Tetracaine hydrochloride 0.5% eye drops (0.5ml unit doses) - P/free
Minims Tetracaine hydrochloride 1% eye drops (0.5ml unit doses) - P/free

06.05.01 Tetracosactide Synacthen®

Tetracosactide Acetate 250mcg/ml Solution for Injection Amp
Tetracosactide Acetate 1mg/ml Suspension for Injection Amp

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 

Brand must be stated

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) 

09.06.02 Thiamine 

Thiamine 50mg tablets
Thiamine 100mg tablets

 

 

 

 

09.06.04 Thorens® Colecalciferol

Maintenance dose (without calcium)

Thorens®Colecalciferol 10,000unit/ml drops (1 drop ≡ 200unit Colecalciferol)

 

 

02.09 Ticagrelor Brilique®

Ticagrelor Tablet 60mg
Ticagrelor Tablet 90mg
Ticagrelor Orodispersible tablets 90mg

Restriction: In line with NICE Guidance only

Ticagrelor can now be used up to a maximum of 3 years as per NICE TA420.
Duration needs to be specified by initiating specialist.

13.05.03 Tildrakizumab Ilumetri®

Restriction: In line with NICE Guidance only

11.06 Timolol maleate 

Timolol maleate 0.25% eye drops
Timolol maleate 0.5% eye drops
Timolol maleate 0.1% eye gel
Timolol maleate 0.5% eye gel (Timoptol-LA)
Timolol maleate 0.25% and 0.5% eye drops (0.2ml unit doses)- P/free

 

 

03.01.02 Tiotropium Spiriva®Respimat

Tiotropium 2.5 mcg/dose Respimat® device only

Long-Acting Antimuscarinic 
For use in Asthma only

03.01.02 Tiotropium Braltus®Zonda

Tiotropium 10 microgram per delivered dose (with Zonda Inhaler)

For use in COPD only

The delivered dose of Spiriva® and Braltus® inhalation powder products are the same (10 micrograms); no dose adjustment is necessary when switching between brands.

MHRA/CHM advice: Braltus® (tiotropium): risk of inhalation of capsule if placed in the mouthpiece of the inhaler (May 2018)

03.01.04 Tiotropium & 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)

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

For use in COPD only

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

08.01.05 Tisagenlecleucel Kymriah®

Restriction: In line with NICE guideline only

08.01.05 Tivozanib Fotivda®

Restriction: In line with NICE Guidance only

10.02.02 Tizanidine hydrochloride 

Tizanidine hydrochloride 2mg tablets
Tizanidine hydrochloride 4mg tablets - EXPENSIVE

Monitor liver function monthly for first 4 months and in those who develop unexplained nausea, anorexia or fatigue.

There is currently no ESCA developed for this drug

 

05.01.04 Tobramycin dry powder for inhalation Tobi® Podhaler

28mg Inhalation Powder Capsules with device

Restriction:

  • CF - In line with NICE Guidance. This is an NHS England Specialised Commissioning Drug for Cystic Fibrosis.

 

  • Non-CF Bronchiectasis - 2nd line only. Prior approval is required from CCG. Respiratory consultant prescription only
05.01.04 Tobramycin nebuliser solution 

300mg/5ml nebuliser liquid Amps

Restriction: Non-CF Bronchiectasis. 1st line

10.01.03 Tocilizumab RoActemra®

Restriction: In line with NICE Guidance 

Restriction: In accordance with NHS England prescribing policies

 

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

06.01.02.01 Tolbutamide 

Tolbutamide Tablets 500mg

07.04.02 Tolterodine 

Tolterodine 1mg Tablet 
Tolterodine 2mg Tablet

 

 

07.04.02 Tolterodine tartrate Modified release

Tolterodine MR 2mg capsule 
Tolterodine MR 4mg capsule

(prescribe as Neditol XL) 

 

06.05.02 Tolvaptan Jinarc®

Tablets 15mg
Tablets 30mg
Tablets 45mg
Tablets 60mg
Tablets 90mg

Restriction: In line with NICE guidelines
(For treating autosomal dominant polycystic kidney disease- Blueteq form needed for this indication only as CCG Commissioned)

This is an NHS England Specialised Commissioning Drug for Hyponatremia in Cancer.

04.07.04.02 Topiramate 

Topiramate Tabs 25mg
Topiramate Tabs 50mg
Topiramate Tabs 100mg 
Topiramate Tabs 200mg

1st line
(As per Anti-Migraine Prescribing Guide)

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.

08.01.05 Topotecan Hycamtin®

Restriction: In line with NICE Guidance only

08.01.05 Trabectedin Yondelis®

Restriction: In line with NICE Guidance only

04.07.02 Tramadol Hydrochloride 

Tramadol Capsules 50mg

Restriction: Only to be used in line with the Non-Malignant Chronic Pain Guide

More costly than other weak opioids(Applicable in Primary care only)

04.07.03 Tramadol Hydrochloride immediate release

Tramadol Capsules 50mg

Restriction: Only to be used in line with the Non-Malignant Chronic Pain Guide

More costly than other weak opioids (Applicable in Primary care only)

08.01.05 Trametinib Mekinist®

Restriction: In line with NICE Guidance only

02.11 Tranexamic Acid 

Tranexamic Acid 500mg tablet
Tranexamic Acid 500mg/5mL solution for injection ampoules

08.01.05 Trastuzumab 

Restriction: In line with NICE Guidance only

 

11.06 Travoprost 

Travoprost 40microgram/ml eye drops

04.03.01 Trazodone Hydrochloride 

Trazodone Capsules 50mg 
Trazodone Capsules 100mg
Trazodone Tablets 150mg

Note liquid preparation is expensive (Applicable in Priamary care only)

 

13.06.01 Tretinoin with clindamycin phosphate Treclin®

Topical retinoids and related preparations with antibacterial

Treclin®- Clindamycin phosphate 1% and tretinoin 0.025% gel 30g

13.06.01 Tretinoin with erythromycin Aknemycin® Plus

Topical retinoids and related preparations with antibacterial

Aknemycin®Plus - Tretinoin 0.025% and erythromycin 4.0% solution, 25ml

06.03.02 Triamcinolone Kenalog®

Triamcinolone Acetonide Susp for Injection 40mg/ml Vial
Triamcinolone Acetonide Susp for Injection 80mg/2ml Vial

10.01.02.02 Triamcinolone acetonide Adcortyl®

Adcortyl® - Intra-articular/Intradermal triamcinolone acetonide 10mg/1ml suspension for injection ampoules
Kenalog®  - Intra-articular/Intradermal triamcinolone acetonide 10mg/1ml suspension for injection vials

For doses below 5 mg use Adcortyl®; for larger doses greater than 15mg, use Kenalog®.

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

12.03.01 Triamcinolone Acetonide 0.1% in Adhesive Basis Adcortyl in Orabase®

DISCONTINUED

If prescribed, an unlicensed special will be dispensed at a high cost. 
Consider Hydrocortisone Buccal Tablets or Orabase protective paste 30g (which can be used in the mouth to provide a protective film over sore areas and ulcers).

13.11.05 Triclosan  

Triclosan 1% surgical scrub
Triclosan 2% (Ster-Zac Bath Concentrate®), 500ml

AQUASEPT DISCONTINUED

04.02.01 Trifluoperazine 

Trifluoperazine Tablets 1mg
Trifluoperazine Tablets 5mg
Trifluoperazine Oral solution 5mg/5ml SF

Standard release preparations only

08.01.05 Trifluridine-tipiracil Lonsurf®

Restriction: In line with NICE Guidance only

04.09.02 Trihexyphenidyl 

Trihexyphenidyl Tablets 2mg
Trihexyphenidyl Tablets 5mg

Not recommended for use in Parkinson’s disease because of toxicity in the elderly and the risk of aggravating dementia.

08.03.04.02 Triptorelin  

1st line

Decapeptyl SR (triptorelin acetate) 3mg vials - monthly
Decapeptyl SR (triptorelin) 11.25mg vials - three monthly
Decapeptyl SR (triptorelin embonate) 22.5mg vials - six monthly
Gonapeptyl Depot (triptorelin acetate) 3.75mg pre-filled syringes - monthly

 

In endometriosis do not use for longer than 6 months (do not repeat)

 

 

 

11.05 Tropicamide 

Mydriacyl®- Tropicamide 1% eye drops
Minims Tropicamide 0.5% eye drops 0.5ml unit dose
Minims Tropicamide 1% eye drops 0.5ml unit dose

07.04.02 Trospium chloride 

Trospium 20mg tablet

Good choice in patients taking other medicines, as does not affect CYP450 liver enzymes.

 

07.03.04 T-Safe® Cu 380A Quickload 

Recommendation: First line use

Banded coil (Copper sleeves)

For uterine length 6.5cm - 9cm; replacement every 10 years.

07.03.04 TT 380® Slimline 

Recommendation: First line use

Banded coil (Copper sleeves).

For uterine length 6.5cm – 9cm; replacement every 10 years.

07.03.05 Ulipristal EllaOne®

Ulipristal Acetate 30mg tablets

See APC/NMC recommendation

06.04.01.02 Ulipristal acetate Esmya®

Ulipristal acetate 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)

Manufacturer advises perform liver function tests before treatment initiation—do not initiate if transaminases exceed 2 times the upper limit of normal. During the first 2 treatment courses, monitor liver function monthly; for further treatment courses, perform liver function tests once before each new treatment course and when clinically indicated. At the end of each treatment course, perform liver function tests after 2–4 weeks. Discontinue treatment if serum transaminases exceed 3 times the upper limit of normal and closely monitor patient.

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

The formulary status of Esmya is now re-classified from 'Amber' to 'Red'.

03.01.02 Umeclidinium Incruse®Ellipta

Umeclidinium Bromide 65mcg/dose DPI
Incruse Ellipta 55mcg/dose DPI

Long-Acting Antimuscarinic 
For use in COPD ONLY.

03.01.04 Umeclidinium & 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.

For use in COPD only

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

02.10.02 Urokinase 

Injection

Can be used for the unblocking of central venous lines (See BNF/ SPC)

01.09.01 Ursodeoxycholic acid 

Ursodeoxycholic Acid Tablets 250mg - preferred option

Ursodeoxycholic Acid Capsules 250mg
Ursodeoxycholic Acid Suspension 250mg/5ml S/F
Ursodeoxycholic Acid Tablet 150mg
Ursodeoxycholic Acid Tablet 300mg 

500mg tablets are VERY EXPENSIVE - 250mg tablets are the preferred option as more cost effective( Applicable in Primary care only)

01.05.03 Ustekinumab Stelara®

Restriction: In line with NICE Guidance only

13.05.03 Ustekinumab Stelara®

Restriction: In line with NICE Guidance only

 

07.03.04 UT 380 Standard® 

Not banded (copper in stem only) coil.

For uterine length 6.5-9cm; replacement every 5 years.

13.08.01 Uvistat ® UVB

Prescriptions in primary care must be endorsed ‘ACBS’

Uvistat® suncream SPF 30 and 50 125ml
Uvistat® lipscreen SPF 50

Self Care  Self Care Medicine. Available OTC for self care

04.02.03 Valproic Acid Depakote®

Valproic Acid Tablet EC 250mg (As Semisodium Valproate)
Valproic Acid Tablet EC 500mg (As Semisodium Valproate)

Restriction: Initiation by psychiatrist

Contraindicated in women of childbearing potential unless part of the Pregnancy Prevention Programme (MHRA, March 2018).

Women of Childbearing Potential: Educational Risk Minimisation Materials

Patient Card – to be given by pharmacists to all female patients who are dispensed valproate medicines to inform them of the risks

04.10.02 Varenicline Champix®

Varenicline Tartrate Tablet 0.5mg 
Varenicline Tartrate Tablet 1mg
Varenicline Starter Pack (11 x 500mcg Tabs + 14 x 1mg Tabs)

2nd line for smoking cessation.

Restriction: As part of a smoking cessation programme only.

APC Advice: Varenicline (Champix®), revised May 2008.

  • Nicotine Replacement Therapy remains the pharmacological agent of choice for smoking cessation.
  • Consider varenicline or bupropion if NRT ineffective, not tolerated or inappropriate.
  • Only use as a component of a smoking cessation programme. 
  • Current evidence is insufficient to recommend an additional treatment course in those who have stopped smoking after the initial 12 weeks of therapy
06.05.02 Vasopressin Pitressin®

20units/ml Solution for Injection Amps

01.05.03 Vedolizumab 

Restriction: In line with NICE Guidance only

08.01.05 Vemurafenib Zelboraf®

Restriction: In line with NICE Guidance only

 

Drug rash with eosinophilia and systemic symptoms (DRESS syndrome)

MHRA/CHM advice (November 2015): Risk of potentiation of radiation toxicity

08.01.05 Venetoclax Venclyxto®

Restriction: In line with NICE Guidance only

04.03.04 Venlafaxine 

Venlafaxine Capsules 75mg 
Venlafaxine Capsules 75mg M/R
Venlafaxine Capsules 150mg M/R 
Venlafaxine Capsules 225mg M/R
Venlafaxine tablets 75mg M/R
Venlafaxine tablets 150mg M/R 
Venlafaxine tablets 225mg M/R

Restriction: 2nd line option after prior SSRI treatment

Vencarm XL is a cost-effective branded alternative to generic venlafaxine capsules. Venlalic XL is a cost-effective branded alternative to generic venlafaxine tablets (Applicable in primary care only).

 

02.03.02 Verapamil Hydrochloride 

Verapamil Hydrochloride Capsule 120mg M/R
Verapamil Hydrochloride Capsule 180mg M/R
Verapamil HydrochlorideCapsule 240mg M/R
Verapamil Hydrochloride Tablet 40mg
Verapamil Hydrochloride Tablet 80mg
Verapamil Hydrochloride Tablet 120mg
Verapamil HydrochlorideTablet 120mg M/R- Prescribe brand
Verapamil Hydrochloride Tablet 160mg
Verapamil Hydrochloride Tablet 240mg M/R- Prescribe brand

Restriction: Initiation under direction of cardiologist

02.06.02 Verapamil Hydrochloride 

Standard release tablets
Modified release formulations.

Securon SR tablets are cost-effective brands.

11.08.02 Verteporfin Visudyne®

15mg powder for solution for infusion vials

Restriction: In line with NICE Guidance only

 

04.08.01 Vigabatrin Sabril®

Vigabatrin Tablet 500mg 
Vigabatrin Powder Sachet 500mg S/F

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

09.06.07 Vitamin 

Vitamin capsules BPC (or equivalent)

Multivitamins may be prescribed in the NHS to prevent or treat deficiency but not as dietary supplements.

09.06.01 Vitamin A palmitate  

Retinol 50,000units/ml solution for injection vials (Unlicensed, Imported)

09.06.02 Vitamin B and C Pabrinex®

Pabrinex® Intramuscular High Potency solution for injection 5ml and 2ml ampoules
Pabrinex® Intravenous High Potency solution for injection 5ml and 5ml ampoules

 

MHRA advice: Pabrinex- allergic reactions (Dec 2014)

09.06.02 Vitamin B compound 

Vitamin B compound (nicotinamide 15mg/riboflavin 1mg/thiamine hydrochloride 1mg) tablets

HCD - Designated less suitable for prescribing in BNF and high cost. If indicated, consider Vitamin B Compound Strong tablets instead.(Applicable in Primary care only)

09.06.02 Vitamin B compound strong 

Vitamin B compound strong (nicotinamide 20mg/pyridoxine hydrochloride 2mg/riboflavin 2mg/thiamine hydrochloride 5mg) tablets

 

NICE no longer recommends vitamin B Co (strong) for patients with alcohol use disorders (NICE CG100). Clinicians should review use accordingly.

09.06.01 Vitamins A and D 

Vitamins A and D (vitamin A 4000unit/vitamin D 400unit) capsules BPC 1973

09.04 Vitasavoury® Soup 

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

04.03.03 Vortioxetine 

Vortioxetine 5mg Tablets
Vortioxetine 10mg Tablets
Vortioxetine 20mg Tablets

Restriction: In line with NICE Guidance

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 Tablet 1mg 
Warfarin Sodium Tablet 3mg 
Warfarin Sodium Tablet 5mg 

12.02.02 Xylometazoline hydrochloride 

Otrivine®- Xylometazoline hydrochloride 0.5% child nasal drops
Otrivine®- Xylometazoline hydrochloride 1% adult nasal drops
Xylometazoline hydrochloride 0.5% child nasal spray
Xylometazoline hydrochloride 1% adult nasal spray

CHM/MHRA advice: With intranasal use in children

The CHM/MHRA has stated that non-prescription cough and cold medicines containing  xylometazoline can be considered for up to 5 days’ treatment in children aged 6–12 years after basic principles of best care have been tried; these medicines should not be used in children under 6 years of age.

Maximum duration of 7 days to avoid rebound congestion.

Self Care Self Care Medicine- Available OTC for self-care as nasal spray 0.1%,nasal drops 0.05%(paediatric) and nasal drops 0.1%(adult).

 

 

 

01.07.02 Xyloproct ® 

Ointment

05.03.04 Zanamivir inhalation Relenza®

Zanamivir Powder For Inhalation 5mg blister + Diskhaler device

Only to be prescribed on the recommendation of Public Health England

Restriction: In line with NICE Guidance

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 who can start treatment within 48 hours of the onset of symptoms.

13.02.01 ZeroAQS®cream 

Light (low paraffin)

Can also be used as a soap substitute

Pack size 500g

09.05.04 Zinc sulfate Solvazinc®

Solvazinc®Zinc sulfate monohydrate 125mg effervescent tablets
(contains zinc sulfate monohydrate 125 mg (45 mg zinc))

Please note Valupak Zinc tablets 10mg are available as a food supplement and they are more cost effective but a much lower dose.

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

 

06.06.02 Zoledronic acid Aclasta®

5mg/100ml solution for infusion

Restriction: In line with NICE Guidance only

  • For Treatment of postmenopausal osteoporosis and osteoporosis in men (including corticosteroid-induced osteoporosis) in those for whom oral treatment options for osteoporosis are inappropriate and when initiated by a specialist. ONCE yearly administration.  Before first infusion give 50 000–125 000 units of vitamin D.

 

  • Also in treatment of Paget's disease of bone (at least 500 mg elemental calcium twice daily (with vitamin D) for at least 10 days is recommended following infusion).

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

06.06.02 Zoledronic acid  Zometa®

4mg/100ml Solution for infusion Vials

Restriction: For prevention of skeletal related events in adult patients with Myeloma

  • Reduction of bone damage in advanced malignancies involving bone (calcium 500 mg daily and vitamin D 400 units daily should also be taken).
  • Hypercalcaemia of malignancy

MHRA/CHM advice: Bisphosphonates: atypical femoral fractures (June 2011)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the jaw (November 2009) and Intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk (July 2015)

MHRA/CHM advice: Bisphosphonates: osteonecrosis of the external auditory canal (December 2015)

04.07.04.01 Zolmitriptan 

Zolmitriptan Orodispersible Tablets 2.5mg
Zolmitriptan Orodispersible Tablets 5mg
Zolmitriptan Tablets 2.5mg
Zolmitriptan Tablets 5mg

2nd line triptan. 
(As per Anti-Migraine Prescribing Guide)

NICE (CG150) recommends this for Menstrual-related Migraine. If this is not tolerated then consider Frovatriptan 2.5mg tablets instead (Unlicensed indication).

04.07.04.01 Zolmitriptan nasal spray Zomig®

Zolmitriptan 5mg/0.1ml Nasal Spray 0.1mg unit dose

Not for children under 18 years
(As per Anti-Migraine Prescribing Guide)

1 spray of Zomig® nasal spray = 5 mg zolmitriptan.

04.08.01 Zonisamide Zonegran®

Zonisamide 25mg capsules
Zonisamide 50mg capsules
Zonisamide 100mg capsules

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

04.01.01 Zopiclone Zimovane®

Zopiclone 3.75mg tablets
Zopiclone 7.5mg tablets

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).

04.02.01 Zuclopenthixol Clopixol®

Zuclopentixol Tablets 2mg
Zuclopentixol Tablets 10mg
Zuclopentixol Tablets 25mg

04.02.02 Zuclopenthixol acetate Clopixol-Acuphase®

Zuclopentixol Acetate injection 50mg/ml 1ml Amp

Restriction: Initiation under direction of a psychiatrist

Used for an acute episode only. Not to be confused with decanoate depot preparation.

04.02.02 Zuclopenthixol decanoate Clopixol®

Zuclopenthixol Decanoate Injection 200mg/ml 1ml Amp 
Zuclopenthixol Decanoate Injection 500mg/ml 1ml Amp 

Restriction: Initiation under direction of a psychiatrist

Used for maintenance treatments only. Not to be confused with acetate preparation used in the acute phase.

North Staffordshire Joint Formulary