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

Unlicensed preparation

Restriction: To be initiated by a dermatology consultant

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

Restriction: In line with NICE guidance only

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

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

• Staffordshire CCG’s – Humankind - Staffordshire treatment and recovery service (STARS) – Link to website
• Stoke-on-Trent CCG – North Staffordshire Combined Healthcare – Community drug and alcohol service (CDAS) - Link to website

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

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).

Acipimox 250mg capsules

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.

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

For low or moderately thick hyperkeratotic actinic keratoses

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)

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)

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

Maintenance dose (with calcium)

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

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).

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

Restriction: In line with NICE Guidance only

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

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

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.

Restriction: In line with NICE Guidance only

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.

Almotriptan (as Almotriptan hydrogen malate) Tablets 12.5mg

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

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

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

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'. 

Injection

Restriction: In line with NICE Guidance only

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

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

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

Amantadine Capsules 100mg

Restriction: Initiation by specialist

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.

Brand must be stated

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

DISCONTINUATION (Feb 2021)
Phyllocontin® (aminophylline) Continus 225mg and Phyllocontin® Forte Continus 350mg modified-release tablets are being discontinued in the UK. Stocks will be exhaused by March 2021

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

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

Amlodipine 5mg Tablet
Amlodipine 10mg Tablet

Anagrelide hydrochloride 500microgram capsules

Link to ESCA

Anastrozole 1mg tablets

Anusol HC Ointment
Anusol HC Suppository

  Self Care Medicine-Available OTC for self care

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)

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.

Restriction: In line with NICE Guidance only

Creamy with Urea Content

Pack size 100g

Self Care Medicine-Available OTC for self care.

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

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

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

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).

Restriction: In line with NICE Guidance only

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

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

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'.

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance only

For the treatment of Inflammatory Bowel Disease [unlicensed indication]

Link to ESCA

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

Azathioprine 25mg tablets
Azathioprine 50mg tablets

For the treatment of Inflammatory Skin Disease [unlicensed indication]

Azathioprine 25mg tablets
Azathioprine 50mg tablets

Link to ESCA

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

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

 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

Creamy with Urea Content

Pack size 50g, 500g

Balsalazide 750mg Capsule

Restriction: For acute relapses of ulcerative colitis

Restriction: In line with NICE Guidance only

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.

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

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.

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)

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.

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

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

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

Betahistine Dihydrochloride  Tablet 8mg 
Betahistine Dihydrochloride  Tablet 16mg 

Scalp applications

Potent

Diprosalic®scalp application 100ml

Moderate potency

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

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.

Betamethasone sodium phosphate 0.1% eye/ear/nose drops

Scalp applications

Potent

Betacap®scalp application 100ml

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). 

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

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

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

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

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.

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

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance only

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

Restriction: Initiation by specialist only where alternative funding is secured

Monophasic

Brimonidine tartrate 0.2% eye drops

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

Restriction: In line with NICE Guidance only

Budenofalk 3mg gastro-resistant Capsule

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

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

Restriction: Nebuliser use only

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

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

Monitor Potassium Levels - Risk of Hypokalaemia 

2nd line if furosemide ineffective

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

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

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.

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).

Maintenance dose (with calcium)

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

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

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)

Calcitriol 250nanogram capsules
Calcitriol 500nanogram capsules

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

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

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

1st line angiotensin II antagonist

Restriction: In line with NICE Guidance only

Captopril 12.5mg Tablet
Captopril 25mg Tablet
Captopril 50mg Tablet

Restriction: Initiation by a Paediatrician

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

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)

Carboprost trometamol 250microgram/1ml solution for injection ampoules

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

Carteolol 1% eye drops
Carteolol 2% eye drops

DISCONTINUED 2017

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

Creamy (equivalent to Epaderm® Cream)

2nd Line

Pack size 150g, 500g 

Self Care Medicine-Avilable OTC self care.

Restriction: In line with NICE Guidance only

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)

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.

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

 Self Care Medicine-Available OTC for self care.

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

Bonjela^® Original gel

 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.

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)

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

Restriction: In line with NICE Guidance only

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

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

Restriction: In line with NICE Guidance

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. 

Clarithromycin 250mg tablets
Clarithromycin 500mg tablets

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.

 - Liquid Suspension

Scalp applications

Very potent

Dermovate®scalp application 30ml, 100ml

Moderate potency

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

Clomethiazole 192mg capsules

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

Standard release preparations only

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

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.

Clotrimazole 1% (cream, powder, solution)

 Self Care Medicine. Available OTC for self care

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)

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

For patients on multiple tablets only. 

Careful monitoring of U&Es is required.

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

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.

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

Restriction: Terminally ill patients only

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

Colestyramine 4g oral powder sachets sugar free

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

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.

Mucogel Suspension
Maalox Suspension

Magnesium hydroxide, dried aluminium hydroxide (low Na+)

Combination of aluminium and magnesium may reduce GI side effects.

 Self Care Medicine-Available OTC for self-care.

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

Restriction: In line with NICE Guidance only

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

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

Cyproterone acetate 50mg tablets
Cyproterone acetate 100mg tablets

Restriction: In line with NICE Guidance only

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

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)

Restriction: In line with NICE Guidance only

Solution for injection ampoules/ pre-filled syringes

In Obstetrics

Link to ESCA

Solution for injection ampoules/ pre-filled syringes

Treatment of DVT and PE in medical patients

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)

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)

Restriction: In line with NICE Guidance only

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

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance only

Demeclocycline hydrochloride 150mg Capsules 

Link to ESCA

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

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

500mg powder for solution for injection vials

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.

Maintenance dose (without calcium)

Desunin^®Colecalciferol 400unit tablets

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

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

Dexamfetamine Sulfate Tablet 5mg

Restriction: Initiation and stabilisation by specialist

Link to ESCA  (in production)

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).

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

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. 

Diethylstilbestrol 1mg tablets
Diethylstilbestrol 5mg tablets

Restriction: Consultant use only

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

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

Dihydrocodeine Tartrate Tablet 30mg 

Standard release preparations only

Restriction: In line with NICE Guidance only

Restriction: Named patient supply; requires consultant letter.

Unlicensed medicine
 

Restriction: In line with NICE Guidance only

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

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

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

Disopyramide 100mg Capsule
Disopyramide 150mg Capsule

Restriction: Initiation by cardiologist only

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.

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

Restriction: In line with NICE Guidance only

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

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

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

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.

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. 

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

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

IV infusion or injection

Restriction: In line with NICE Guidance only

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

Restriction: In line with NICE Guidance only

Dydrogesterone Tablets 10mg

Restriction: In line with NICE Guidance only

Restriction: In accordance with NHS England prescribing policy

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

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

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)

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)

Restriction: Anaesthetics and CICU only

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

Entacapone Tablet 200mg

Restriction: Initiation by specialist

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance only

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

CHM/MHRA advice: With intranasal use in children

Rich Cream (equivalent to Doublebase®)

1st line

Pack size 100g, 500g

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

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

Restriction: In line with NICE Guidance only

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)

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

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

Eslicarbazepine Tablets 200mg
Eslicarbazepine Tablets 800mg 

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

Etamsylate 500mg tablets

Unlicensed preparation. Available from special-order manufacturers.

Restriction: In line with NICE Guidance only

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

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

Pack size 30g, 100g

Self Care Medicine-Available OTC for self care.

Restriction: In line with NICE Guidance only

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

PRODUCT DISCONTINUATION

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

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

Restriction: Treatment should be initiated by a diabetes specialist clinician 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.

Light (low paraffin)

Pack size 50g, 500g

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

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

Monophasic

Recommendation: - Second Line due to increased risk of thromboembolism

DISCONTINUED 

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

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).

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).

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

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.

Finasteride Tablets 5mg

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

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

Flecainide Acetate 50mg Tablet
Flecainide Acetate 100mg Tablet

Restriction: Initiation under direction of cardiologist

Restriction: In line with NICE Guidance only

Moderate potency

Pack size 20cm

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

Iluvien® 190micrograms intravitreal implant

Restriction: In line with NICE Guidance only

Moderate potency

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

Scalp applications

Potent

Synalar®gel 30g

Topical corticosteroids with antimicrobials

Potent

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

Fluorometholone 0.1% opthalmic suspension

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

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)

Avamys^®- Fluticasone furoate 27.5microgram/dose nasal spray

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

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.

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

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

Solution for injection pre-filled syringes

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

Forceval^®capsules

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

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)

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

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

Restriction: In line with NICE Guidance only

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

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

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).

HIGH DOSE BOOST

Fultium D3^®Colecalciferol 20,000unit capsules

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

1st line loop diuretic

Monitor Potassium Levels - Risk of Hypokalaemia 

Fusidic acid cream 15g
Fusidic acid ointment 15g

Restriction: For acute impetigo, minor infections only

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

 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)

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).

Self Care Medicine-Available OTC for self-care.

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)

Gemeprost 1mg pessaries

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.

Gentamicin sulfate 0.3% ear/eye drops

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.

Glecaprevir & Pibrentasvir Tablets 100/40mg

Restriction: In line with NICE Guidance
NHS England Commissioned

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

40% gel (25g triple pack)

Glycerol Suppositories 4g Adult
Glycerol Suppositories 2g Children
Glycerol Suppositories 1g Infant

Self Care Medicine-Available OTC for self care.

Restriction: Only for regular use in place of IV

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

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

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

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

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.

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

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

Restriction: Initiation under direction of a specialist

Restriction: In line with NICE Guidance only

Restriction: Initiation by specialist

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.

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

Hyaluronidase 1,500unit powder for solution for injection ampoules

Standard release

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)

Topical corticosteroids with antimicrobials

Mild potency

Canesten HC®cream 30g

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

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)

Hydrocortisone acetate 1% & Gentamicin sulfate 0.3% ear drops

Note: more expensive

Hydrocortisone foam 10% aerosol

1st line rectal preparation

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

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 Medicine-Available OTC for self care.

Hydroxocobalamin 1mg/1ml solution for injection ampoules

Hydroxychloroquine sulfate 200mg tablets

(Rheumatology)

Link to ESCA

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

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

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

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)

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)

1st line NSAID

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

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

Restriction: In line with NICE Guidance only

Indomethacin 1mg vial

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

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance only