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

Eylea 2mg/50microlitres solution for injection vials

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.

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

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.

Budesonide 2mg/dose foam enema

Steroid foam enemas are interchangable. Due to current stock issues with hydrocortisone (Colifoam), budesonide enema is the current preferred choice.

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).

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.

Buprenorphine sublingual Tablets 200mcg
Buprenorphine sublingual Tablets 400mcg 

Tablets only. Prescribe by brand

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

Restriction: In line with NICE Guidance only

Restriction: In line with NICE Guidance only

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

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)

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

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.

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

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)

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

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

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)

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

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)

Light with Antimicrobial Effect

Pack size 500ml

Self Care Medicine-Available OTC self care.

Creamy with Antimicrobial Effect

Pack size 100g, 500g

Self Care Medicine-Available OTC for self care.

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.

Desogestrel 75mcg tablets

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

Dexamethasone Tablets 500mcg
Dexamethasone Tablets 2mg

Dexamethasone Soluble tablets 2mg, 4mg and 8mg

Oral Solution 400mcg/1ml, 2mg/1ml and 4mg/1ml -  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.

Ozurdex® 700micrograms intravitreal implant

Restriction: In line with NICE Guidance only

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

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

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

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

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

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

Very potent

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

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.

Diltiazem Hydrochloride 60mg Tablet - 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).

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

Restriction: In line with NICE Guidance only

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.

Creamy (equivalent to Epaderm® Cream)

3rd Line

Pack size 50g, 500g

Self Care Medicine-Available OTC for self care.

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)

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

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

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

- Time to effect is approximately 24 to 48 hours 

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. 

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

50mg/5mL concentrate for solution for infusion

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

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


**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.

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

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)

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

Restriction: In line with NICE Guidance only

Light (low paraffin)

Pack size 50g, 125g, 500g

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)

Elbasvir & Grazoprevir Tablets 50/100mg

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

Restriction: In line with NICE Guidance

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

Very Greasy

Restriction: Under specialist advice only

Pack size 150ml, 240ml

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.

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

Entresto^® 24/26mg Tablet
Entresto^® 49/51mg Tablet
Entresto^® 97/103mg Tablet

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, titrated and dose stabilised by heart failure specialists ONLY (APC decision Nov 2019)

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

Creamy (equivalent to Epaderm® Cream)

1st line

Pack size 100g, 500g

Self Care Medicine-Available OTC for self care.

Eplerenone 25mg Tablet
Eplerenone 50mg Tablet

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

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

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)

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

Restriction: In line with NICE Guidance only

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

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.

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

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

Restriction: In line with NICE Guidance

Restriction: In accordance with NHS England prescribing policies

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

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)

Restriction: In line with NICE Guidance only

Exemestane 25mg tablets

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

Ezetimibe Tablet 10mg

Combined preparation with simvastatin (Inegy®) non-formulary

Use in accordance with locally agreed hyperlipidaemia guidelines

In line with NICE Guidance

Febuxostat 80mg tablets
Febuxostat 120mg tablets

Restriction: In line with NICE Guidance

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

Monophasic

Recommendation: - Second Line due to increased risk of thromboembolism

Monophasic

Low strength ethinylestradiol pill

Recommendation: - Second Line due to increased risk of thromboembolism

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.

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

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)

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

Fexofenadine Hydrochloride 120mg tablets
Fexofenadine Hydrochloride 180mg tablets

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

Creamy with Urea Content

For severe hyperkeratosis

Pack size 40g, 75g

Fludrocortisone acetate Tablets 100mcg 

Flumetasone pivalate 0.02%/clioquinol 1% ear drops

Locorten-vioform discontinued, thus generic prescribing please

Mild potency

Pack size 30g, 100g

Potent

Synalar®cream 50g
Synalar®ointment 50g

Topical corticosteroids with antimicrobials

Potent

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

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

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

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

Flutamide 250mg tablets

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

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

For use in Asthma only

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.

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®

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

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

  Self Care Medicine. Available OTC for self care

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

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

Fosfomycin 3g granules sachets.

Restriction: At the recommendation of microbiologist in line with proforma

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

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

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

Maintenance dose (without calcium)

Fultium D3^®Colecalciferol 800unit capsules

Fusidic acid 1% modified-release eye drops

Restriction: 2nd line to chloramphenicol
Only covers staphylococcal infections

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

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)

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

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

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

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

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

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 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)

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)

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

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

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

HIGH STRENGTH

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

(Long-acting insulin)