Vous êtes sur la page 1sur 194

North of Tyne Area Prescribing Committee

North of Tyne Formulary


Version 5.4 July 2014
This version of the North of Tyne Formulary shows the drugs included in the Drugs
and Preparations sections (1-15) plus a section on products used in the treatment of
poisoning (section 16).
This formulary lists the medicines and related pharmaceutical products that are
approved for use in the North of Tyne NHS area and includes indications as to
the first choice and alternative drugs,
those drugs that are classified as Red hospital only (R), those appropriate
for shared care Amber (A),
those products that are unlicensed, but have been approved for use in the
local health economy by the Area Prescribing Committee (APC)
This version of the document has been updated to include drugs that have been
approved for use up to the end of July 2014. Further updates will be made to take
account of feedback from users and decisions made by the APC and its Formulary
Subcommittee.
In the electronic version of this document most of the drug names are formatted as
hyperlinks to the BNF monograph to provide access prescribing and other information.
The formulary is supported by all of the NHS Trusts in Northumberland, North
Tyneside and Newcastle i.e.
Newcastle upon Tyne Hospitals NHS Foundation Trust
NHS Newcastle West Clinical Commissioning Group (NHS NWCCG)
NHS Newcastle North and East Clinical Commissioning Group (NHS NNECCG)
NHS North Tyneside Clinical Commissioning Group (NHS NTCCG)
Northumberland Tyne and Wear NHS Foundation Trust
NHS Northumberland Clinical Commissioning Group (NHS NCCG)
Northumbria Healthcare NHS Foundation Trust
Information in this document must not be used for promotional activities by the
pharmaceutical industry without permission.

Copyright
All rights reserved. No part of this document may be reproduced, stored in a retrieval
system or transmitted in any form or by any means, without permission.
North of Tyne Area Prescribing Committee 2014
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

Contents
Abbreviations

...................................................................................................................................

Contact Details
Introduction

................................................................................................................................

.....................................................................................................................................

Changes to formulary since previous version

Classified Details of Drugs and Preparations


1.

Gastro-intestinal System

....................................................................................................

2.

Cardiovascular System

.......................................................................................................

15

3.

Respiratory System

..............................................................................................................

29

4.

Central Nervous System

5.

Infections

6.

Endocrine System

7.

Obstetrics, Gynaecology and Urinary-Tract Disorders

8.

Malignant Disease and Immunosuppression

9.

Nutrition and Blood

....................................................................................................

35

.................................................................................................................................

55

.................................................................................................................
...........................................

78

.............................................................

85

..............................................................................................................

96

10. Musculoskeletal and Joint Diseases


11. Eye Diseases

...............................................................................

106

...........................................................................................................................

112

12. Ear, Nose and Oropharynx


13. Skin

66

...............................................................................................

120

............................................................................................................................................

125

14. Immunological Products and Vaccines


15. Anaesthesia

.........................................................................

138

.............................................................................................................................

142

16. Treatment of Poisoning

......................................................................................................

148

17. Enteral Nutrition (to be developed) ................................................................................

150

18. Wound Management Products..........................................................................................

151

Appendix

..................................................................................................................................

162

...................................................................................................................................................

166

Index

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

Caps
Disp
e/c
Eff
Inj
m/r
Microg
Sol
Suppose
Susp
Tabs

=
=
=
=
=
=
=
=
=
=
=

Capsules
Dispersible
Enteric coated
Effervescent
Injection
Modified release
Microgram
Solution
Suppositories
Suspension
Tablets

Abbreviations etc.

Some products are also marked with a suffix (es) to give additional information:
R

Red Drug (hospital only)

Amber Drug (shared Care)

Blue Drug (drugs which are initiated by specialists for which information sheets are
being developed to provide GPs with information to assist with prescribing etc.)

Green Drug Drugs that may be initiated in primary care only used with drugs
where there has been some debate as to whether they should be initially prescribed
by GPs

Specialist advice/ initiation- see comments next to each entry

Unlicensed

Restricted use (e.g. to a certain consultant or speciality, or in specific clinical


circumstances)

Abbreviations used to represent different hospitals/trusts/Committees


APC
NHCT
NTW
NUTH
NECS

North of Tyne Area Prescribing Committee


Northumbria Healthcare NHS Foundation Trust
Northumberland Tyne and Wear Trust
Newcastle upon Tyne Hospitals NHS Foundation Trust
North of England Commissioning Support

Contact Details
For enquiries and queries contact:
Matthew Lowery
Sarah Chandler
Matt Haggerty
Susan Turner

Newcastle upon Tyne Hospitals


NHS Foundation Trust
Northumbria Healthcare NHS
Foundation Trust
Northumberland, Tyne and
Wear NHS Foundation Trust
North of England
Commissioning Support

Tel: 0191 223 1386


Matthew.Lowery@nuth.nhs.uk
Tel: 0191 293 2729
Sarah.Chandler@nhct.nhs.uk
Tel: 0191 2232302
Matthew.Haggerty@ntw.nhs.uk
Tel: 0191 217 2762
Susanturner4@nhs.net

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

Introduction
The North of Tyne Formulary is produced under the auspices of the North of Tyne
Area Prescribing Committee (APC). It gives details of medicines that are approved for
use in NHS organisations in Newcastle, North Tyneside and Northumberland.
The range of medicines included in this formulary is intended to encourage safe,
effective and economical prescribing. Having a common range of medicines available
for use in the North of Tyne Area should help ensure seamless prescribing for patients
between general practice and hospital trusts, facilitating continuity of treatment and
minimising supply problems. It should also help those healthcare professionals that
work for more than one organisation in the local health economy.
Where appropriate the formulary gives information as to which drugs are regarded as
being the first choice and alternatives. It is not intended to be a comprehensive
prescribing guide or to replace the BNF or BNF for children. The drug names in the
electronic version are however formatted as hyperlinks to the BNF. As the formulary
develops, further links will be provided to North of Tyne Guidelines etc.
The formulary is a dynamic document that is updated regularly after each APC
meeting. The most up to date version of the formulary is maintained in electronic form
on the APCs Internet site:
http://www.northoftyneapc.nhs.uk/formulary/
An up to date version of the formulary may also be located on the individual Trusts
Intranet sites, thereby providing links to that Trusts locally adapted electronic version
of the BNF giving additional information and links e.g. to that Trusts policies and
guidelines. However, in most organisations this is still in development.
1. Notes on using the formulary
Medicines in the formulary are listed in chapters and subsections that generally
correspond with those in the BNF. Where possible drug names have been formatted
as hyperlinks to BNF monographs. This is to enable users to easily refer to the BNF for
information on doses, side effects, cautions, contraindications and drug interactions.
The Microsoft Word version of this document can also be navigated by using the
document map Click on View and then select document map.
Recommended International Non-proprietary Names (INNs) are used throughout the
text, but proprietary names are used for some combination and modified release
products, where brand name prescribing is recommended.
The cheapest available solid dosage form should be used when there are no
bioavailablity issues.
Products listed in the formulary are flagged to indicate if they are hospital only
products, suitable for shared care, are unlicensed or have been approved for an
unlicensed indication. Hospital doctors should not ask GPs to prescribe hospital only
medicines (Red drugs) unless there is a very exceptional reason and agreement with
the GP.
When prescribing unlicensed medicines it is important that prescribers are aware that
they are taking on additional responsibilities regarding the patients safety. Further
information and guidance can be obtained from individual Trust unlicensed medicines
policies.
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

2. NICE approved treatments


All NICE Technology Appraisals are automatically endorsed by the North of Tyne APC;
relevant medicines are incorporated into the formulary and are available for clinicians
to prescribe within 90 days of publication by NICE.
3. Requests for products to be included in the formulary
Requests for products to be added to the formulary have to be approved by the North
of Tyne Area Prescribing Committee.
Requests normally have to be made by a consultant, general practitioner or other
appropriate senior healthcare professional (e.g. optician, dentist, nurse, podiatrist,
dietician or pharmacist) and wherever possible the request should be submitted
electronically by email.
A copy of the New Product Request Form can be downloaded from the APCs Internet
site:
http://www.northoftyneapc.nhs.uk/formulary/
4. Use of Non-Formulary Medicines
GPs and other prescribers in primary care are strongly encouraged to prescribe
medicines that are included in the formulary.
The formulary is intended to be followed closely in hospitals. Consequently the
hospital pharmacies may not stock medicines that are not included in the formulary.
However it is recognised there are some circumstances where it will be necessary to
use a non-formulary medicine and individual trusts have their own procedures for
dealing with this. However, the following principles apply:
a) Initiating therapy with a Non-Formulary Medicine
In cases where it is considered that there is no formulary medicine appropriate for
treating an individual hospital patient, the consultant responsible for the patients care
should contact a senior pharmacist at the hospital where the patient is being treated.
The request will then need to be dealt with in accordance with the hospital trusts nonformulary request procedure, which may include completion of a non-formulary request
form.
In exceptional circumstances only, if a hospital doctor wishes a patients GP to
prescribe a non-formulary drug, then he/she should explain to the GP that the desired
treatment is not in the formulary and give the reason(s) why it is being requested
instead of a formulary medicine, e.g. if the patient has failed to tolerate or respond to
possible formulary alternatives.
b) Patients admitted to hospital on Non-Formulary medicines
The process for dealing with this issue varies between organisations, as it is largely
dependent on how patients own medicines are handled. Prescribers should familiarise
themselves with systems in their own organisation and act accordingly.
In the absence of a system for routinely using patients own medicines during hospital
stay, consideration should be given to changing to a formulary medicine where this is
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

practicable and not likely to be detrimental to the individual patients care. Where it is
not practicable to change the patients medication, a pharmacist should be contacted
so that appropriate arrangements for continuing the treatment can be made.
When therapy with a non-formulary drug is continued on admission, medication
brought into hospital by the patient may be used, provided that it is clearly labelled and
appears to be of good quality, in accordance with the hospital trusts policy.
4. Unlicensed Medicines and Use of Medicines for Unlicensed Indications
This formulary contains a number of unlicensed medicines, and medicines that have
been approved for unlicensed or off-label indications. Their inclusion has been agreed
after careful consideration of their benefits versus any known or perceived risks
associated with their use by the North of Tyne Area Prescribing Committee (APC) and
its Formulary Subcommittee. Many unlicensed medicines are formulations of well established drugs that are included the BNF, whereas others are products that are less
well known, but considered to be of benefit in the treatment of patients with conditions
where licensed medicines cannot be used or fail to produce an adequate response.
Unlicensed medicines included in the Formulary are marked using the suffix u and
those that are considered unsuitable for prescribing by GPs (even if treatment has
been started and stabilised by a hospital clinician) are classified as RED, or hospital
only, medicines.
When prescribing an unlicensed or a licensed product off-label for an unlicensed
indication it is important prescribers are aware that it is not only they who take on
additional responsibilities regarding the patients safety and welfare, but the burden is
shared with others involved in supply and administration.
Further information and guidance can be obtained from the GMC website
5. Prescribing of branded generic medicines
Branded generic preparations can be prescribed (where appropriate to do so e.g. on
cost grounds) without being specifically listed in the formulary.
This must be in accordance with the North of Tyne APC Guidance for the prescribing
of generic medicines.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

Changes to the Formulary since previous version


(Version 5.3 May 2014)
Section
Contact
details
1.6.2
2.5.1
3.4.3
4.6
4.7.2

5.3.3.2

6.1.2.3
8.2.3
8.2.4
10.1.3
13.2.1

Change

Reason for change

Contact details for respective trusts updated


Addition of sodium picosulfate elixir for paediatric
patients with constipation
Addition of macitentan for treatment of pulmonary
hypertension in adults
Addition of Emerade (adrenaline) for use in emergency
treatment of anaphylaxis
Addition of fosaprepitant for chemotherapy induced
nausea and vomiting
Addition of dihydrocodeine for use in breast feeding
mothers immediately post-delivery/c-section
Addition of sofosbuvir with either daclatastivir /
ledipasvir in combination with ribavirin for treatment of
chronic hepatitis C in line with NHS England Early
Access Programme
Addition of canagliflozin for use as combination
therapy treating type 2 diabetes
Addition of alemtuzumab for the treatment of active
relapsingremitting multiple sclerosis
Addition of NHS England Commissioning Policy for
fingolimod
Addition of approved indications, ankylosing
spondylitis and psoriatic arthritis, for certolizumab
pegol
Addition of Zerodouble gel as emollient

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

APC approval
NHS England SSC1425
APC approval
APC approval
APC approval
NHS England SSC1424
NICE TA315
NICE TA312
NHS England SC1426
APC approval
APC approval

1. Gastro-Intestinal System
1.1 Dyspepsia and Gastro-oesophageal Reflux Disease
1.1.1 Antacids and Dimeticone
1.1.1 - Plain Antacids
First Choice
Co-magaldrox 195/220
(Mucogel, Maalox)

Sugar-free suspension - 195mg magnesium


hydroxide & 220mg dried aluminium hydroxide in 5ml
-for indigestion.

Mucogel is cheaper than Maalox in the community

Sodium citrate 0.3 Molar solution


- used in obstetrics for prophylaxis of acid aspiration see
section 15.1.9

Infacol

Sugar-free- simeticone 40mg/m l- only approved for use in


endoscopy procedures.

1.1.1 - Antacids with Dimeticone


Co-simalcite125/500
(Altacite Plus)

Sugar-free suspension (activated dimeticone 125mg &


hydrotalcite 500mg in 5ml)

1.1.2 Compound Alginates and Proprietary Indigestion Preparations


Peptac

Sugar-free liquid (sodium alginate 500mg, sodium


bicarb. 267mg, calcium carb. 160mg in 10ml 6.2mmol sodium)

- preferred antacid for treating reflux. Use instead of Gaviscon

Infant Gaviscon

Oral sugar-free powder in dual sachets (sodium


alginate 225mg, magnesium alginate 87.5mg with
colloidal silica and mannitol sodium content
0.92mmol/dose)

- N.B. Each half of the dual-sachet is identified as one dose'. To

avoid errors prescribe as dual-sachet' with directions in terms of


dose'

1.1.3 - Antacid with Local Anaesthetic


Antacid with Oxetacaine s u

Sugar-free suspension (contains aluminium hydroxide


mixture 4.75ml, magnesium hydroxide 100mg and oxetacaine
[Oxethazaine] in 5ml)
- Used to relieve symptoms in patients who have had radiotherapy

and may be of value in some patients with acute oesophagitis. Not


for routine use as an antacid.

1.2 - Antispasmodics and Other Drugs Altering Gut Motility


Antimuscarinic (anticholinergic) Antispasmodics
First Choice
Dicycloverine (Dicyclomine)
Hyoscine Butylbromide

10mg tablets
10mg in 5ml syrup
20mg in 1ml injection

first Choice if injection needed 10mg tablets - poorly absorbed

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

Alternatives
Propantheline Bromide

15mg tablets

Atropine Sulphate

600 microgram tablets; 500 microgram in 5ml mixture u

Other Antispasmodics
Mebeverine

135mg tablets; 50mg in 5ml sugar-free liquid

Peppermint oil

0.2ml m/r, e/c capsules (Colpermin)

Motility stimulants
Domperidone
(also see section 4.6)

10mg tablets; 5mg in 5ml sugar-free suspension


30mg suppositories

Metoclopramide
(also see section 4.6)

10mg tablets; 5mg in 5ml oral solution


10mg in 2ml injection

1.3 - Ulcer Healing Drugs


1.3.1 - H2 Receptor Antagonists
First Choice
Ranitidine

150mg & 300mg tablets; 150mg effervescent tablets


150mg in 10ml sugar-free oral solution (contains 7.5%-8%
alcohol & sorbitol)

50mg in 2ml injection


Alternative
Cimetidine

- injection mainly used for prophylaxis of stress ulceration

200mg & 400mg tablets


200mg in 5ml syrup

1.3.3 Chelates and Complexes


Sucralfate

1g tablets
1g in 5ml suspension
- mainly for prophylaxis of stress ulceration and acute
gastrointestinal bleeding

1.3.4 Prostaglandin Analogues


Proton pump inhibitors are usually preferred for the prevention of gastro-intestinal bleeding
(better tolerated). Most hospital use of misoprostol is for the induction of labour or termination
of pregnancy (unlicensed indications).

Misoprostol

200 microgram tablets


100 microgram tablets s u

- mainly for use in paediatric nephrology at the RVI

1.3.5 - Proton Pump Inhibitors


Preferred Drugs
Omeprazole

10mg, 20mg & 40mg capsules


10mg, 20mg & 40mg orodispersible tablets (MUPS)
40mg IV Infusion
40mg Injection (powder for reconstitution)
- for acute Gastrointestinal bleeding see North of Tyne Acid
suppression guidelines

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

- omeprazole orodispersible (MUPs) tablets should only be used


in patients who cannot swallow capsules or tablets and where
lansoprazole orodispersible tablets are unsuitable.
- a 10mg in 5ml oral suspension (unlicensed) can be obtained for
use in very small children and where a suspension has to be
given down a very fine NG tube (below French Size 8)

Lansoprazole

15mg & 30mg capsules


15mg & 30mg orodispersible tablets
- N.B. The orodispersible tablets should only be used in patients
who cannot swallow capsules or tablets and for NG/PEG/PEJ
use. Omeprazole capsules are currently cheaper than
lansoprazole capsules in primary care

1.3.5 Helicobacter Pylori Eradication


First Choice Regimen

Lansoprazole 30mg (or omeprazole 20mg),


clarithromycin 500mg & amoxicillin 1g all twice daily
for 7 days.
- metronidazole 400mg bd, clarithromycin 250mg bd &
lansoprazole 30mg bd should be used instead of amoxicillin in
patients who are allergic to penicillins

1.4 Acute Diarrhoea


1.4.1- Adsorbents and Bulk-Forming Drugs
Adsorbents such as Kaolin are not recommended for acute diarrhoea. Bulk-forming drugs
such as methylcellulose and ispaghula (section 1.6.1) are useful in controlling faecal
consistency in colostomy and ileostomy, and in controlling diarrhoea associated with
diverticular disease.

1.4.2 Antimotility Drugs


First Choice
Loperamide

2mg capsules;
s
2mg Orodispersible tablets
-approved for use in primary care following specialist initiation in
secondary care for patients with high output stoma only

1mg in 5ml sugar-free syrup

- to relieve diarrhoea post-surgery following extensive


gastrointestinal surgery. A therapeutic test should be carried out
and if there is inappropriate response after 5 days, and it should
be stopped.

Alternative
Codeine Phosphate

15mg, 30mg & 60mg tablets


(see section 4.7.2 for other formulations)

1.5 - Chronic Bowel Disorders


Oral/Parenteral Preparations
Aminosalicylates
First Choice
Mesalazine

400mg e/c m/r tablets (Octasa MR )


- approved as first choice 400mg e/c m/r preparation for all new
patients. Patients receiving Asacol and Mesren should be
switched to Octasa when appropriate.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

10

400mg e/c m/r tablets (Asacol brand)- to be used for


existing patients who are unable to change to Octasa MR
500mg m/r (sustained release) tablets (Pentasa)
1g m/r granules/ sachet
- only to be used in patients with difficulty in swallowing
Different brands of oral mesalazine are not automatically
interchangeable

Alternatives
Balsalazide s

750mg capsules

-for use on consultant gastroenterologist advice only

Sulfasalazine

500mg plain & 500mg e/c tablets


250mg in 5ml suspension
Corticosteroids (see section 6.3 for systemic corticosteroids)
First Choice
Prednisolone

5mg tablets See section 6.3

Alternative
Budesonide

3mg capsules enclosing e/c pellets (Budenofalk)


3mg capsules enclosing e/c m/r pellets (Entocort)
-for use on consultant gastroenterologist advice only

Immunosuppressants and Cytokine Inhibitors


For use on consultant gastroenterologists advice only
A Azathioprine

50mg tablets

A Mercaptopurine

50mg tablets - unlicensed indication

A Methotrexate

2.5mg tablets - unlicensed indication

RAdalimumab

100mg vials for intravenous infusion


- approved for Crohns disease in line with NICE

RInfliximab

100mg vials for intravenous infusion

Rectal Preparations
Aminosalicylates
Mesalazine

- approved for severe Crohns disease in line with NICE


-approved for acute exacerbations of ulcerative colitis in line
NICE
- not approved for sub-acute manifestations of ulcerative colitis
NICE

250mg & 500mg & 1g suppositories


1g in 100ml retention enema, 2g in 59ml enema
1g foam enema

Corticosteroids (see section 6.3 for systemic corticosteroids)


First Choice
Prednisolone

20mg retention enema, 5mg suppositories


20mg/metered application rectal foam

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

11

Alternative
Hydrocortisone
Acetate

10% rectal foam 125mg/metered application


Application device may be preferred to that for prednisolone

foam (Predfoam ) enema

1.6 Laxatives
1.6.1 Bulk-Forming Laxatives
First Choice
Ispaghula Husk

3.5g sachets orange flavour Fybogel preferred

Alternative
Methylcellulose

500mg tablets

1.6.2 - Stimulant Laxatives


First Choice
Senna

7.5mg tablets; 7.5mg in 5ml syrup

Alternatives
Docusate sodium

100mg capsules
12.5mg in 5ml & 50mg in 5ml sugar-free solutions
-also acts as a faecal softener

Bisacodyl

5mg e/c tablets; 5mg & 10mg suppositories

Glycerol (Glycerin)

1g, 2g & 4g suppositories

Sodium picosulfate elixir

5mg/5ml elixir
-for use as a second line agent in paediatric patients with

constipation when Movicol, lactulose and senna are ineffective as


single agent therapy

Co-danthramer r

25/200 suspension, 25/200 capsules (25mg Dantron &

Co-danthrusate r

50/60 capsules (50mg Dantron & 60mg Docusate sodium)

200mg Poloxamer 188 per 5ml/capsule)


37.5/500 strong capsules (37.5mg Dantron & 500mg
Poloxamer 188)
75/1,000 strong suspension (75mg Dantron & 1g
Poloxamer 188 in 5ml)

N.B. Co-danthramer and Co-danthrusate are generally restricted to use in the


treatment of constipation in terminally ill patients. A combination of Senna and
Docusate is normally preferred.

1.6.3 Faecal Softeners


Docusate Sodium

100mg capsules
12.5mg in 5ml & 50mg in 5ml sugar-free solutions

Arachis Oil Enema

Enemas containing 130ml arachis (peanut) oil

1.6.4 Osmotic Laxatives

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

12

Lactulose

Solution containing 3.1g to 3.7g in 5ml with other ketoses

Sodium Citrate MicroEnema

5ml micro-enemas (sodium citrate 450mg together with a

Phosphate Enema

Enemas (sodium acid phosphate 12.8g + sodium phosphate

surfactant, glycerol & sorbitol)

10.24g in 128ml)

Macrogol Oral Powder


Laxido - To be used first
line, as considerably cheaper
than other preparations)

Movicol
including Movicol Half and
Movicol Paediatric
Plain

Laxido and Movicol, - Oral powder in sachets


(containing 13.125g macrogol 3350, sodium bicarbonate
178.5mg, sodium chloride 350.7mg & potassium chloride
46.6mg).

Movicol Half and Movicol Paediatric Plain Oral


powder in sachets (containing 6.563g macrogol 3350,
sodium bicarbonate 89.3mg, sodium chloride 175.4mg,
potassium chloride 23.3mg).

Movicol paediatric plain is unflavoured.


-for use in impaction and for 2nd line use in treating constipation
see local guidelines. If maintenance therapy needed, keep
dosage to a minimum.

1.6.5 Bowel Cleansing Solutions


First Choice
Sodium picosulfate
(Picolax, Citrafleet)

Powder for oral solution. Sachets (sachets containing sod.


picosulfate 10mg & magnesium oxide 3.5g, anhydrous citric acid
12g)

Alternatives
Moviprep

Powder (lemon-flavoured) in sachets -Sachet A


(containing macrogol 3350 100g, anhydrous sodium sulphate
7.5g, sodium chloride 2.691g, potassium chloride 1.015g) and
Sachet B (containing ascorbic acid 4.7g, sodium ascorbate 5.9g) .

For use as a laxative bowel preparation prior to clinical


procedures such as colonoscopy. To be used instead of Klean
Prep

Fleet Phospho-Soda

Sugar-free oral solution (sodium dihydrogen phosphate


24.4g, disodium phosphate dodecahydrate 10.8g in 45ml)

Klean Prep
(Bowel cleansing solution)

Sachets (containing 59g macrogol [polyethylene glycol] 3350 &


electrolytes.

-dissolved in water to give 1 litre of an iso-osmotic solution

1.6.7 Other drugs used in constipation


Prucalopride

1mg & 2mg tablets f/c (as succinate)

B Linaclotide

290 microgram capsules

- approved the symptomatic treatment of chronic constipation in


women whom laxatives fail to provide adequate relief in line with
NICE

- approved for specialist initiation for the symptomatic treatment


of moderate-to-severe irritable bowel syndrome with constipation
(IBS-C).

1.7 Local Preparations for Anal and Rectal Disorders


1.7.1 Soothing Haemorrhoidal Preparations

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

13

Anusol

Cream
Suppositories

) both contain a mixture of bismuth


) salts, Peru balsam & zinc oxide

1.7.2 Compound Haemorrhoidal Preparations with Corticosteroids


) contain hydrocortisone acetate, benzyl
Suppositories
Anusol HC
) benzoate, bismuth oxide, bismuth
Ointment
) subgallate, Peru balsam & zinc oxide

Max. recommended duration of treatment 7 days

Xyloproct

Ointment containing lidocaine 5%, hydrocortisone acetate


0.275%, aluminium acetate 3.5% & zinc oxide 18%

1.7.3 Rectal Sclerosants


Oily Phenol Injection

Recommended for short-term use only

Injection - 5% Phenol in a suitable oil (e.g. almond oil)

1.7.4 Chronic Anal Fissure


First line

Glyceryl Trinitrate

0.4% ointment (Rectogesic - licensed)


0.2% ointment u

Second line

Diltiazem

2% cream u
May cause fewer side effects than glyceryl trinitrate

R Botulinum Toxin

Botulinum A toxin haemagglutinin complex 100 unit vials


see section 4.9.3 for full list of botulinum products
- approved for use by specialists as an alternative to surgery in
patients failing other treatments. Also approved for use in paediatrics
but there must be documented informed consent from patients/
carers

1.9 Drugs Affecting Intestinal Secretions


1.9.1 Drugs Affecting Biliary Composition and Flow
Ursodeoxycholic Acid

150mg tablets; 250mg capsules


250mg in 5ml sugar-free suspension

1.9.2 Bile Acid Sequestrants


Colestyramine

4g sachets
4g sugar-free sachets

Colesevelam

625mg tablets

- approved for second line use (after Colestyramine) for the


treatment of bile malabsorption that results in diarrhoea

1.9.4 Pancreatin
Creon

5,000, 10,000 & 25,000 s & 40,000 s capsules

(10,000, 25,000 AND 40,000 units lipase activity)- for use


on advice of GI/respiratory specialist only

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

14

2. Cardiovascular System
2.1 Positive Inotropic Drugs
2.1.1 Cardiac Glycosides
Digoxin

62.5, 125 & 250 microgram tablets


50 microgram per ml elixir
100 microgram in 1ml u & 500 microgram in 2ml inj.

2.1.1a Digoxin-specific Antibody


R Digoxin-specific
antibody

Vials containing 38mg digoxin-specific antibody


fragments (Fab) for administration by IV infusion - For
the treatment of life-threatening digoxin toxicity only, requests
must be cleared by appropriate clinician.

2.1.2 Phosphodiesterase Inhibitors


R Milrinone

10mg in 10ml injection

2.2 Diuretics
2.2.1 Thiazide and Related Diuretics
First Choice
Bendroflumethiazide
(Bendrofluazide)

2.5mg tablets
- 5mg tablets also available, but not recommended for general
use

Alternatives
Indapamide s

2.5mg tablets

Metolazone su

5mg tablets

Chlorothiazide su

250mg in 5ml suspension


-Treatment should only be on advice from paediatric cardiology.

- Modified release indapamide tablets are not included in this


formulary- Treatment should only be on advice from stroke
physicians.

Treatment should only be on advice from cardiology.

2.2.2 Loop Diuretics


First Choice
Furosemide (Frusemide)

Alternative
Bumetanide

20mg, 40mg & 500mg tablets


40mg in 5ml sugar-free solution
20mg in 2ml, 50mg in 5ml & 250mg in 25ml
injections
1mg & 5mg tablets

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

15

1mg in 5ml sugar-free solution


2mg in 4ml injection
2.2.3 Potassium-Sparing Diuretics and Aldosterone Antagonists
First Choice
Amiloride

5mg tablets
5mg in 5ml sugar-free solution

Alternatives (aldosterone antagonists)


Spironolactone

25mg & 100mg tablets use is also extended for treatment


in post-acute myocardial infarction patients and patients with
mild heart failure. Treatment should only be initiated on the
advice of a cardiologist. (Spironolactone is considerably cheaper
than eplerenone)

10mg, 25mg & 50mg in 5ml sugar-free suspensions u


Eplerenone s

25mg & 50mg tablets

-for use in post-acute myocardial infarction patients with left


ventricular dysfunction and heart failure. Only to be used in
patients who are unable to tolerate the estrogenic side effects of
spironolactone. Treatment should only be on advice from a
cardiologist.

2.2.4 Potassium-Sparing Diuretics with Other Diuretics


Co-amilofruse

5/40 tablets (amiloride 5mg + furosemide 40mg)


2.5/20 tablets (amiloride 2.5mg + furosemide 20mg)

Spironolactone &
Chlorothiazide u

Capsules containing Spironolactone and


Chlorothiazide in the proportions of 1:10

used in paediatric cardiology


spironolactone
spironolactone
spironolactone
spironolactone
spironolactone

1mg & chlorothiazide 10mg


2mg & chlorothiazide 20mg
3mg & chlorothiazide 30mg
5mg & chlorothiazide 50mg
10mg & chlorothiazide 100mg

2.2.5 Osmotic Diuretics


Mannitol

10% & 20% intravenous infusions

2.3 Anti-arrhythmic Drugs


2.3.2 Drugs for Arrhythmias
Supraventricular Arrhythmias

R Adenosine

6mg in 2ml injection, 25mg in 5ml injection u


30mg in 10ml injection for infusion (NHCT only) SPC
130mg in 130ml IV infusion u

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

16

R Regadenoson

Digoxin

A myocardial perfusion imaging agent that contains


80micrograms in 1ml (400 micrograms) regadenoson
- for radionuclide myocardial perfusion imaging in patients who
are unable to undergo adequate exercise stress e.g. for patients
with COPD and asthma where dobutamine is indicated and for
obese patients who require several vials of adenosine.

see section 2.1.1

Supraventricular and Ventricular Arrhythmias

Amiodarone

100mg & 200mg tablets; 50mg in 5ml suspension u


150mg in 3ml injection
300mg in 10ml injection (prefilled syringes for CPR)

Flecainide

50mg & 100mg tablets; 5mg in 1ml liquid u


150mg in 15ml injection

R Ajmaline u

50mg in 10ml injection

Procainamide

1g in 10ml injection

Propafenone

150mg tablets

A Dronedarone

400mg tablets

for the use in the diagnostic testing of Brugada syndrome.


under review

- approved for patients who are unsuitable for or not tolerant of


amiodarone. Treatment is to be initiated by cardiologists. NICE
Linked to Shared Care Guideline

Ventricular Arrhythmias

Lidocaine (Lignocaine)

100mg injection, pre-filled syringes


1mg/ml (0.1%) & 2mg/ml (0.2%) IV infusions
(500ml)

2.4 Beta-Adrenoreceptor Blocking Drugs


First Choice
Atenolol
(cardioselective)

25mg, 50mg & 100mg tablets


25mg in 5ml sugar-free syrup
5mg in 10ml injection

Propranolol
(non-cardioselective)

10mg, 40mg, 80mg & 160mg tablets


80mg & 160mg m/r capsules (sustained release)
10mg & 50mg in 5ml sugar-free oral solutions
1mg in 1ml injection

Alternatives
Metoprolol

50mg & 100mg tablets


5mg in 5ml injection

Labetalol

50mg, 100mg & 200mg tablets


100mg in 20ml injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

17

Bisoprolol

5mg & 10mg tablets


1.25mg, 2.5mg, 3.75mg & 7.5mg tablets
- for use in the treatment of heart failure only. The 5mg and
10mg tablets should be used where possible - cheaper than
other strengths

Carvedilol

3.125mg, 6.25mg, 12.5mg & 25mg tablets

Sotalol s

40mg & 80mg tablets

R Esmolol

100mg in 10ml injection


2.5g in 250ml ready-made intravenous infusion

Nadolol sr

80mg tablets
- limited to use by cardiologists in patients with long QT

- for use in the treatment of heart failure only

- treatment should only be initiated on the advice of cardiology

syndrome/idiopathic ventricular fibrillation.


- Liquid formulations (unlicensed) can be obtained for use in
children if necessary. Treatment should only be on the advice of
a cardiologist.

Nebivolol sr

5mg tablets

Celiprolol sr

200mg tablets

- for specialist use in the treatment of patients who cannot


tolerate other beta-blockers. Treatment should only be on the
advice of a cardiologist.

- for specialist use in the treatment of patients who cannot


tolerate other beta-blockers. Treatment should only be on the
advice of a cardiologist.

2.5 Drugs Affecting the Renin-Angiotensin System and Some Other


Antihypertensive Drugs
2.5.1 Vasodilator Antihypertensive Drugs
Hydralazine

25 & 50mg tablets


20mg injection

Minoxidil s

5mg & 10mg tablets


- treatment should only be on the advice of a cardiologist/
nephrologist

R Sodium Nitroprusside

50mg injection

R Diazoxide

300mg in 20ml injection

2.5.1a Treatments for Pulmonary Hypertension


R Bosentan

62.5mg & 125mg tablets


In line with NHS England Clinical Commissioning Policy

R Iloprost

50 microgram in 0.5ml & 100 microgram in 1ml inj u


10 microgram in 1ml and 20 microgram in 2ml

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

18

nebules
R Treprostinil u

50mg in 20ml and 100mg in 20ml injections

R Sildenafil

20mg tablets (Revatio)


25mg, 50mg and 100mg tablets u

R Tadalafil

20mg tablets
- approved for the treatment of pulmonary arterial
hypertension (PAH) in adults for whom treatment with
sildenafil is not tolerated or effective.

R Macitentan

10mg film coated tablets


-approved for the treatment of pulmonary hypertension in
adults. In line with NHS England Clinical Commissioning
Policy

R Ambrisentan

100mg tablets
- much less likely to cause liver problems than bosentan - for use

in pulmonary hypertension where bosentan or sitaxentan has


failed, is not tolerated or not suitable. In line with NHS England

Clinical Commissioning Policy

2.5.2 Centrally Acting Antihypertensive Drugs


Moxonidine

200, 300 & 400 microgram tablets

Methyldopa

125mg, 250mg & 500mg tablets

Clonidine

100 microgram tablets s


treatment should be on the advice of a cardiologist/
nephrologist
R 150 microgram in 1ml injection For use in paediatric

cardiac ITU and in adult ITU patients with delirium and agitation,
often around extubation.

2.5.4 - Alpha-Adrenoreceptor Blocking Drugs


First Choice
Doxazosin

1mg, 2mg & 4mg tablets


- N.B. 4mg m/r & 8mg m/r tablets are not included in this
formulary - plain tablets are less expensive

Others (specialist use)


Phenoxybenzamine

10mg capsules; 100mg in 2ml injection

Phentolamine

10mg in 1ml injection

2.5.5 Drugs Affecting the Renin-Angiotensin System


2.5.5.1 Angiotensin Converting Enzyme Inhibitors
First Choice
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

19

Lisinopril

2.5mg, 5mg, 10mg & 20mg tablets

Ramipril

1.25mg, 2.5mg, 5mg & 10mg capsules

Alternatives
Perindopril

2mg, 4mg & 8mg tablets (3rd-line)


- perindopril is third line for all indications including
prevention of stroke.

Captopril

2mg capsules u and 5mg in 5ml (1mg/ml) oral


suspension su
treatment should only be on the advice of a hospital
paediatrician.

Enalapril

2.5mg, 5mg, 10mg & 20mg tablets


for use in breastfeeding mothers only. Mothers are to be
converted to ramipril when no longer breastfeeding.

2.5.5.2 Angiotensin-II Receptor Antagonists


N.B. These drugs are only approved for use where ACE inhibitors are not tolerated
and specific indications where a combination with an ACE inhibitor is required e.g.
in proteinuric renal disease.

First Choice
Losartan

Alternatives

12.5mg, 25mg, 50mg & 100mg tablets to be used


1st line treatment in all new patients.
2.5mg/ml suspension For use as an alternative to crushing
tablets for paediatric and adult patients

Candesartan

2mg, 4mg, 8mg, 16mg & 32mg tablets

Irbesartan

75mg, 150mg & 300mg tablets


only to be used in the treatment of existing patients

Valsartan

40mg, 80mg & 160mg tablets


- only to be used in the treatment of existing patients

2.5.5.3 Renin Inhibitor


Aliskiren

150mg & 300mg tablets

- only approved for use in the treatment of hypertension in


patients who have failed to respond adequately to, or not
tolerated, other treatments (including thiazide diuretics, calcium
channel blockers, ACE inhibitors, angiotensin receptor blockers
and beta-blockers). Aliskiren has NOT been approved for use in
combination with other drugs to maximise suppression of the
renin angiotensin system in patients with diabetes and/or renal
disease.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

20

2.6 Nitrates, Calcium-Channel Blockers and Potassium-channel


Activators
2.6.1 Nitrates
Glyceryl Trinitrate

400 microgram/metered dose aerosol spray


5mg & 10mg/day patches for use in cardiothoracic
critical care unit
5mg in 5ml , 50mg in 10ml & 50mg in 50ml injections

Isosorbide Dinitrate

10mg in 10ml injection

Isosorbide Mononitrate

10mg, 20mg & 40mg tablets, 60mg m/r tablets r

- N.B. The m/r isosorbide mononitrate tablets should only be


used in patients when the plain tablets are unsuitable

2.6.2 Calcium-Channel Blockers


Preferred Drugs
Hypertension
Amlodipine

Angina
Diltiazem

5mg & 10mg tablets.


- if a 10mg dose is not tolerated e.g. due to leg/ankle
oedema, consider reducing dose before changing to an
alternative such as lercanidipine
60mg m/r tablets

Once daily tablets/capsules

- Zemtard is the Formulary brand of choice for starting


new patients on long acting diltiazem.

Alternatives
Lercanidipine

10mg & 20mg tablets


- for use as a 2nd line calcium channel blocker where amlodipine
is not tolerated

Nifedipine

Once Daily formulations (Preferred)

20mg controlled release tablets (Adalat LA), 30mg &


60mg m/r capsules (Coracten XL)
Other Formulations

5mg & 10mg capsules


10mg & 20mg retard tablets
20mg per ml (1mg/drop) drops u
Nimodipine s

30mg tablets Treatment should be on the advice of


the stroke team/ cardiologist

10mg in 50ml (200 micrograms/ml) for IV infusion


Verapamil

40mg, 80mg, & 120mg tablets, 240mg m/r tablets


40mg in 5ml sugar-free oral solution
5mg in 2ml injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

21

2.6.3 Other Antianginal Drugs


Nicorandil

10mg & 20mg tablets

Ivabradine s

5mg and 7.5mg tablets


- for initiation on advice from consultant cardiologists in patients
with contra-indications to or intolerance of beta-blockers
- for use in heart failure in line with NICE

Ranolazine s

375mg, 500mg and 750mg prolonged release tablets.


-for use in the treatment of angina in those patients for whom
other treatments have been unsuccessful. Initial prescribing
should be by a consultant cardiologist only

2.6.4 Peripheral and Cerebral Vasodilators


General Notes
In Raynauds phenomenon some patients may require treatment with a vasodilator.
Nifedipine may be of use, especially in primary Raynauds syndrome.

Naftidrofuryl oxalate

100mg capsules

- approved for the treatment of intermittent claudication in people


with peripheral arterial disease in line with NICE

2.7 Sympathomimetics
2.7.1 Inotropic Sympathomimetics
R Dobutamine

250mg in 20ml injection,


250mg in 50ml injection

R Dopamine

200mg in 5ml injection

R Isoprenaline sulphate u

100 microgram in 2ml injection, 2mg in 2ml injection

R Dopexamine r

50mg in 5ml injection

R Levosimendan u

12.5mg in 5ml injection for infusion

2.7.2 Vasoconstrictor Sympathomimetics


Noradrenaline
(Norepinephrine)

2mg in 2ml & 4mg in 4ml (1 in 1,000) injections

Ephedrine

30mg in 1ml injection R


30mg in 10ml syringeu & 15mg tablets

R Metaraminol u

10mg in 1ml injection

R Phenylephrine

10mg in 1ml injection & 3000mcg in 30ml syringeu

Midodrine su

5mg tablets

- for limited specialist use in treating symptomatic hypotension


that has not responded to conventional therapies

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

22

2.7.3 Cardiopulmonary Resuscitation


Adrenaline
(Epinephrine)

1 in 1,000 injections in 1ml syringes and 1ml & 10ml


ampoules
1 in 10,000 injections in 1ml & 10ml ampoules &
syringes. See section 3.4.3 for EpiPens

2.8 Anticoagulants and Protamine


2.8.1 Parenteral Anticoagulants
First Choice
Tinzaparin

2,500 units in 0.25ml, 3,500 units in 0.35ml & 4,500


units in 0.45ml pre-filled syringes
- for prophylaxis
10,000 units in 0.5ml, 14,000 units in 0.7ml & 18,000
units in 0.9ml graduated pre-filled syringes

- for the treatment of pulmonary embolism and deep vein


thrombosis

20,000 units and 40,000 units in 2ml vials


Alternatives
Enoxaparin r

40mg in 0.4ml, 60mg in 0.6ml, 80mg in 0.8ml,


100mg in 1ml & 120mg in 0.8ml pre-filled syringes
- only for use in the treatment of acute coronary syndromes

Heparin Sodium

50 units in 5ml & 200 units in 2ml

- for flushing cannulae (other dilute Heparin solutions are kept in


some units for flushing central venous lines)

1,000 units in 1ml, 5,000 units in 1ml, 5,000 units in


5ml, & 25,000 units in 1ml ampoules
5,000 units in 5ml, 10,000 units in 10ml & 20,000
units in 20ml ampoules for use in infusion pumps
(Pump-Hep)
Multidose vials containing 5,000 units in 5ml (1,000
units/ml) & 25,000 units in 5ml (5,000 units/ml) &
125,000 units in 5ml (25,000 units/ml)
2,500 & 5,000 units in 1,000ml sodium chloride 0.9%
infusion
Fondaparinux s

1.5mg in 0.3ml injection, 2.5mg in 0.5ml injection,


5mg in 0.4ml injection, 7.5mg in 0.6ml injection &
10mg in 0.8ml injection in pre-filled syringes

- approved for high risk orthopaedic surgery patients and as an


alternative to enoxaparin in line with NICE

R Danaparoid

750 units in 0.6ml injection (1,250 units/ml)


-for use on advice from haematologists in patients who develop
thrombocytopaenia with heparins - cross reactivity with heparin
antibodies is probably <10%

R Argatroban

250mg injection

- for use on advice of haematologists in patients with heparin


induced thromboyctopenia

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

23

R Bivalirudin

250mg injection

- approved for preventing thrombosis in patients undergoing


percutaneous coronary artery interventions. For use instead of
abciximab in some low risk patients.
- approved in combination with aspirin and clopidogrel for the
treatment of adults with ST segment elevation MI undergoing
percutaneous coronary intervention. NICE

R TauroLock
(Taurolidine and Citrate
catheter lock solution)

5ml ampoules containing 1.35% taurolidine and 4% sodium

R TauroHep
(Taurolidine and Citrate
catheter lock solution with
heparin)

5ml ampoules containing 1.35% taurolidine and 4% sodium

R Epoprostenol

500 microgram injection & 1.5mg injection

R Iloprost

50 microgram in 0.5ml & 100 microgram in 1ml


injections
- mainly for use in treating pulmonary hypertension see section

citrate.
-for use in the prevention of central intravenous line infections

in:
Haemodialysis patients
Adult parenteral nutrition patients
Patients with recurrent line infections
Immune deficiency unit patients
Use in other areas is being evaluated

citrate with heparin 500 units/ml


-for use in the prevention of central intravenous line infections in:

Haemodialysis patients
Adult parenteral nutrition patients
Patients with recurrent line infections
Immune deficiency unit patients
Use in other areas is being evaluated

2.5.1a

2.8.2 Oral Anticoagulants


Warfarin

500 microgram, 1mg, 3mg & 5mg tablets


1mg/1ml oral suspension s

- for use in paediatric patients on mechanical support using


ventricular assistance devices, and for patients with mechanical
heart valves or irregular heart rythms who have not been weaned

Phenindione

10mg, 25mg & 50mg tablets

Apixaban

2.5mg tablets

approved for the prevention of venous thromboembolism in


patients undergoing elective total knee or hip replacement
surgery in line with NICE

2.5mg & 5mg tablets

- approved for the prevention of stroke and systemic embolism


in adult patients with non-valvular AF in line with NICE

Dabigatran

75mg & 110mg & 150mg capsules

- approved for the prevention of venous thromboembolism in

patients undergoing elective total knee or hip replacement


surgery in line with NICE
- approved for the prevention of stroke and systemic embolism in
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

24

adult patients with non-valvular AF in line with NICE


- Also approved for use prior to cardioversion.

Rivaroxaban

10mg tablets

- approved for the prevention of venous thromboembolism in


patients undergoing elective total knee or hip replacement
surgery in line with NICE

10mg, 15mg, 20mg tablets

- approved for the prevention of stroke and systemic embolism in


adult patients with non-valvular AF in line with NICE
- approved for the treatment of DVT and the prevention of
recurrent DVT and pulmonary embolism in line with NICE
- approved for treating pulmonary embolism and preventing
recurrent venous thromboembolism NICE

2.8.3 Protamine Sulphate


Protamine Sulphate

50mg in 5ml injection

2.9 Antiplatelet Drugs


First Choice
Aspirin

75mg dispersible tablets


(75mg e/c tablets no longer recommended for use);
500mg in 5ml injection u
- for specialist use in the endovascular treatment of cerebral
aneurysms

Alternatives
Clopidogrel

75mg tablets

- approved for use in cardiac patients being fitted with stents /


acute coronary syndromes and where aspirin is contraindicated/not tolerated, despite its use in combination with acid
suppressants e.g. omeprazole.
- approved ischaemic stroke; in peripheral arterial/ multivascular
disease; or after MI only if aspirin not suitable in line with NICE
- The North of Tyne APC recommends the use of generic 75mg
clopidogrel tablets in all the approved indications for clopidogrel.
Care should be taken to ensure that the brand supplied is suitable
if it is to be packed into monitored dosage systems

R 75mg/5ml suspension u s

- approved for use in paediatric patients with Berlin Heart devices

Prasugrel s

5mg & 10mg tablets


- approved in line with NICE for people with acute coronary
syndromes having percutaneous coronary intervention, only
when:
- immediate primary percutaneous coronary intervention for STsegment-elevation myocardial infarction is necessary, or
- Stent thrombosis has occurred during clopidogrel treatment.
- or diabetes mellitus
- Also approved for use in other acute coronary syndrome
patients (unstable angina or non ST segment elevation myocardial
infarction) in high risk patients who have a true allergy to
clopidogrel. Treatment to be initiated by a cardiologist

Dipyridamole

200mg m/r capsules

- approved in line with NICE:


- in combination with aspirin, after a TIA; or after an ischaemic

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

25

stroke, only if clopidogrel is unsuitable


- as monotherapy, after an ischaemic stroke if aspirin and
clopidogrel are unsuitable; or after a TIA if aspirin is unsuitable

50mg in 5ml sugar-free suspension u


100mg tablets,
R Abciximab

10mg in 5ml solution for injection

R Tirofiban

12.5mg in 250ml infusions, 12.5mg in 50ml (250


microgram/ml) vials for preparing infusions

Ticagrelor s

90mg tablets

- approved for acute coronary syndromes (ACS) in line with NICE

2.10 Myocardial Infarction and Fibrinolysis


N.B. Primary Percutaneous Coronary Intervention (PCI) is now preferred to
thrombolysis in patients with myocardial infarction with ST segment elevation
(STEMI)
First Choice
Streptokinase

250,000, 750,000 & 1,500,000 unit injections

Alternatives
R Alteplase

10mg, 20mg & 50mg injections.


- approved for acute ischaemic stroke in line with NICE
2mg in 2ml injection u

- approved for unblocking intravenous lines, mainly in paediatric


dialysis patients

Reteplase

10 unit injection
preferred for acute treatment of myocardial infarction where
streptokinase is unsuitable; used in NUTH.

Tenecteplase

40mg (8,000 unit) and 50mg (10,000 unit) vials both


with prefilled syringe of water for injection
- Used in NHCT and by ambulance service

R Urokinase

25,000 unit injection

2.11 Antifibrinolytic Drugs and Haemostatics


Tranexamic Acid

500mg tablets
500mg in 5ml syrup u
500mg in 5ml injection

R Aprotinin u

500,000 units in 50ml (10,000 units/ ml) injection

R Aminocaproic acid u

4g in 10ml injection

- for limited use in cardiothoracic surgery

- approved for the use in paediatric patients undergoing


extracorporeal membrane oxygenation (ECMO)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

26

Blood Products
R Beriplex - P/N
(Dried Prothrombin
Complex) r

250 unit & 500 unit vials

R Octanate

1000 unit vial


- approved for patients with severe Haemophilia A and an inhibitor

- approved for reversing the effects of oral anticoagulants in

patients with life or limb threatening bleeding in accordance with a


regional protocol

and in whom there is agreement to undertake immune tolerance


induction with a plasma derived product.

R Octaplas & Octaplas LG

Solution for infusion containing 45 - 70 mg/mL human


plasma proteins

A range of blood factors including factors VII & VIII are stocked at the RVI for use in
the treatment of haemophilia etc.

2.12 Lipid-Regulating Drugs


2.12 HMG-CoA Reductase Inhibitors

See FATS 5 Guidance for recommendations on use


First Choice
Simvastatin

10mg, 20mg, 40mg & 80mg tablets

Alternatives
Atorvastatin

10mg, 20mg, 40mg & 80mg tablets


10mg & 20mg chewable tablets

- to be used instead of simvastatin suspension, where solid osage


forms cannot be used. People should be assessed for the benefits
and risks of treatment, including considering any co-morbidities
and preferences of the patient, when deciding about treatment.

Pravastatin

10mg, 20mg & 40mg tablets

Rosuvastatin r

5mg, 10mg, 20mg & 40mg tablets

strictly limited use on the advice of specialists working in lipid


clinics for the treatment of patients with familial
hypercholesterolaemia who do not respond adequately or do not
tolerate the maximum doses of other statins.

2.12 Ezetimibe
Ezetimibe

10mg tablets
- approved for use in line with NICE For further information refer
to FATS6.

2.12 Bile Acid Sequestrants


Colestyramine
(Cholestyramine)

4g sachets & 4g sugar-free sachets

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

27

Colesevelam

625mg tablets

- approved for use in patients with familial hypercholesterolaemia,


with substantial cardiovascular risk and who are unable to tolerate
existing treatments, and when colestyramine is not available.

2.12 Fibric Acid Analogues


First Choice
Fenofibrate

67mg, 200mg & 267mg capsules

Alternative
Bezafibrate

200mg tablets, 400mg m/r tablets

2.12 Fish Oils


Omega-3-acid ethyl esters

1g capsules
- for the treatment of hypertriglyceridaemia following specialist
advice

2.12 Nicotinic Acid Group


Nicotinic acid s
(Niacin, Niaspan)

500mg, 750mg &1g m/r (sustained release) tablets

- for initiation by consultant cardiologist or clinical biochemist only

2.13 Local Sclerosants


Sodium Tetradecyl
Sulphate

0.2%, 5ml; 1%, 2ml & 3%, 2ml & 5ml injections

Ethanolamine Oleate

5% injection 5ml

2.14 Drugs affecting the ductus arteriosus


Closure of the ductus arteriosus
R Indometacin
(Indomethacin)
R Ibuprofen IV (Pedea)

1mg injection

10mg injection

- approved only for use when there is a supply problem with


indometacin u .

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

28

3. Respiratory System
Choice of inhaler device should be dependent on patient ability to use. Metered dose
inhalers (MDI) +/- spacer remain the first choice for most patients. Alternative devices
such as automatic inhalers and Turbohalers should be chosen based on availability
for the type of drug to be prescribed, the patients ability to use and cost.
3.1 Bronchodilators
3.1.1 Adrenoceptor Agonists
3.1.1.1 Selective Beta2 Agonists
Short acting
First Choice
Salbutamol

100 microgram/puff metered dose CFC-free inhaler &


100 microgram/puff breath actuated CFC-free inhaler
(Airomir Autohaler & Salamol Easi-Breathe)

200 microgram/dose Accuhaler


100 microgram/puff metered dose Easyhaler For use in
children only, as a second line treatment after the Accuhaler.

2.5mg in 2.5ml & 5mg in 2.5ml nebules


2mg in 5ml sugar-free oral solution
500 microgram in 1ml & 5mg in 5ml injections Alternative
Terbutaline
Longer acting

Parenteral use is rarely indicated

500 microgram/dose turbohaler


500 microgram in 1ml injection

Salmeterol

25 microgram/puff metered dose inhaler


50 microgram/dose accuhaler

Formoterol (Eformoterol)

6 microgram & 12 microgram turbohalers

3.1.1.2 Other Adrenoceptor Stimulants


Ephedrine s

15mg tablets; 30mg injection

3.1.2 Antimuscarinic Bronchodilators


Aclidinium Bromide

400 microgram powder for inhalation

Glycopyrronium Bromide

50 microgram capsule for inhalation

-approved for use in patients who cant tolerate or who are unable
to use either the tiotropium bromide or glycopyrronium bromide
inhaler devices

approved for second line use in the maintenance treatment of


COPD

Ipratropium

20 microgram/puff CFC-free inhaler


250 microg in 1ml & 500 microg. in 2ml nebuliser sol.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

29

Tiotropium

18 microgram capsules for use in Handihaler device


2.5 micrograms/metered inhalation (solution for
inhalation Respimat)
- Tiotropium Respimat is only for use in those who are
unable to use a tiotropium Handihaler properly despite
adequate training.

3.1.3 Theophylline
Seldom indicated. Modified release formulations must be prescribed by brand name.
Asthma: consider for patients not controlled on Long-acting beta agonist (LABA) plus
inhaled corticosteroid - discontinue if no benefit see national guidelines.
First Choice
Theophylline

200mg m/r, 300mg m/r & 400mg m/r tablets


(Uniphyllin)
60mg, 125mg & 250mg m/r capsules (Slo-Phyllin)

Nuelin SA tablets can be supplied to continue treatment if needed

Alternatives
Aminophylline

100mg & 225mg m/r tablets (Phyllocontin)


250mg in 10ml injection - COPD: intravenous
aminophylline of limited benefit. Injection used in hospital
for acute asthma not responding to steroids and continuous
inhaled bronchodilators. NB: plasma levels need to be
checked before administration if patient has previously
taken theophylline/ aminophylline.

3.1.4 Compound Bronchodilator Preparations


Combivent s

Nebuliser solution in 2.5ml unit dose vials isotonic


solution containing ipratropium 500 microgram & salbutamol
2.5mg

only for use when combination product is clearly indicated

3.2 Corticosteroids
First Choice
Beclometasone
(Beclomethasone)

Clenil Modulite 50, 100 & 250 microgram/puff CFCFree inhalers (first choice)
QVAR 50 microgram & 100 microgram CFC-free
inhaler & breath actuated inhalers see note below
N.B. CFC-Free beclometasone must be prescribed by
Brand Name. 50 microgram QVAR is equivalent to 100
microgram for a conventional inhaler & 100 microgram is
equivalent to 250 microgram conventional beclometasone.

Alternatives
Budesonide

100, 200 & 400 microgram/dose turbohalers(100 & 200 microgram/puff CFC-free inhalers
(replaces 50 and 200microgram CFC containing inhalers)discontinued April 2011)

500 microgram in 2ml & 1mg in 2ml nebuliser susp.


North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

30

Combination Products
Symbicort

R Oral viscous budesonide - A 0.5mg or 1mg nebule


is added to 13ml of syrup and this is then mixed and
swallowed
100/6 & 200/6 & 400/12 turbohaler dry powder
inhalers

(100/6 = budesonide 100 microg/formoterol fumarate 6 microg


per dose; 200/6 = budesonide 100 microg/ formoterol fumarate 6
microg per dose)

Seretide

CFC-free metered dose inhalers


Seretide 50 salmeterol 25 microg/fluticasone 50 microg
Seretide 125 salmeterol 25 microg/fluticasone 125 microg
Seretide 250 salmeterol 25 microg/fluticasone 250 microg

Accuhaler dry powder inhalers

Seretide 100 salmeterol 50 microg/fluticasone 100 microg


Seretide 250 salmeterol 50 microg/fluticasone 250 microg
Seretide 500 salmeterol 50 microg/fluticasone 500 microg
Higher dose product more effective in the treatment of COPD
Seretide 500 Accuhaler preferred - cheaper than metered dose
inhaler

Fostair

CFC-free metered dose inhaler containing


beclometasone dipropionate 100 micrograms and
formoterol fumarate 6 micrograms/metered inhalation
- N.B. 100 micrograms of beclometasone in Fostair is
equivalent to a 250 microgram dose in a conventional
beclometasone metered dose inhaler (e.g. Becloforte,
Beclazone and Clenil Modulite).

Flutiform

CFC-free metered dose inhalers


Formoterol 5 microg/fluticasone 50 microg
Formoterol 5 microg/fluticasone 125 microg
Formoterol 10 microg/fluticasone 250 microg
- approved the use for maintenance treatment of asthma

3.3 Cromoglicate and Leukotriene Receptor Antagonists


3.3.2 Leukotriene Receptor Antagonists
Montelukast

4mg & 5mg chewable tablets


10mg tablets
4mg paediatric granules (sachets)
Review treatment after 6 weeks of initiation and discontinue
if no evidence of improvement. Should typically only be
initiated by hospital specialist. Montelukast is 2nd line after
an inhaled corticosteroid for asthmatic children < 5 years
old.

3.4 Antihistamines, Hyposensitisation and Allergic Emergencies


3.4.1 Antihistamines
Preferred Drugs
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

31

Non-sedating
Cetirizine

10mg tablets
5mg in 5ml sugar-free oral solution

Loratadine

10mg tablets
5mg in 5ml syrup

Sedating
Chlorphenamine
(Chlorpheniramine)

4mg tablets, 2mg in 5ml syrup


10mg in 1ml injection

Alternatives

Non-Sedating

Desloratadine
Fexofenadine

5mg tablets
2.5mg in 5ml syrup Loratadine preferred

under review

30mg (paediatric), 120mg & 180mg tablets

Sedating
Hydroxyzine

10mg & 25mg tablets


10mg in 5ml syrup

Promethazine

10mg & 25mg tablets; 5mg in 5ml sugar-free elixir


25mg in 1ml injection

Alimemazine
(Trimeprazine)

10mg tablets
7.5mg in 5ml syrup (+ 30mg in 5ml used for pre-medication)

3.4.2 Allergen/Immunotherapy
R Pharmalgen r

Bee or Wasp venom extract

R Grazax r

Grass pollen extract 75,000 units oral lyophilisates

Pollinex Vaccines

Pollinex Grasses and Pollinex Trees initial and extension


kits -for use by immunologists

Pollinex Quattro
Vaccines u

Vaccine -for specialist use by immunologists (less injections than

R Omalizumab

150mg injection & 75mg & 150mg prefilled syringes

-approved for IgE-mediated bee and wasp venom allergy in line


with NICE

(freeze-dried tablets)
- for use in adults and children by adult and paediatric
immunologists only.

with conventional Pollinex)

- approved for severe persistent allergic asthma in adults and


children (6 years and older) in line with NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

32

3.4.3 Allergic Emergencies


Anaphylaxis
Adrenaline (Epinephrine)
- JEXT & JEXT junior

1mg in 1ml (1 in 1,000) injection, 150 & 300


microgram automatic injection devices (Jext junior &
Jext) - see section 2.7.3 for other formulations

B Adrenaline (Epinephrine)
- Emerade

1mg in 1ml (1:1,000) injection, 500 microgram


automatic injection device (0.5ml)

Angioedema
R Icatibant

-approved for use in the emergency treatment of anaphylaxis for


patients with a BMI of >40 or who have required more than one
auto-injector previously to control symptoms. Specialist
immunologist initiation only

30mg in 3ml injection


- for use on the advice of immunologist in the treatment

hereditary angioedema associated with C1-esterase inhibitor

3.5 Respiratory Stimulants and Pulmonary Surfactants


3.5.1 Respiratory Stimulant
R Doxapram

2mg per ml 500ml infusion, 100mg in 5ml injection

R Caffeine Citrate u

50mg in 5ml injection (equivalent to 25mg caffeine base


in 5ml [5mg caffeine base/ ml])

50mg in 5ml oral solution


3.5.2 Pulmonary Surfactants
R Poractant Alfa

120mg in 1.5ml & 240mg in 3ml vials (Curosurf)

3.6 Oxygen
Oxygen

3.7 Mucolytics
Carbocisteine

375mg capsules, 250mg in 5ml syrup - for use in COPD


patients in accordance with local guidelines

B Dornase alfa

2.5mg in 2.5ml solution for nebulisation

B Acetylcysteine u

600mg plain and effervescent tablets

Sodium Chloride s

7% solution for nebulisation (Nebusal - replaces

Mannitol

40mg capsules for inhalation

-for use on specialist advice in the treatment of idiopathic


pulmonary fibrosis and for the prevention of x-ray contrast media
induced renal damage Linked to information sheet

unlicensed 5% solution and Mucoclear 6% solution) Treatment


initiated by respiratory physician

- approved for treating CF in line with NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

33

Mannitol

0mg, 5mg, 10mg, 20mg, 40mg capsules for inhalation


-approved for bronchial provocation testing in patients unable to
tolerate the taste of methacholine.

3.8 Aromatic Inhalations


Benzoin Tincture, Compound

3.9 Cough Preparations

(Friars Balsam)

3.9.1 Cough Suppressants


Codeine Phosphate

15mg in 5ml linctus see section 4.7.2 for other preps

Pholcodine

5mg in 5ml sugar-free linctus

3.9.2 Expectorant and Demulcent Cough Preparations


Simple Linctus

Simple linctus and Paediatric simple linctus

3.10 Systemic Nasal Decongestants


Pseudoephedrine

60mg tablets
30mg in 5ml elixir

3.11 Antifibrotics
R Pirfenidone

267mg capsules
- approved for idiopathic pulmonary fibrosis in line with NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

34

4. Central Nervous System


4.1 Hypnotics and Anxiolytics
4.1.1 Hypnotics
Hypnotics should not be prescribed for more than 10 nights without being reviewed.
Use in the elderly is discouraged.
Nitrazepam is no longer included in the formulary for use as a hypnotic
First Choice
Temazepam

10mg & 20mg tablets


10mg in 5ml oral solution

Alternatives
Zopiclone

3.75mg and 7.5mg tablets

Chloral Hydrate

500mg in 5ml mixture

c) Other Hypnotics
Clomethiazole
(Chlormethiazole)

192mg capsules
250mg in 5ml sugar-free syrup
- chlordiazepoxide is preferred in the management of
alcohol withdrawal
Heminevrin Syrup has been discontinued.
31mg in 1ml syrup u

Melatonin

2mg modified release tablets


2mg, 2.5mg & 5mg capsules u (Used in NUTH only)
1mg in 1ml solution u B Linked to information sheet
- for the management of sleep wake disorders in children and

Promethazine
Hydrochloride

young people A
-

10mg & 25mg tablets


5mg in 5ml sugar-free elixir
25mg in 1ml injection

4.1.2 Anxiolytics
Benzodiazepines should not be used as an anxiolytic for more than 4 weeks without
being reviewed. Use in the elderly is discouraged.
First Choice
Diazepam

2mg & 5mg tablets - 2mg tablets are the preferred


strength in primary care.
10mg diazepam tablets should no longer be used.

2mg in 5ml oral solution


2.5mg, 5mg & 10mg rectal solution (rectal tubes)
10mg in 2ml injection (plain & emulsion)
- for use in epilepsy (see section 4.8.2)
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

35

Alternatives
Chlordiazepoxide

5mg & 10mg capsules

Lorazepam

1mg & 2.5mg tablets


4mg in 1ml injection

4.2 Drugs Used in Psychoses and Related Disorders


4.2.1 Antipsychotics Drugs
Typical Antipsychotics
Preferred drugs
Sulpiride

200mg & 400mg tablets


200mg in 5ml sugar-free oral solution

Haloperidol

500 microgram capsules; 1.5mg, 5mg & 10mg tablets


1mg in 1ml & 2mg in 1ml oral liquid
5mg in 1ml & 20mg in 2ml injections

Perphenazine

2mg & 4mg tablets

Chlorpromazine

10mg, 25mg, 50mg & 100mg tablets


25mg in 5ml & 100mg in 5ml oral solutions
50mg in 2ml injection

Alternatives
Trifluoperazine

1mg & 5mg tablets


1mg in 5ml syrup, 5mg in 5ml oral sugar-free solution

Flupentixol
(Flupenthixol)

500 microgram, 1mg & 3mg tablets

Levomepromazine
(Methotrimeprazine)

6mg tablets u, 25mg tablets


25mg in 1ml injection
- for use in palliative care

Atypical Antipsychotics
Linked to information sheet

Preferred drugs
B Risperidone

500microgram, 1mg, 2mg, 3mg, 4mg & 6mg tablets


1mg per ml liquid
0.5mg, 1mg & 2mg orodispersible tablets (Quicklets)
N.B. The dispersible tablets should only be used in
situations where the plain tablets are unsuitable

B Amisulpride

50mg & 200mg tablets


100mg in 1ml oral solution

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

36

Alternatives
R Clozapine

25mg & 100mg tablets


- first choice in patients with treatment-resistant schizophrenia

B Quetiapine

25mg, 100mg, 150mg 200mg & 300mg tablets


50mg, 200mg, 300mg & 400mg prolonged release
tablets (Seroquel XL)
this formulation is only approved for use in patients who require
an outside carer to administer their medicines, and for short term
use when rapid dose titration is considered important e.g. where
its use might avoid the need to admit the patient to hospital.

B Olanzapine

2.5mg, 5mg, 7.5mg & 10mg, 15mg & 20mg tablets


5mg, 10mg & 15mg orodispersible tablets r
N.B. The orodispersible tablets should only be used in
situations where the plain tablets are unsuitable.

10mg injection
-for rapid control of agitation and disturbed behaviours in patients
with schizophrenia or manic episode, when oral therapy is not
appropriate.
- the orodispersible tablets and injection are also approved for
2nd/3rd- line use in the management of delirium in critical care
patients unlicensed indication.

B Aripiprazole

5mg, 10mg, 15mg & 30mg tablets

- approved for schizophrenia in people aged 15 to 17 years in line


with NICE
- approved for moderate to severe manic episodes in young
people aged 13 and older with bipolar I disorder NICE

10mg & 15mg orodispersible tablets


- For doses over 5mg for those patients who have difficulty
swallowing.

1mg/ 1ml oral solution


- only for doses of 5mg or less, or when titrating patients on doses
of increments of less than 5mg, in patients who have difficulty
swallowing tablets.

4.2.2 Antipsychotics Depot Injections


First Choice
Zuclopentixol Decanoate
(Zuclopenthixol
Decanoate)

200mg in 1ml & 500mg in 1ml injections

Alternatives
Flupentixol Decanoate
(Flupenthixol Decanoate)

20mg in 1ml, 40mg in 2ml, 50mg in 0.5ml,


100mg in 1ml & 200mg in 1ml injections

Fluphenazine
Decanoate

12.5mg in 0.5ml, 25mg in 1ml,


50mg in 0.5ml & 100mg in 1ml injections

Haloperidol Decanoate

50mg in 1ml & 100mg in 1ml injections

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

37

Pipotiazine Palmitate s
(Pipothiazine Palmitate)

50mg in 1ml & 100mg in 2ml injections

Risperidone r

25mg, 37.5mg and 50mg injections

Zuclopenthixol Acetate r

50mg in 1ml and injection


- for short-term use by NTW specialists only

only for use by psychiatrists in accordance with NTW guidelines

4.2.3 Antimanic Drugs


Carbamazepine

100mg, 200mg & 400mg tablets


100mg in 5ml sugar-free liquid

-see section 4.8.1 for other formulations

A Lithium Carbonate

250mg tablets (6.8 mmol Li+)


200mg & 400mg m/r tablets (5.4 & 10.8 mmol Li+)
- Lithium should be prescribed by brand name
Link to Shared Care Guideline

A Lithium Citrate

509mg in 5ml liquid (5.4 mmol Li+/5ml)


1,018mg in 5ml liquid (10.8mmol Li+/5ml)
564mg m/r tablets (6 mmol Li+)
Link to Shared Care Guideline

Sodium Valproate

200mg, 300mg & 500mg m/r tablets (Epilim Chrono)


- used for the prevention and treatment of manic episodes
associated with bipolar disorder (unlicensed indication). May be
useful in patients unresponsive to lithium. See section 4.8.1 for
other sodium valproate formulations.

Valproate semi sodium

250mg and 500mg tablets (Depakote)

-Licensed alternative to sodium valproate m/r tablets.

Other anticonvulsant drugs are used in the management of bipolar disorders e.g.
Lamotrigine for the depressive phase. Such use is off-licence.

4.3 Antidepressant Drugs

4.3.1 Tricyclic and Related Antidepressant Drugs

Antidepressant
Trazodone

Other Indications
Amitriptyline

50mg & 100mg capsules; 150mg tablets


50mg in 5ml sugar-free liquid
- Trazodone is widely used off-licence for night sedation and
behavioural symptoms of dementia see section 4.1.1

10mg, 25mg & 50mg tablets


25mg in 5ml sugar-free oral solution

Alternatives
Lofepramine

70mg tablets
70mg in 5ml sugar-free oral suspension
safer than amitriptyline in overdosage, but not as
effective

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

38

Imipramine
Clomipramine

10mg & 25mg tablets; 25mg in 5ml syrup u


10mg, 25mg & 50mg capsules

4.3.2 Monoamine Oxidase Inhibitors (MAOI)


Phenelzine s

15mg tablets

Moclobemide s

150mg tablets

- for use on advice from psychiatrists only

- for use on advice from psychiatrists only

4.3.3 Selective Serotonin Reuptake Inhibitors (SSRIs)


Preferred drugs
Fluoxetine

20mg capsules; 20mg in 5ml liquid

Citalopram

10mg, 20mg & 40mg tablets


40mg in 1ml sugar-free oral drops

Paroxetine

10mg, 20mg & 30mg tablets


10mg in 5ml sugar-free oral liquid

Sertraline

50mg & 100mg tablets

4.3.4 Other Antidepressants

These drugs are for use in patients not responding adequately to first-line treatments.
Venlafaxine

37.5mg & 75mg tablets


75mg & 150mg m/r tablets
B for patients on doses of 300mg/day or more
Linked to information sheet
- Patients who are deemed stable on doses of up to 225mg daily
of m/r venlafaxine should be switched to the equivalent dose of
immediate release venlafaxine
- M/R tablets are only to be used in patients currently prescribed
doses of 300mg and over and for whom there is no suitable
alternative, those who have experienced discontinuation reactions
(at any dose), and for patients who need to take the once daily
formulation in order to facilitate care visits.

Mirtazapine

15mg, 30mg & 45mg tablets


15mg, 30mg & 45mg orodispersible tablets

- the orodispersible tablets should only be prescribed for use when


other formulations are unsuitable (more expensive)

Reboxetine

4mg tablets - not licensed for use in elderly

Duloxetine s

30mg & 60mg capsules

- for use on advice of psychiatrists as a 3rd line antidepressant but


only for use in patients, who cannot tolerate high-dose (>150mg
daily) venlafaxine, or patients with hypertension, established CHD
or other cardiovascular risk factors which would make the use of
high-dose venlafaxine undesirable. Also approved for third-line use
(after drugs such as the tricyclic antidepressants and gabapentin)
in the treatment of neuropathic pain on the advice of pain
specialists

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

39

B Agomelatine

25mg film coated tablets- NETAG approved for the treatment of depression only following

an adequate trial of at least three alternative antidepressant drugs


at maximally tolerated doses (as described by NICE and as stated
in the BNF). Prescribing and monitoring should be initiated by
specialist mental health physicians. After a minimum of 12 weeks,
prescribing may be transferred to primary care.
Linked to information sheet

4.4 Central Nervous Stimulants and Other Drugs Used for Attention
Deficit Hyperactivity Disorder
Methylphenidate, atomoxetine and dexamfetamine for attention deficit
hyperactivity disorder (ADHD) in children and adolescents NICE

A Atomoxetine

10mg, 18mg, 25mg, 40mg, 60mg & 80mg capsules

A Dexamfetamine
(Dexamphetamine)

5mg tablets
Link to Shared Care Guideline

R For use in narcolepsy for doses > 30mg


B For the in narcolepsy for doses < 30mg
Linked to information sheet

A Methylphenidate

5mg & 10mg tablets;


5mg, 10mg, 20mg, 30mg and 40mg m/r capsules
(Medikinet XL)
10mg, 20mg & 30mg m/r capsules (Equasym XL),
18mg, 27mg & 36mg m/r tablets (Concerta XL)
-the effects of Equasym XL last for about 8 hours compared
with about 12 hours for Concerta XL
Link to Shared Care Guideline

- also approved for the treatment of narcolepsy in paediatrics


- see section 7.4.2 for use in giggle incontinence

A Lisdexamfetamine

30mg, 50mg and 70mg capsules (Elvanse)


- for third line use after an inadequate response to methylphenidate.
-for specialist initiation and only transferred to GPs after at least 6

month stable symptom control.

B Modafinil r

100mg tablets

only approved for limited use in the treatment of patients with


narcolepsy
Linked to information sheet

4.5 Drugs Used in the Treatment of Obesity


Only for use in accordance with NICE guidelines NICE
4.5.1 Anti-Obesity Drugs Acting on the Gastro-Intestinal Tract
Orlistat

120mg capsules

4.5.2 Centrally Acting Appetite Suppressants


Sibutramine has been withdrawn from the UK market due to evidence that suggests
that there is an increased risk of non-fatal heart attacks and strokes with this medicine that
outweighs the benefits of weight loss.

4.6 Drugs Used in Nausea and Vertigo


Antihistamines
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

40

Cinnarizine

15mg tablets

Cyclizine

50mg tablets; 50mg in 5ml suspension u


50mg in 1ml injection

Promethazine
Hydrochloride

10mg & 25mg tablets; 5mg in 5ml sugar-free elixir


25mg in 1ml injection

Phenothiazines and Related Agents


Haloperidol

500 microgram capsules,1.5mg, 5mg & 10mg tablets


1mg in 1ml & 2mg in 1ml oral liquid
5mg in 1ml & 20mg in 2ml injections

Prochlorperazine

5mg tablets; 5mg in 5ml syrup


12.5mg in 1ml injection
5mg & 25mg suppositories
3mg tablets (buccal) (Buccastem)

- for the treatment of nausea associated with migraine when the


oral route cannot be used due to vomiting.

Levomepromazine
(Methotrimeprazine)

6mg tablets u, 25mg tablets


25mg in 1ml injection For use in palliative care

Domperidone and Metoclopramide


Metoclopramide

10mg tablets; 5mg in 5ml sugar-free oral solution


10mg in 2ml injection

Domperidone

10mg tablets
5mg in 5ml sugar-free suspension
-approved for use as a galactagogue to re-establish breast-feeding u
30mg suppositories

5HT3 Antagonists
First Choice
Ondansetron

Alternative
R Palonosetron r

4mg & 8mg tablets


4mg in 5ml sugar-free solution
4mg in 2ml & 8mg in 4ml injections
16mg suppositories
250 microgram in 5ml injection, 500 microgram
capsules

- for 2nd line of treatment for chemotherapy induced nausea


vomiting only

Others
Hyoscine
Hydrobromide

300 microgram oral/sublingual tablets


1mg/72 hour patches

- for the management of excessive secretions where tablets are


unsuitable

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

41

R Aprepitant r

80mg & 125mg capsules


- for the prevention of chemotherapy induced nausea and vomiting
(CINV) in high risk patients in accordance with North of England
Cancer Network: CINV Guidelines in adult oncology and
haematology patients

R Fosaprepitant

150mg injection
- for the prevention of chemotherapy induced nausea and vomiting
(CINV) in high risk patients in accordance with North of England
Cancer Network: CINV Guidelines in adult oncology and
haematology patients

R Nabilone

250 microgram capsules u, 1mg capsules


- also approved for very limited use in the treatment of chronic pain
(unlicensed indication) that has not responded to other treatments.
Treatment must be initiated by pain consultants and reviewed after
about one month. Treatment to be stopped immediately in nonresponders.

Other Drugs for Menires Disease


Betahistine

8mg tablets

4.7 Analgesics
4.7.1 Non Opioid Analgesics
First Choice
Paracetamol

500mg plain & soluble tablets


120mg & 250mg in 5ml suspensions (sugar-free)
1g injection for IV infusion
- for limited short-term use where oral and rectal routes cannot be
used and NSAIDs are not appropriate.
- in paediatric areas only, the 50ml formulation should be stocked.

Alternatives

15mg u, 30mg u, 60mg u, 120mg u, 240mg u & 500mg u


suppositories used in NUTH Licensed 60mg, 125mg, 250mg
& 500mg suppositories are available in primary care

Aspirin

300mg dispersible & enteric coated tablets


75mg, 150mg & 300mg u suppositories used in NUTH
-licensed 300mg suppositories are available in primary care

NSAIDs

Oral NSAIDs (section 10.1.1) such as diclofenac,


ibuprofen and naproxen are also used as analgesics

see section 10.1.1.

NSAID Injections e.g. parecoxib s injections are also available


for use as post-operative analgesics see section 15.1.4.2

Nefopam

30mg tablets

R Nabilone

250 microgram capsules u, 1mg capsules


- for very limited use in the treatment of chronic pain (unlicensed
indication) that has not responded to other treatments. Treatment
must be initiated by pain consultants and reviewed after about one
month. Treatment to be stopped immediately in non-responders.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

42

4.7.1.1 Compound Analgesic Preparations


Co-codamol 8/500

8/500 tablets & 8/500 dispersible tablets containing


codeine phosphate 8mg & paracetamol 500mg

- while co-codamol 8/500 is commonly used, no advantages over


paracetamol have been substantiated. The low dose of codeine
may be enough to cause opioid side-effects (in particular,
constipation) and can complicate the treatment of overdosage, yet
may not provide significant additional relief of pain. Use is
therefore discouraged.

4.7.2 Opioid Analgesics


Preferred drugs
Morphine Sulphate

10mg, 20mg & 50mg immediate release tablets


10mg, 30mg, 60mg, 100mg and 200mg m/r capsules
(Zomorph) for twice daily administration
- this is the preferred formulation

5mg, 10mg, 15mg, 30mg, 60mg, 100mg & 200mg


m/r tablets for twice daily administration
- only for use when Zomorph isnt unsuitable

10mg in 5ml & 100mg in 5ml (20mg per ml) oral


solutions
20mg, 30mg, 60mg, 100mg & 200mg sachets of m/r
granules for preparing oral suspensions
- only for use when other formulations are unsuitable
5mg u, 10mg, 15mg & 30mg in 1ml & 60mg in 2ml
injections
10mg in 1ml u preservative free, 2mg in 5ml u
epidural and 50mg in 50ml PCA injection u are also
available
5mg, 10mg, 30mg, 100mg & 500mg injections
- intranasal diamorphine u is approved for use in children for the

R Diamorphine

relief of severe pain due to clinically suspected limb fractures,


burns and significant fingertip injuries. Appropriate risk
assessments are to be conducted by each organisation in order to
determine formulation of choice i.e. ampoules or intranasal spray.

Codeine Phosphate

5mg, 30mg & 60mg tablets


25mg in 5ml syrup
30mg in 1ml injection u & 60mg in 1ml injection
2mg, 3mg, 6mg, 15mg & 30mg suppositories u

Alternatives

The use of dihydrocodeine 30mg tablets & 10mg in 5ml oral solution is no longer
recommended for regular use. Codeine is the preferred weak opioid analgesic

R Dihydrocodeine

30mg tablets
-approved for use in breast feeding mothers immediately postdelivery/c-section where adequate pain relief has not been
achieved using paracetamol and NSAIDs.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

43

Buprenorphine

200 microgram sublingual tablets


300 micrograms in 1ml injection

Fentanyl

12, 25, 50, 75 & 100 microgram/hour transdermal


patches - see section 15.4.1.3 for injections
200 microgram lozenges with oromucosal applicator sr
only approved for limited short-term use in RVI burns unit and
for the treatment of very severe incident pain on the advice of
pain/palliative care specialists

100,200,300,400,600,800 microgram sublingual


tablets (Abstral)

only approved for patients experiencing incident pain during


radiotherapy, restricted to palliative care use only.

Hydromorphone

1.3mg & 2.6mg capsules


2mg, 4mg, 8mg, 16mg & 24mg m/r capsules

B Methadone

5mg tablets
2mg in 5ml linctus & 5mg in 5ml mixture DTF &
5mg in 5ml sugar free solution
20mg in 1ml concentrated oral solution u
10mg in 1ml injection

Oxycodone r

5mg in 5ml & 10mg in 1ml sugar-free oral solutions


5mg, 10mg, 20mg, 40mg & 80mg m/r tablets
10mg in 1ml, 20mg in 2ml injection
50mg Under
in 1mlReview
injection
-approved for use in controlled circumstances in palliative patients
following risk assessment by individual organisations

The oral solution should be used instead of immediate


release tablets
Oxycodone only to be used in patients who are
intolerant of morphine

Pethidine
B Tapentadol

50mg in 1ml & 100mg in 2ml injections


r

50mg,100mg, 150mg, 200mg and 250mg m/r tablets


50mg and 75mg immediate release tablets

- approved for use by chronic pain specialist in adults with severe


pain who have been screened for a neuropathic element to their
pain and are uncontrolled or experiencing GI side effects on
existing therapy.

Tramadol

50mg capsules; 50mg dispersible tablets


100mg in 2ml injection

- for use as a 2nd line weak opioid analgesic


- only recommended for use in patients where treatment with
possible alternatives such as paracetamol, NSAIDs, and codeine is
insufficiently effective, not tolerated or considered unsuitable for
other reasons. Modified release tramadol is not recommended.

4.7.3 Neuropathic Pain


First Choice
Amitriptyline

See section 4.3

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

44

Second Choice
Gabapentin

See section 4.8.1


- also approved for hospital use as an adjunct to other treatment
in the management of peri/post-operative pain. GPs should not be
asked to prescribe gabapentin for this unlicensed indication.

Pregabalin r

See section 4.8.1


- restricted to use in the management neuropathic pain as a
second choice where treatment with gabapentin has been
unsuccessful or not tolerated. NICE

Alternatives
Carbamazepine

See section 4.8.1


-restricted use in treatment of trigeminal neuralgia only

Duloxetine s

30mg & 60mg capsules 30mg & 60mg capsules


- for third-line use (after drugs such as the tricyclic

antidepressants and gabapentin) in the treatment of neuropathic


pain on the advice of pain specialists.
See section 4.8.1

Phenytoin
B Mexiletine

200mg & 50mg capsules


- for use in the treatment of neuropathic pain. ECG monitoring is

required to be carried out by pain clinic consultants as part of the


initiation process of mexiletine, as patients are required for cardiac
arrhythmias.

Postherpetic Neuralgia
Capsaicin

0.075% cream See section 10.3.2

B Lidocaine

5% medicated plasters (700mg lidocaine/plaster)

- for use in the treatment of chronic neuropathic pain on the advice


of pain specialists only, and subject to an appropriate trial of efficacy
in each individual patient
Linked to information sheet

N.B. Other drugs such as Ketamine (see section 15.1.1) may also be advised by
pain/palliative care specialists in the management of neuropathic pain.

4.7.4 Antimigraine Drugs


4.7.4.1 Treatment of Acute Migraine Attack
Analgesics
Paracetamol
Aspirin
Co-codamol 8/500

See section 4.7.1

NSAIDs e.g.
Ibuprofen, naproxen
diclofenac

See section 10.1.1

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

45

5HT1 Agonists
First Choice
Sumatriptan
Alternatives

50mg & 100mg tablets; 10mg in 0.1ml nasal spray


6mg in 0.5ml injection (pre-filled syringes)

Frovatriptan

2.5mg tablets

Zolmitriptan

2.5mg tablets

Adjunctive Therapy
Metoclopramide
(used to help promote
absorption of analgesics)

10mg tablets
5mg in 5ml sugar-free syrup
See section 4.6 for other formulations

4.7.4.2- Prophylaxis of Migraine


Pizotifen

500 microgram & 1.5mg tablets


250 microgram in 5ml sugar-free elixir

Sodium Valproate

100mg crushable tablets, 200mg & 500mg e/c tablets


200mg, 300mg & 500mg m/r tablets (Epilim Chrono).
150mg & 300mg m/r capsules; 500mg & 1000mg m/r
granules (Episenta)

unlicensed indication

- for use in those who have difficulty swallowing sodium valproate


tablets. May be more convenient to use than large volumes of
liquid formulations

200mg in 5ml sugar-free liquid; 400mg in 4ml


injection
Propranolol

10mg, 40mg & 80mg tablets

Metoprolol

50mg & 100mg tablets, 200mg m/r tablets

Amitriptyline

10mg, 25mg & 50mg tablets; 25mg in 5ml sugar-free


oral solution

unlicensed indication

Clonidine

25 microgram tablets
- not generally recommended, may aggravate
depression/cause insomnia

R Botulinum toxin A
(Botox)

-for the treatment of chronic migraine in line with NICE

4.7.4.2 - Cluster headaches


A Lithium Carbonate

250mg tablets (6.8 mmol Li+)


200mg & 400mg m/r tablets (5.4 & 10.8 mmol Li+)
- Lithium should be prescribed by brand name. For use in the

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

46

treatment of cluster headaches u


Link to Shared Care Guideline

509mg in 5ml liquid (5.4 mmol Li+/5ml) 1,018mg in 5ml


liquid (10.8mmol Li+/5ml)
564mg m/r tablets (6 mmol Li+)
- Lithium should be prescribed by brand name.
u
- for use in the treatment of cluster headaches.

A Lithium Citrate

Link to Shared Care Guideline

4.8 Antiepileptics (Anticonvulsants)


4.8.1 Control of Epilepsy

Adapted from Antiepileptic drug (AEDs) options by seizure type NICE


Seizure Type

First Line AEDs

Adjunctive
AEDs

Other AEDs
that may be
considered on
referral to
tertiary care

Carbamazepine
Lamotrigine
Oxcarbazepineu
Sodium
valproate

Clobazama
Lamotrigine
Levetiracetam
Sodium
valproate
Topiramate

Sodium
valproate

Lamotrigine

Rufinamideu
Topiramateu

Absence

Ethosuximide
Lamotrigineu
Sodium
valproate

Ethosuximide
Lamotrigineu
Sodium
valproate

Clobazama
Clonazepam
Levetiracetamu
Topiramateu
Zonisamideu

Myoclonic

Levetiracetamu
Sodium
valproate
Topiramateu

Levetiracetam
Sodium
valproate
Topiramateu

Clobazama
Clonazepam
Piracetam
Zonisamideu

Carbamazepine
Lamotrigine
Levetiracetam
Oxcarbazepine
Sodium

Carbamazepine
Clobazama
Gabapentinu
Lamotrigine
Levetiracetam

Eslicarbazepine
acetate
Lacosamide
Phenobarbital
Phenytoin

Generalised
tonicclonic

Tonic or atonic

Focal

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

Do not offer
AEDs (may
worsen
seizures)
(If there are
absence or
myoclonic
seizures, or if
JME suspected)
Carbamazepine
Gabapentin
Oxcarbazepine
Phenytoin
Pregabalin
Tiagabine
Vigabatrin
Carbamazepine
Gabapentin
Oxcarbazepine
Pregabalin
Tiagabine
Vigabatrin
Carbamazepine
Gabapentin
Oxcarbazepine
Phenytoin
Pregabalin
Tiagabine
Vigabatrin
Carbamazepine
Gabapentin
Oxcarbazepine
Phenytoin
Pregabalin
Tiagabine
Vigabatrin

47

valproate

Oxcarbazepine
Sodium
valproate
Topiramate

Pregabalin
Tiagabine
Vigabatrin
Zonisamideu
Perapanel

MHRA guidance
Different antiepileptic drugs (AEDs) vary considerably in their characteristics, which
influences the risk of whether switching between different manufacturers products of
a particular drug may cause adverse effects or loss of seizure control. AEDs have been
divided into three risk-based categories to help healthcare professionals decide
whether it is necessary to maintain continuity of supply of a specific manufacturers
product.
Dispensing pharmacists should ensure the continuity of supply of a particular product
when the prescription specifies it. If the prescribed product is unavailable, it may be
necessary to dispense a product from a different manufacturer to maintain continuity
of treatment of that AED. Such cases should be discussed and agreed with both the
prescriber and patient (or carer)
Usual dispensing practice can be followed when a specific product is not stated.
Category 1
For these drugs it is advised to ensure that the patient is maintained on a
specific manufacturers product.
Carbamazepine

100mg, 200mg & 400mg tablet


100mg in 5ml sugar-free liquid
125mg & 250mg suppositories
200mg & 400mg m/r tablets (Tegretol retard) are available on
consultant request for those in whom conventional Carbamazepine
has been shown to be unsuitable

Phenobarbital
(Phenobarbitone)

15mg, 30mg & 60mg tablets; 15mg in 5ml elixir; 20mg


in 1ml suspension (alcohol free)
15mg in 1ml, 30mg in 1ml & 200mg in 1ml injections

Phenytoin

25mg, 50mg & 100mg capsules (sodium salt)


50mg infatabs (base)
30mg in 5ml suspension (base) 90mg (15ml) is
equivalent to one 100mg phenytoin sodium capsule
250mg in 5ml injection (sodium salt)

Category 2
For these drugs, the need for continued supply of a particular
manufacturers product should be based on clinical judgement and
consultation with patient and/or carer, taking into account factors such as
seizure frequency and treatment history.
Clobazam s

10mg tablets
1mg in 1ml & 2mg in 1ml suspensions u

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

48

Clonazepam

500 microgram & 2mg tablets


500 microgram in 5ml sugar-free oral solution u
1mg in 1ml injection

Eslicarbazepine Acetate

800mg tablets
- approved for use by specialists only in those patients for
whom intolerance of carbamazepine is a major concern and
when use of this agent is more cost effective than
alternatives available.

Lamotrigine

25mg, 50mg, 100mg & 200mg tablets


5mg, 25mg & 100mg dispersible tablets

Oxcarbazepine s

150mg, 300mg & 600mg tablets

Perampanel

2mg, 4mg, 6mg, 8mg, 10mg, 12mg tablets.

B Retigabine

50mg, 100mg, 200mg, 300mg & 400mg tablets

R Rufinamide r

100mg, 200mg & 400mg Tablets & 40mg in 1ml


suspension

- NETAG approved for partial (focal) seizure epilepsy only when


other treatment options recommended by NICE have been tried or
fully considered.

- approved for use by specialists in line with NICE

- approved for limited use as a 2nd or 3rd line treatment in patients


with Lennox-Gastaut syndrome and related encephalopathies.
Should only be used on the advice of paediatric neurologists and
other neurologists specialising in the treatment of epilepsy.

Sodium Valproate

100mg crushable tablets, 200mg & 500mg e/c tablets


200mg, 300mg & 500mg m/r tablets (Epilim Chrono)
150mg & 300mg m/r capsules; 500mg & 1000mg m/r
granules (Episenta)
- for possible use in those who have difficulty swallowing sodium

valproate tablets. May be more convenient to use than large volumes


of liquid formulations

200mg in 5ml sugar-free liquid; 400mg in 4ml injection


Topiramate s

25mg, 50mg, 100mg & 200mg tablets


15mg, 25mg & 50mg sprinkle capsules

Zonisamide s

25mg, 50mg and 100mg capsules


- for specialist use only in patients that are refractory to treatment
with other drugs - use in children is unlicensed

Category 3
For these drugs it is usually unnecessary to ensure that patients are
maintained on a specific manufacturers product unless there are specific
reasons such as patient anxiety and risk of confusion or dosing errors.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

49

Ethosuximide s

250mg capsules; 250mg in 5ml syrup

Gabapentin

100mg, 300mg & 400mg capsules


600mg & 800mg tablets
250mg in 5ml oral solution u

Lacosamide s

50mg, 100mg, 150mg & 200mg tablets


10mg per ml syrup, 10mg per ml intravenous infusion
- on advice from consultant neurologists, in patients that are
refractory to treatment with other drugs

Levetiracetam s

250mg, 500mg, 750mg & 1g tablets; 500mg in 5ml


liquid
500mg in 5ml (100mg/ml) concentrate for IV infusion

Pregabalin s

25mg, 50mg, 75mg, 100mg, 150mg, 200mg & 225mg


capsules
20mg/1ml oral solution

- approved for specialist advice in the management of treatment


resistant epilepsy
- also approved as a second line agent for General Anxiety Disorder.
Although treatment can be given 2-3 times daily, it is more cost
effective to give as a twice daily dose. NICE

A Vigabatrin

500mg tablets; 500mg sugar-free sachets

Acetazolamide s

250mg tablets

Stiripentol s

250mg & 500mg capsules


250mg & 500mg powder in sachets

Linked to Shared Care Guideline

for use as adjunctive therapy of refractory generalised tonic-clonic


seizures in children with severe myoclonic epilepsy in infancy

4.8.2 Drugs Used in Status Epilepticus


First Choice
Diazepam

10mg in 2ml injection (solution & emulsion)


2.5mg, 5mg & 10mg rectal solution (rectal tubes) see
section 4.1.2 for other formulations

B Midazolam

5mg/ml buccal solution (Buccolam) 2.5mg, 5mg,


7.5mg and 10mg prefilled oral syringes.
- first choice for status epilepticus in children aged 3 months
to 18 years
Epistatus 10mg in 1ml (5ml pack) buccal solution u
for use in the treatment of epileptic seizures in infants
under 3 months and adults over 18 years of age
Linked to information sheet

Injection solutions (section 15.1.4) can also be given buccally


2.5mg in 5ml oral solution u
- for use as a sedative. To be used in preference to

Alternatives

administering the injection orally -much cheaper.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

50

For initiation by neurologists only


Clonazepam s
Lorazepam s

1mg in 1ml injection


1mg & 2.5mg tablets; 4mg in 1ml injection & 2mg/ml
suspension u & 4mg/ml suspension u

suspensions are only approved for use in paediatrics for buccal


administration, in patients with status epilepticus in whom buccal
midazolam, rectal paraldehyde and rectal diazepam are ineffective. R

Paraldehyde s

Rectal liquid u

Phenytoin Sodium s

250mg in 5ml injection

4.9 Drugs Used in Parkinsonism and Related Disorders


4.9.1 - Dopaminergic Drugs
Levodopa plus Decarboxylase Inhibitors
Co-beneldopa (benserazide + levodopa, Madopar) see table for list of
Co-careldopa (carbidopa + levodopa, Sinemet) formulations
Brand Names
Co-beneldopa

Approved Names

Madopar 62.5

Co-beneldopa 12.5/50

Madopar 125

Co-beneldopa 25/100

Madopar 250
Madopar 125 CR

Co-beneldopa 50/200
Co-beneldopa 25/100 m/r

Co-careldopa

Sinemet 62.5
Sinemet 110
Sinemet Plus
Sinemet 275
Half Sinemet CR
Sinemet CR

Co-careldopa
Co-careldopa
Co-careldopa
Co-careldopa
Co-careldopa
Co-careldopa

12.5/50
10/100
25/100
25/250
25/100 m/r
50/200 m/r

Form
capsules &
disp. tablets
capsules &
disp. tablets
capsules
controlled
release caps.
tablets
tablets
tablets
tablets
m/r tablets
m/r tablets

Decarboxylase
inhibitor content

Benserazide

Levodopa
content

12.5mg

52mg

25mg

100mg

50mg
25mg

200mg
100mg

Carbidopa

12.5mg
10mg
25mg
25mg
25mg
50mg

50mg
100mg
100mg
250mg
100mg
200mg

Other Dopaminergic Drugs


Ergot derivatives such as bromocriptine and cabergoline can cause fibrotic reactions
baseline tests and monitoring needed see BNF
B Ropinirole

250 microgram, 1mg, 2mg & 5mg tablets


2mg, 4mg & 8mg modified release tablet

once daily formulation that is only approved for use in


Parkinsons disease patients with proven compliance problems
Linked to information sheet

B Pramipexole

88, 180 & 700 microgram tablets


- approved for 2nd line use in Parkinsons disease
Linked to information sheet

Selegiline

5mg tablets

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

51

10mg in 5ml oral liquid


Bromocriptine

2.5mg tablets

B Rasagiline

1mg tablets

B Rotigotine

1mg/24hours, 2 mg/24 hours, 3mg/24hours, 4 mg/24


hours, 6 mg/24 hours, and 8 mg/24 hours, selfadhesive patches

Linked to information sheet

- for use on the advice of specialists in the treatment of


Parkinson's disease. Mainly for use in patients who have difficulty
with swallowing. Also approved for second line use in patients with
restless legs syndrome. Linked to information sheet

R Apomorphine

20mg in 2ml & 50mg in 5ml injections & 30mg in 3ml


pre-filled multiple dose pen injection device
5mg in 1ml pre-filled syringe
10mg lozenges also available (unlicensed) at the RVI

Entacapone

200mg tablets

Stalevo

Tablets containing:

R Tolcapone

100mg tablets

Amantadine

100mg capsules; 50mg in 5ml syrup-

50mg levodopa/12.5mg carbidopa/200mg entacapone


75mg levodopa/18.75mg carbidopa/200mg entacapone
100mg levodopa/25mg carbidopa/200mg entacapone
125mg levodopa/31.25mg carbidopa/200mg entacapone
150mg levodopa/37.5mg carbidopa/200mg entacapone
200mg levodopa/50mg carbidopa/200mg entacapone

For use on the advice of neurologists

4.9.2 Antimuscarinic Drugs


Trihexyphenidyl
(Benzhexol)
Orphenadrine

2mg & 5mg tablets;


5mg in 5ml syrup
50mg tablets; 25mg in 5ml sugar-free elixir

Procyclidine

5mg tablets
2.5mg in 5ml & 5mg in 5ml sugar-free syrups
10mg in 2ml injection

4.9.3 Drugs Used in Essential Tremor, Chorea, Tics and Related Disorders
Tetrabenazine s
R Riluzole

25mg tablets
- For use on the advice of neurologists
50mg tablets approved for motor neurone disease in line with

Botulinum A Toxin Haemagglutinin Complex

50 unit injection (Vistabel) sr


100 unit injection (Botox) s

NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

52

500 unit injection (Dysport) s

- approved as a treatment of overactive bladder in patients who

have failed to respond to conservative therapy and treatment with


at least two anti-muscarinic drugs (unlicensed indication)
-Botox only approved for use in paediatric patients with severe
bladder over-activity and neuropathic bladder who have not
responded to other treatment.
- approved as an alternative to surgery in the treatment of
hyperhidrosis affecting the axillae, palms of the hands and soles of
the feet which has not responded to treatment such as
antiperspirants (use on the hands or feet is unlicensed)
- the 50mg injection (Vistabel) is restricted to use in private
patients receiving aesthetic treatment

Botulinum Toxin Type A


(Xeomin) s

100 units injections similar potency to Botox, and may be


less expensive (depending on price agreements/ contracts), but
not licensed for the full range of indications

N.B. Botulinum Toxin Type A products should be prescribed by brand name


Botulinum B Toxin s

2,500 units in 0.5ml, 5,000 units in 1ml & 10,000 units


in 2ml injections

Memantine s

10mg tablets
-for use as last line drug after other alternatives have been
considered, in the treatment of congenital and acquired nystagmus

4.10 - Drugs Used in Substance Dependence


Alcohol Dependence
Acamprosate s

333mg e/c tablets

Chlordiazepoxide

5mg & 10mg capsules

Disulfiram s

200mg tablets

Cigarette Smoking
NRT products should be prescribed by brand to ensure the first choice products are
supplied

Nicotine

2mg & 4mg sugar-free chewing gum (Nicorette is the


gum of choice)
10mg, 15mg & 25mg/16 hour patches (Nicorette
Invisi)
7mg & 14mg & 21mg /24 hour patches (Nicotinell is
the patch of choice as potential savings to be made)
2mg & 4mg lozenges (Niquitin is the lozenge of choice);
2mg sublingual tablets
15mg cartridges for use in inhalator
Nicorette Quickmist 1mg per dose
1.5mg & 4mg mini lozenges (NiQuitin Minis Lozenges)

Bupropion
(Amfebutamone)

150mg m/r tablets

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

53

Varenicline

500microgram & 1mg tablets


- approved in line with NICE

http://www.bnf.or

Opioid Dependence
A Buprenorphine

400 microgram, 2mg & 8mg sublingual tablets


- approved for the management of opioid dependence in line
with NICE

A Suboxone

2mg/500microgram sublingual tablets containing,


buprenorphine 2 mg, & naloxone 500 micrograms
8mg/2mg tablets sublingual tablets containing
buprenorphine 8 mg & naloxone 2 mg

A Lofexidine

200 microgram tablets

A Methadone

5mg in 5ml oral solution &


5mg in 5ml sugar free solution
- approved for the management of opioid dependence in line
with NICE
- see section 4.7.2 for other preparations

A Naltrexone

50mg tablets
- approved for the management of opioid dependence in
detoxified formerly opioid-dependent people in line with
NICE

- also approved for use in reducing agitation and/ or selfinjurious behaviour in patients with learning disabilities or
autism (unlicensed indication). Treatment must be initiated
by an appropriate hospital specialist and GPs should only be
asked to prescribe it for responders in accordance with a
shared care guideline Link to Shared Care Guideline
4.11 - Drugs for Dementia
N.B. Treatment with these drugs should only be initiated by
psychogeriatricians and certain neurologists. Linked to information sheet
B Donepezil

5mg & 10mg tablets


5mg & 10mg orodispersible tablets
- approved in line with NICE

B Rivastigmine

1.5mg, 3mg, 4.5mg & 6mg capsules


4.6mg and 9.5mg per 24 hour patches

- approved in line with NICE


- Patches approved for patients unable to tolerate treatment with
oral rivastigmine due to nausea and vomiting, and for patients
requiring treatment with an acetylcholinesterase inhibitor who are
unable to take oral medication e.g. due to swallowing difficulties or
nil by mouth prior to surgery.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

54

B Galantamine

4mg, 8mg & 12mg tablets


8mg, 16mg & 24mg sustained release capsules;
4mg / ml oral solution

- the oral solution is only approved for limited short-term use in the
management of hospital patients who are unable to swallow
tablets/ capsules. It is not for use in patients whose dementia is so
severe that they can no longer swallow tablets
- approved in line with NICE

Memantine

Treatment titration pack.


10mg & 20mg tablets
10mg / ml oral solution B
- approved in line with NICE

Linked to information sheet

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

55

5. Infections
Antimicrobial agents should be used according to locally agreed guidelines and
restrictions.

5.1 Antibacterial Drugs


5.1.1 Penicillins
5.1.1.1 Benzylpenicillin and Phenoxymethylpenicillin
Benzylpenicillin

600mg injection

Phenoxymethylpenicillin
(Penicillin V)
Long Acting Penicillins

250mg tablets
125mg in 5ml & 250mg in 5ml oral solutions

R Procaine Penicillin u

1,200,000 units in 2ml injection

Benzathaine Penicillin u

2.4mega unit injection

For use in genitourinary medicine

5.1.1.2 Penicillinase Resistant Penicillins


Flucloxacillin

250mg & 500mg capsules


125mg in 5ml & 250mg in 5ml oral solutions
250mg, 500mg & 1g injections

5.1.1.3 Broad Spectrum Penicillins


Amoxicillin

250mg & 500mg capsules; 3g sachets


125mg in 1.25ml paediatric suspension
125mg & 250mg in 5ml sugar-free syrups
250mg, 500mg & 1g injections

Co-amoxiclav

Amoxicillin with clavulanic acid:


250/125 & 500/125 tablets
250/125 dispersible tablets
125/31 & 250/62 sugar-free suspensions
400/57 sugar-free suspension (Augmentin Duo)
500/100 (600mg) & 1,000/200 (1.2g) injections
(quantities are indicated in the form co-Amoxiclav x/y
where x = mg amoxicillin and y = mg clavulanic acid)

5.1.1.4 Antipseudomonal Penicillins


Piperacillin with
Tazobactam

2.25g & 4.5g injections containing piperacillin 2g &


tazobactam 250mg/2.25g vial & piperacillin 4g &
tazobactam 500mg/4.5g vial

5.1.1.5 Mecillinams
Pivmecillinam

200mg tablets

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

56

5.1.2 Cephalosporins and other Beta-Lactam Antibiotics


Cephalosporins
Cefalexin

250mg & 500mg capsules

Cefuroxime

250mg, 750mg & 1.5g injections

Ceftazidime

250mg, 500mg, 1g & 2g injections

Cefotaxime

500mg, 1g & 2g injections

Ceftriaxone

250mg, 1g & 2g injections

Cefixime

200mg tablets
100mg in 5ml paediatric suspension

- also approved for the prevention of irinotecan induced diarrhoea,


specialist use only R

R Ceftaroline

600mg injection

- approved for use on the advice of microbiology or infectious


disease consultants.

Other Beta-Lactam Antibiotics


R Aztreonam

500mg, 1g & 2g injections


75mg powder for inhalation
-approved in line with NHS England specialised commissioning

criteria for the treatment of chronic pulmonary Pseudomona


aeruginosa infection in patients with cystic fibrosis

R Doripenem

500mg injection
- for use as a 2nd line alternative to meropenem in patients known
to be infected with organisms resistant to meropenem, or with
those organisms with raised MICs to meropenem. Should only be
on the advice of microbiology or infectious disease consultants.

Ertapenem

1g injection

Meropenem

500mg & 1g injections

5.1.3 Tetracyclines
Oxytetracycline

250mg tablets

Doxycycline

50mg & 100mg capsules; 100mg dispersible tablets

Minocycline

50mg & 100mg capsules and tablets

Lymecycline

408mg capsules ( tetracycline 300mg)

R Tigecycline

50mg injection (Used by NUTH only)

Demeclocycline s

150mg capsules

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

57

- for the treatment of inappropriate antidiuretic hormone secretion


treatment is initiated by specialists only.

5.1.4 Aminoglycosides
R Gentamicin

80mg in 2ml & 20mg in 2ml IV/IM injections


5mg in 1ml intrathecal injection
bone cement & beads (for use in orthopaedic surgery) s

Gentamicin sulphate su

Powder for mixing in bone cement to created antibiotic


loaded spacers and beads.
- for the treatment of patients with infections associated with total
knee or hip arthroplasty, and for local antibiotic therapy in other
orthopaedic infections

B Nebulised Gentamicin u

- for long term therapy in non-cystic fibrosis bronchiectasis usually


in patients having > 3 exacerbations per annum with an organism
identified as being sensitive to gentamicin.
Linked to information sheet

R Amikacin

100mg in 2ml & 500mg in 2ml injections

R Neomycin

500mg tablets; 1g in 10ml syrup u

R Tobramycin s

80mg in 2ml & 240mg in 6ml injections


300mg in 4ml (Bramitob) nebuliser solution

- only for long-term 2nd line use in the management of chronic

pulmonary infection due to Pseudomonas aeruginosa in cystic


fibrosis (CF) patients

300mg in 5ml (Tobi)

- only to be used in existing patients as it is cheaper to use


Bramitob.

TOBI Podhaler 28mg capsule plus podhaler


- approved for CF patients in line with NICE
Spectinomycin

2g injection

- only approved for the treatment of gonorrhoea in adults.

5.1.5 Erythromycin and Related Drugs


Preferred Choices
Erythromycin

250mg e/c tablets


125mg, 250mg & 500mg in 5ml syrups
1g intravenous injection (as lactobionate)

Clarithromycin

250mg & 500mg tablets


125mg in 5ml & 250mg in 5ml suspensions
500mg injection

Alternative
Azithromycin

250mg capsules & tablets


200mg in 5ml suspension

5.1.6 Clindamycin
Clindamycin

150mg capsules

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

58

75mg in 5ml suspension u


300mg in 2ml & 600mg in 4ml injections
5.1.7 Some Other Antibacterials
Colistin

1,500,000 unit tablets


250,000 units in 5ml syrup
500,000, 1,000,000 & 2,000,000 unit injections
R Colobreathe 125mg capsule plus Turbospin inhaler
- approved for CF patients in line with NICE

Chloramphenicol

250mg capsules
1g injection

R Daptomycin

350mg injection & 500mg injection

R Linezolid

600mg tablets
100mg in 5ml suspension
600mg in 300ml IV infusion

Rifampicin

150mg & 300mg capsules


100mg in 5ml syrup
600mg vials for IV infusion

Fidaxomicin

Fosfomycin

200mg tablets

- approved for third line use in the treatment of C. difficile.


To be initiated on the recommendation of a consultant
microbiologist

500mg capsules R
2g & 5g injections R
3g sachets s
- sachets can be initiated in primary care for the treatment of UTIs
caused by multi-resistant organisms following advice from
microbiology only

R Rifaximin

550mg tablets
- for use in the treatment of persistent hepatic encephalopathy
where lactulose and neomycin have failed or are unsuitable

Sodium Fusidate
(Fusidic acid)

250mg film coated tablets


250mg in 5ml suspension (Fusidic Acid)
- equivalent in therapeutic effect to 175mg sodium fusidate

Vancomycin

125mg capsules
500mg injection

Teicoplanin

200mg & 400mg injections


20mg in 4ml intrathecal injection u

5.1.8 Sulphonamides and Trimethoprim


Trimethoprim

100mg & 200mg tablets


50mg in 5ml suspension

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

59

Co-trimoxazole

(Sulphamethoxazole 5 parts & trimethoprim 1 part)


480 mg tablets (plain or dispersible)
960mg tablets
240mg in 5ml & 480mg in 5ml suspensions
480mg in 5ml ampoules for IV infusion

5.1.9 Antituberculous Drugs


Isoniazid

50mg & 100mg tablets


50mg in 5ml elixir u
50mg in 2ml injection

Rifampicin

150mg & 300mg capsules


100mg in 5ml syrup
600mg injection (for IV infusion)

Rifampicin &
Isoniazid

Rifinah 150 tablets rifampicin 150mg + isoniazid 100mg


Rifinah 300 tablets rifampicin 300mg + isoniazid 150mg

Rifater

Tablets - rifampicin 120mg, isoniazid 50mg & pyrazinamide


300mg

Pyrazinamide u

500mg tablets
- licensed formulation discontinued, consider using Rifater
where appropriate

Ethambutol

100mg & 400mg tablets

Rifabutin

150mg capsules

Streptomycin

1g injection

5.1.10 Antileprotic Drugs


Dapsone

50mg & 100mg tablets


used in the treatment of leprosy and some skin conditions (e.g.
dermatitis herpetiformis, pemphigoid on the advice of
dermatologists)

5.1.11 Metronidazole
Metronidazole

200mg & 400mg tablets


200mg in 5ml suspension
500mg & 1g suppositories
50mg in 10ml injection & 500mg in 100ml IV infusion

5.1.12 Quinolones
First Choice
Ciprofloxacin

250mg, 500mg & 750mg tablets


250mg in 5ml suspension
100mg & 200mg, 400mg intravenous infusions

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

60

Alternatives
Moxifloxacin

400mg tablets

Ofloxacin

200mg & 400mg tablets


200mg in 100ml intravenous infusion

Levofloxacin

- for use in the treatment of pelvic inflammatory disease and


chlamydia genital tract infections in accordance with local primary
care guidelines

250mg & 500mg tablets


500mg in 100ml intravenous infusion
- not normally used in Newcastles hospitals

5.1.13 Urinary-Tract Infections


Nitrofurantoin

50mg & 100mg tablets


50mg capsules
) in macrocrystalline form
100mg m/r capsules ) (Macrodantin & Macrobid)
25mg in 5ml sugar-free suspension

5.2 Antifungal Drugs


Amphotericin

50mg injection
50mg liposomal injection (Ambisome)

R Anidulafungin

100mg injection
- approved for the treatment of invasive candidiasis.

R Caspofungin
R Micafungin

Fluconazole
Flucytosine
Itraconazole

Posaconazole

Griseofulvin

50mg & 70mg injections


50mg & 100mg injections

- for second line use as an alternative to caspofungin in children


and neonates.

50mg, 150mg & 200mg capsules


50mg in 5ml & 200mg in 5ml suspensions
50mg in 25ml & 200mg in 100ml IV infusions
500mg tablets u
2.5g in 250ml IV infusion
100mg capsules
50mg in 5ml oral solution
250mg in 25ml injection for IV infusion
200mg in 5ml oral suspension.

- approved for the prevention of invasive fungal infection in


immunocompromised patients in whom there is a specific risk of
aspergillus infection or where fluconazole and itraconazole are not
tolerated or are unlikely to be sufficiently effective (largely for
secondary prevention)
-approved for patients with invasive fungal infections that are not
responding to other treatments or where they are not tolerated
(largely in place of liposomal amphotericin/ voriconazole)

125mg & 500mg tablets


- very limited use where terbinafine is contraindicated

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

61

Terbinafine

250mg tablets

Nystatin

100,000 units/ml suspension


R 100,000 unit pessaries u
second line treatment for vaginal non albicans infection, for
patients who have not responded to standard treatments such as
azoles. Prescribing is restricted to the GUM clinics.

R Voriconazole

50mg & 200mg capsules


200mg vials for IV infusion

5.3 Antiviral Drugs


5.3.1 Human Immunodeficiency Virus
Nucleoside Reverse Transcriptase Inhibitors
R Abacavir

300mg tablets
100mg in 5ml (20mg per ml) sugar-free oral solution

R Didanosine

100mg & 200mg tablets; 250mg & 400mg e/c caps

R Abacavir & Lamivudine


(Kivexa)

600mg abacavir/600mg lamivudine tablets

R Lamivudine (3TC)

150mg & 300mg tablets (treatment of HIV)


50mg in 5ml oral solution (HIV)

R Stavudine

20mg, 30mg & 40mg capsules


5mg in 5ml oral solution

R Tenofovir

245mg tablets

R Zidovudine

100mg & 250mg capsules


50mg in 5ml sugar-free syrup
200mg in 20ml (10mg/ml) concentrate for IV infusion

- approved for chronic hepatitis B in line with NICE

Protease Inhibitors
R Atazanavir

150mg,200mg & 300mg capsules

- for limited use as part of triple therapy where other protease


inhibitors are unsuitable

R Darunavir u

300mg, 400mg, 600mg & 800mg tablets

R Fosamprenavir u

700mg tablets

R Nelfinavir

250mg tablets

R Lopinavir & Ritonavir


(Kaletra)

100mg lopinavir/25mg ritonavir and 200mg


lopinavir/50mg ritonavir tablets
400mg lopinavir/100mg ritonavir in 5ml oral solution

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

62

R Indinavir

200mg & 400mg capsules

R Ritonavir

100mg capsules

R Saquinavir

200mg capsules, 200mg gel filled capsules

Non-Nucleoside Reverse Transcriptase Inhibitors


R Efavirenz

50mg, 100mg & 200mg capsules

R Etravirine

100mg tablets & 200mg tablets

R Nevirapine

200mg tablets, 50mg in 5ml suspension

R Rilpivirine

25mg tablets
-for patients who, due to renal impairment, require reduced doses
that are not able to be accommodated by the fixed combination
product.

Other Antiretroviral Agents


R Enfuvirtide

90mg/ml injection

R Maraviroc

150mg & 300mg tablets

R Raltegravir

400mg tablets

Combination Products

- approved For use in the treatment of patients with HIV infections


that are resistant to standard therapy in accordance with British
HIV Association and EACS guidelines

- approved for use in the treatment of patients with HIV infections


that are resistant to standard therapy in accordance with British
HIV Association and EACS guidelines

R Atripla

Tablets containing efavirenz 600 mg, emtricitabine


200 mg & tenofovir disoproxil (as fumarate) 245 mg

R Combivir

Tablets containing lamivudine 150mg & zidovudine


300mg
Tablets containing rilpivirine 25mg, emtricitabine
200mg & tenofovir disoproxil (as fumarate) 245 mg
- for use in patients who cannot tolerate Atripla therapy.

R Eviplera

R Stribild

Tablets containing cobicistat 150mg, elvitegravir 150mg,


emtricitabine 200mg, tenofovir disoproxil (as fumarate)
245mg

R Trizivir

Tablets containing abacavir 300mg, lamivudine 150mg


& zidovudine 300mg

R Truvada

Tablets containing 200mg of emtricitabine & 245mg of


tenofovir disoproxil (equivalent to 300mg of tenofovir
disoproxil fumarate or 136mg of tenofovir)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

63

5.3.2 - Herpesvirus infections


5.3.2.1 Herpes simplex and varicellazoster infection
First Choice
Aciclovir
(Acyclovir)

200mg, 400mg & 800mg tablets/dispersible tablets


200mg in 5ml suspension
250mg & 500mg IV infusions

Alternative
Valaciclovir

500mg tablets

5.3.2.2 Cytomegalovirus infections


R Foscarnet Sodium

24mg/ml intravenous infusion (6g in 250ml)

R Ganciclovir

500mg intravenous infusion

R Valganciclovir

450mg tablets, 250mg in 5ml oral solution


- this has replaced an unlicensed 450mg in 5ml suspension

R Cidofovir r

375mg in 5ml (75mg/ml) solution for injection.

- for use in the prevention and treatment of cytomegalovirus


infection and for limited use by ENT Surgeons in the treatment of
selected patients with respiratory papillomatosis (an unlicensed
indication)

5.3.3 Viral Hepatitis


R Lamivudine
(3TC)

100mg tablets
25mg in 5ml oral solution

R Adefovir

10mg tablets

R Entecavir

500 microgram & 1mg tablets

R Tenofovir

245mg tablets

- other formulations licensed for use in patients with HIV infection


- see section 5.3.2

- mainly used in combination with lamivudine. Other treatments


now preferred for new patients
- approved for chronic hepatitis B in line with NICE

- approved for Hepatitis B in line with NICE

- for use in the treatment of chronic hepatitis B. Preferred


treatment for many patients and may be used in combination with
lamivudine

5.3.3.2 Chronic hepatitis C


R Boceprevir

200mg capsules
- approved in combination with peginterferon alfa and ribavirin for
genotype 1 chronic hepatitis C in adults with compensated liver
disease in line with NICE

R Telaprevir

375mg tablets

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

64

- approved in combination with peginterferon alfa and ribavirin for


genotype 1 chronic hepatitis C in adults with compensated liver
disease in line with NICE

R Sofosbuvir with either


Daclastavir or Ledipasvir u

- approved in combination with ribavirin in line with the NHS


England Early Access Programme

5.3.4 Respiratory Syncytial Virus


R Palivizumab

50mg & 100mg injections

R Ribavirin

6g in 300ml inhalation
1.2g in 12ml IV injection u
- for use on specialist microbiological advice e.g. in Lassa
fever
200mg tablets and capsules
- approved for chronic hepatitis in line with NICE, see
peginterferon alfa 2a/2b

- approved treatment for children and young people with chronic


hepatitis C NICE

5.3.5 Influenza Virus


First Choice
Oseltamivir

30mg, 45mg & 75mg capsules


6mg in 1ml (30mg in 5ml) oral suspension
- approved for the treatment of influenza in line with NICE
- approved for the prophylaxis of inlfluenza in line with NICE

Alternative
Zanamivir

5mg/blister dry powder for inhalation via Diskhaler


- approved for the treatment of inlfluenza in line with NICE
- approved for the prophylaxis of inlfluenza in line with NICE
- for use if there is resistance to oseltamivir

5.4 Antiprotozoal Drugs


5.4.1 Antimalarials
Chloroquine Sulphate

200mg tablets ( 150mg chloroquine base)


68mg in 5ml syrup ( 50mg in 5ml chloroquine)
272.5mg in 5ml injection ( 200mg in 5ml chloroquine)

Mefloquine

250mg tablets

Primaquine u

7.5mg tablets

Proguanil

100mg tablets

Pyrimethamine

25mg tablets

Malarone

Tablets (100mg proguanil & 250mg atovaquone)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

65

Paediatric tablets (proguanil 25mg & atovaquone 62.5mg)


R Artesunate u

60mg injection
- approved for severe malaria in in line WHO guidance.

Quinine

Quinine sulphate 200mg tablets


Quinine dihydrochloride 300mg in 1ml injection u

5.4.2 Amoebicides
Metronidazole

- see section 5.1.11

Diloxanide

Diloxanide furoate 500mg tablets

included in North of Tyne antimicrobial guidelines for use after


metronidazole in the treatment of amoebic dysentery

5.4.4 Antigiardial Drugs


Metronidazole

- see section 5.1.11

Mepacrine u

100mg tablets

5.4.5 Leishmaniacides
R Sodium stibogluconate

100mg/ml injection

- approved for the treatment of visceral and cutaneous


leishmaniasis

5.4.8 Drugs for Pneumocystis Pneumonia


R Pentamidine

300mg injection
300mg in 5ml nebuliser solution

Co-trimoxazole

- see section 5.1.8

R Atovaquone

750mg in 5ml sugar-free suspension

-approved for use in patients intolerant of co-trimoxazole

5.5 Anthelmintic
5.5.1 Drugs for Threadworms
R Albendazole u

400mg chewable tablets

Mebendazole

100mg tablets
100mg in 5ml suspension

Pripsen

Sachets - containing piperazine phosphate 4g & sennosides


15.3mg/sachet

5.5.5 Schistosomicides
R Praziquantel Biltricide u

500mg tablets

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

66

6. Endocrine System
6.1 Drugs Used in Diabetes
6.1.1 Insulins
Preferred
(All Human)

Alternatives
(All Human)

Type of prefilled pen inj


device / Comments

6.1.1.1 Short acting insulins


Very Rapidly Acting
Insulin Aspart (Novorapid)
Insulin Lispro (Humalog)

Vial

Cartridge

Pen

10ml
10ml

5x3ml*
5 x 3ml

5x3ml
5x3ml

Human Actrapid

10ml

Humulin S

10ml

5x3ml

R Humulin R u 500 units/ml

10ml

Flexpen
Kwikpen pen

Rapidly Acting

For use in a very small number of


insulin resistant patients that
require very high doses

6.1.1.2 Intermediate and Long Acting Insulins


NPH (isophane) insulins
Insulatard

10ml

5x3ml*

Humulin I

10ml

5x3ml

Mixtard 30

10ml

5x3ml*

Humulin M3

10ml

5x3ml

5x3ml*

5x3ml

Flexpen

5x3ml

5x3ml

Kwikpen pen

5x3ml

5x3ml

Optiset, OptiClik &


SoloStar

5x3
ml

Innolet

5x3
ml

Biphasic insulin mixtures

Conventional

Analogue
Biphasic Insulin Aspart
(NovoMix 30)
Biphasic Insulin Lispro
(Humalog Mix 25 & Mix 50)

Long acting (basal) insulins


Insulin Glargine (Lantus)
10ml

5x3
ml

Innolet

5x3
ml

5x3ml
5x3ml For use in line NICE
Insulin Detemir (Levemir)
N.B. Preloaded pens and Innolet devices should only be used where cartridges are not
suitable.
* For use with Novopen and Novopen Penmate injection devices

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

67

6.1.2 Oral Antidiabetic Drugs


6.1.2.1 Sulphonylureas
First Choice
Gliclazide

40mg & 80mg tablets

Alternatives
Glimepiride

1mg, 2mg, 3mg & 4mg tablets

Tolbutamide

500mg tablets

Glibenclamide

2.5mg & 5mg tablets


not used in Newcastles hospitals

6.1.2.2- Biguanides
Metformin

500mg & 850mg tablets; 500mg, 750mg & 1000mg


m.r. tablets r
500mg and 1g powder for oral solution in sachets
500mg in 5ml sugar-free oral solution
The sachets are preferred to the ready-made oral solutionmuch cheaper. The once daily m.r. tablets (Glucophage SR)
are only approved for use in patients who have failed to
tolerate the conventional tablets despite careful dose
titration
Metformin is also approved for use in Polycystic Ovary
Syndrome

6.1.2.3 Other Antidiabetic Drugs


B Exenatide r

5 microgram and 10 microgram per dose prefilled


injection pens containing a 250microgram/ml solution
for subcutaneous injection.
- treatment must be initiated by a consultant diabetologist and use
is limited to overweight patients with type 2 diabetes in line with
NICE
Linked to information sheet

2mg prolonged release injection


- approved for use in line with NICE

Liraglutide s

18mg prefilled pen containing a 6mg/ml solution for


subcutaneous injection.
- approved for type 2 diabetes in line NICE

B Lixisenatide

10 microgram and 20 microgram per dose pre filled


injection pens

Pioglitazone

15mg, 30mg & 45mg tablets

Sitagliptin s

25mg, 50mg & 100mg tablets Treatment must be


initiated by a consultant diabetologist

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

68

Acarbose s

50mg & 100mg tablets

Dapagliflozin

5mg & 10mg film coated tablets

Canagliflozin

100mg film coated tablets

-approved for treatment of type 2 diabetes in line with NICE

-approved for combination treatment of type 2 diabetes in line with


NICE

6.1.4. Treatment of Hypoglycaemia


Glucose (or sugar)

40% oral gel 9.2g glucose/23g oral ampoule


(GlucoGel, formerly known as Hypostop)

25% & 50% injections (also 5% & 10% IV infusions)


Chronic Hypoglycaemia
Glucagon

1mg (1 unit) injection (with syringe)

Diazoxide

50mg tablets (suspensions can be obtained / prepared if


needed)

6.1.5 Treatment of Diabetic Neuropathy


First Line
Duloxetine

30mg & 60mg capsules 30mg & 60mg capsules -

Second Line
Amitriptyline

See section 4.3

Third Line
Gabapentin

See section 4.8.1

also approved for hospital use as an adjunct to other treatment in


the management of peri/post-operative pain. GPs should not be
asked to prescribe gabapentin for this unlicensed indication.

Alternatives
Tramadol

50mg capsules; 50mg dispersible tablets


100mg in 2ml injection

6.2 Thyroid and Antithyroid Drugs


6.2.1 Thyroid Hormones
First Choice
Levothyroxine
(Thyroxine)

25, 50 & 100 microgram tablets


25 & 100 microgram in 5ml sugar-free suspensionsu

Alternative
Liothyronine

20 microgram tablets; 20 microgram injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

69

6.2.2 Antithyroid Drugs


First Choice
Carbimazole

5mg & 20mg tablets

Alternatives
Propylthiouracil

50mg tablets

R Aqueous Iodine Oral


Solution

Oral solution (Lugols Iodine) containing 130mg total


iodine/ml (5% iodine & 10% potassium iodide)

R Iopanoic acid u

500mg tablets
- approved for use in rapid blockade of thyrotoxicosis in otherwise

medically resistant patients prior to surgery/thyroidectomy

R Potassium iodate u

85mg tablets - mainly used by medical physics

Propranolol

80mg m/r capsules


- preferred formulation for relief of thyrotoxic symptoms -see
section 2.4 for other formulations

6.3 Corticosteroids
6.3.1 Replacement Therapy
Fludrocortisone

100 microgram tablets

Hydrocortisone

10mg & 20mg tablets


10mg in 5ml suspension u
100mg injection (as the sodium succinate)

6.3.2 Glucocorticoid Therapy


First Choice
Prednisolone

1mg, 5mg, 25mg & 50mg tablets; 5mg soluble tablets

Alternatives
Dexamethasone

500 microgram & 2mg tablets


2mg in 5ml oral solution; 5mg in 5ml oral solution u
4mg in 1ml and 8mg in 2ml injections (as dexamethasone
sodium phosphate)

Betamethasone

500 microgram soluble tablets


4mg in 1ml injection (as betamethasone sodium phosphate)

Methylprednisolone

2mg, 4mg & 16mg tablets NHCT


40mg, 125mg, 500mg & 1g injections (as the sodium
succinate)

Hydrocortisone

10 & 20mg tablets; 10mg in 5ml suspension u


100mg injection (as the sodium succinate)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

70

Triamcinolone Acetonide

40mg in 1ml intramuscular / intra-articular injection

6.4 Sex Hormones


6.4.1 Female Sex Hormones
6.4.1.1 Oestrogens and Hormone Replacement Therapy (HRT)
Oestrogen Only
Tablets
First Choice
Estradiol (Oestradiol)

1mg & 2mg tablets

Alternative
Oestrogens, conjugated
(Premarin)

625 microgram & 1.25mg tablets

Ethinylestradiol s

2 microgram u & 10 microgram tablets

- approved for use on advice from appropriate specialists (mainly


endocrinologists)

Patches and Other Formulations


Estradiol

Twice weekly matrix patches releasing approximately


25, 50, 75 & 100 microgram/24 hours (e.g. Evorel)
Once weekly matrix patches releasing approx. 50 &
100 microgram estradiol/24 hours (Progynova TS)
0.1% gel (Sandrena)

Oestrogen and Progestogen


Sequential Combined Therapy (tablets)
First Choice
Prempak-C

0.625 & 1.25 tablets (packs of 28 conjugated


oestrogen tablets [625 microgram or 1.25mg] + 12
norgestrel 150 microgram tablets)

Alternatives
Elleste Duet

Packs of 16 x 1mg estradiol tablets + 12 x 1mg


estradiol & 1mg norethisterone tablets

Femoston 1/10

Packs of 14 estradiol 1mg tablets + 14 tablets


containing estradiol 1mg & dydrogesterone 10mg
Packs of 14 estradiol 2mg tablets + 14 tablets
containing estradiol 2mg & dydrogesterone 10mg

Femoston 2/10

Sequential Combined Therapy (patches)


Evorel Sequi

Pack containing 4 patches releasing 50 micrograms


estradiol/24 hours & 4 patches releasing 50
micrograms estradiol and 170 micrograms
norethisterone acetate/ 24 hours

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

71

Continuous Combined Therapy (tablets)

Low dose

0.3mg conjugated oestrogen + medroxyprogesterone


acetate 1.5mg tablets.

Standard dose

Tablets containing estradiol 1mg & norethisterone


acetate 500 micrograms

High dose

Tablets containing 2mg estradiol & norethisterone


acetate 1mg

Premique low -dose

Kliovance
Kliofem

Continuous Combined Therapy (patches)


Evorel Conti patches
Gonadomimetic
Tibolone

Pack containing 8 patches releasing 50 micrograms


estradiol/24 hours & 170 micrograms norethisterone
acetate/24 hours
2.5mg tablets

Selective Oestrogen Modulator


Raloxifene s

6.4.1.2 Progestogens
First Choice
Norethisterone

60mg tablets

- for use on the advice of specialists in the prevention and


treatment of osteoporosis where alternative treatments are
inappropriate

5mg tablets

Alternatives
Medroxyprogesterone
acetate

2.5mg, 5mg & 10mg tablets

- sometimes used as a progestogen component of HRT

100mg & 200mg tablets

- for use in malignant disease see section 8.3.2.

50mg in ml injection
- see sections 7.3.2.2 for use of medroxyprogesterone acetate
injection in contraception.

Progesterone

200mg & 400mg pessaries


50mg in 1ml injection

R Ulipristal

5mg tablets

- approved for the per-operative treatment of uterine fibroids

6.4.2 Male Sex Hormones


Testosterone and Esters
First Choice
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

72

Testosterone Undecanoate

1g in 4ml (250mg/ml) oily injection (Nebido)

Alternatives
Testosterone gel s

50mg/5g (1%) sachets (Testogel)


10mg/0.5ml (2%)/ metered dose from pump
(Tostran)
50mg/5g (1%) tubes (Testim)
For use on advice from endocrinologists

Sustanon 250

1ml injection (testosterone propionate 30mg, testosterone


phenylpropionate 60mg, testosterone isocaproate 60mg &
testosterone decanoate 100mg)

Testosterone Undecanoate

40mg capsules

Anti-Androgens
Cyproterone Acetate s

50mg & 100mg tablets

Finasteride

5mg tablets

- approved for use on the advice of a urologist

6.4.4 Gender Dysphoria (Unlicensed Indication)


A Goserelin

3.6mg injection

A Leuprorelin

11.25mg injection

A Estradiol (Oestradiol)

1mg & 2mg tablets

A Estradiol

Twice weekly matrix patches releasing approximately


50, 75 & 100 microgram/24 hours
0.1% gel (Sandrena)

A Finasteride

5mg tablets

A Cyproterone Acetate

50mg & 100mg tablets

A Spironolactone

25mg & 100mg tablets

A Testosterone
Undecanoate

1g in 4ml (250mg/ml) oily injection (Nebido)

A Sustanon 250

1ml injection (testosterone propionate 30mg, testosterone

A Testosterone gel

50mg/5g (1%) sachets (Testogel)

phenylpropionate 60mg, testosterone isocaproate 60mg &


testosterone decanoate 100mg)

6.5 Hypothalamic and Pituitary Hormones and Anti-Oestrogens


6.5.1 Hypothalamic and Anterior Pituitary Hormones and Anti-Oestrogens

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

73

Anti-Oestrogens
Clomifene Citrates

50mg tablets Under review

Anterior Pituitary Hormones


Corticotrophins
R Tetracosactide
(Tetracosactrin)

250 microgram in 1ml injection,


1mg in 1ml depot injection

Gonadotrophins
R Chorionic
Gonadotrophin

1,500 units & 5,000 units injections


R Fertility treatment
B HypogonadismH Linked to information sheet

R Menotrophin
(Menopur)

(75 units FSH & 75 units LH activity) injection


Pre filled syringes

Growth Hormones
TA188 Human growth hormone (somatropin) for the treatment of growth failure in
children

R Somatropin

1st line
Omnitrope 5-mg (15-unit) vial (powder with
diluent) for use with Omnitrope Pen L device
3.3 mg (10 units)/ml, 1.5 ml (5-mg, 15-unit) cartridge
& 6.7 mg (20 units)/ml, 1.5 ml (10-mg, 30-unit)
cartridge - for use with Omnitrope Pen 5 &
Omnitrope Pen 10 devices respectively
- least expensive formulation of somatropin. Omnitrope should be
used in all de novo paediatric patients where possible.

2nd line
Norditropin SimpleXx 1.5ml cartridges for use in
Nordipen devices - 5mg (15 units), 10mg (30 units)
& 15mg (45 units)
- 2nd least expensive alternative formulation for patients who
cannot tolerate omnitrope.

Saizen 8mg vials (powder with diluent)


Saizen 5.83 mg/ml solution for injection (6mg
cartridges), 8 mg/ml solution for injection (12mg and
20mg cartridges)
- for use in EasyPod device
- to be used in patients with compliance issues

3rd line
Genotropin Miniquick syringes 0.2mg (0.6 units) 0.8mg (2.4 units)1.4mg (4.2 units)
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

74

0.4mg (1.2 units) 1mg (3 units) 1.6mg (4.8 units)


0.6mg (1.8 units) 1.2mg (3.6 units) 2mg (6 units)
- to be used for patients when travelling.

Zomacton 12 unit (4mg) injection


- Needle free presentation.

1st line: 75% to 85% of total mg usage


2nd line: 15% to 25% of total mg usage
3rd line: up to 5% of total mg usage
TA64 Human growth hormone (somatropin) in adults with growth hormone
deficiency

R Somatropin

Genotropin cartridges for use in Genotropin pens 16 unit (5.3mg) & 36 unit (12mg) in 1ml
Genotropin Miniquick syringes 0.2mg (0.6 units) 0.8mg (2.4 units)1.4mg (4.2 units)
0.4mg (1.2 units) 1mg (3 units) 1.6mg (4.8 units)
0.6mg (1.8 units) 1.2mg (3.6 units) 2mg (6 units)
- To be used for patients when travelling.

Hypothalamic Hormones
Gonadorelin

100 microgram in 1ml injection

Protirelin (TRH)

200 microgram in 1ml injection u

6.5.2 Posterior Pituitary Hormones and Antagonists


Posterior Pituitary Hormones
Desmopressin

10 microgram/dose nasal spray


R 2.5 & 150 microgram/dose nasal sprays u
100 microgram/ml nasal drops
100 microgram & 200 microgram tablets
120 microgram sublingual tablets
R 4 microg in 1ml inj. & 15 microg in 1ml injection

R Argipressin

20 units in 1ml injection (Synthetic Vasopressin)

R Terlipressin

1mg vials for preparing injection

Antidiuretic Hormone Antagonists


Demeclocycline s

150mg capsules Treatment to be initiated by specialist

6.6 Drugs Affecting the Bone Metabolism


6.6.1 Calcitonin
Calcitonin (Salmon) s /
Salcatonin

400 units in 2ml injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

75

Teriparatide s

250 microgram/ml prefilled pen


- approved for the secondary prevention of osteoporotic fragility
fractures in postmenopausal women who are confirmed to have
osteoporosis primary in line with NICE

6.6.2 Bisphosphonates and Other Drugs Affecting Bone Metabolism


Treatment of Hypercalcaemia
Preferred Products
R Disodium Pamidronate

30mg injection

R Zoledronic Acid

4mg injection

Alternative
Sodium Clodronate

- for use in hypercalcaemia of malignancy and the prevention of


skeletal events in patients with metastatic breast cancer. Not
approved for preventing skeletal events in patients with prostate
cancer.

To avoid confusion it is recommended that this product is


prescribed by brand name i.e. Zometa

520mg tablets or 800mg tablets

Osteoporosis Prevention and Treatment


First Choice
Alendronate Sodium

10mg tablets (taken daily)


70mg tablets (taken once weekly) preferred
- approved for the primary prevention of osteoporosis in
postmenopausal women in line with NICE
- approved for the secondary prevention of osteoporotic fragility
fractures in postmenopausal women who are confirmed to have
osteoporosis primary in line with NICE

Alternatives
Risedronate Sodium

5mg tablets (taken daily)


35mg tablets (taken once weekly for osteoporosis) preferred
- approved for the primary prevention of osteoporosis in line
with NICE
- approved for the secondary prevention of osteoporotic fragility
fractures in postmenopausal women who are confirmed to have
osteoporosis in line with NICE

30mg tablets (for Pagets disease)


Strontium Ranelate

2g sachets

Ibandronic Acid

50mg tablets

- approved for the primary prevention of osteoporosis in


postmenopausal women in line with NICE
- approved for the secondary prevention of osteoporotic fragility
fractures in postmenopausal women who are confirmed to have
osteoporosis in line with NICE
approved for 2nd line use in patients who do not respond
adequately to bisphosphonates

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

76

- for use in the reduction of bone damage in patients with

metastatic breast cancer. Not approved for use in the treatment of


patients with other forms of cancer (e.g. prostate) or for the
treatment of osteoporosis

3mg in 3ml injection

- for use where oral bisphosphonates are not appropriate (not


tolerated, contra-indicated because of upper gastro-intestinal
problems or insufficiently effective)

R Zoledronic acid

5mg injection
- approved for the treatment of Pagets disease and post-menopausal
osteoporosis in those patients where oral risedronate is
contraindicated, inconvenient, poorly tolerated or ineffective in
reducing bone turnover. Postmenopausal osteoporosis in patients
where oral bisphosphonates are contraindicated, not tolerated or
where they are ineffective, as reflected by declining bone density
measurements. To avoid confusion it is recommended that this
product is prescribed by brand name i.e. Aclasta

Raloxifene s

60mg tablets
- not recommend for primary prevention of osteoporosis in
postmenopausal women NICE
- approved for the secondary prevention of osteoporotic fragility
fractures in postmenopausal women who are confirmed to have
osteoporosis in line with NICE
- approved for use on the advice of specialists in the prevention and
treatment of osteoporosis where alternative treatments are
inappropriate

B Denosumab

60mg in 1ml solution in prefilled syringe

- approved for use in the treatment of postmenopausal osteoporosis


in line with NICE
- also approved for male patients who cannot tolerate
bisphosphonates or strontium ranelate
. Linked to information sheet

70mg in 1ml (120mg) vial


- approved for the prevention of skeletal-related events in adults
with bone metastases from solid tumours in line with NICE
- not approved for therapy induced bone loss in non-metastatic
prostate cancer NICE

6.7 Other Endocrine Drugs


6.7.1 Bromocriptine and Other Dopaminergic Drugs
B Bromocriptine

2.5mg tablets

Cabergoline

500 microgram & 1mg tablets

6.7.2 Drugs Affecting Gonadotrophins


First choice
Leuprorelin s

3.75mg & 11.25mg pre filled syringes (also see section


8.3.4.2)

Alternatives
Goserelin s

3.6mg & 10.8mg injections (also see section 8.3.4.2)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

77

N.B. Leuprorelin is now substantially less expensive than


goserelin

Nafarelin s

200 micrograms/dose nasal spray

B Triptorelin s

3.75mg injection (Gonapeptyl Depot)


both products only approved for use in the treatment of
precocious puberty Linked to information sheet

11.25mg injection (Decapeptyl SR)


both products only approved for use in the treatment of
precocious puberty Linked to information sheet

Danazol s

100mg & 200mg capsules

Buserelin s

150 micrograms/dose nasal spray

R Cetrorelix

0.25mg injection
3mg vial powder for reconstitution

-only approved for the inhibition of premature LH surges in women

undergoing controlled ovarian stimulation

6.7.3 Metyrapone and Trilostane


Metyrapone s

250mg capsules

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

78

7. Obstetrics, Gynaecology and Urinary-Tract Disorders


7.1 Drugs Used in Obstetrics
7.1.1 Prostaglandins and Oxytocics
Dinoprostone

0.75mg in 0.75ml injections


3mg vaginal tablets

Oxytocin

10 units in 1ml injection


5 units in 50ml syringes u

R Gemeprost

1mg pessaries

Syntometrine

Injection (ergometrine maleate 500 microg & oxytocin 5 units)

Ergometrine

500 micrograms in 1ml injection

R Carboprost

250 micrograms in 1ml injection

7.1.2 - Mifepristone
R Mifepristone

200mg tablets

7.1.3 Myometrial Relaxants


6.75mg in 0.9ml injection & 37.5mg in 5ml (7.5mg/ml)
concentrate for IV infusion

R Atosiban

7.2 Treatment of Vaginal and Vulval Conditions


Preparations for Vaginal Atrophy
First Choice
Estriol
(Oestriol)
Alternatives

0.01% cream (Gynest) 80g preferred choice


0.1% cream (Ovestin)

Estradiol
(Oestradiol)

10 microgram vaginal tablets

Non hormonal preparations for vaginal atrophy


Hyalofemme

Vaginal moisturiser 30g plus applicator


- for restricted use for the relief of symptoms of atrophic vaginitis,
in women who have had treatment for gynaecological malignancy
and where topical estriol is not a treatment option.

7.2.2 Anti-infective Drugs


Candidiasis
First Choice
Clotrimazole

1% cream
2% thrush cream; 10% vaginal cream
100mg & 200mg & 500mg pessaries

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

79

Other Infections
Metronidazole

0.75% vaginal gel

Clindamycin

2% vaginal cream

7.3 Contraceptives
7.3.1 Combined Hormonal Contraceptives
Standard Oestrogen Content (30 or 35 micrograms Ethinylestradiol)
First Choice
Rigevidon
Alternatives

Ethinylestradiol 30 microg. & levonorgestrel 150


microg.

Microgynon 30

Ethinylestradiol 30 microg. & levonorgestrel 150


microg

Cilest

Ethinylestradiol 35 microg. & norgestimate 250


microg.

Millinette 30/75

Ethinylestradiol 30 microg. & gestodene 75 microg.

Femodene

Ethinylestradiol 30 microg. & gestodene 75 microg.

Loestrin 30

Ethinylestradiol 30 microg. & norethisterone 1.5 mg

Gedarel 30/150

Ethinylestradiol 30 microg. & desogestrel 150 microg.

Marvelon

Ethinylestradiol 30 microg. & desogestrel 150 microg.

Ovysmen

Ethinylestradiol 35 microg. & norethisterone 500


microg.

Yasmin

Ethinylestradiol 30 microg. & drospirenone 3 mg

Co-cyprindiol

Ethinylestradiol 35 microg. & cyproterone acetate 2mg


- Co-cyprindiol should be reserved for those women requiring
treatment for the androgenic conditions such as severe acne or
moderately severe hirsutism. It is recommended that treatment
be withdrawn 3 to 4 cycles after the androgenic condition(s)
has/have completely resolved and that it is not continued solely
to provide oral contraception. Venous thromboembolism occurs
more frequently in women taking co-cyprindiol than those
taking a low-dose combined oral contraceptive Repeat courses
may be given if the androgen-dependent condition(s) recur.
Generic co-cyprindiol is much cheaper than Dianette

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

80

Low Dose Oestrogen Content (20 micrograms Ethinylestradiol)


First Choice
Millinette 20/75

Ethinylestradiol 20 microg. & gestodene 75 microg.

Femodette

Ethinylestradiol 20 microg. & gestodene 75 microg.

Gedarel 20/150

Ethinylestradiol 20 microg. & desogestrel 150 microg.

Mercilon

Ethinylestradiol 20 microg. & desogestrel 150 microg.


tablets

Phased Formulations
Tri-Regol

6 Ethinylestradiol 30 microg. & levonorgestrel 50


microg. + 5 Ethinylestradiol 40 microg. &
levonorgestrel 75 microg. + 10 ethinylestradiol 30
microg. & levonorgestrel 125 microg.

Logynon

6 Ethinylestradiol 30 microg. & levonorgestrel 50


microg. + 5 Ethinylestradiol 40 microg. &
levonorgestrel 75 microg. + 10 ethinylestradiol 30
microg. & levonorgestrel 125 microg.

Transdermal (standard strength)


Evra

Self-adhesive patches releasing approx. 20


micrograms ethinylestradiol and 150 micrograms
norelgestromin/ 24 hours
for use by a small number of women with gastrointestinal
absorption problems or with compliance issues

Vaginal (low strength)


NuvaRing

Vaginal ring releasing ethinylestradiol approx. 15


micrograms/24 hours and etonogestrel approx.. 120
micrograms/24 hours
-to be initiated by a specialist in contraceptive services for
patients who are unable to tolerate progesterone-only
contraceptives, have experienced skin irritation with the
transdermal patch, and are unable to take oral contraceptives
due to allergy

Emergency Contraception
Levonorgestrel
(Levonelle 1500)

Pack containing one levonorgestrel 1.5mg tablet

Ulipristal
(ellaOne)

Pack containing one ulipristal acetate 30mg tablet


- recommended by NETAG as the preferred drug treatment
option for post-coital contraception for patients who present
between 72 and 120 hours following unprotected
intercourse. Levonorgestrel is still recommended for

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

81

patients who present at up to 72 hours following


unprotected intercourse, and the use of ulipristal should
be second-line to the use of a copper containing IUCD SPC

7.3.2 Progestogen-Only Contraceptives


7.3.2.1 Oral Progestogen-Only Contraceptives
First Choice
Cerazette

Desogestrel 75 microgram tablets

Alternatives
Femulen

Ethynodiol diacetate 500 microgram tablets

Micronor

Norethisterone 350 microgram tablets

Norgeston

Levonorgestrel 30 microgram tablets

7.3.2.2 Parenteral Progestogen-Only Contraceptives


Etonogestrel

68mg implant (Nexplanon)


- replaced Implanon and differs in that it is impregnated
with radio opaque material.

Medroxyprogesterone
acetate

150mg in 1ml depot injection

7.3.2.3 Progestogen-Only Intra-Uterine System


Levonorgestrel
(Mirena)

Levonorgestrel 52mg in a T-shaped intra-uterine


system
- for idiopathic menorrhagia. Especially in women requiring

(reversible) contraception. Also used for protection with


endometrial hyperplasia during oestrogen replacement therapy.
Lasts for up to 5 years- for use in accordance with agreed
guidelines

7.3.3 Spermicidal Contraceptives


Nonoxynol 9 (Gygel)

2% gel

7.3.4 Copper Intrauterine Devices


First Choice
TT380 Slimline

Intrauterine device replacement every 10 years

Mini TT380 Slimline

Intrauterine device replacement every 5 years

T-Safe Cu380A

Intrauterine device replacement every 10 years

Alternatives
Nova T 380

Intrauterine device replacement every 5 years

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

82

7.4 Drugs for Genito-Urinary Disorders


7.4.1 Drugs for Urine Retention
Alpha-Blockers
First Choice
Tamsulosin

400 microgram m/r capsules

Alternatives
Alfuzosin XL

10mg m/r tablets


-for use on advice of urologists only

Doxazosin

1mg, 2mg & 4mg tablets

7.4.2 Drugs Used for Urinary Frequency, Enuresis and Incontinence


Urinary Incontinence
First Choice
Oxybutynin

2.5mg & 5mg tablets


2.5mg in 5ml elixir

(licensed product available from November 2013)

Tolterodine

1mg & 2mg tablets

Alternatives
Solifenacin Succinate

5mg & 10mg film coated tablets


for use if CNS side effects are a concern with other drugs in group

Tolterodine

4mg XL capsules (Detrusitol XL)

Duloxetine r

20mg & 40mg capsules


- for the treatment of stress incontinence it may be offered as 2nd line
therapy in combination with pelvic floor muscle training in women who
prefer pharmacological to surgical treatment or are not suitable for
surgical treatment. If duloxetine is prescribed, women should be
counselled about its adverse effects

R Fesoterodine

4mg & 8mg f/c tablets

A Methylphenidate

5mg & 10mg tablets;


10mg, 20mg & 30mg m/r capsules (Equasym XL), 18mg,
27mg & 36mg m/r tablets (Concerta XL) - The effects of

-treatment to be initiated by specialists only. Patients should be


subject to a trial of therapy and the drug discontinued if ineffective.

Equasym XL last for about 8 hours compared with about 12 hours for
Concerta XL

- approved for use as a third line option in the treatment of giggle


incontinence. Its use should be subject to a therapeutic trial to be
reviewed after two months and considered for Shared Care if patients
have been shown to respond after the trial period.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

83

Mirabegron

25mg and 50mg m/r tablets


-approved for use when antimuscarinics dont work, are not suitable or
side effects are unacceptable, in line with NICE

Trospium Chloride

20mg tablets

Nocturnal Enuresis
Desmopressin

100 & 200 microgram tablets


120 microgram sublingual tablets

Nasal formulations no longer licensed for treating


nocturnal enuresis (see section 6.5.2 for other formulations)

Amitriptyline

10mg, 25mg & 50mg tablets


25mg in 5ml sugar-free oral solution

Imipramine

10mg & 25mg tablets; 25mg in 5ml syrup u

7.4.3 Drugs Used in Urological Pain


Alkalinisation of Urine
Potassium Citrate

Mixture (potassium citrate 3g & citric acid 500mg in 10ml)

Treatment of Interstitial Cystitis


R Pentosan Polysulphate
Sodium u
Sodium Hyaluronate u
(Cystistat)
R Sodium hyaluronate
(1.6%)/ Sodium chondroitin
Sulphate (2%) (Ialuril)u

50mg capsules

40mg in 50ml solution for instillation into the bladder


50ml solution for instillation into the bladder

- second line treatment in patients who have failed Cystistat

7.4.4 Bladder Instillations and Urological Surgery


Glycine

1.5% large volume solutions (up to 3 litres)

Sodium Chloride

0.9% large volume solutions (up to 3 litres)

Water

Large volumes (up to 3 litres)

Catheter Patency Solutions


Chlorhexidine

0.02% (1 in 5,000) solution in 100ml sachets

Sodium Chloride

0.9% solution in 100ml sachets

Solution G
(Urotainer Twin Suby G)

2 x 30ml sachets (citric acid 3.23%, magnesium oxide 0.38%,


sodium bicarbonate 0.7%, disodium edetate 0.01%)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

84

Solution R
(Urotainer Twin Solution
R)

2 x 30ml sachets (citric acid 6%, gluconolactone 0.6%,


magnesium carbonate 2.8%, disodium edetate 0.01%)

7.4.5 Drugs for Erectile Dysfunction


First Choice
Sildenafil

25mg, 50mg & 100mg tablets


- also approved for specialist use in treating pulmonary hypertension
(see section 2.5.1a) R and secondary Raynauds disease R

Alternatives
Tadalafil

10mg & 20mg tablets


- also approved for specialist use in treating secondary
Raynauds disease R

Alprostadil

10 & 20 microgram dual chamber injections, 10, 20 &


40 microg. Injections, (Caverject) Caverject dual
chamber injections are easier to use and less expensive
than the vials.
125, 250, 500 microg. & 1mg urethral sticks (Muse)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

85

8. Malignant Disease and Immunosuppression


8.1 Cytotoxic Drugs
8.1.0 Drugs for Cytotoxic Induced Side Effects
Dexrazoxane

500mg vials (with diluent)


for use in line with NECN Extravasation

Methotrexate-Induced Mucositis and Myelosuppression


Calcium Folinate
15mg tablets
(Folinic Acid)
3mg, 15mg, 30mg & 300mg injections
A 1mg per ml mouthwash u can be prepared if needed
Urothelial Toxicity
Mesna

1g in 10ml injection; 400mg tablets

8.1.1 Alkylating Agents


R Bendamustine

25mg & 100mg injections- For


- approved for the first line treatment of CLL (Binet stage B or C) in
patients for whom fludarabine combination chemotherapy is not
appropriate in line with NICE
- NECDAG approved for use in combination with rituximab for
patients with CLL not fit for FCR chemotherapy and not fit for
alemtuzumab.
- approved for Low Grade Non-Hodgkins Lymphoma in line with
NICE

- not recommended for (low grade) non-Hodgkin's lymphoma that


is refractory to rituximab or a rituximab-containing regimen NICE

R Busulfan (Busulphan)

2mg tablets; 25mg capsules u


60mg in 10ml inj

R Carmustine

100mg injection
7.7mg implants
- approved for newly diagnosed glioblastoma multiforme
(GBM) in line with NICE

R Chlorambucil

2mg tablets

R Cyclophosphamide

50mg tablets
1g injection

R Estramustine

140mg capsules

R Ifosfamide

2g injection

R Lomustine

10mg u & 40mg capsules

R Melphalan

2mg tablets; 50mg injection

R Thiotepa

15mg injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

To be reviewed

86

R Treosulfan

5g infusion

8.1.2 Cytotoxic Antibiotics


R Dactinomycin

500 microgram injection

R Bleomycin

15,000 units injection (strength formerly expressed as 15mg)

R Daunorubicin

20mg injection, 10mg, 15mg, 35mg & 40mg prefilled


syringes

R Doxorubicin

50mg injection

- also approved for use in intralesional sclerotherapy in the


treatment of low-flow vascular lesions unlicensed indication

- includes use with DC Beads for use in transcatheter arterial


chemoembolisation (TACE) therapy in patients with hepatocellular
cancer

20mg & 50mg liposomal injection

- approved for second-line (or subsequent) treatment in advanced


ovarian cancer in line with NICE

R Epirubicin

50mg & 100mg u injections

R Idarubicin

5mg & 10mg capsules


10mg injection

R Mitomycin

10mg, 20mg & 40mg injections

- Also approved for treatment in combination with 5-Fluorouracil

for bladder cancer concurrent with radiotherapy.

0.04% preservative free eye drops su


R Mitoxantrone

20mg in 10ml injection

R Pixantrone

29mg powder for reconstitution injection

-approved as a possible treatment for adults with multiply relapsed


or refractory aggressive non-Hodgkin's B cell lymphoma if they
have previously been treated with rituximab and they are having
third- or fourth-line treatment. NICE

8.1.3 Antimetabolites
R Azacitidine

100mg vial
- approved for myelodysplastic syndromes, CLL and AML In line
with NICE

R Capecitabine

150mg & 500mg tablets


- approved for dukes c colon cancer in line with NICE

- approved for advanced gastric cancer in line with NICE


- approved for metastatic colorectal cancer in line with NICE

R Cladribine (Leustat)

10mg in 10ml solution for preparing infusions,


2mg in 1ml subcutaneous injection
- approved for Hairy Cell Leukemia only

R Cytarabine

100mg in 5ml & 1g in 10ml injections

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

87

50mg vial- Intrathecal injection , cytarabine


encapsulated in liposomes
R Fludarabine

10mg tablets; 50mg injection

R Fluorouracil

2.5g in 50ml & 2.5g in 100ml injections


10mg in 0.4ml subconjunctival injection u

- approved for the second line therapy of B-cell CLL in line with
NICE
- not approved for monotherapy in the first line treatment of CLL
NICE

(FOLFIRINOX is approved for the management of selected patients


with inoperable pancreatic cancer in patients with performance
status 0-1).

R Gemcitabine

200mg & 1g & 2g injection


- approved in combination with paclitaxel for metastatic breast

cancer in line with NICE


- NECDAG approved for the second line treatment of women with
partially platinum sensitive, platinum resistant or platinum
refractory advanced ovarian cancer (To be used when liposomal
doxorubicin (Caelyx)) is unavailable).
- approved for pancreatic cancer in line with NICE

R Mercaptopurine
A when used for inflammatory

50mg tablets
20mg in 1ml suspension u

R Methotrexate

2.5mg tablets
10mg in 5ml oral solution u
Injections (various strengths) including prefilled

bowel disease

A when used in chronic


inflammatory conditions, e.g.
Crohns disease, rheumatoid
arthritis

syringesu

5mg in 2ml intrathecal injection

R Tegafur with Uracil


(Uftoral)

Capsules containing tegafur 100mg & uracil 224mg


- approved for metastatic colorectal cancer in line with NICE

R Tioguanine
(Thioguanine)

40mg tablets
50mg in ml suspension u

R Pemetrexed

100mg & 500mg injection


- approved for mesothelioma in line with NICE. Funding has to

be agreed on an individual patient basis if treatment is not in line


with NICE.
- not approved for locally advanced or metastatic NSCLC NICE
- approved in combination with cisplatin for the first line treatment
of locally advanced or metastatic NSCLC (non-squamous cell
histology) in line with NICE
- approved for the maintenance treatment for locally advanced or
metastatic NSCLC (non-squamous cell histology) in line with
NICE

8.1.4 Vinca Alkaloids and Etoposide


R Etoposide

50mg & 100mg capsules


100mg in 5ml & 500mg in 25ml injections

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

88

R Vinblastine

10mg injection

R Vincristine

2mg in 2ml injection


2mg in 20ml prefilled syringe
2mg in 50ml infusion bags

R Vindesine

5mg injection

R Vinorelbine

20mg, 30mg capsules


10mg in 1ml & 50mg in 5ml injections

8.1.5 Other Antineoplastic Drugs


R Amsacrine

75mg in 15ml injection

R Arsenic Trioxide

10mg in 10ml ampoule

R Carboplatin

50mg in 5ml & 450mg in 45ml injections

R Bortezomib

3.5mg injection

R Cetuximab

100mg in 20ml & 500mg in 100ml vials for IV infusion


- approved for the first-line treatment of metastatic colorectal

- NECDAG approved relapsed or refractory acute promyelocytic


leukaemia (APL).

- approved for relapsed multiple myeloma in line with NICE


- approved in combination with an alkylating agent and a
corticosteroid for the first-line treatment of multiple myeloma in
line with NICE
- approved as induction therapy for multiple myeloma in line with
NICE

cancer in combination with FOLFOX in line with NICE


- monotherapy or combination chemotherapy is not recommended
for the treatment of people with metastatic colorectal cancer that
has progressed after first-line chemotherapy NICE
- NECDAG approved for K-RAS wild type metastatic colorectal
cancer:
- second line use in combination with chemotherapy in
patients that have progressed on previous chemotherapy
- third line use as a single agent in patients who have
failed oxaliplatin- and irinotecan based therapy and who
are intolerant to irinotecan
- approved for locally advanced squamous cell carcinoma of the
head and neck in line with NICE
- not approved in combination with platinum-based chemotherapy
for recurrent and/or metastatic squamous cell cancer of the head
and neck NICE

R Cisplatin

50mg in injection

R Crisantaspase

10,000 units injection Asparaginase(E-coli) (MEDAC)

R PEG Asparaginase u

3750iu vial Approved for the treatment of ALL

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

89

R Dacarbazine

500mg injection

R Streptozocin u

1g injection (only available on a named patient basis)

R Tretinoin

10mg capsules

R Irinotecan

40mg in 2ml & 100mg in 5ml injections

R Docetaxel

20mg & 80mg injections


- approved for early node-positive breast cancer in line with
NICE
- approved for hormone refractory metastatic prostate
cancer in line with NICE

R Hydroxycarbamide
(Hydroxyurea)

500mg capsules
500mg in 5ml suspension u

R Mitotane

500mg tablets

R Paclitaxel

30mg in 5ml, 100mg in 16.7ml and 150mg in 25ml


concentrate for preparing IV infusion
Abraxane r- 5mg in 1ml powder for suspension for
infusion - restricted for use within its current license for
metastatic breast cancer patients who cannot tolerate
standard taxanes.
- approved in combination with a platinum-based compound
or platinum-based therapy alone (cisplatin or carboplatin)
for first line therapy in ovarian cancer in line with NICE
- approved in combination with a platinum-based drug
(carboplatin or cisplatin) for second-line (or subsequent)
therapy in ovarian cancer in line with NICE
- approved metastatic breast cancer in line with NICE
- not recommended for the adjuvant treatment of women
with early node-positive breast cancer NICE

R Procarbazine

50mg capsules

R Trastuzumab

150mg vial for preparing IV infusion


- approved for metastatic or locally advanced inoperable gastric
cancers in line with NICE
- approved for early stage HER2-positive breast cancer in line with
NICE
- approved for advanced HER2-positive breast cancer in line with
NICE
- not recommended in combination with an aromatase inhibitor
for the first-line treatment in postmenopausal women with
metastatic hormone-receptor-positive breast cancer that
overexpresses HER2 NICE

600mg s/c injection

- approved by NHS England for HER2-positive breast cancer in


line with NECN guidance

R Afatinib

20mg, 30mg, 40mg, 50mg film coated tablets


-approved as a possible treatment for adults with locally advanced
or metastatic non-small-cell lung cancer if their cancer tests
positive for the epidermal growth factor receptor tyrosine kinase

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

90

(EGFR-TK) mutation and they have not had an EGFR-TK inhibitor


before NICE and additional NHS England criteria

R Imatinib

100mg & 400mg capsules

- approved for the first-line management of people with KIT


(CD117)-positive unresectable and/or KIT (CD117)-positive
metastatic gastrointestinal stromal tumours (GISTs) in line with
NICE

- not approved for the adjuvant treatment of gastrointestinal

stromal tumours (GISTs) after surgery NICE


- approved for Philadelphia-chromosome-positive CML in the
accelerated phase or with blast crisis in line with NICE
- standard-dose imatinib is recommended as an option for the
first-line treatment of adults with chronic phase Philadelphiachromosome-positive CML in line with NICE
- high-dose imatinib not recommend for people with Philadelphiachromosome-positive CML in the chronic, accelerated or blast-crisis
phase that has got worse after treatment with standard-dose
imatinib NICE

R Erlotinib

25mg, 100mg & 150mg tablets

R Gefitinib

250mg tablets
- approved for first line use in locally advanced or metastatic

- approved for the first line treatment of locally advanced or


metastatic NSCLC that has tested positive for mutations to EGFRTK in line with NICE
- also approved for second line use, as an alternative to
docetaxel, in NSCLC in line with NICE
- monotherapy not approved for maintenance after platinum
chemotherapy in advanced or metastatic NSCLC NICE

NSCLC in line with NICE


- not approved for second line use in locally advanced or
metastatic NICE

R Nilotinib

150mg & 200mg capsules

R Oxaliplatin

50mg & 100mg injections


- approved for Dukes C colon cancer in combination with 5-

- approved for the first-line treatment of adults with chronic phase


Philadelphia-chromosome-positive CML in line with NICE

fluorouracil and folinic acid in line with NICE


- approved for advanced and metastatic colorectal cancer in line
with NICE

R Pazopanib

200mg & 400mg tablets


- approved for advanced renal cell carcinoma in line with NICE

R Picibanil u

100 microgram injection

R Sunitinib

50mg 100mg & 400mg capsules


- approved for gastrointestinal stromal tumours (GISTs) in
line with NICE
- approved for advanced and/or metastatic renal cell carcinoma
in line with NICE
- not approved for second line use in advanced and/or metastatic
renal cell carcinoma NICE

R Temozolomide

5mg, 20mg, 100mg & 250mg capsules

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

91

- approved for newly diagnosed glioblastoma multiforme


(GBM) in line with NICE
R Topotecan

0.25mg & 1mg capsules


1mg & 4mg vials

- approved for relapsed NSCLC in line with NICE

- approved for recurrent or stage IVB cervical cancer in line with


NICE
- approved for second-line (or subsequent) treatment in advanced
ovarian cancer in line with NICE

R Ipilimumab

50mg vial for preparing IV infusion


- approved for Melanoma (stage III or IV) in line with NICE

R Vemurafenib

240mg tablets
- approved melanoma (BRAF V600 mutation positive, unresectable
metastatic) in line with NICE

8.2 Drugs Affecting the Immune Response


Linked to Shared care guidelines:
Immunosuppressive treatment following paediatric renal transplantation
Immunosuppressive treatment following adult renal transplantation
Immunosuppressive treatment following liver transplants
Immunosuppressive treatment following heart and lung transplants

8.2.1 Antiproliferative Immunosuppressants


A Azathioprine

25mg & 50mg tablets; 50mg in 5ml u suspension


50mg injection

A Mycophenolate Mofetil

250mg capsules; 500mg tablets


1g in 5ml (200mg/ml) oral suspension
500mg vial for preparing IV infusion
- approved for child and adolescent renal transplant recipients in
line with NICE

A Mycophenolate
Sodium r

180mg & 360mg e/c tablets 2nd line therapy in patients


who do not tolerate mycophenolate mofetil

8.2.2 Corticosteroids & Other Immunosuppressants


Preferred Product for Most Indications
A Ciclosporin
(Cyclosporin, Neoral)

10mg, 25mg, 50mg & 100mg capsules


100mg in 1ml sugar-free oral solution (oily)

Alternatives
R Basiliximab

20mg vial for preparing IV infusion

Ciclosporin (Sandimmun)

50mg in 1ml & 250mg in 5ml concentrate (oily) for IV


infusion R

- approved for limited use in adult renal transplant patients with


high risk of acute organ rejection
- approved for severe graft versus host disease post
haematopoietic stem cell transplantation
- approved for induction therapy in renal transplantation in
children and adolescents in with combinations that include
ciclosporin in line with NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

92

Original oral formulations Sandimmun supplied on request


for patients who cannot take Neoral

25mg & 100mg capsules u A


100mg in 1ml sugar-free oral solution (oily) A
A Tacrolimus

500 microgram, 1mg & 5mg capsules (Prograf &


Adoport)
1mg in 1ml oral suspension u (to replace 0.5mg/ml oral
suspension)

5mg in 1 ml concentrate for preparing IV infusion

- approved for renal transplantation in children and adolescents in


line with NICE

500microgram, 1mg, 3mg & 5mg m/r capsules


(Advagraf)
- only approved for use for prophylaxis of organ rejection in

kidney and liver transplantation. Advagraf is approved for use in


patients who are currently prescribed Prograf, and de novo
patients should be prescribed Adoport.

A Sirolimus

1mg & 2mg tablets


1mg per ml oral solution

- approved for renal transplantation in children and adolescents in


line with NICE

R Antithymocyte
Immunoglobulin (Rabbit)

25mg injection

R Antithymocyte
Immunoglobulin (Horse) u

250mg in 5ml injection

used in the management of transplant rejection

-NETAG approved for aplastic anaemia in adults

8.2.3 Rituximab and Alemtuzumab


R Rituximab r

100mg in 10ml & 500mg in 50ml concentrate for IV


infusion
- for musculoskeletal indications see chapter 10
- approved for first line use in NHL in combination with CHOP in
line with NICE
- approved for maintenance therapy in follicular NHL that has
responded to first line induction therapy with rituximab in
combination with chemotherapy in line with NICE
- approved for stage III and IV follicular lymphoma in previously
untreated people in line with NICE
- approved for replased or refractory follicular NHL in line with
NICE
- approved for Post-transplant lymphoproliferative disease
- approved for first line use in CLL in combination with
fludarabine and cyclophosphamide in line with NICE
- approved for combination with fludarabine and
cyclophosphamide for relapsed or refractory CLL in line with
NICE
- approved for autoimmune haematological conditions (where
conventional treatments have failed) Autoimmune haemolytic
anaemia (AIHA), Evans syndrome, pure red cell aplasia (PRCA),
acquired haemophilia A, immune thrombocytopenic purpura (ITP)
& thrombocytopenia purpura (TTP).
- approved for vasculitis (including Wegeners granulomatosis in
adults and children) that has not responded adequately to
conventional treatment (e.g. corticosteroids, cyclophosphamide)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

93

NICE and additional NHS England criteria.


- NECDAG approved for the treatment of NLPHL
- NECDAG approved for newly diagnosed mantle cell NHL in
patients aged <60 years old.
- approved in combination with bendamustine for first line use in
CLL (Binet stage B or C) in patients for whom fludarabine
combination chemotherapy is not appropriate NICE
- NECDAG approved in combination with bendamustine for
patients with CLL not fit for FCR chemotherapy or for patients who
relapse within 2 years of FCR chemotherapy and not fit for
alemtuzumab.
- NECDAG approved with salvage chemotherapy for patients
relapsing > 12 months post 1st line therapy with R-CHOP
- NECDAG approved with a standard NHL induction regimen in
patients who cannot be given an anthracycline. Rituximab with
other chemotherapy regimens is an alternative treatment option
e.g. DECC, CVP for this group of patients, as part of their first line
therapy. Also in addition to the MACOP-B regimen for the small
number of young patients with DLBCL, subtype Primary
Mediastinal B cell Lymphoma
- NECDAG approved for the treatment of hairy Cell Leukaemia
(HCL) or Hairy cell Leukaemia varian (HCL-v) who:
- relapse early after purine analogue therapy (< 2 years
post treatment)
- are refractory to purine analogues.

R Alemtuzumab r

30mg in 1ml concentrate for IV infusion


- for use in lymphocytic leukaemia & prevention of graft vs. host
disease on bone marrow transplant patients
- approved for use in high-risk kidney and pancreas transplantation
- approved as an option for treating adults with active relapsing
remitting multiple sclerosis in line with NICE

8.2.4 Other Immunomodulating Drugs


R Interferon alfa-2b

10 mega units & 30 mega units multidose pen


injections

R Peginterferon alfa 2a

135 & 180 microgram injections in prefilled syringes &


135 &180 microgram prefilled pens
- approved in combination therapy with ribavirin for moderate to
severe chronic hepatitis C in line with NICE
- approved for mild chronic hepatitis C in line with NICE
- approved in line with NICE for combination therapy with ribavirin
for adults with chronic hepatitis C:
- who have been treated previously with peginterferon alfa
and ribavirin in combination, or with peginterferon alfa
monotherapy, and whose condition either did not respond
to treatment or responded initially to treatment but
subsequently relapsed
- or who are co-infected with HIV.
- approved for the initial treatment of adults with chronic hepatitis B
in line with NICE
- approved treatment for children and young people with chronic
hepatitis C NICE

R Peginterferon alfa 2b

50, 80, 100, 120, & 150 microgram prefilled inj pens
- approved for chronic hepatitis C as for peginterferon alfa 2a

R Interferon beta1a

30 microgram (6 million units) prefilled pen (Avonex)


22 microgram (6 million units) & 44 microgram (12

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

94

million units injections -(Rebif), 1.5ml cartridges


containing 22 microgram and 44 microgram per 0.5ml
for use in Rebismart injection device
20 microgram prefilled pen (Rebidose) - approved for use
when the cartridges and prefilled syringes are unsuitable.

R Interferon beta1b

Vials for preparing 750 microgram in 3ml injection


(Betaferon)

R Interferon beta1b

Vials for preparing 250 microgram in 1ml injection


(Extavia)

R Glatiramer

20mg prefilled syringe injection

R Natalizumab

300mg in 15ml (20mg/ml) vial for preparing infusions


- approved for rapidly evolving severe relapsing remitting multiple
sclerosis in line with NICE

R Fingolimod

500 microgram capsules


- approved for the treatment of highly active relapsingremitting
multiple sclerosis in line with NICE
- approved for patients who have progressed on glatiramer
acetate and for those patients who are at high risk of
progressive multifocal leukoencephalopathy (PML) in line withNHS
England Clinical Commissioning Policy

R BCG Connaught

81mg vial for bladder instillation

R Thalidomide

50mg capsules
- approved in combination with an alkylating agent and a

corticosteroid for the first-line treatment of multiple myeloma in


line with NICE
- approved for the treatment of bleeding from bowel
angiodysplasia in patients with an inherited/acquired bleeding
disorder on specialist advice only.

R Lenalidomide
R Mifamurtide

5mg, 10mg, 15mg, & 25mg capsules


- approved for multiple myeloma in line with NICE
4mg vial
- approved for high-grade resectable non-metastatic osteosarcoma
in line with NICE

R Teriflunomide

14mg film coated tablets


-approved as a possible treatment for adults with active relapsingremitting multiple sclerosis that isnt highly active or rapidly
evolving severe relapsing-remitting multiple sclerosis NICE

8.3 Sex Hormones and Hormone Antagonists in Malignant Disease


8.3.1 Oestrogens
Diethylstilbestrol s
(Stilboestrol)

1mg tablets Initiated with specialist advice.

8.3.2 Progestogens
Medroxyprogesterone

100mg & 200mg tablets

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

95

acetate

500mg in 2.5ml injections

Megestrol acetate

40mg (discontinued) & 160mg tablets

Norethisterone

5mg tablets

8.3.4 Hormone Antagonists


8.3.4.1 Breast Cancer
NICE Hormonal therapies for the adjuvant treatment of early oestrogen receptor positive
breast cancer

Tamoxifen

10mg & 20mg tablets


10mg in 5ml sugar-free oral solution

Anastrozole

1mg tablets

Exemestane s

25mg tablets

Letrozole

2.5mg tablets

Fulvestrant s

250mg in 5ml (50mg/ml) injection in a prefilled


syringe
- not recommended as an alternative to aromatase inhibitors for

the treatment of oestrogen-receptor-positive, locally advanced or


metastatic breast cancer in postmenopausal women whose cancer
has relapsed on or after adjuvant anti-oestrogen therapy, or who
have disease progression on anti-oestrogen therapy NICE

8.3.4.2 Prostate Cancer and Gonadorelin Analogues


Gonadorelin Analogues
First Choice
Clinicians are encouraged to prescribe the least expensive product that is clinically
appropriate
Leuprorelin Acetate

3.75mg & 11.25mg prefilled syringes

Goserelin

3.6mg & 10.8mg implants

Triptorelin

3mg, 11.25mg and 22.5mg IM injection

Degarelix (Firmagon)

80mg & 120mg vials (with diluent)

- for the first line treatment of advanced hormone dependant


prostate cancer with a PSA > 20ng/l at presentation

Alternatives
Buserelin
Anti-Androgens
Abiraterone

5mg in 5ml injection


150 microgram metered dose nasal sprays
250mg tablets
- approved for castration-resistant metastatic prostate cancer in
line with NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

96

Bicalutamide s

50mg tablets- initiated with specialist advice

Cyproterone Acetate

50mg & 100mg tablets

Flutamide

250mg tablets under review

8.3.4.3 Somatostatin Analogues


B Octreotide

50, 100 & 500 microg. in 1ml & 1mg in 5ml injections
10mg, 20mg & 30mg long-acting injections
Linked to information sheet

B Lanreotide

30mg long-acting injection


60mg, 90mg & 120mg autogel injections
Linked to information sheet

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

97

9. Nutrition and Blood


9.1 Anaemias and Some Other Blood Disorders
9.1.1 Iron Deficiency Anaemia
9.1.1.1 Oral Iron
First Choice
Ferrous Sulphate

200mg tablets (65mg iron)

Alternatives
Ferrous Fumarate

140mg in 5ml syrup (45mg iron/5ml) First Choice


oral liquid iron preparation
210mg tablets (68mg iron/tablet)

Ferrous Gluconate

300mg tablets (35mg iron)

Sodium Feredetate
(Sodium Ironedetate,
Sytron)

190mg in 5ml sugar-free elixir (27.5mg iron/5ml)

9.1.1.2 Parenteral Iron


Iron Sucrose

100mg in 5ml injection

Iron Dextran

100ml in 2ml & 500mg in 10ml injections

R Ferric carboxymaltose

100ml in 2ml & 500mg in 10ml injections

For use as an alternative to iron dextran or iron sucrose.


Approved for use by renal physicians, gastroenterologists
and haematologists. Unlicensed for use in children under 14
years of age. If used in this age-group, use should only be on the
advice of a consultant with the informed consent of the patient
and/or his/her parents/carers.

9.1.2 Drugs Used in Megaloblastic Anaemias


Folic Acid

400 microgram & 5mg tablets


2.5mg in 5ml sugar-free syrup
15mg in 1ml injection u
30mg in 2ml injection

Hydroxocobalamin

1mg in 1ml injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

98

9.1.3 Drugs Used in Hypoplastic, Haemolytic and Renal Anaemias


Epoetin Alfa and Beta
First Choice
A Darbepoetin

10, 15, 20, 30, 40, 50, 60, 80, 100, 150 & 300 microgram
injections in prefilled syringes

20, 40, 60, 80, 100 & 300 microgram Sureclick pens
- approved for management of cancer treatment-induced anaemia
in women receiving platinum-based chemotherapy for ovarian
cancer in line with NICE

Alternatives
A Epoetin Alfa r

Prefilled syringes (various strengths)


- approved for management of cancer treatment-induced anaemia
in women receiving platinum-based chemotherapy for ovarian
cancer in line with NICE
- no longer regularly used in NUTH

A Epoetin Beta r

Cartridges for use in Recopens


Prefilled syringes
- approved for management of cancer treatment-induced anaemia
in women receiving platinum-based chemotherapy for ovarian
cancer in line with NICE
- no longer regularly used in NUTH

A Methoxy polyethylene

30, 50, 100, 120, 150, 200 & 250 microgram in 0.3ml and
360 microgram in 0.6ml injections in prefilled syringes.
- approved for use as a longer-acting alternative to darbepoetin in
a small number of patients receiving peritoneal dialysis

glycol-epoetin beta r
(Mircera, Pegzerepoetin
alfa)

Iron Overload
Desferrioxamine s

500mg & 2g injections


500mg & 2g injections

Deferasirox s

125mg, 500mg & 250mg tablets

Approved for iron chelation in patients with myelodysplastic


syndromes (MDS) - (as per NECN Haematology Group Guidelines)
and recommended for use in patients when treatment with
desferrioxamine is no longer considered to be appropriate due to
progressive iron overload despite maximally tolerated doses of
desferrioxamine. Initiated by specialists only

9.1.4 Drugs Used in Platelet Disorders


R Anagrelide r

500 microgram capsules for the treatment of

R Romiplostim

250 microgram vial

thrombocythemia as a 2nd line agent in patients poorly/nonresponsive to hydroxycarbamide therapy

- for the treatment of adults with chronic immune (idiopathic)


thrombocytopenia purpura in line with NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

99

25mg and 50mg film coated tablets


R Eltrombopag

-for the treatment of adults with chronic immune (idiopathic)


thrombocytopenia purpura NICE

9.1.6 Drugs Used in Neutropenia


Recombinant Human Granulocyte-Colony Stimulating Factor
R Pegfilgrastim (G-CSF)

6mg in 0.6ml injection in prefilled syringes

R Filgrastim (G-CSF)

300 microgram (30 million units) injection in 0.5ml


syringes and 1ml vials
480 microgram (48 million units) injection in 0.5ml
syringes available as Neupogen (original brand) and
Ratiograstim a biosimilar product

R Lenograstim
(rHuG-CSF)

263 microgram (33.6 million units) injection vials

R Plerixafor (Mozobil)

24mg in 1.2ml injection SPC


-approved by NHS England Specialist Services for stem cell
mobilisation for patients with Hodgkins disease, Non-Hodgkins
lymphoma or multiple myeloma and meet the policy for
Haematopoietic Stem Cell Transplantation.

9.2 Fluids and Electrolytes


9.2.1 Oral Preparations for Fluid and Electrolyte Imbalance
9.2.1.1 Oral Potassium
First Choice
Sando-K

Effervescent tablets (12mmol potassium 8 mmol chloride)

Alternative
Potassium Chloride

600mg m/r tablets (8 mmol potassium)


- for use where the effervescent tablets or syrup are unsuitable

5mmol in 5ml sugar-free syrup (Kay-Cee-L)


Potassium Removal
Polystyrene Sulphonate Resins
Calcium Resonium

Powder (Calcium polystyrene sulphonate)

Resonium A

Powder (Sodium polystyrene sulphonate)

9.2.1.2 Oral Sodium and Water


Sodium Chloride

600mg m/r tablets (Slow Sodium) - approx. 10 mmol


sodium & chloride per tablet

1mmol / ml oral solution s


treatment should only be initiated with the advice of a
specialist
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

100

Oral Rehydration Salts


Dioralyte

Powder (sodium 12 mmol, potassium 4 mmol, chloride 12

mmol, citrate 2 mmol & glucose 18 mmol (3.56g) / sachet)

9.2.1.3 Oral Bicarbonate


Sodium Bicarbonate

500mg capsules (500mg contains approx. 6 mmol


each of sodium and bicarbonate)
1mmol/ml oral solution u

9.2.2 Parenteral Preparations for Fluid and Electrolyte Imbalance


Potassium chloride 0.3% (20mmol); sodium chloride
0.9%; and glucose 5% (500ml bag)

R Steriflex 165 u

- approved for diabetic ketoacidosis in paediatric patients


9.2.2.1 - Electrolytes and Water
SECTION UNDER DEVELOPMENT
9.2.2.2 Plasma and Plasma Substitutes
Gelatin Based Solutions

http://bnf.org/bnf/bnf/current/5008.htm

Succinylated Gelatin
Volplex (or Gelofusine)

4% succinylated gelatin infusion in sodium chloride


0.9% (500ml bags)

Isoplex

4%succinylated gelatin infusion in a balanced


electrolyte solution containing Na+ 145 mmol, K+ 4 mmol,
Mg2+ 0.9 mmol, Cl- 105 mmol, lactate 25 mmol/litre

Starch Based Solutions

mainly for use in critical care areas and other


situations where the perceived advantages of a
balanced electrolyte plasma substitute are likely to
be clinically important. N.B. Not yet cleared for use
in NUTH.

Tetrastarch
Tetraspan

Volulyte r

6% & 10% tetrastarch infusions in a balanced


electrolyte solution containing Na+ 140 mmol, K+ 4 mmol,
Mg2+ 1 mmol, Cl- 118 mmol, Ca2+ 2.5 mmol, acetate
24 mmol, malate 5 mmol/litre. N.B. contains calcium
6% tetrastarch infusion in a balanced electrolyte
solution containing Na+ 137 mmol, K+ 4 mmol, Mg2+
1.5 mmol, Cl- 110 mmol, acetate 34 mmol/litre. N.B.

calcium-free. Mainly for use in indications where


North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

101

calcium containing fluids are unsuitable.

Plasma-Lyte 148 and


Plasma-Lyte & 5% Glucose r

infusion in a balanced electrolyte solution containing


Na+ 140 mmol, K+ 5 mmol, Mg2+ 1.5 mmol, acetate
27 mmol/litre. Gluconate 23 mmol/litre. N.B calcium
free. Approved for use in paediatric theatres only.

Phoxilium 1.2mmol/l
phosphate r

A haemofiltration and haemodialysis fluid containing


Na+ 140 mmol, K+ 4 mmol, Mg2+ 0.6 mmol, Ca2+
1.25mmol/l, Cl- 115.9 mmol/l, HCO3- 30.0mmol/l,
HPO42- 1.20mmol/l Approved for use in CRRT in
patients not requiring reduced potassium or low
bicarbonate.

9.3 Intravenous Nutrition


Contact Pharmacy for details of Parenteral Nutrition Services

9.4 Oral Nutrition


9.5 Minerals
9.5.1 Calcium and Magnesium
9.5.1.1 Calcium Supplements
Preferred Preparations
Calcium Carbonate

1.25g chewable tablets (500mg, 12.6 mmol calcium)


2.5g chewable tablets (1g, 25 mmol calcium)
500mg in 5ml suspension u -

Sandocal tablets and


Calcium Sandoz syrup

Sandocal 1000 tablets (calcium lactate gluconate, calcium

Alternatives

carbonate & citric acid providing 1000mg, 25 mmol calcium)


Calcium Sandoz syrup (calcium gluconate & calcium
lactobionate providing 108mg, 2.7 mmol calcium in 5ml)

Calcium Gluconate

10% 10ml injection (approx. 2.2mmol, 89mg calcium)

Calcium Chloride

5 mmol in 5ml & 10 mmol in 10ml injections


10% 10ml injection in syringes also used in some
resuscitation boxes at Freeman Hospital Under review

9.5.1.2 Hypercalcaemia and Hypercalciuria


Preferred Products
Disodium Pamidronate

30mg injection

R Zoledronic Acid r

4mg injection
- for hypercalcaemia of malignancy and the prevention of skeletal
events in patients with metastatic breast cancer. Prescribe by

Alternatives

brand name (Zometa) to avoid confusion with a different


strength product used to treat osteoporosis and Pagets
disease

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

102

Sodium Clodronate

520mg or 800mg tablets

Calcitonin (Salmon)/
Salcatonin

See section 6.6.1 for 200 units/dose nasal spray

400 units in 2ml injection

Hyperparathyroidism
R Paricalcitol

1 microgram, 2 micrograms & 4 micrograms capsules


& 5 micrograms per ml injection
- approved for use in patients with PTH levels < 800mcg/l but

whose treatment with alfacalcidol is restricted due to a high


calcium level.

R Cinacalcet r

30mg, 60mg & 90mg tablets


- approved for the treatment of secondary hyperparathyroidism

in patients with end stage renal disease on maintenance


haemodialysis where parathyroid gland surgery has failed or is
inappropriate in line with NICE
- also for short term use to control symptoms prior to a second
attempt at more definitive surgery
A - For use in patients with primary hyperparathyroidism for
whom parathyroidectomy would be indicated based on serum
calcium levels, symptoms and end organ damage, but in whom
parathyroidectomy is either not clinically appropriate or is
contraindicated. It should be clearly documented as to why
surgery is not an appropriate treatment option for the particular
patient.

9.5.1.3 Magnesium
R Magnesium Sulphate

50% 2ml (4 mmol), 50% 10ml (20 mmol) & 10%


10ml (4 mmol) injections
60 mmol in 500ml sodium chloride 0.9% infusion u

R Magnesium Chloride u

10 mmol magnesium in 1 litre sodium chloride 0.9%


with potassium chloride 0.15% (20 mmol)
64mg sustained release tablets (2.6mmol magnesium)

Magnesium
Glycerophosphate u

1g (4mmol) chewable tablets - 640mg (3.3mmol) capsules


1mmol/ml suspension - also available if supply problems
with tablets

Magnesium Aspartate u

6.5g (10 mmol) sachets


614.8mg (2.5mmol) tablets

- for 2nd line treatment in patients with short bowel syndrome

9.5.2 Phosphorus
9.5.2.1 Phosphate Supplements
Phosphate Sandoz

Effervescent tablets (phosphate 16.1 mmol, sodium


20.4 mmol & potassium 3.1 mmol / tablet)

R Phosphate Solution u

4.15 mmol phosphate in 10ml oral solution

Phosphate Polyfusor

500ml intravenous infusion containing 50mmol

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

103

phosphate per 500ml (PO43- 100 mmol, K+ 19 mmol,


and Na+ 162 mmol/litre)
9.5.2.2 Phosphate-binding Agents
Preferred Preparations
Phosex 1g tablets (containing 250mg, 6.2mmol of

Calcium Acetate s

calcium)

PhosLo 667mg capsules (containing 169mg, 4.2mmol of


calcium)

Alternatives
Calcium Carbonate

1.25g & 2.5g chewable tablets (Calcichew)


(Other formulations e.g. Remegel, Rennies, Rennie Soft gel and
Settlers Tums are also stocked at the RVI for use in paediatric
renal patients)

OsvaRen s
(formerly named
Rephoren)

Tablets containing calcium acetate 435mg &


Magnesium carbonate heavy 235mg.

- for use, after calcium carbonate and calcium acetate, but before
the much more expensive sevelamer and lanthanum

Sevelamer Carbonate s

800mg f/c tablets


2.4g powder for oral suspension
- specialist advice

Lanthanum s

500mg, 750mg & 1g chewable tablets


- for 3rd line use

9.5.3 Fluoride
Duraphat

2800 ppm

Duraphat 5000 ppm

Sodium fluoride 0.619% (75ml)

- approved for prescribing by dentists and dental prescribers only.


r

Sodium Fluoride
Mouthwash r

Sodium fluoride 1.1% (51g)


- approved for prescribing by dentists and dental prescribers only.
Sodium fluoride 0.05%
-approved for use within the dental hospital

9.5.4 Zinc
Zinc Sulphate(Solvazinc)

Zinc sulphate monohydrate 125mg effervescent


tablets (45mg zinc)

9.6 Vitamins
9.6.1 Vitamin A
Vitamin A su

20,000 unit injection


- for the treatment of night blindness/ vitamin A deficiency as a
result of malabsorption in patients with short bowel syndrome,
ileal resection or pancreatic insufficiency

Vitamins A & D

Capsules containing vitamin A 4000 units, vitamin D


400 units

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

104

9.6.2 Vitamin B Group


Compound Preparation
Vitamin B & C Injection
(Pabrinex)

IVHP injection (ascorbic acid 500mg, nicotinamide 160mg,

pyridoxine hydrochloride 50mg, riboflavin 4mg & thiamine


hydrochloride 250mg & 1g anhydrous glucose / pair of ampoules)

IMHP injection also used


Pyridoxine

10mg u & 50mg tablets

R Pyridoxal Phosphate u

25mg tablets and 50mg capsules

Thiamine

50mg & 100mg tablets

R Vitamin B compound
strong

Tablets (nicotinamide 20mg, pyridoxine hydrochloride 2mg,


riboflavin 2mg & thiamine hydrochloride 5mg per tablet)
-for short term use in refeeding syndrome only

9.6.3 Vitamin C
Ascorbic Acid

50mg, 100mg & 500mg tabs; 500mg in 5ml injection u

9.6.4 Vitamin D
Alfacalcidol

250 nanogram & 1 microgram capsules


2 microgram/ml sugar-free oral drops one drop
containing approx. 100 nanograms of alfacalcidol
1 microgram in 0.5ml & 2 micrograms in 1ml injections

Ergocalciferol (Calciferol)

250 microg. (10,000 units) & 1.25mg (50,000 units) tablets


a 3000 units in 1ml suspension u may be supplied if
cholecalciferol oral solution is not available

7.5mg (300,000 units) in 1ml injection


Colecalciferol

20microgram (800 units) capsules or tablets


for first line use in the long term maintenance treatment of

patients with documented vitamin D deficiency following high


strength therapy and also for use in patients with symptoms and
insufficient levels.

500 microgram (20,000 units)u capsules for use when


ergocalciferol tablets are not available

R Colecalciferol

3000 units in 1ml oral solution


1000iu and 3000iu buccal spray (DLux)
-approved for use in paediatric parenteral nutrition patients with

short bowel syndrome and adults with metabolic bone disease who
have vitamin D deficiency despite previous treatment.

Calcium Carbonate 1.25g


1.5g & Vitamin D 400 units

Calcium carbonate/ vitamin D

Calcium Phosphate &


Vitamin D

Calfovit D3 powder in sachets calcium phosphate 3.1g

Calcichew D3 Forte tablets 1.25g (500mg Ca) 400 units


Adcal-D3 tablets
1.5g (600mg Ca) 400 units
(1.2g calcium) & Vitamin D3 800 units

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

105

Calcium & Ergocalciferol


tablets

Tablets calcium lactate 300mg, calcium phosphate 150mg (Ca


97mg, 2.4 mmol) & ergocalciferol 10 micrograms (400 units)

9.6.5 Vitamin E
Alpha Tocopheryl acetate

500mg in 5ml suspension; 134mg (200 unit) capsules

9.6.6 Vitamin K
First Choice
Phytomenadione
(Vitamin K1)

50 microgram in 0.25ml drops (NeoKay) u


1mg capsule- preferred product for use in neonates
10mg in 1ml injection u
2mg in 0.2ml mixed micelles injection (Konakion MM
Paediatric) may be taken by mouth as well as being
given by IM or IV injection
N.B. Phytomenadione 10mg tabs now discontinued

Alternative
Menadiol Sodium Phosphate

10mg tablets

water soluble derivative of vitamin K for use in patients with fat


malabsorption, especially in hepatic disease or biliary obstruction
including cystic fibrosis patients

9.6.7 Multivitamin Preparations


First Choice
Vitamins BPC
Alternatives

Capsules containing ascorbic acid 15mg, nicotinamide 7.5mg,


riboflavin 500 micrograms, thiamine HCl 1mg, vitamin A 2,500
units, & vitamin D 300 units

Abidec

Drops containing in each 0.6ml dose ascorbic acid 50mg,


ergocalciferol 400 units, nicotinamide 5mg, pyridoxine HCL
500micrograms, riboflavin 400 micrograms, thiamine 1mg &
vitamin A 1,333 units- To be used in children and adults.

Dalivit

Drops containing in each 0.6ml dose ascorbic acid 50mg,


ergocalciferol 400 units, nicotinamide 5mg, pyridoxine HCl 500
micrograms, riboflavin 400 micrograms, thiamine 1mg & vitamin A
5,000 units)- Dalivit drops are to be retained for use in
patients requiring a full supplement of vitamin A.

Forceval sr

Capsules & junior capsules


-For limited use as a vitamin and mineral supplement in patients

with phenylketonuria The capsules are also approved as an oral


supplement in burns patients with malnutrition or alcohol
dependency and patients with major burns after discontinuation of
IV therapy, and have also been approved for use in patients with
severe anorexia nervosa. Treatment initiated with specialist advice

Soluble

- approved for short term use in patients who are unable to


swallow Forceval capsules.

Healthy Start Vitaminsr

These formulations are prepared for the NHS and


recommended in NICE guidance. DOH offers the Healthy

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

106

Ketovite s
Renavit r

Start Vitamins to pregnant women and children less than 4


years. They are only available through clinics and from
midwives and are not prescribable on FP10 prescriptions

Tablets and liquid - see BNF for details of contentTreatment initiated with specialist advice

Tablets

-water soluble vitamin supplementation therapy for maintenance


haemodialysis patients only.

9.8 Metabolic Disorders


9.8.1 Wilsons Disease, Carnitine Deficiency and Gauchers Disease
9.8.1a Wilsons disease and Cystinuria
R

Penicillamine

125mg & 250mg tablets - also used for the treatment of


cystinuria and rheumatoid arthritis section 10.1.3

Tiopronin u

500mg tablets - for use as 2nd line treatment for cystinuria in


patients who fail to tolerate/respond to penicillamine.

9.8.1b Carnitine deficiency


R Carnitine s
(Levocarnitine)

30% oral solution


1g in 5ml injection

9.8.1c Urea cycle disorders


R Sodium
Phenylbutyrate su

500mg tablets - Licensed formulation marketed as


Ammonaps1g in 5ml & 2g in 10ml injections

9.8.1d Mitochondrial & muscle disorders


Ubiquinone su
(Coenzyme Q10,
Ubidecarenone)

10mg, 30mg, & 100mg capsules


50mg in 5ml & 30mg in 1ml (150mg in 5ml) oral
solution
- nutritional supplement and antioxidant approved for use in
the management of mitochondrial disorders. Also approved
for use under specialist consultant supervision in the
management of patients with severe hyperlipidaemia who
are not tolerating statins due to myopathy. Use in statin
induced myopathy is subject to treatment being initiated by
a consultant.

9.8.1e Nephropathic cystinosis


R Mercaptamine

50mg & 150mg capsules

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

107

10. Musculoskeletal and Joint Diseases


10.1 Drugs Used in Rheumatic Diseases and Gout
10.1.1 Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Preferred Drugs
Diclofenac can be used for short term use for post-operative pain.
Long Term use:

Ibuprofen low dose First line treatment

Naproxen low dose Second line treatment


Naproxen high dose Third line treatment
Diclofenac Fourth line treatment

Ibuprofen

200mg, 400mg & 600mg tablets


100mg in 5ml sugar-free suspension

Naproxen

250mg & 500mg tablets; 125mg in 5ml suspension u


500mg suppositories

Diclofenac

25mg & 50mg e/c tablets; 50mg dispersible tablets


75mg & 100mg m/r tablets or capsules
75mg in 2ml injection (Dyloject) - mainly for use in
postoperative analgesia
12.5mg, 25mg, 50mg & 100mg suppositories

Alternatives
Celecoxib

100mg & 200mg capsules

Etodolac

600mg m/r tablets

Indometacin
(Indomethacin)

25mg & 50mg capsules; 75mg m/r capsules


25mg in 5ml suspension; 100mg suppositories

Mefenamic Acid

250mg capsules & 500mg tablets

Piroxicam

20mg orodispersible Melt tablets - For use in operating

theatres and for use in children with juvenile idiopathic rheumatoid


arthritis. Older children should be changed to another
NSAID when they reach the age of 14 (or earlier if
considered appropriate)

Meloxicam

7.5mg & 15mg tablets

Nabumetone

500mg tablets; 500mg in 5ml suspension

Etoricoxib

30mg, 60mg, 90mg & 120mg tablets

Phenylbutazonesr

100mg & 200mg tablets- For use in ankylosing spondylitis

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

108

10.1.2.2 Local Corticosteroid Injections


Hydrocortisone Acetate

25mg in 1ml injection

Methylprednisolone
Acetate

40mg in 1ml depot injection (Depo-Medrone)

Methylprednisolone
Acetate & Lidocaine

1ml injection - methylprednisolone acet. 40mg + lidocaine 1%


2ml injection - methylprednisolone acet. 80mg + lidocaine 1%

Prednisolone Acetate

25mg in 1ml depot injection

Triamcinolone
Acetonide

40mg in 1ml & 80mg in 2ml intramuscular/ intraarticular injections


10mg in 1ml & 50mg in 5ml intradermal/intra-articular
injections

Triamcinolone
Hexacetonide ru

20mg in 1ml intra-articular injection Paediatric use only

10.1.3 Drugs Which Suppress the Rheumatic Disease Process


Gold Salts
A Sodium Aurothiomalate

10mg, 20mg & 50mg in 0.5ml injections

Penicillamine
A Penicillamine

125mg & 250mg tablets

Antimalarials
B Hydroxychloroquine

200mg tablets

Drugs Affecting the Immune Response


A Azathioprine

See section 8.2.1

A Ciclosporin

See section 8.2.2

A Methotrexate

See section 8.1.3

A Leflunomide

10mg, 20mg & 100mg tablets

Cytokine Modulators
R Abatacept r

250mg injection
- approved for juvenile idiopathic arthritis in patients aged six

years and above (licensed) and under six years. It should only be
prescribed with informed consent
- approved for rheumatoid arthritis after the failure of a TNF
inhibitor in line with NICE
- approved for rheumatoid arthritis in line with NICE

125mg injection (prefilled syringe)


North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

109

- approved for moderate to severe rheumatoid arthritis and used


in line with NICE

Adalimumab r

40mg injection (prefilled syringe)


- approved for rheumatoid arthritis in line with NICE
- approved for rheumatoid arthritis after the failure of a TNF
inhibitor in line with NICE
- approved for ankylosing spondylitis in line with NICE
- approved for psoriatic arthritis in line with NICE
- approved as second-line anti-TNF therapy in children with
juvenile idiopathic arthritis and uveitis.

Anakinra r

100mg injection (prefilled syringe)


- approved for use by specialists in Systemic onset Juvenile

Idiopathic Arthritis (SoJIA) and Chronic Infantile Neurocutaneous


Arthritis (CINCA) and Muckle-Wells Syndrome (unlicensed
indications)
- approved for the treatment of severe gout in patients who have
not responded to other treatment and for patients with pseudogout
who have failed to respond to conventional treatment or unable to
tolerate conventional treatment.

- approved for adult onset stills disease

R Certolizumab Pegol

Each pre-filled syringe contains 200 mg certolizumab


pegol in one ml
- for use in rheumatoid arthritis in line with NICE
- for use in ankylosing spondylitis
- for use in psoriatic arthritis

R Etanercept r

25mg injection
- approved for rheumatoid arthritis in line with NICE

- approved for rheumatoid arthritis after the failure of a TNF


inhibitor in line with NICE
- approved for psoriatic arthritis in line with NICE
- approved for ankylosing spondylitis in line with NICE
- approved for 4-17 year olds with active JIA in line with NICE
- approved for the treatment of Juvenile Scleroderma (Its use
will be subject to informed consent and specialists using etanercept
in this indication should collect data on patient outcomes. If after a
six month trial, treatment were found to be beneficial, it would be
continued for two years. If unsuccessful after six months,
treatment should be discontinued).

R Golimumab r

50mg injection (prefilled pen & syringe)


- approved for rheumatoid arthritis in line with NICE
- approved for psoriatic arthritis in line with NICE

- approved for ankylosing spondylitis in line with NICE


- not approved for rheumatoid arthritis in methotrexate naive
patients NICEf

R Infliximab r

100mg injection

- approved for rheumatoid arthritis in line with NICE


- approved for rheumatoid arthritis after the failure of a TNF
inhibitor in line with NICE
- approved for psoriatic arthritis in line with NICE
- approved for JIA in patients who have not responded to
etanercept.
- approved for Juvenile dermatomyositis and paediatric onset

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

110

Behcets disease where there has been intolerance or lack of


response to 1st and 2nd line therapies.

100mg in 10ml & 500mg in 50ml concentrate for IV


infusion
- approved for adults and children with severe systemic lupus

R Rituximab r

erythematosus who have failed conventional therapies


- approved for rheumatoid arthritis after the failure of a TNF inhibitor
in line with NICE
- NETAG approved in combination with methotrexate as first-line
biological therapy in cases where there is an absolute
contraindication to tumour necrosis factor inhibitors
- NETAG approved for combination with other (non-methotrexate)
disease modifying antirheumatic drugs and as monotherapy in
cases in which conventional treatment with tumour necrosis factor
inhibitors or methotrexate is deemed unsafe.

R Tocilizumabr

80mg in 4ml & 200mg in 10ml & 400mg in 20ml


concentrate for IV infusion
- approved for systemic JIA in children and young people aged 2

years and older in line with NICE


- NETAG approved as an alternative treatment to anakinra for
patients with systemic onset JIA who have already received
treatment with etanercept and adalimumab. Not recommended for
polyarticular JIA.
- approved for rheumatoid arthritis in line with NICE

A Sulfasalazine

500mg e/c tablets

Others
Minocycline s

50mg and 100mg capsules and tablets

- this is an unlicensed indication. To be used to treat rheumatoid


arthritis who are unable to tolerate biologics and other DMARDs

10.1.4 Drugs Used in the Treatment of Gout and Cytotoxic Induced


Hyperuricaemia
Acute Attacks
NSAIDs

see section 10.1.1

Colchicine

500 microgram tablets

Long-term Control of Gout


First Choice
Allopurinol
Alternatives
Febuxostat

100mg & 300mg tablets


100mg in 5ml suspension u
80mg & 120mg tablets

- approved for patients where allopurinol is not tolerated or


contraindicated SPC in line with NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

111

Probenecid su

500mg tablets

Hyperuricaemia Associated with Cytotoxic Drugs


First Choice
Allopurinol s

100mg & 300mg tablets


100mg in 5ml suspension su

Alternative
R Rasburicase r

1.5mg & 7.5mg vials


- prophylactic use in high risk patients only

10.2 Drugs Used in Neuromuscular Disorders


10.2.1 Drugs which Enhance Neuromuscular Transmission
Anticholinesterases
R Edrophonium

10mg injection

Neostigmine s

15mg tablets; 2.5mg injection

Pyridostigmine s

60mg tablets & 60mg/5ml suspension

10.2.2 Skeletal Muscle Relaxants


First Choice
Baclofen

10mg tablets
5mg in 5ml sugar-free liquid
50 microgram in 1ml (test dose), 10mg in 20ml, 10mg
in 5ml injections
36mg in 12ml su & 72mg in 12ml su intrathecal
injections

Diazepam

2mg & 5mg tablets; 2mg in 5ml syrup


10mg injection (solution & emulsion Diazemuls) see section 4.1.2 for other formulations

N.B. Diazepam 10mg tablets are no longer included in the


Formulary

Alternatives
Dantrolene

25mg capsules

Tizanidine s

2mg & 4mg tablets for use on advice from neurologists


when other treatments are unsuitable

Nocturnal Leg Cramps


Quinine Sulphate

200mg tablets
- MHRA advice now states that quinine should not be
used routinely in the treatment of nocturnal leg cramps,
and should only be considered when cramps cause
regular disruption of sleep. After a period of 4 weeks,
treatment should be discontinued if no benefit is

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

112

gained.

10.3 Drugs for the Relief of Soft Tissue Inflammation


10.3.1 Enzymes
Collagenase

900 microgram injection


- approved for Dupuytrens contracture limited to one joint or cord
and when the flexion contracture is greater than 40o from the
horizontal plane (NETAG).

Hyaluronidase s

1,500 unit injection - for use on advice from specialist

10.3.2 Rubefacients and Other Topical Antirheumatics

Topical NSAIDs, Counter Irritants etc.


Ibuprofen

5% gel

PR Freeze Spray

Aerosol spray

Capsaicin s

0.075% cream

- for use with specialist advice in post-herpetic neuralgia & severe


neuropathic pain mainly in diabetes patients
0.025% cream for symptomatic relief in osteoarthritis

10.4 Intra-Articular Preparations


Hyaluronic Acid

20mg in 2ml prefilled syringes for intra-articular


injection into the knee

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

113

11. Eye
Preservative Free Eye Drops
Microbial contamination of multidose bottles of eye drops can cause eye infections that
may lead to damage of the eye and in extreme cases loss of sight. To minimise the
risk, multidose bottles of eye drops contain an antimicrobial preservative such as
benzalkonium chloride. The preservatives used in eye drops are normally well
tolerated, but they are not completely harmless. They can cause irritation and
damage to the corneal epithelium. This risk is understood to be greater in patients
with pre-existing damage to the ocular surface and where large quantities of
preservative containing eye drops are applied repeatedly over a prolonged period (e.g.
if applied more than 4 to 6 times daily for several weeks/ months).
To avoid these problems the use of preservative-free eye drops is recommended in:
Patients who have experienced hypersensitivity reactions or irritation due to preservatives
in eye drops.
Patients who have received corneal grafts.
Patients with conditions where there is already damage to the ocular surface as a result of
disease or trauma, such as dry eye, blepharitis, ocular burns etc.

Treatment with preservative-free eye drops will usually be initiated by an


ophthalmologist and details on their availability and use is available from the
pharmacy at Newcastles Royal Victoria Infirmary (and on the North of Tyne Area
Prescribing Committees Website).

11.3 Topical Anti-infective Preparations


11.3.1 Antibacterials
Preferred Drug
Chloramphenicol
Alternatives
Fusidic Acid
(Fucithalmic)
Ofloxacin
Gentamicin

0.5% eye drops + 0.5% minims; 1% eye ointment


0.5% preservative free eye drops u
1% eye drops in a gel basis which liquefies on contact
with the eye
0.3% eye drops
0.3% eye/ear drops, 0.3% minims
1.5% eye drops with and without preservative u R

Erythromycin u

0.5% eye ointment

Benzylpenicillin u

0.3% eye drops

Cefuroxime u

5% eye drops

Povidone Iodine u

5% preservative-free eye drops

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

114

Propamidine
Isethionate

0.1% eye drops For use in the treatment of acanthamoeba

R Polyhexamethylene
biguanide (PHMB) u

0.02% eye drops For use in the treatment of acanthamoeba

keratitis used with PHMB

keratitis

11.3.2 Antifungals
There are currently no licensed topical antifungal agents available for the treatment of eye
infections. Products such as those below can be obtained as unlicensed medicines to meet
specific needs on request from an ophthalmologist or microbiologist. Contact pharmacy at
the RVI (0191 2825398) for details.

Amphotericin B u

0.1% & 0.3% preservative free eye drops

Econazole u

1% in arachis oil eye drops

Voriconazole u

100 micrograms in 0.1ml (0.1%) preservative free eye


drops

11.3.3 Antivirals
Aciclovir (Acyclovir)
R Trifluorothymidine

3% eye ointment
u

1% eye drops

11.4 Corticosteroids and Other Anti-inflammatory Preparations


11.4.1a Plain Corticosteroids
First Choice
Betamethasone

0.1% eye/ear/nasal drops, 0.1% eye ointment

Alternatives
Dexamethasone

0.1% eye drops (Maxidex) & minims


0.1% preservative free eye drops u

Fluorometholone sr

0.1% eye drops


- for use in patients who experience ocular hypertension with

other corticosteroids treatment to be initiated with the advice of


an ophthalmologist

Prednisolone

0.1% su, 0.3% su & 0.5% eye drops,


0.5% minims
0.1%, 0.3%, 0.5% & 1% preservative free eye
drops su

- treatment to be initiated with the advice of an ophthalmologist

Prednisolone Acetate s

1% eye drops (Pred-Forte)

Rimexolone sr

1% eye drops for use where Fluorometholone (FML)


drops (which are much cheaper) are likely to be
insufficiently effective

- treatment to be initiated with the advice of an opthalmologist

- treatment to be imitated with the advice of an ophthalmologist


North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

115

Loteprednol etabonates

0.5% eye drops

R Dexamethasone implant

700 microgram intravitreal implant


- approved for of macular oedema following central retinal vein

- approved as a second line agent to conventional corticosteroid eye


drops, treatment to be imitated with the advice of an ophthalmologist
only

occlusion in line with NICE

R Fluocinolone acetonide
implant

190 microgram intravitreal implant

- are recommended as a possible treatment for people with chronic


diabetic macular oedema who have an artificial lens in their eye if
the implant is used in the eye with the artificial lens and
their diabetic macular oedema has not got better with other
treatments. NICE

11.4.1b Corticosteroids with Antibacterial Agents


First Choice
Betamethasone and
Neomycin

Eye drops containing betamethasone sodium


phosphate 0.1% and neomycin sulphate 0.5%

Alternatives
Maxtor

Eye drops & eye ointment containing dexamethasone


0.1%, hypromellose 0.5%, neomycin 0.35% &
polymyxin B sulphate 6,000 units/ml (drops)/g (oint.)

Prednisolone and
Neomycin

Eye drops containing prednisolone sodium phosphate


0.5% & neomycin sulphate 0.5%

11.4.2 Other Anti-inflammatory Preparations


Olopatadine

1mg in 1ml (0.1%) eye drops

Otrivine-Antistin

Eye drops containing antazoline sulphate 0.5% +


xylometazoline hydrochloride 0.05%

Sodium Cromoglicate

2% eye drops , 2% preservative free eye drops su

- treatment to be imitated with the advice of an ophthalmologist


only

11.5 Mydriatics and Cycloplegics


Tropicamide

0.5% & 1% minims

Cyclopentolate

0.5% & 1% eye drops, 0.5% & 1% minims

Atropine

1% eye drops, 1% minims, 1% eye ointment


1% preservative free eye drops u

Phenylephrine

2.5% u eye drops and 2.5% minims

R Mydricaine No 2

0.3ml injection containing procaine HCL 6mg, atropine


sulphate 1mg and adrenaline solution (1 in 1,000)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

116

11.6 Treatment of Glaucoma


Miotics
Pilocarpine

0.5%, 1%, 2% & 4% eye drops pilocarpine is for


1%, 2% & 4% minims

Sympathomimetics
Brimonidine

- 3rd line use only

0.2% eye drops

Beta-Blockers
Timolol

0.25% & 0.5% eye drops & 0.2ml unit dose eye drops

- Betaxolol, carteolol and long-acting timolol eye drops are not


included in the formulary and should not be used for new patients.

Carbonic Anhydrase Inhibitors and Systemic Drugs


First Choice
Brinzolamide

1% (10mg per ml) eye drops

Dorzolamide

2% eye drops

Alternative
Acetazolamide

250mg tablets; 500mg injection

Prostaglandin analogues
First Choice
Latanoprost

50 micrograms per ml eye drops (2.5ml pack)

Alternative
Bimatoprost
Tafluprost

300 micrograms/ml eye drops


15 micrograms/ml unit dose eye drops

- approved for use in children and adults. To be initiated by

ophthalmologists only and is to be used third line after


preservative containing latanoprost and preservative free timolol.
The ophthalmologists must clearly document that signs and
symptoms of preservative intolerance/ allergy have been
demonstrated in their patient prior to initiation.

Combination Products
Xalacom

Eye drops containing latanoprost 50 micrograms &


timolol (0.5%) 5mg per ml
- for use as a second/third-line agent in patients insufficiently

responsive to monotherapy with a prostaglandin analogue or beta


blocker

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

117

Ganfort

Eye drops containing bimatoprost 300 micrograms &


timolol (0.5%) 5mg per ml

- for use as a second/third-line agent in patients insufficiently


responsive to monotherapy with a prostaglandin analogue or beta
blocker

Cosopt

Eye drops containing dorzolamide 2% & timolol 0.5%


Unit dose eye drops (preservative free) containing
Dorzolamide 2% & Timolol 0.5% r

- approved for use in patients with confirmed allergy presenting as


conjunctival changes or skin allergy. To be initiated by
ophthalmologists only. The ophthalmologists must clearly
document that signs and symptoms of preservative allergy have
been demonstrated in their patient prior to initiation.

11.7 Local Anaesthetics


Tetracaine
(Amethocaine)

1% minims eye drops

Oxybuprocaine
(Benoxinate)

0.4% minims eye drops

Proxymetacaine

0.5% minims eye drops

Lidocaine and Fluorescein

Minims eye drops containing lidocaine 4% &


fluorescein sodium 0.25%

11.8 Miscellaneous Ophthalmic Preparations


11.8.1 Tear Deficiency, Ocular Lubricants and Astringents
First Choice
Hypromellose
Alternatives
Acetylcysteine s u

0.3% eye drops; 0.3% preservative free eye dropssu


- treatment to be imitated with the advice of an ophthalmologist
only

5% eye drops & preservative free eye drops


(Ilube eye drops containing acetylcysteine 5% and
hypromellose 0.35% are available for use in the
community)

- treatment to be imitated with the advice of an ophthalmologist


only

VitA-POS s
Lacri-Lube

Eye ointment (5g) containing retinol palmitate (vitamin


A) 250iu/g, white soft paraffin, light liquid paraffin,
liquid paraffin and wool fat
Eye ointment (3.5g) containing 57.3% white soft
paraffin, 42.5% liquid paraffin & 0.2% wool alcohols

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

118

Duolube s u

Lanolin and preservative free eye ointment containing


white soft paraffin and mineral oil
- treatment to be imitated with the advice of an opthalmologist
only

Carbomer 980

0.2% ophthalmic gel eye drops and single dose unit


eye drops (0.6%) - Viscotears or GelTears

Carmellose Sodium

0.5% & 1% 0.4ml unit dose eye drops

Sodium Chloride

0.9% eye drops & minims


5% eye drops with & without preservative u
5% eye ointment u

Sodium hyaluronate

0.4% minims (Clinitas)

R Balanced Salt Solution

Sterile solution containing sodium chloride 0.64%,


sodium acetate 0.39%, sodium citrate 0.17%, calcium
chloride 0.048%, magnesium chloride 0.03%,
potassium chloride 0.075% in 15ml bottles and 500ml
bags

- approved for the treatment of Keraconjunctiva sicca, post


refractive surgery and Corneal healing disorders

- for intra-ocular or topical irrigation during surgical procedures

Systane

10ml Multidose bottles


0.8ml Preservative free vials
Contains hydroxypropyl guar, polyethylene glycol 400,
propylene glycol (and other ingredients)
- Long-acting ocular lubricant used for the treatment of dry eye
syndrome. Liquid formulation which turns into a gel on contact with
eyes providing fast and long lasting relief. The multidose bottle may
be used for up to six months after opening in primary care.
In contact lens wearers, Systane should be applied before inserting
lenses and after removal to extend comfortable wearing times.

R Ciclosporin u

0.2% eye ointment


0.06% eye drops

- approved for use in patients with keratoconjunctivitis who cannot


tolerate the 0.2% eye ointment

11.8.2 Ocular Diagnostic and Peri-operative Preparations and


Photodynamic Treatment
R Ocriplasmin

2.5mg/ml concentrate for solution for intravitreal


injection
-approved for use in patients with vitreomacular traction who also

have no epiretinal membrane and a hole (up to 400 micrometres) in


the centre of their retina or severe sight problems in line with NICE

11.8.2.1 - Diagnostic Preparations


Fluorescein

2% minims eye drops, 1mg ophthalmic strips, Fluorets


10% 5ml & 20% 5ml injections su

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

119

R Indocyanine Green u

25mg injection

R Lissamine Green

1.5mg ophthalmic strips

11.8.2.2 - Ocular Peri-operative Drugs


R Diclofenac Sodium r

0.1% eye drops + minims

Ketorolac Trometamol s

0.5% eye drops

R Povidone Iodine u

5% eye drops (for use in eye surgery only)

R Acetylcholine

20mg in 2ml injection

Apraclonidine s

0.5% & 1% eye drops

R Duovisc u

Injection for use in cataract surgery containing VisCoat

R Hydroxypropylmethylcellulose HV (Oasis)

2% 2.3ml intraocular injection

R Sodium Hyaluronate

10mg in 1ml bag (Z-Hyalin, formerly Ophthalin Gelbag)


14mg in 1ml syringe (Healon GV)

R Ethanol u

20% eye drops

- for post-operative inflammation limited to patients where


corticosteroids are unsuitable

(1% sodium hyaluronate) and ProVisc (3% sodium


hyaluronate, 4% chondroitin sulphate)

- for use in the debridement of the corneal epithelium in patients


with recurrent corneal erosion syndrome.

11.8.2.3 - Subfoveal Choroidal Neovascularisation


R Aflibercept

4mg in 0.1ml injection

- approved for wet age related macular degeneration in line with


NICE

-approved for macular oedema central retinal vein occlusion


NICE

R Ranibizumab

10mg in 1ml injection

- approved for wet age related macular degeneration in line with


NICE
- approved for diabetic macular oedema in line with NICE
- approved for visual impairment caused by macular oedema
secondary to retinal vein occlusion NICE
- as a possible treatment for sight problems caused by choroidal

neovascularisation in people who also have pathological myopia


NICE

R Bevacizumab

1.25mg in 0.5ml syringe

- NETAG approved for use in the management of macular oedema


secondary to retinal vein occlusion. This is considered a more cost
effective treatment option in RVO compared with ranibizumab.
- NETAG approved for age related macular degeneration.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

120

R Verteporfin

15mg injection
-approved for photodynamic therapy in wet age-related macular
degeneration in line NICE

11.8.2.4 Other Products Mainly for Treating Ocular Injuries


R Disodium Edetate u

0.37% solution (20ml)

R Sodium Citrate u

10.11% eye drops


(equivalent to citrate 6.5%)

R Ascorbic acid u
(Potassium ascorbate)

10% preservative free eye drops

R Tretinoin u
(Retinoic acid)

0.05% eye drops

11.9 Contact Lenses


Contact lenses are only provided on the NHS when there is a medical need. Usually
this is when vision cannot be improved with spectacles, but can be improved with
contact lenses. The contact lens clinical staff at the RVI will assess eligibility. Examples
of eligibility include some disorders of the cornea, very high prescriptions and
'bandage' lenses.
The following contact lens care products stocked for the care of contact lenses for
patients attending the ophthalmology department at the RVI. GPs are not allowed to
prescribe contact lens solutions on the NHS.
Alcon Optifree Express system
Bausch & Lomb contact lens solutions
(Boston)
Bausch & Lomb saline (Salette)

Clens 100
Miraflow daily cleaner
Systane
Oxysept 1 - Step

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

121

12. Ear, Nose and Oropharynx


12.1 Drugs Acting on the Ear
12.1.1 Otitis Externa
Anti-inflammatory Preparations
First Choice
Betamethasone

0.1% eye/ear/nose drops (betamethasone sod. phosph.)

Alternative
Prednisolone

0.5% eye/ear drops (prednisolone sodium phosphate)

Anti-infective Preparations
Gentamicin

0.3% eye/ear drops

Chloramphenicol

5% (or 10%) ear drops (in propylene glycol)

Clotrimazole

1% solution (in polyethylene glycol 400)

Compound Antibacterial / Corticosteroid Preparations


First Choice
Gentamicin and
Hydrocortisone

Ear drops (Gentisone HC) containing gentamicin 0.3%


& hydrocortisone acetate 1%

Alternatives
Sofradex

Eye/ear drops containing dexamethasone 0.05%,


framycetin sulphate 0.5% & gramicidin 0.005%

Otomize

Spray containing dexamethasone 0.1%, neomycin


3,250 units/ml & acetic acid 2%

Betamethasone and
Neomycin

Eye/ear drops containing betamethasone sodium


phosphate 0.1% & neomycin sulphate 0.5%

Otosporin

Ear drops containing hydrocortisone 1%, neomycin


sulph. 0.439% & polymyxin B sulph. 10,000 units/ml

12.1.3 Removal of Ear Wax


Sodium Bicarbonate

Ear drops (sodium bicarbonate 5% & glycerol 30%)

Olive Oil

Ear drops

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

122

12.2 Drugs Acting on the Nose


12.2.1 Drugs Used in Nasal Allergy
Antihistamine
Azelastine

0.1% nasal spray (140 micrograms/metered spray)

Corticosteroids
First Choice (in primary care)
Beclometasone

50 microgram/metered dose aqueous nasal spray

Alternatives
Mometasone

50 microgram/metered dose nasal spray

Fluticasone Furoate
(Avamys)

27.5 microgram / dose nasal spray. N.B. Take care to

Fluticasone Propionate

50 microgram / dose nasal spray

avoid confusion with fluticasone propionate

N.B. Take care to avoid confusion with fluticasone


furoate

400 microgram unit dose nasal dropss


- treatment to be with specialist advice only

Betamethasone

0.1% eye/ear/nose drops (betamethasone sod. phos.)

Triamcinolone Acetonide

55 microgram metered dose nasal spray

Other Alternative
12.2.2 Topical Nasal Decongestants
Sympathomimetic
First Choice
Xylometazoline

0.05% & 0.1% nasal drops, 0.1% nasal spray

Alternative
Ephedrine

0.5% & 1% nasal drops

Antimuscarinic
Ipratropium

21 micrograms/puff metered dose nasal spray

Sodium Chloride
Sodium Chloride

0.9% nasal drops

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

123

NeilMed Sinus Rinse

Sachets containing powder for preparing a buffered


saline solution for nasal irrigation using the NeilMed
Irrigation device. Available as kits containing the
irrigation device and sachets and separate (isotonic)
sachets. N.B NeilMed Sinus Rinse is classified as a

medical device and, as it is not currently included in


the Drug Tariff, it cannot be prescribed on the NHS
in primary care

12.2.3 Nasal Preparations for Infection and Epistaxis


Naseptin

Cream (chlorhexidine HCl 0.1% & neomycin sulph. 0.5%)

Mupirocin

2% nasal ointment (Bactroban) -First Choice for use in

R Bismuth Subnitrate and


Iodoform (B.I.P.P.)

Paste
1.25cm x 100cm & 2.5cm x 100cm impregnated gauze

MRSA eradication

12.3 Drugs Acting on the Oropharynx


12.3.1 Drugs for Oral Ulceration and Inflammation
Benzydamine

0.15% oral rinse (mouthwash) & spray

Carmellose Sodium
(Orabase)

Paste containing carmellose sodium 16.7%, pectin


16.7% & gelatin 16.7% in plastibase

Choline Salicylate

8.7% sugar-free gel in a flavoured basis (Bonjela)

Hydrocortisone

2.5mg lozenges (pellets)

Hyaluronan (Gengigel)

0.2% gel & 0.025% mouthwash

R Caphosol

1 dose=1 x 15ml Caphosol A + 1 x 15ml Caphosol B


mixed together

- for limited second-line use on specialist advice in the treatment


of orofacial granulomatosis, severe oral ulceration and mucositis
secondary to immunosuppression where conventional treatments
are unsuitable or have failed

- for limited use in patients having chemo-radiotherapy or


radiotherapy to malignancies of the oral cavity, hypopharynx and
oro-pharynx. r

Drugs for Periodontitis


Doxycycline

20mg tablets

12.3.2 Oropharyngeal Anti-infective Drugs


Fungal Infections
Nystatin

100,000 units/ml suspension

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

124

Miconazole

24mg/ml (20mg/g) sugar-free oral gel;


50mg muco-adhesive buccal tablets

- restricted to use in immunocompromised patients with severe


oropharyngeal candidiasis, where the use of other antifungal
agents e. g. nystatin, fluconazole is not appropriate and for use on
the advice of microbiologists

R Amphotericin u
Viral Infections
Aciclovir

100mg/1ml oral suspension

- approved for specialist use in chronic mucocutaneous candidiasis

Tablets & suspension see section 5.3.2

12.3.3 Antiseptic Lozenges Sprays and Gels


Cetylpyridinium Chloride

1.4 mg lozenges (Merocet)

Merocaine

Lozenges (benzocaine 10mg + cetylpyridinium Cl 1.4mg)

12.3.4 Mouthwashes, Gargles and Dentifrices


Chlorhexidine

0.2% mouthwash; 0.2% mint flavoured spray;


1% dental gel;
2% oral gel u

- for hospital use in the prevention of ventilator-associated


pneumonia in adult patients who are ventilated (for >48 hours)

Hexitidine

0.1% mouthwash

Mouthwash solution
tablets

Solution tablets containing antimicrobial, flavouring


and colouring agents

Triclosan (Mentadent P)

Toothpaste containing triclosan - for use in MRSA

eradication. If Mentadent P is not available, Colgate Total is a


suitable alternative

12.3.5 Treatment of Dry Mouth


Section to be reviewed
Saliva Substitutes
First Choice
Saliva Orthana

50ml spray, 450ml refill (mucin 3.5% - of porcine


origin, xylitol 2%, sodium fluoride 4.2mg / litre)
preferred to Glandosane as it is less likely to damage
tooth enamel

Alternative
Glandosane

Aerosol spray (carmellose sodium, sorbitol, potassium


chloride, sodium chloride, magnesium chloride,
calcium chloride & dipotassium hydrogen phosphate)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

125

Other Products for Dry Mouth


Malic Acid (Salivix)

Sugar-free pastilles containing malic acid

Pilocarpine s

5mg tablets treatment to be initiated with specialist advice

Biotene Oral Balance

Saliva replacement gel - prescribable on the NHS in


primary care as a Borderline Substance

BioXtra

Salivary gel and toothpaste. The gel, but not the


toothpaste, is prescribable on the NHS in primary care
as a Borderline Substance

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

126

13. Skin
13.2 Emollients and Barrier Preparations
13.2.1 Emollients
Plain Emollients
Aqueous Cream or
ZeroAQS

Aqueous Cream: Liquid paraffin 6%, 15% white


petroleum jelly & emulsifying wax 9%
- due to the SLS content to be used as a soap substitute only
ZeroAQS: Liquid paraffin 6%, white soft paraffin (WSP)
15% & macrogol cetrostearyl ether 1.8% (SLS free)

Aveeno cream

Emulsifying ointment 30%, phenoxyethanol 1% &


cetostearyl alcohol

Cetraben

Liquid paraffin 10.5%, white soft paraffin (WSP) 13.2%

Emulsifying
Ointment BP

WSP 50%, emulsifying wax 30% & liquid paraffin 20%

Hydromol ointment

Yellow soft paraffin 30%, emulsifying wax 30% & liquid


paraffin 40%.
- this product is also known locally as Emulsifying Ointment RVI
Formula. It is softer than emulsifying ointment BP. Epaderm
ointment is made to the same formula, but is more expensive.

Dermol cream

10% liquid paraffin, 10% isopropyl myristate & 0.1%


benzalkonium chloride & 0.1% chlorhexidine chloride

Doublebase gel or
Zerodouble gel

15% liquid paraffin & 15% isopropyl myristate

R QV cream

10% light liquid paraffin, 5% white soft paraffin & 10%


glycerol
- approved for used in radiotherapy only

R Aquamax cream
Yellow Soft Paraffin

8% light liquid paraffin, 20% WSP


- approved for used in radiotherapy only

White Soft Paraffin


Paraffin sterile liquid
Hydrous Ointment
(Oily Cream)
E45 Cream
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

127

or ZeroCream
Diprobase Cream or
Zerobase cream
Urea Containing Emollient
Calmurid

Cream containing urea 10% & lactic acid 5%

13.2.1.1 Emollient Bath Additives


Zeroneum

Liquid containing soya oil 83.35%

Oilatum Emollient or
Zerolatum

Liquid containing liquid paraffin 63.4% & acetylated


wool alcohols 5%

Dermol bath

25% liquid paraffin, 10% isopropyl myristate & 0.5%

13.2.2 Barrier Preparations


Sorbaderm

2g & 92g barrier cream, 28ml pump spray, sterile 1ml


no sting barrier film foam applicator, sterile 3ml no
sting barrier film foam applicator

Dimeticone (Siopel)

Cream containing dimeticone 1000 10% & Cetrimide


0.3%. Also contains arachis (peanut) oil

Drapolene

Cream containing benzalkonium chloride 0.01% &


Cetrimide 0.2%

Sudocrem

Cream containing benzyl alcohol 0.39%, benzyl


benzoate 1.01%, benzyl cinnamate 0.15%, hydrous
wool fat (hypoallergenic lanolin) 4%, zinc oxide
15.25%

Zinc and Castor Oil


ointment (cream)

Ointment containing zinc oxide 7.5%, castor oil 50%,


arachis (peanut) oil 30.5%, white beeswax 10% and
cetostearyl alcohol 2%

Deegans Ointment su

Ointment containing 3% benzoin compound tincture in


a base containing zinc and castor oil paste and olive
oil under review

Metanium

Ointment containing titanium oxide 20%, titanium


peroxide 5% and titanium salicylate 3% in a basis
containing dimeticone, paraffins and benzoin
compound tincture under review

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

128

R Sucralfate u

4% cream
- for limited use around gastrostomies when wound
breakdown is thought to be aggravated by leakage of
gastric acid

13.3 Topical Local Anaesthetics and Antipruritics


Antipruritics
Calamine Lotion

Lotion (calamine 15%, zinc oxide 5%, glycerol 5% bentonite 3%, sodium citrate 0.5% & liquefied phenol 0.5%)

Crotamiton

10% cream (Eurax)

Menthol in Aqueous cream

1% menthol in aqueous cream. Available as


Dermacool

Local Anaesthetics
Lidocaine

5% ointment

13.4 Topical Corticosteroids


Very Potent
Clobetasol Propionate
(Dermovate)

0.05% cream, ointment & scalp application

Potent
Betamethasone Valerate
(Betnovate)

0.1% cream, ointment, lotion & scalp application

Fluocinolone Acetonide
(Synalar)

0.025% cream, ointment & gel

Hydrocortisone Butyrate
(Locoid)

0.1% cream

With Antimicrobials
Betnovate C

Cream & ointment (betamethasone 0.1% - as the


valerate & clioquinol 3%)

Betnovate N

Cream & ointment (betamethasone 0.1% - as the


valerate & neomycin sulphate 0.5%)

Dermovate NN

Ointment (clobetasol propionate 0.05%, neomycin


sulphate 0.5%, nystatin 100,000 units/g)u

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

129

With Salicylic Acid


Diprosalic
Moderately Potent

Ointment - betamethasone 0.05% (as dipropionate) &


salicylic acid 3%: Scalp application - betamethasone
0.05% (as dipropionate) & salicylic acid 2%

Clobetasone Butyrate
(Eumovate)

Cream & ointment (0.05% clobetasone butyrate)

Betamethasone 0.025%
(Betnovate RD)

Cream & ointment (betamethasone 0.025% - as the


valerate)

Fludroxycortide tape
(Flurandrenolone,
Haelan)
With Antimicrobials

Polythene adhesive film impregnated with


fludroxycortide (4micrograms/cm2), supplied as 7.5cm
wide strips in lengths of 50cm & 2m.

Trimovate

Cream (clobetasone butyrate 0.05%, oxytetracycline


3%, & nystatin 100,000 units/g)

Triadcortyl u

Nystatin, neomycin, gramicidin ointment

- for the treatment of otitis externa in those patients who have ear
canal stenosis or who have failed to respond to other first or
second line treatments

Mild
Hydrocortisone

0.5%, 1% & 2.5% creams & ointments

With Antimicrobials
Canesten HC

Cream (clotrimazole 1% & hydrocortisone 1%)

Daktacort

Cream (miconazole nitrate 2% & hydrocortisone 1%)

Nystaform HC

Cream (chlorhexidine HCl 1%, nystatin 100,000


units/g & hydrocortisone 0.5%)

Timodine

Cream (nystatin 100,000 units/g, benzalkonium


chloride 0.1%, hydrocortisone 0.5% & dimeticone
350 10%)

With Other Ingredients


Eurax Hydrocortisone

Cream (crotamiton 10% & hydrocortisone 0.25%)

13.5 Preparations for Eczema and Psoriasis


13.5.1 Preparations for Eczema
Zinc Paste and
North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

130

Ichthammol Bandage
(Ichthopaste)
R Alitretinoin

10mg and 30mg capsules

- approved for adults with severe chronic hand eczema that have
not responded to potent topical corticosteroids in line with NICE

13.5.2 Preparations for Psoriasis


Coal Tar Preparations
Coal Tar

Coal tar lotion 1% - see Exorex


Coal tar strong solution 1%, 2.5% & 5% in
emulsifying ointment RVI u

Coal Tar & Salicylic Acid

Ointment containing coal tar 2% & salicylic acid 2%

Coconut oil Compound


(Sebco)

Scalp ointment (Coal tar solution 12%, salicylic acid


2%, precipitated sulphur 4%, in a coconut oil
emollient basis) marketed as Cocois and Sebco
(Sebco is recommended as it is less expensive)

Exorex

Lotion containing prepared coal tar 1% in an emollient


basis. Excipients include hydroxybenzoates (parabens)
and polysorbate 80

Tar Pomade (RVI) u

Pomade containing 6% coal tar solution and salicylic


acid 2% in an emulsifying ointment base

Zinc and Coal Tar Paste


(Whites Tar Paste) u

Paste containing zinc oxide 6%, coal tar 6%,


emulsifying wax 5%, starch 38% and yellow soft
paraffin 45%

With Corticosteroid
Alphosyl HC

Cream containing coal tar extract 5%, hydrocortisone


0.5% and allantoin 2%

Dithranol Preparations
Dithranol
R Dithranol in Full
Strength Lassars Paste u
R Dithranol with Salicylic
Acid 0.5% u

0.1%, 0.25%, 0.5%, 1% & 2% creams (Dithrocream)


0.2%, 0.4% & 0.6% pomade u
0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1%, 2%, 4%, 6% &
8%
0.2%, 0.4%, 0.6%, 0.8%, 1%, 2%, 4%, 6%, 8% &
16% in emulsifying base

Other Topical Preparations


Calcipotriol
(Dovonex)

50 micrograms/g (0.005%) cream & ointment


50 micrograms/ml (0.005%) scalp application

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

131

Salicylic Acid

2%, 5%, 10% & 20% in emulsifying ointment u

Zinc and Salicylic Acid


Compound Paste, Half
Strength u

Half Strength Lassars Paste

Dovobet

Ointment containing betamethasone 0.05% (as


dipropionate) and calcipotriol 50 micrograms/g
Gel containing betamethasone 0.05% (as
dipropionate) and calcipotriol 50 micrograms/g - For the

treatment of scalp and mild to moderate non scalp plaque psoriasis


vulgaris in adults.

Oral Retinoids for Psoriasis


R Acitretin u

10mg & 25mg capsules

Psoralens (used with phototherapy)


R 8-Methoxypsoralen u
(Methoxsalen)

10mg tablets

R 5-Methoxypsoralen u

20mg tablets

R Methoxypsoralen u

1.2% bath additive

Other treatments
R Fumaric acid esters u

30mg & 120mg tablets

13.5.3 Drugs Affecting the Immune Response


Methotrexate

See section 8.1.3

Ciclosporin

See section 8.2.2

R Adalimumab r

40mg injection (prefilled syringe)

R Etanercept r

25mg injection

R Infliximab r

100mg injection

R Ustekinumab r

45mg vial

- approved for psoriasis in line with NICE

- approved for psoriasis in line with NICE

- approved for psoriasis in line with NICE

- approved for psoriasis in line with NICE

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

132

B Tacrolimus s

0.03% & 0.1% ointment

B Pimecrolimus s

1% cream
-approved for moderate disease on face and neck for those

- approved for moderate to severe disease atopic eczema in


patients over 2 years in line with NICE

between 2 and 16 years in line NICE

13.6 Preparations for Acne


13.6.1 Topical Preparations
Benzoyl Peroxide and azelaic acid
Azelaic Acid

15% gel (Finacea)

Benzoyl Peroxide

2.5%, 5% & 10% aqueous gel (Panoxyl Aquagel)

Epiduo

Gel containing adapalene 0.1% and benzoyl peroxide


2.5%

Antibiotics
Clindamycin

1% topical solution (alcohol water basis)


1% lotion (aqueous)

Zineryt

Topical solution containing erythromycin 4% zinc


acetate 1.2% (when reconstituted)

Erythromycin

2% topical solution (alcoholic)

Topical Retinoids
Adapalene

0.1% gel and cream

13.6.2 Oral Preparations


R Isotretinoin

5mg & 20mg capsules

Co-cyprindiol

Tablets containing cyproterone acetate 2mg &


ethinylestradiol 35 micrograms

- isotretinoin is a toxic drug that must only be prescribed by or


under the supervision of a consultant dermatologist see BNF and
product literature.

generic co-cyprindiol is much cheaper than Dianette

See section 5.1 for systemic antibiotics

13.7 Preparations for Warts and Calluses


Salactol Paint

Paint (salicylic acid 16.7% & lactic acid 16.7% in


flexible collodion)

Glutaraldehyde Paint

10% Solution (paint) Glutarol

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

133

Salicylic Acid

Various strength preparations in Emulsifying ointment


see section 13.5.2

Podophyllotoxin s

0.15% cream (Warticon)

Silver Nitrate

75% & 95% applicators 6 inch & 95% pencils


(Caustic pencils). 0.5% solution also available see

to be initiated with specialist advice

section 13.11.6
Imiquimod rs

5% cream 12 sachet pack 2nd line specialist use for

Trichloroacetic Acid u

10%, 75% & 90% solutions

treatment of ano-genital warts (mainly in genitourinary


medicine [GUM] clinics)

13.8 Sunscreens and Camouflagers


13.8.1 Sunscreen Preparations
Preferred Products
Uvistat Ultrablock
(Sunblock factor 30)

Cream (UVB SPF 30) - mexenone 2%, ethylhexyl pmethoxycinnamate 7.5%,


Butylmethoxydibenzoylmethane 4% & titanium dioxide
6.5%

Sunsense Ultra
(Sunblock factor 50+)

Lotion (UVA and UVB SPF 50+ protection)


containing octinoxate 7.5%, oxybenzone 3%, titanium
dioxide 3.5% - 125ml pack

Photodamage
Fluorouracil s
(Efudix)

5% cream

- for the treatment of superficial malignant and premalignant skin


lesions. To be initiated with advice of specialists

13.8.2 Camouflaging Preparations


Products from the Dermacolor Camouflage Crme and Veil cover cream ranges are
included in this Formulary. They are classified as borderline substances and can be
prescribed on FP10 prescription forms (marked ACBS) for postoperative scars and
other deformities and as an adjunctive therapy in the relief of emotional
disturbances due to disfiguring skin disease, such as vitiligo.

13.9 Shampoos and Some Other Preparations for Scalp and Hair
Conditions
Alphosyl 2 in 1

Shampoo containing alcoholic coal tar extract 5%

Polytar Liquid

Shampoo containing a mixture of tar preparations &


0.3% Cade oil

Ketoconazole

2% shampoo (Nizoral)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

134

Selenium Sulphide

2.5% shampoo (Selsun)

Simple Shampoo

Simple shampoo (Gentle/Frequent) 200ml

Hirsutism
Co-cyprindiol

Tablets containing cyproterone acetate 2mg &


ethinylestradiol 35 micrograms
- generic co-cyprindiol is much cheaper than Dianette

Eflornithine

11.5% cream

- approved for use as a second-line treatment of facial hirsutism in


patients where co-cyprindiol (Dianette) is ineffective, contra-indicated
or considered inappropriate. Treatment should be initiated by or on
the specific advice of an appropriate specialist - endocrinologist (or
gynaecologist)

13.10 Anti-Infective Skin Preparations


13.10.1 Antibacterial Preparations
13.10.1.1 Antibacterial Preparations Only Used Topically
Mupirocin Ointment s

2% ointment (Bactroban)

Polyfax Ointment

Ointment (polymyxin B sulph. 10,000 units &


bacitracin zinc 500 units/g)

Silver Sulfadiazine

1% Cream (Flamazine)

R Nitrofurazone Soluble su

0.2% Ointment

- to be initiated with advice from specialist

for limited use in burns/ plastic surgery patients only

13.10.1.2 Antibacterial Agents Also Used Systemically


Fusidic Acid

2% cream, gel & ointment

Metronidazole Gel

0.75% cream & gel,

13.10.2 Antifungal Preparations (Topical)


First Choice
Miconazole Nitrate

0.16% Dual Action Spray powder

Alternatives
Ketoconazole

2% cream & shampoo

Nystatin

Nystatin cream & ointment have now been


discontinued

Terbinafine

1% cream

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

135

Amorolfine

5% nail lacquer cream for use in primary care only

13.10.3 Antiviral Preparations


Aciclovir (Acyclovir)

5% cream

13.10.4 Parasiticidal Preparations


Preferred Products
Malathion

0.5% lotion (aqueous), 0.5% lotion (alcoholic)

Phenothrin
(Full Marks)

0.2% lotion (contains 69% isopropyl alcohol)

Alternative
Permethrin

5% skin cream; 1% cream rinse

Dimeticone (Hedrin)

4% lotion (50ml)

13.10.5 Preparations for Minor Cuts and Abrasions etc.


Antiseptic Creams / Ointments
Drapolene

Cream (cetrimide 0.2%, benzalkonium chloride 0.01%)

Proflavine cream

Oily emulsion containing 0.1% Proflavine


hemisulphate for limited use in hospitals

Preparations for Boils


Magnesium Sulphate

Paste (dried magnesium sulphate 45g, glycerol 55g & phenol


500mg per 100.5g)

Collodion
Flexible Collodion

2.5% castor oil & colophony 2.5% in a collodion base

Skin tissue Adhesives


Enbucrilate

Tissue adhesives (Liquiband, Liquiband Optima,


Indermil X-Fine, Histoacryl Blue)

Glues / sealants for intra-operative use


Bioglue
Floseal matrix sealant
Evicel Human Fibrin Glue

For use in neurosurgery and vascular surgery


2ml & 5ml kit

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

136

Tisseel Lyo Fibrin Glue

2ml, 4ml & 10ml kit

R TachoSil

4.8 & 9.5 cm 2 Haemostatic (collagen sponge coated


with fibrinogen and thrombin) for use in liver and renal
surgery

Artiss fibrin sealant

2ml, 4ml & 10ml prefilled syringe.


- for use in plastic surgery to close dead spaces, adhere skin

- also approved for use in the treatment of mesh fixation in hernia


repair

graft, close simple wounds and stabilise bone grafts.

e) For Use ENT surgery & Epistaxis


R Bismuth Subnitrate and
Iodoform (B.I.P.P.)

Paste
1.25cm x 100cm & 2.5cm x 100cm impregnated gauze

13.11 Disinfectants and Cleansers


13.11.1 Alcohols, Saline and water
Alcohol Impregnated
Wipes

Containing 70% isopropyl alcohol or methylated spirit


(e.g. Clini-wipes, Alcowipes)

Methylated Spirit

70% liquid & 70% spray

(industrial)

Skin Preparation Swabs

Containing 70% isopropyl alcohol (Sterets)

Alcohol Hand Rub Gel


Sodium Chloride 0.9%

Sterile solution bottles, 25ml & 100ml sachets


(Normasol) & 45ml plastic ampoules/pods
(Miniversol)

Water for Irrigation

(Sterile)

13.11.2 Chlorhexidine Salts


Chlorhexidine
(CX Antiseptic Powder)

1% chlorhexidine acetate dusting powder

Chlorhexidine Gluconate

0.02% & 0.05% solutions, 25ml & 100ml sachets


0.5% solution in 70% methylated spirit (pink,
colourless & red staining),
2.5% in 70% methylated spirit wipes
0.5% hand rub (contains 70% isopropyl alcohol + emollients)
4% surgical scrub

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

137

2% in 70% isopropyl alcohol wipes (Sanicloth &

Clinell ), skin swabs & skin cleanser


3ml & 10.5ml applicators (Chloraprep)
Obstetric cream
Prontosan s

Solution containing Betaine 0.1% (surfactant) and


Polyhexanide 0.1% (a chlorhexidine polymer). Mainly
for use from 40ml plastic ampoules.
Also available as a gel. Prontosan
- to be prescribed/ used only on the advice of tissue viability
specialists

13.11.3 Cationic Surfactants, Soaps and Other Antiseptics


Mediscrub

Scrub containing 2% polymeric biguanide


hydrochloride

Octenisan

Body wash containing octenidine

- used in some trusts as an alternative to chlorhexidine scrub and


Triclosan skin cleanser in MRSA prophylaxis/eradication

13.11.4 Chlorine and Iodine


Iodine Containing Preparations
Povidone Iodine
Chlorinated Products
Sodium
Hypochlorite u
Sodium
dichloroisocyanurate

2.5% dry powder spray 10% alcoholic solution


7.5% surgical scrub10% antiseptic solution (aqueous)

1% sterilising solution
500mg & 5g solution tablets:
granules

13.11.5 Phenolics
Hexachlorophene and Triclosan
Triclosan
(Aquasept, Manusept,
& Skinsan)

1% or 2% skin cleanser
0.5% hand rub

13.11.6 Astringents, Oxidisers and Dyes


Hydrogen Peroxide

10 volume (3%) & 20 volume (6%) solutions

Potassium Permanganate

400mg solution tablets


5% solution u
under review
0.5% solutions used on advice from dermatologists

Silver Nitrate

Under review

R Bonneys Blue u

Paint containing brilliant green and crystal violet for


limited use in some operating theatres only

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

138

R Crystal Violet u

0.5% paint

Magenta paint BPC su


(Castellanis paint)

Paint containing magenta 0.4%, boric acid 0.8%,


phenol 0.004%, resorcinol 8%, acetone and alcohol (or
industrial methylated spirit) unlicensed under review

- for limited use in some operating theatres / critical care areas


only

13.11.7 Preparations for Promotion of Wound Healing


See Section 18
LarvE

Sterile larvae (maggots) used for the management of


sloughy wounds

13.12 Antiperspirants
Aluminium Chloride
(Driclor, Anhydrol forte)

Aluminium chloride hexahydrate 20% solution in an


alcoholic basis

Botulinum A Toxin Haem agglutinin complex s

100 unit vials for injection (Botox) see section 4.9.3

Glycopyrrolate su

1% cream To be initiated by specialist

- For limited use as an alternative to surgery in some patients.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

139

14. Immunological Products and Vaccines


Please refer to the DoH Green Book on vaccines for the most up to date
information on the recommended preparations and use.

14.4 Vaccines and Antisera


For use in line with formal DOH guidance
Bacillus Calmette-Gurin Vaccine
(BCG Vaccine, Dried/Tub/BCG)

1ml multidose vials containing freeze


dried powder for preparing intradermal
injections

Tuberculin Purified Protein Derivative


(Tuberculin PPD) u

20 units/ml (2 units/0.1-ml dose) (for


routine use), 1.5-ml vial; 100 units/ ml
(10 units/0.1-ml dose), 1.5-ml vial
Dose: By intradermal injection, for Mantoux
test, 2 units (0.1 ml of 20 units/ml strength)
for routine Mantoux test; if first test is
negative and a further test is considered
appropriate 10 units (0.1 ml of 100 units/ml
strength). The tuberculin PPD currently
supplied is unlicensed in the UK.

Botulism Antitoxin

1 vial of Botulism antitoxin trivalent


(equine) A B & E 5000 units injection
normally stocked at Newcastle General
Hospital for emergency use. If required,
contact pharmacy.

Diphtheria/Tetanus/Pertussis (Acellular,
Component), Poliomyelitis (inactivated)
and Haemophilus Type b Conjugate
Vaccine (adsorbed) (DTaP/IPV/Hib)

0.5ml vial

Adsorbed Diphtheria, Tetanus, Pertussis


(Acellular, Component)
Adsorbed Diphtheria, Tetanus, Pertussis
(Acellular, Component) and Inactivated
Poliomyelitis Vaccine, (dTaP/IPV or
DTaP/IPV)

0.5ml prefilled syringe

Adsorbed Diphtheria (low dose),


Tetanus, Pertussis (Acellular,
Component) and Inactivated
Poliomyelitis Vaccine
(dTaP/IPV or DTaP/IPV)

0.5ml prefilled syringe

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

140

Adsorbed Diphtheria (low dose),


Tetanus and Inactivated Poliomyelitis
Vaccine

0.5ml prefilled syringe

Haemophilus Influenzae type b


conjugated vaccine

Vial with syringe containing diluent


(0.5ml)

Haemophilus Influenzae type b &


Meningococcal Group C Conjugate
Vaccine (Menitorix)

Vial with syringe containing diluent


(0.5ml)

Hepatitis A Vaccine

720 ELISA units in 0.5ml prefilled syringe


for use in children aged 1-15 years
(Havrix Monodose Junior).
1440 ELISA units in 1ml prefilled syringe
for use in adults (Havrix Monodose).

Hepatitis B Vaccine
(High Strength)

40 microgram/ml only licensed for use


in dialysis and predialysis patients

Hepatitis B Vaccine

Hepatitis B surface antigen 10


micrograms/ml 0.5ml (paediatric) & 1ml
(adult) prefilled syringes (HBvaxPRO) preferred product:
20 micrograms/ml 0.5ml (paediatric) &
1ml (adult) vials prefilled syringes
(Engerix B) also available

Hepatitis A & B Vaccine

1ml syringe (Adult Twinrix) & 0.5ml


syringe (Paediatric Twinrix)

Human Papilloma Virus Vaccine

0.5ml prefilled syringe Cervarix brand


For the prevention of cervical cancer (Gardasil
brand is available for limited uses i.e. for
giving protection against cancer in
patients with Fanconi anaemia use in
children with HIV infection and infections
with other blood borne viruses)

Influenza Vaccine

0.5ml prefilled syringes containing either


split viron or surface antigen vaccine.

- also approved for immune testing in non CF


bronchiectasis patients

-The formulary includes both standard influenza


vaccine and pandemic influenza vaccine

Fluenz nasal spray

Suspension of live, attenuated influenza


virus. 0.2ml nasal applicator

Japanese Encephalitis Vaccine su

Vials

Measles, Mumps & Rubella Vaccine, Live


(MMR [live])

Powder and solvent for suspension for


injection in pre-filled syringe (0.5ml)

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

141

Meningococcal A, C, W135 & Y Vaccine


(ACWY Vax)

Powder and solvent for suspension for


injection in pre-filled syringe (0.5ml)

Meningococcal A, C, W135 & Y


conjugate Vaccine (Menveo)

Powder and solvent for suspension for


injection in pre-filled syringe (0.5ml)

Meningococcal Group C Conjugate


Vaccine

0.5ml prefilled syringe

Pneumococcal Polysaccharide Vaccine


(Pneumovax II)

0.5ml vial
- also approved for immune testing in non CF
bronchiectasis patients

Pneumococcal Polysaccharide Conjugate


Vaccine (adsorbed)
(Prevenar)

0.5ml prefilled syringe

Poliomyelitis Vaccine, Inactivated

0.5ml prefilled syringe


- not for routine use, use combined vaccines

Rabies Vaccine

Vial with syringe containing diluent


- used in hospitals for post exposure management
(on advice from infectious diseases specialists)
and for pre-exposure prophylaxis in those at high
risk e.g. in travellers prescribed on a private
prescription

R Tetanus Vaccine Adsorbed

0.5ml injection immunology use only


- for primary immunisation against tetanus in
previously unimmunised adults and children over
10 years, 3 doses of diphtheria (low dose), tetanus
& inactivated poliomyelitis vaccine at monthly
intervals are now recommended.

Typhoid Vaccine (vi Polysaccharide)


R

Varicella Zoster Vaccine

Yellow Fever Vaccine Live

0.5 ml prefilled syringe


- for limited use only
Available only to designated Yellow Fever
Vaccination centres

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

142

14.5 Immunoglobulins
Normal Immunoglobulin
(Human normal Immunoglobulin, HNIG)
Normal Immunoglobulin
injections

For Deep Intramuscular Injection

250mg & 750mg vials - Available from the


Centre for Infections and other regional Health
Protection Agency offices.

For Subcutaneous Administration

800mg in 5ml and 1,600 mg in 10ml vials


(Subcuvia) for SC infusion. Can IM if SC
route not available (replaces Gammabulin).
250mg, 750mg & 1500mg vials (Subgam)
mainly for use in Northumbria Healthcare Trust

For Intravenous Administration

2.5g, 5g & 10g for IV infusions


(Flebogamma, Octagam 5% & 10%, &
Vigam)
5g in 50ml, 10g in 100ml & 20g in 200ml
IV infusions (Privigen replaces Sandoglobulin)
1g, 2.5g, 5g, 10g & 20g for IV infusions
(Kiovig).
Specific Immunoglobulins

The brand supplied and strengths


available may change from time to time.

Tetanus Immunoglobulin (HTIG)

250 units in 1ml injection

Anti D (Rho)
Immunoglobulin

1,500 units in 2ml prefilled syringes

(Rhophylac )

1,500 unit (300 microgram) & 5,000 unit


(1mg) vials (WinRho) s

- approved for the prevention of RhoD sensitisation in


women in line NICE
- also approved for use by haematologists in
appropriate patients with immune thrombocytopenia. The 1,500 and 5,000 unit vials (WinRho)
are much more expensive than the other
formulations and should only be used on advice from
haematologists. It is the only formulation licensed for
use in immune thrombocytopaenia.

Varicella-Zoster Immunoglobulin

R Hepatitis B Immunoglobulin su

200 international units injection (for infant use)


3g injection (for use in liver unit / critical care)
3g injection has been discontinued, replaced
with Hepatect.

HEPATECT 500 international units injection and


2000 international units injection.

North of Tyne Area Prescribing Committee. Formulary - Version 5.4 July 2014

143

15. Anaesthesia
15. 1 General Anaesthesia
15.1.1 Intravenous Anaesthetics
First Choice
Propofol

1% (10mg/ml) injections (Propofol Lipuro) available as


200mg in 20ml ampoules,
500mg in 50ml and 1g in 100ml bottles
1% (10mg/ml) 50ml (500mg) prefilled syringes for use
in Diprifusor pumps (Diprivan)
2% (20mg/ml) injection - 1g in 50ml bottles for ITU use
only

Others
Etomidate

20mg in 10ml injection

Ketamine

200mg in 20ml (10mg/ml), 500mg in 10ml (50mg/ml) &


1g in 10ml (100mg/ml) injections
50mg in 5ml oral solution u
- often used as an analgesic in the management of
neuropathic pain by specialist pain teams R
- also for palliative care A

Thiopental Sodium
(Thiopentone)

500mg in 20ml injection

15.1.2 Inhalational Anaesthetics


First Choice
Isoflurane
Others
Nitrous Oxide
Entonox

50% nitrous oxide and 50% oxygen mixture used for


analgesia

R Sevoflurane
R Halothane u

For use in elective and emergency airway anaesthesia only


(mainly paediatrics)

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

144

R Desflurane

For use in neurosurgery patients as an alternative to


sevoflurane or desflurane and in the following groups of
patients as an alternative to sevoflurane/ isoflurane in
Bariatric surgery.
Prolonged procedures over 2 hours e.g.
oesophagectomy.
Surgery in the elderly where there are concerns of
cognitive impairment
Major surgery in the elderly with or without cognitive
dysfunction
Subject to the following limitations:
Desflurane is not for use in day surgery unless the
patient is morbidly obese.
There is no role at present for its use in paediatrics or
cardio-thoracic surgery.
Desflurane must be used in conjunction with low fresh
gas flow.
Its use should be monitored and audited.

15.1.3 Antimuscarinic Pre-medication Drugs


Atropine Sulphate

600 microgram injection


1mg in 5ml and 3mg in 30ml injections in prefilled
syringes used in cardiac resuscitation

Glycopyrronium Bromide

200 microgram in 1ml & 600 microgram in 3ml


injections

Hyoscine
Hydrobromide

400 microgram injection

15.1.4 Sedative and Analgesic Pre-operative Drugs


15.1.4.1 Anxiolytics and Neuroleptics
Benzodiazepines
Diazepam

2mg, 5mg tablets 10mg tablets should no longer be


used.
2mg in 5ml oral solution
10mg in 2ml injection (plain & emulsion)
- For use in epilepsy see section 4.8.2 and use in anxiety
see section 4.1.2

Midazolam

5mg in 5ml (1mg/ml) injection for general use


10mg in 2ml & 10mg in 5ml injections
- these higher strengths are restricted to use in general
anaesthesia, intensive care, palliative medicine and where
its use has been formally risk assessed and agreed, for
example, where syringe drivers are used
50mg in 50ml prefilled syringes - ITU use only
2.5mg in 1ml oral solution u
R Intranasal midazolam 40mg/ml + lidocaine
20mg/ml
- approved for use prior to cannulation for adult patients
with special needs receiving dental treatment under IV
sedation.

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

145

Temazepam

(see section 4.1.1)

Lorazepam

(see section 4.1.2)

Phenothiazine
Alimemazine
(Trimeprazine)

30mg in 5ml syrup see section 3.4.1 for other

formulations

15.1.4.2 Non Opioid Analgesics


Diclofenac

75mg in 2ml injection (Dyloject)


- mainly for use in postoperative analgesia see section
10.1.1 for other formulations

R Parecoxib

40mg injection - for peri-operative use only.

Ketorolac Trometamol

10mg in 1ml & 30mg in 1ml injections


- The use of is no longer recommended, other parenteral
analgesics are now preferred

15.1.4.3 Opioid Analgesics (see section 4.7.2 for other opioid analgesics)
Alfentanil s

1mg in 2ml, 5mg in 10ml & 5mg in 1ml injections


- approved for initiation by specialists in palliative care

R Fentanyl

100 microgram in 2ml & 500 microgram in 10ml


injections
2.5mg in 50ml (50 micrograms/ml) syringe u
2 micrograms/ml with levobupivacaine 0.1% in sodium
chloride 0.9% infusion, 100ml, 250ml & 500ml u
4 micrograms/ml with levobupivacaine 0.125% in
sodium chloride 0.9% infusion, 500ml (RVI) u

Remifentanil

1mg, 2mg & 5mg injections

15.1.5 Muscle Relaxants (Neuromuscular Blocking Drugs)


R Atracurium

25mg in 2.5ml, 50mg in 5ml & 250mg in 25ml injection

R Cisatracurium

20mg in 10ml (2mg/ml) &


150mg in 30ml (5mg/ml) injections

R Mivacurium

10mg in 5ml & 20mg in 10ml injections

R Pancuronium

4mg in 2ml injection

R Rocuronium

50mg in 5ml injection

Suxamethonium

100mg in 2ml injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

146

Vecuronium

10mg in 5ml injection

Papaverine

30mg in 2ml injection u

15.1.6 Anticholinesterases Used in Anaesthesia


R Edrophonium

10mg in 1ml injection

R Glycopyrronium &
Neostigmine

Glycopyrronium 500 microgram & neostigmine 2.5mg


in 1ml injection (Robinul neostigmine)

R Neostigmine

2.5mg in 1ml injection

R Physostigmine u

1mg in 1ml injection

R Sugammadex

200mg in 2ml & 500mg in 5ml injections

- only approved for the emergency reversal of blockade in cases of


failed intubation in patients who are undergoing rapid sequence
induction anaesthesia with rocuronium because of contraindications to suxamethonium.

15.1.7 Antagonists for Central and Respiratory Depression


R Doxapram
see section 3.5.1

100mg in 5ml injection


2mg/ml 500ml intravenous infusion in glucose 5%

Flumazenil

500 microgram in 5ml injection

Naloxone

400 microgram in 1ml injection (ampoules and


syringes)

15.1.8 Drugs for Malignant Hyperthermia


R Dantrolene Sodium

20mg injection

15.1.9 Prophylaxis of acid aspiration


R Sodium Citrate

0.3 Molar peppermint flavoured solution


(50ml packs)

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

147

15.2 Local Anaesthesia


Lidocaine
(Lignocaine)

Injections (plain)

0.5% 10ml
1% 2ml, 5ml, & 10ml (10mg/ml)
2% 2ml, 5ml & 20ml injection (20mg/ml)
5% 2ml Heavy injection (50mg/ml)
5% 10ml injection (50mg/ml) u

Injections (with Adrenaline)

1% & adrenaline 1 in 200,000, 20ml


2% & adrenaline 1 in 200,000, 20ml
2% & adrenaline 1 in 80,000, 2ml cartridges

Topical preparations

1% & 2% gel with chlorhexidine 0.25%


4% topical solution (some packs unlicensed)5%
ointment
Metered dose spray (10mg/spray)
2% spray u
100mg lollipops u
Lidocaine 4%, adrenaline 0.1% & tetracaine 0.5%
(LAT gel) u
- approved for use in anaesthetising lacerations <4cm in length,
particularly in the paediatric population not to be used in
children weighing under 15kg.

R Bupivacaine

0.25% & 0.5% injection 10ml


0.25% & 0.5% + adrenaline 1 in 200,000 inj. 10ml
0.5% in glucose 8% injection (Marcain Heavy)
0.1% & 0.125% u in sodium chloride 0.9% infusions

R Levobupivacaine

0.25%, 25mg in 10ml & 0.5%, 50mg in 10ml


& 0.75%, 75mg in 10ml injections &
R 0.625mg/ml & 1.25mg/ml infusion bags
- for local infiltration in hip and knee replacement surgery.

Mepivacaine

3% 2.2 ml cartridges

Prilocaine

0.5% 10ml injection u, 1% 20ml injection


4% 2ml injection (cartridges)
R 2% 5ml injection (cartridges)
- only to be used in patients undergoing spinal anaesthesia for day
surgery where the procedure is anticipated to last longer than 90
minutes.

3% & felypressin injection (cartridges)


Tetracaine (Amethocaine)

4% gel (Ametop)

R LMX4

Cream (lidocaine 4%) LMX4 is not associated with


methaemoglobinemia, a systemic side effect of Emla.

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

148

EMLA

Cream (lidocaine 2.5% & prilocaine 2.5%)

R Cocaine

4% nasal solution (drops) u


25% paste (1g syringe pack) u
4% solution with adrenaline u

Procaine s

1% 5ml injection u, 2% 2ml injection,


0.1% 500ml infusion u

Lidocaine &
Phenylephrine
(Co-phenylcaine Forte)

5% lidocaine & 0.5% phenylephrine solution with


applicator, or nasal spray (50ml) u

Ethyl Chloride

Spray

PR Freeze spray

Spray

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

149

16. Treatment of Poisoning


16.1 Removal and Elimination
16.1.1 - Emetic
The use of emetics such as Ipecacuanha Mixture is no longer recommended
16.1.2 Prevention of Absorption
Activated Charcoal

Actidose Aqua Advance, 50g in 240ml suspension


Carbomix, - 50g powder supplied in a bottle to which
water is added to prepare a suspension

16.2 Agents Used in Poisoning Due to Specific Drugs


16.2.1 Paracetamol Poisoning
Acetylcysteine

2g in 10ml injection

Methionine

250mg & 500mg tablets

16.2.2 Analgesics (Opioid)


Naloxone

400 microgram injection ampoules and prefilled


syringes

16.2.3 Iron Salts


Desferrioxamine

500mg vials (for preparing injection & oral solution)

16.3 Agents Used in Poisoning by Other Agents


16.3.1 Cyanides
Dicobalt Edetate

300mg in 20ml injection

Sodium Nitrite

3% 10ml injection (30mg/ml) u

Sodium Thiosulphate

50% 10ml injection (500mg/ml) u

16.3.2 Heavy Metals


Dimercaprol

100mg in 2ml injection

Penicillamine

125mg & 250mg tablets

Sodium
calcium edetate

1g in 5ml injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

150

16.3.3 Pesticides etc.


16.3.3.1 Paraquat Poisoning
Activated Charcoal - see 16.1.2 Given with a laxative
16.3.3.2 Organophosphorus Insecticides
Pralidoxime Mesylate

1g in 5ml injection

16.3.4 Snake Bite


Adder Snakebite Antiserum
(European Viper Antivenom)
16.3.5 Ethylene Glycol and Methanol
Fomepizole u

100mg in 20ml injection

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

151

17. Nutrition Products

Fortisip Compact

Protein 9.6g, carbohydrate 29.7g, fat 9.3g per


100ml, 240kcal/100ml. Fortisip Compact is not
Kosher or Halal approved.

- approved for use in patients with renal failure and when a


lower fluid volume is indicated.

Pro-Cal Shot

Liquid formulation of the nutritional supplement ProCal. Approved for use in colo-rectal surgery patients in
an enhanced recovery programme. More convenient to
use than Pro-Cal powder.

Resource Protein

Isotonic nutritional supplement with increased levels of


protein, energy and other nutrients. Claimed to have
better palatability and tolerability than some other
similar nutritional products.

ProZero

Carbohydrate 8.1g, fat 3.8g, energy 278kJ


- approved for children with metabolic disorders

Infatrini peptisorb

Protein 2.6g, carbohydrate 10.3g, fat 5.4g per


100ml, 100kcal/100ml.

Parenteral Nutrition Products


Babiven Maintenance su

Parenteral nutrition solution containing amino acids,


glucose and minerals for use in parenteral nutrition for
babies.

Smofkabiven

Emulsion for infusion (TPN), consisting of three


chambers
- only approved for use as a second line agent, when the
current contracted product is unavailable.

Section Under Development

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

152

18. Wound Management Products


Chapter 18 contains the full list of products contained on the North of Tyne
APC formulary. Subsets of chapter 18 have been produced by the TVN teams
from both NHCFT and NUTH and are distributed accordingly.
18.1 Basic Wound Contact Dressings
18.1.1 Low Adherence Dressings
Knitted Viscose Primary Dressing BP 1993
Tricotex

Warp knitted fabric manufactured from bright viscose


monofilament.
- low adherence wound contact layer.

Paraffin Gauze Dressing BP 1993


Paranet
Other
Atrauman

Non-adherent knitted polyester primary dressing


impregnated with neutral triglycerides.
- abrasions, burns.

18.1.1 Absorbent Dressings


Absorbent Perforated Dressing with Adhesive Border
Mepore

Low adherence dressing consisting of viscose and rayon


absorbent pad with adhesive border.

Absorbent Perforated Plastic Film Faced Dressing


Low adherence dressing consisting of 3 layers

Solvaline N r

Low adherence dressing consisting of 3 layers


- for post-operative and low exudates wounds; low adherence property
and low absorption capacity.
- restricted to podiatry and primary care use. Alternative to melolin for
practice nurses.

Eclypse Adherent r

Soft silicone wound contact layer with absorbent pad and


film-backing
- restricted to use in heavily exudating wounds that require multiple
dressing changes.

Absorbent Cellulose Dressing with Fluid Repellent Backing


Mesorb

Cellulose wadding pad with gauze wound contact layer and


non-woven repellent backing.
- postoperative use for heavily exuding wounds.

KerraMax Care

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

153

18.2 Advanced Wound Dressings


18.2.1 Hydrogel dressings
Hydrogel Sheet Dressings
ActiFormCool

Hydrogel sheets which have fixed structure, such products


have limited fluid handling capacity.
- moderate exuding wounds.

Hydrogel Application (amorphous)


Intrasite Gel

A ready mixed hydrogel containing modified carmellose


polymer applied directly into the wound. 8g only
- for dry, sloughy or necrotic wounds

18.2.2 Vapour-permeable films and membranes


Vapour-permeable Adhesive Film Dressing, BP 1993
(Semi-permeable Adhesive Dressing)

Opsite Flexifix

Unsterile film dressing on a roll.

Tegaderm r

- restricted to IV/sc dressing and podiatry use only

With Absorbent Pad


Vapour-permeable Adhesive Film Dressing with absorbent pad
Opsite plus
Opsite Post Op
18.2.3 Soft Polymer Dressings
Urgotul

Non-adherent soft polymer wound contact dressing


- dry or lightly exuding wounds

Telfa Clear

Clear non-adherent wound contact layer

Adaptic Touch

Non adherent soft silicone wound contact dressing

- available from NHS supply chain via the Total Dressings Scheme
(Currently Northumbria only)

With Absorbent Pad


Allevyn Gentle
Allevyn Gentle Lite

Soft gentle wound contact dressing with polyurethane foam


film backing
r

Soft gentle wound contact dressing with polyurethane foam


film backing
- restricted to podiatry use only

Allevyn Gentle

Silicone gel wound contact dressing with polyurethane foam

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

154

Border

film backing

Mepilex

Absorbent soft silicone dressing with polyurethane film

Mepilex Border

With soft silicone border

Mepilex Transfer

Soft silicone exudates transfer dressing

18.1.4 Hydrocolloid dressings


Without Adhesive Border
Comfeel Plus
Transparent

Hydrocolloid dressing containing carmellose sodium and


calcium alginate.

DuoDerm Extra Thin

Sterile, thin, hydrocolloid dressing.


- minimally exuding wounds.

DuoDerm Signal

Hydrocolloid dressing with Time to change indicator.


- pressure ulcers, burns.

Hydrocolloid Fibrous Dressing


Aquacel
Aquacel Extra

Soft sterile non-woven pad containing hydrocolloid fibres.


Ribbon.
- moderate to heavily exuding wounds.
Soft sterile non-woven pad containing hydrocolloid fibres.
- moderate to heavily exuding wounds.

18.2.5 Foam Dressings


Polyurethane Foam Film Dressing, Sterile without Adhesive Border.
Polymem

- moderate to heavy exuding wounds

18.2.6 Alginate dressings


Plain Alginate
Melgisorb

Alginate containing hydrocolloid dressing sterile.

Sorbsan Ribbon with


Probe

18.3 Antimicrobial Dressings


18.3.1 Honey
Sheet Dressing
L-Mesitran Hydro
(formerly Mesitran)

Hydrogel, semi-permeable dressing impregnated with


medical grade honey, without adhesive border.
- pressure ulcer, fungating wounds, donor sites.

L-Mesitran Border
(formerly Mesitran

Hydrogel, semi-permeable dressing impregnated with


medical grade honey, with adhesive border.

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

155

Border)
L-Mesitran Net
(Formerly Mesitran
Mesh)
Algivon

Hydrogel, non-adherent wound contact layer, without


adhesive border

Absorbent, sterile, non-adherent calcium alginate dressing


impregnated with medical grade manuka honey.

Honey Based Topical Application


L-Mesitran

Ointment containing 47% medical grade honey

L-Mesitran Soft

Ointment containing 40% medical grade honey

18.3.2 Iodine
Iodoflex

Paste iodine 0.9% as cadexomer-iodine in a paste basis with


gauze backing. 5g unit, 10g unit, 17g unit.
- for chronic exuding wounds.
- max single application 50g. Max weekly application 150g.
- duration up to 3 months in any single course of treatment.
- cautions: Severe renal impairment or history of thyroid disorders
- contra-indications: avoid in thyroid disorders, in those receiving lithium,
in pregnancy and breast feeding and in children.

Iodosorb

Ointment, iodine 0.9% as cadexomer-iodine in an ointment


basis. 10g

- uses for chronic exuding wounds.


- max single application 50g. Max weekly application 150g.
- duration up to 3 months in any single course of treatment.
- cautions: Severe renal impairment or history of thyroid disorders
- contra-indications: avoid in thyroid disorders, in those receiving lithium,
in pregnancy and breast feeding and in children.

Povidone-Iodine Fabric Dressing


Inadine

- wound contact layer for abrasions and minor burns

- cautions: iodine may be absorbed particularly in large wounds.


- contra-indications: severe renal impairment, pregnancy, breast feeding.

18.3.3 Silver
Low Adherence Dressings
Acticoat s

Three-layer antimicrobial barrier dressing consisting of a


polyester core between low adherent silver-coated high
density polyethylene mesh.
- specialist use only.

Acticoat Flex 3 s

Conformable antimicrobial barrier dressing consisting of a


polyester core between low adherent silver-coated high
density polyethylene mesh (for 3-day wear).
- specialist use only.

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

156

Acticoat Flex 7 s

Conformable antimicrobial barrier dressing consisting of a


polyester core between low adherent silver-coated high
density polyethylene mesh (for 7-day wear).
- specialist use only.

With charcoal
Actisorb Silver 220

Knitted fabric of activated charcoal, with one-way stretch,


with silver residues within spun-bonded nylon sleeve.

Soft polymer Dressings


Urgotul SSD

With silver sulphadiazine.


- antimicrobial dressing for dry or lightly exuding wounds.

Alginate Dressings
Silvercel

Sterile hydrocolloid and alginate dressing impregnated with


silver.
- antimicrobial dressing for moderate to heavily exuding wounds.

Tegaderm Alginate Ag Calcium alginate dressing.


18.3.4 Other Antimicrobials
Flaminal

Alginate containing hydrogels with glucose peroxidase and


lactoperoxidase enzymes with antimicrobial properties. For
use as an alternative to some silver or iodine containing
products
Forte gel, 15g and 50g.
- for use on moderately to heavily exuding wounds.
Hydro gel, 15g and 50g.
- for use on lightly to moderately exuding wounds.

Prontosan Wound
Gel

A ready mixed hydrogel containing betaine surfactant and


polyhexanide. 30ml

Prontosan Irrigant

20ml pods and 100ml bottle

18.4 Specialised Dressings


18.4.1 Protease modulating matrix dressings
Promogran Prisma
Matrix r

Sterile, collagen and oxidised regenerated cellulose matrix.


- chronic wounds free of necrotic tissue and infection
- podiatry use only

18.5 Adjunct Dressings and Appliances


18.5.2 Wound Drainage Pouches
Draina S
Eakin

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

157

18.5.3 Topical negative pressure therapy


KCI VAC negative
pressure
Renasys Go
Topical Negative
Pressure
Pico

18.7 Wound Care Accessories


18.7.1 Dressing Packs
Non-Drug Tariff Specification Sterile Dressing Pack
First Choice on FP10

Polyfield Nitrile Patient


Pack

Contains powder free nitrile gloves, laminate sheet,


polythene sterile field, non-woven swabs, towel, polythene
disposable bag, apron.
-cheaper than Dressit, lamiate sheet for kneeling on.

Second Choice on
FP10

Dressit

Contains vitrex gloves, large apron, disposable bag, paper


towel, soft swabs, absorbent pad and sterile field.

Soft drape

Universal dressing pack, latex free; includes ivtrex gloves


- available from NHS supply chain via the Total Dressings Scheme
(Currently Northumbria only)

Sterile Gloves
18.7.2 Woven and Fabric swabs
Non-woven fabric swab
Non-woven fabric
swab

Sterile
Non-sterile

Appeel single use


wipes

- removes adhesive build up without damaging skin.

18.7.3 Surgical adhesive tapes


Permeable Apertured Non-woven Synthetic Adhesive Tape, BP 1988
Mefix
Hypafix
Permeable Non-woven Synthetic Adhesive Tape BP 1988

Scanpore tape

- primary care only

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

158

Transpore tape

- secondary care only

18.8 Bandages
Bandages and adhesives
According to their structure and performance bandages are used for dressing retention, for
support and for compression.

18.8.2 Light-weight conforming bandages


Knitted Polyamide and Cellulose Contour Bandage BP1988
K-Band
Actiwrap Latex-free
Bandage
18.8.3 Tubular Bandages and Garments
Elasticated Tubular Bandages BP1993
Elasticated Viscose Stockinette
Cotton Stockinette Bleached BP1988
Ribbed cotton and viscose surgical tubular stockinette BP1988
Full Comfi range
(Synergy Health)

- available from NHS supply chain via the Total Dressings Scheme
(Currently Northumbria only)

Full Clini range


(CliniSupplies)
18.8.4 Support bandages
Knitted Elastomer and Viscose Bandage
K-Lite
18.8.6 Cohesive bandages
Cohesive extensible bandages
These adhere to themselves, but not to the skin, and are useful for providing support for sports
use where ordinary stretch bandages might become displaced and adhesive bandages are
inappropriate. Care is needed in their application, since the loss of ability for movement
between turns of the bandage to equalise local areas of high tension carries the potential for
creating a tourniquet effect. They should not be used if arterial disease is suspected.

18.8.7 Compression bandages


Short stretch compression bandages
Actico
Comprilan
Sub-compression wadding bandage
Profore #1

also available as latex free

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

159

18.8.8 Multi-layer compression bandaging


Four layer systems
Profore

also available as latex free

Profore Lite
Two layer system
Coban 2
Coban 2 Lite
K-Two
18.8.9 Medicated bandages
Zinc Paste Bandage
(Viscopaste PB7)

Open-wove bleached cotton bandage impregnated evenly


with a paste containing zinc oxide 6%

Zinc Paste and


Ichthammol Bandage
(Ichthopaste)

Open-wove bleached cotton bandage impregnated evenly


with a paste containing zinc oxide 6% and ichthammol 2%

Medicated stocking
Zipzoc

4 pouch carton, 10 pouch carton

18.9 Compression Hosiery and Garments


18.9.1 Graduated compression hosiery
First Choice
Activa hosiery

Full range

Second Choice
Medi hosiery

Full range

18.10 Other wound products not listed in BNF, but on Drug Tariff or
available from NHS Supply Chain.
Actiglide

Product to aid the application of compression hosiery

Kerraped

A shoe to accommodate bulky bandages and offload


pressure from the front of the foot. ]

- restricted to leg ulcer management only


- available on FP10

- restricted to leg ulcer management only.


- available on FP10

Limbo

Transparent limb-shaped plastic cover with flexible seal at the


opening.

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

160

- restricted to leg ulcer management only.


- keep leg dressings dry during bathing/showering
- available on FP10

Seal Tight

Transparent limb-shaped plastic cover with flexible seal at


the opening.
- restricted to leg ulcer management only.
- keep leg dressings dry during bathing/showering
- available on FP10

Debrisoft
Sorbaderm

- debridement of supifical wounds

2g & 92g barrier cream, 28ml pump spray, sterile 1ml no


sting barrier film foam applicator, sterile 3ml no sting
barrier film foam applicator.

Products also in Dermatological section of Formulary and BNF


13.1.2
13.11.1 Skin cleansers and antiseptics
Sodium Chloride

Irripod 0.9% Solution sterile, 25 x 20ml

Miniversol 0.9% Solution sterile, 30 x 45ml unit and


30x100ml unit dose vials (pods)
13.11.7 Desloughing Agents
Biobag s

Sterile larvae (maggots) sealed in a finely woven polyester


pouch with PVA foam spacers.
- specialist use only

Larvae300 s

Free range larvae with a retention net kick pack.


- specialist use only

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

161

Appendix
This section lists some products that have been approved for prescribing/use by the
North of Tyne Area Prescribing Committee, but do not fit into existing sections of the
Formulary. Some will be added to additional sections as these are developed.

MRI Contrast Media


Gadobutrol (Gadovist)

Gadolinium based MRI Contrast medium for use as an


alternative to Magnevist. One of the safer gadolinium
contrast media with regard to the potential risk of
nephrogenic systemic fibrosis.

- for use in the differential diagnosis of liver disease

Gadobenate dimeglumine
(Multihance)
Gadofosveset (Vasovist)

Gadolinium (MRI) contrast agent that binds to albumin


for use in MRI angiograms

Gadoxetic acid (Primovist)

Gadolinium based MRI Contrast medium for use in:


The assessment of hepatic vascular structures and
biliary system of potential living, related liver
donors.
The detection and characterisation of focal liver
lesions using MRI, when standard imaging with
other agents has been inconclusive.
The detection and characterisation of focal liver lesions
which potentially communicate with the biliary system
e.g. large liver cysts.

Gastrografin

A contrast medium for the radiological examination of


the gastrointestinal tract.

Meglumine gadoterate
(Dotarem)

Gadolinium MRI contrast medium that is licensed for


use in children. Gadoterate is considered to be much
less likely to cause nephrogenic systemic fibrosis than
dimeglumine gadopentetate (Magnevist), which has
previously been used in children.

Miscellaneous
Sonovue

Sulphur hexafluoride. Available as a kit including one


vial of gas, one vial of powder and one pre-filled
syringe containing 5ml of solvent. On reconstitution, 1
ml of the resulting dispersion contains 8 microliters of
sulphur hexafluoride in the microbubbles, equivalent
to 45 microgrammes
- approved for use in visualising blood vessels in liver and
diagnosing cancer, and used for the diagnosis of pancreatic
cancers, and also for use when echocardiography images are
unsatisfactory for answering the clinical question due to poor
definition.

Acetic acid 5%u

To be diluted to 2.5%

- approved for the use in the detection of dysplasia/


neoplasia in Barretts oesophagus

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

162

Dialysis Fluids
Citrasate

A sodium citrate based dialysate with a citrate


concentration of 0.8mmol/l
approved for use in place of standard dialysate
formulations for patients in whom anticoagulation is
problematic or contraindicated.

Primsocitrate 18/0

Citrate containing anticoagulant solution containing


18mmol/L citrate, 140mmol/l sodium and 86mmol/l
chloride
- approved for regional anticoagulation using citrate in
continuous renal replacement therapies (CRRT)

PrimsOcal B22

A calcium free dialysate containing 22mmol/l


bicarbonate, 3mmol/l lactate, 140mmol/l sodium,
4mmol/l potassium, 0.75mmol/l magnesium,
120.5mmol/l chloride and 6.1mmol/l glucose
- approved for regional anticoagulation using citrate in
continuous renal replacement therapies (CRRT)

Probiotics
VSL#3

Probiotic containing high concentration of lyophilised


bacteria
- approved for use in the prevention of pouchitis in children
and adults (in patients with ulcerative colitis who have
undergone proctocolectomy with ileal pouch-anal
anastomosis). Not approved for any other indications.

R BioGaia

- approved for prophylaxis against necrotising enterocolitis in


pre-term infants

R Infloran

- approved for prophylaxis against necrotising enterocolitis in


pre-term infants

Wound Care Products


R

Xelma

Amelogenin containing wound treatment that helps


provide an extra cellular matrix protein.
- approved for specialist use in the treatment of hard to heal
leg ulcers that have not responded to standard therapies. Use
should be targeted to ulcers >10cm2 in area and those > 12
months duration. Prescriptions should be signed by an
appropriate consultant vascular surgeon (or dermatologist).
NOT to be used to treat diabetic foot ulcers.

Integuseal IS 100

Sterile, film forming cyanocrylate liquid, provided in a


ready-to-use applicator
- approved for preoperative preparation of the saphenous
vein harvest site

Gentafleece

Collagen based medical device containing gentamicin -

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

163

used during surgical procedures for its haemostatic and


antibiotic properties. Less expensive than Collatamp-G.

Chlorhexidine impregnated
sponge (Biopatch)

An antiseptic hydrophilic wound dressing that is applied


to the venous catheter insertion sites for lines expected
to be in situ for greater than 72 hours in critical care
areas.

Fillers etc, used in Surgery


Hyaluronic Acid injection
(Hydrafil Softline Max)

Hyaluronic acid injection (replacement for Hylaform

Hyaluronic Acid Perlane


(Restylane Perlane)

Hyaluronic acid injection - Viscoelastic gel tissue

Hyaluronic Acid Sub Q


(Restylane Sub Q)

Hyaluronic acid injection - Viscoelastic gel tissue

Juvederm Ultra 3

Hyaluronic acid injection- Viscoelastic gel tissue

Plus ).
- approved for use in ENT surgery as a bulking agent
in the posterior tracheal wall around the tracheooesophageal fistula in the occasional patient with
leakage around Blom-Singe valves.(Discontinued
Sep 2010)

filler
- approved for use in patients with mechanical ptosis
with acute facial nerve palsies

filler
- approved for use in augmentation of orbital volume
after removal of the eye in patients who have already
had other volume enhancement surgery

filler that contains a local anaesthetic.


- onlyapproved for procedures that are not available
on the NHS.

Juvederm Ultra 4

Hyaluronic acid injection - Viscoelastic gel tissue


filler that contains a local anaesthetic.
- approved for use for volumising and correction of
deeper folds and wrinkles, including enhancing
volume in the cheeks and chin.
- only approved for procedures that are not available
on the NHS.

Radiesse Voice u

Calcium hydroxylapatite injection pack contains


a 1ml percutaneous needle, for use as a vocal cord
medialisation injection only by ENT.
- only approved for use in patients who are
anticipated to have a longer life expectancy as it has
a longer duration of action.

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

164

Bone Morphogenic Proteins (BMP)


R Dibotermin Alfa s
(Inductos)

Eptotermin alfa s
(Osigraft)

Inductos contains 1.5mg/ml of dibotermin alfa.


- approved for use in spinal fusion procedures: In
patients who have failed previous spinal fusion
surgery and in patients undergoing spinal fusion
surgery where there is a very high risk of non-union.

Each vial contains 1g of powder with 3.3mg of


eptotermin alfa.
- approved for use in the treatment of the non-union
of the tibia only.

Others
R Indigo Carmine su

20mg in 5ml & 40mg in 5ml solution/injection


- approved for facilitating the identification of malignant and
premalignant lesions during colonoscopy

R Methylthioninium Chloride s

10ml amp 0.5% injection (Proveblue) & 1%


injection (Aggutenent)

R Patent Blue V Sodium sur

5mg in 2ml injection


- restricted to use in sentinel lymph node biopsies.

Personal Best Peak Flow Meter

Peak flow meter that has some advantages over the


Mini-Wright peak flow meter at no extra cost.

Sucrose 24% solutionu

24% solution
- used as an analgesic in neonates whilst carrying out
painful procedures such as heel prick testing

R Taurolidine 2% solution u

- approved for use in washing out the chest cavity prior to


lung transplantation and nebulisation post transplant.

R Biotin u

5mg tablets
- approved for the treatment of multiple carboxylase
deficiency. Only to be initiated by a specialist

R l-lysine 2.5%, l-arginine 2.5%


infusion u
DC Beads

- used for renal protection in patients receiving lutetium 177


dotatate therapy (approved by the Cancer Drug Fund.)

75-150 micron and 100-300 micron


- for the treatment of malignant hypervascularised
tumour(s) using the TACE procedure

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

165

INDEX
3
3TC. see Lamivudine, 62

5
5HT3 Antagonists, 41
5-Methoxypsoralen, 132

8
8-Methoxypsoralen, 132

A
Abacavir, 62
Abacavir & lamivudine, 62
Abacavir, Lamivudine & Zidovudine. see
Trizivir
Abatacept, 109
Abbreviations, 3
Abciximab, 26
Abidec, 106
Abilify. see Aripiprazole
Abiraterone, 96
Abstral. see Fentanyl sublingual
Acamprosate, 53
Acarbose, 69
Acetazolamide

anti-epileptic, 50
epilepsy, 50
glaucoma, 117

Acetic acid 5%

Barrett's oesophagus, 162

Acetylcholine, 120
Acetylcysteine, 33

eye drops, 118


paracetamol poisoning, 150

Aciclovir, 64

cream, 136
eye ointment, 115
oropharyngeal infections, 125

Acitretin, 132
Aclasta. see Zoledronic Acid
Aclidinium, 29
Acne, 133
acquired nystagmus. See memantine
Actemra. See Tocilizumab
Actico, 159
Acticoat, 156
Acticoat Flex 3, 156

Acticoat Flex 7, 157


Actidose-Aqua Advance. see Activated
charcoal
ActiformCool, 154
Actiglide, 160
Actilyse. see Alteplase
Actinomycin D. see Dactinomycin, 87
Actiq. see Fentanyl lozenges
Actisorb Silver 220, 157
Activa hosiery, 160
Activated Charcoal

paraquat poisoning, 151


poisoning, 150

Actiwrap Latex-free Bandage, 159


Actonel. see Risedronate
Actos. see Pioglitazone
Actrapid insulin, 67
Acular. see Ketorolac
Acupan. see Nefopam
Acyclovir, see aciclovir, 64

cream, 136
eye ointment, 115
oropharyngeal infections, 125

Adalat. see Nifedipine


Adalimumab

inflammatory arthritic conditions, 110


inflammatory bowel disease, 11
psoriasis, 132

Adapalene and benzoyl peroxide. see


Epiduo
Adaptic Touch, 154
Adcortyl injection. see Triamcinolone
acetonide
Adefovir, 64
Adenocor. see Adenosine
Adenoscan. see Adenosine
Adenosine, 16
Adenuric. See febuxostat
Adgyn. see Estradiol
Adizem. see Diltiazem
Adrenaline

allergic emergencies, 33
CPR, 23

Adriamycin. see Doxorubicin


Adsorbed Diphtheria (low dose), Tetanus
and Inactivated Poliomyelitis Vaccine,
141
Advagraf. see Tacrolimus
Afatinib, 90
Aflibercept, 120
Aggrastat. see Tirofiban
Agomelatine, 40
Ajmaline, 17
Albendazole, 66
Alcobon. see Flucytosine
Alcohol

hand rub gel, 137

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

166

impregnated wipes, 137


Alcohol Dependence, 53
Alcowipes. see Alcohol impregnated wipes,
137
Aldactone. see Spironolactone
Aldara. see Imiquimod
Aldomet. see Methyldopa
Alemtuzmab, 94
Alendronate sodium, 76
Alfacalcidol, 105
Alfentanil, 146
Algivon, 156
Alimemazine

allergy, 32
in anaesthetics, 146

Alimta. see Pemetrexed


Aliskiren, 20
Alitretinoin, 131
Alkalinisation of urine, 84
Alkeran. see Melphalan
Alkylating agents, 86
ALL. See pegasparinase
Allergen Immunotherapy, 32
Allevyn Gentle, 154
Allevyn Gentle Border, 154
Allevyn Gentle Lite, 154
Allopurinol, 111, 112
Aloxi. see Palonosetron
Alpha tocopheryl acetate, 106
Alpha-blockers

hypertension, 19
treatment of urine retention, 83

Alphagan. see Brimonidine


Alphosyl 2 in 1 shampoo, 134
Alphosyl HC cream, 131
Alprostadil, 85
Altacite plus. see Co-simalcite, 8
Alteplase, 26
Aluminium chloride hexahydrate, 139
Amantadine

parkinsonism, 52

Amaryl. see Glimepiride


AmBisome. see Amphotericin, 61
Ambrisentan, 19
Amethocaine

eye drops, 118


gel for local anaesthesia, 148

Ametop. see Tetracaine


Amfebutamone, 54
Amias. see Candesartan
Amikacin, 58
Amikin. see Amikacin
Amiloride, 16
Amiloride and Frusemide. see Coamilofruse
Aminocaproic acid, 27
Aminoglycosides, 58
Aminophylline, 30
Aminosalicylates, 10, 11
Amiodarone, 17
Amisulpride, 36

Amitriptyline

antidepressant, 38
enuresis, 84
migraine prophylaxis, 46
neuropathic pain, 45

Amitrylptilline. See diabetic neuropathy


Amlodipine, 21
Amoebicides, 66
Amorolfine

skin preparations, 136

Amoxil, 56
Amphotericin, 61

eye drops, 115


oral suspension, 125

Amsacrine, 89
Amsidine. see Amsacrine
Anaemias, 98
Anaesthesia, 144
Anaesthetics

general, 144
local, 148
local - ophthalmic, 118

Anafranil. see Clomipramine


Anagrelide, 99
Anakinra, 110
Anal and rectal disorders, 13
Anal fissure, 14
Analgesics, 42

compound preparations, 43
non-opioid, 42
non-opioid in anaesthetics, 146
opioid, 43
opioid in anaesthetics, 146
opioid -treatment of poisoning by, 150

Anastrozole, 96
Ancotil. see Flucytosine
Androcur. see Cyproterone acetate
Androgens. see Male sex hormones
Anexate. see Flumazenil
Angiox. See bivalirudin
Anhydrol Forte, see aluminium chloride,
139
Anidulafungin, 61
Antabuse. see Disulfiram
Antacid with oxetacaine, 8
Antacids

with alginates and other ingredients, 8


with Dimeticone, 8
with local anaesthetic, 8

Antepsin. see Sucralfate


Anterior pituitary hormones, 74
Anti D (Rho) immunoglobulin, 143
Anti-androgens, 73
Anti-arrhythmic drugs, 16
Antibacterial / corticosteroid

ear preparations, 122


eye preparations, 116

Antibacterial drugs, 56
Anticoagulants, 23
Anticonvulsants, 47

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

167

Antidepressants, 38
Antidiabetic drugs, oral, 68
Antidiarrhoeal drugs, 10
Anti-emetics, 41
Antiepileptics, 47
Antifibrinolytic drugs, 26
Antifungal drugs

eye preparations, 115


skin preparations, 135
systemic, 61
vaginal infections, 79

Antihistamines

general use, 31
nausea etc., 41

Antihypertensive therapy, 18
Antileprotic drugs, 60
Antilymphocyte immunoglobulin, see
antithymocyte immunoglobulin, 93
Antimalarial drugs

malaria prophylaxis and treatment, 65


rheumatoid arthritis, 109

Antimigraine drugs, 45
Antimuscarinic drugs

bronchodilators, 29
gastrointestinal antispasmodic, 8
parkinsonism, 52
premedication, 145
urinary incontinence, 83

Antinauseants, 41
Anti-obesity drugs, 40
Anti-oestrogens, 73
Antiprotozoal drugs, 65
Antipruritics, 129
Antipsychotics, 36
Antispasmodics and other drugs altering
gut motility, 8
Antithymocyte Immunoglobulin (Horse), 93
Antithymocyte immunoglobulin (Rabbit), 93
Antithyroid drugs, 70
Antituberculous drugs, 60
Antiviral drugs, 62

eye, 115
skin preparations, 136

Anusol, 14
Anusol HC, 14
Anxiolytics, 35
Apixaban, 24
APO-go. see Apomorphine
Apomorphine

parkinonism, 52

Appetite suppressants, 40
Apraclonidine, 120
Aprepitant, 42
Apresoline. see Hydralazine
Aprotinin, 26
Aprovel. see Irbesartan
Aquacel, 155
Aquacel Extra, 155
Aquasept. see triclosan
Aqueous Cream, 127
Aqueous iodine solution, 70

Arachis oil enemas, 12


Aramine. see Metaraminol
Aranesp. see Darbepoetin
Arava. see Leflunomide
Arcoxia. see Etoricoxib
Aredia. see Disodium Pamidronate
Argatroban, 23
Argipressin, 75
Aricept. see Donepezil
Arimidex. see Anastrozole
Aripiprazole, 37
Arixtra. see Fondaparinux
Aromasin. see Exemestane
Arrhythmias, drugs for, 16
Arsenic Trioxide, 89
Artensuate

antimalarial, 66

Artificial tears

Carbomer 980, 119

Artiss fibrin sealant, 137


Arythmol. see Propafenone, see
Propafenone
Asacol. see Mesalazine
Ascorbic acid, 105

eye drops, 121

Asparaginase. see Crisantaspase, 89


Aspart insulin, 67
Aspirin

analgesia, 42
antiplatelet, 25

Atarax. see Hydroxyzine


Atazanavir, 62
Atenolol, 17
Ativan. see Lorazepam
Atomoxetine, 40
Atorvastatin, 27
Atosiban, 79
Atovaquone, 66
Atracurium, 146
Atrauman, 153
Atripla, 63
Atropine

eye preparations, 116


oral, 9

Atropine sulphate

in anaesthesia, 145

Atrovent. see Ipratropium


Attention Deficit Hyperactivity Disorder, 40
Aubagio. see Teriflunomide
Augmentin, 56
Avaxim. see Hepatitis A vaccine
Aveeno cream, 127
Avelox. see Moxifloxacin
Avloclor. see Chloroquine
Avonex. see Interferon beta
Axsain. see Capsaicin
Azacitidine, 87
Azactam. see Aztreonam
Azathioprine, 92

inflammatory bowel disease, 11

Azelaic Acid, 133

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

168

Azelastine, 123
Azilect. see Rasagiline
Azithromycin, 58
AZT. see Zidovudine
Aztreonam, 57

Betamethasone and Clioquinol. see


Betnovate C
Betamethasone and Neomycin

Betamethasone dipropionate and Salicylic


acid. see Diprosalic
Betamethasone valerate, 129, 130
Betnesol. see Betamethasone
Betnesol-N. see Betamethasone &
Neomycin
Betnovate C, 129
Betnovate N, 129
Betnovate RD. see Betamethasone skin
preparations, 130
Betnovate. see Betamethasone valerate,
129
Bevacizumab, 120
Bezafibrate, 28
Bezalip. see Bezafibrate
Bicalutamide, 97
Bicarbonate

Babiven, 152
Baclofen, 112
Bactrim. see Co-trimoxazole
Bactroban. see Mupirocin
Balanced Salt solution, 119
Balsalazide, 11
Baraclude. see Entecavir
Basiliximab, 92
Bausch & Lomb

contact lens solutions, 121


saline, 121

BCG Connaught, 95
BCG SSI, see BCG vaccine, 140
Beclazone. see Beclometasone
Becloforte. see Beclometasone
Beclometasone

inhaled (asthma management), 30


nasal spray, 123

Beclometasone and Eformoterol, 31


Beclomethasone. see beclometasone
Beconase. see Beclometasone, nasal
spray
Becotide. see Beclometasone
Bee or Wasp venom extract. see
Pharmalgen, 32
Behcets disease. see infliximab
Bendamustine, 86
Bendrofluazide. see Bendroflumethiazide,
15
Bendroflumethiazide, 15
Benoxinate see Oxybuprocaine, 118
Benzathaine penicillin, 56
BenzhexolseeTrihexyphenidyl, 52
Benzoin tincture, compound, 34
Benzoyl Peroxide, 133
Benzydamine, 124
Benzylpenicillin, 56

eye drops, 114

Beriplex - P, 27
Beta-Blockers, 17

eye drops, 117

Beta-cardone. see Sotalol


Betaferon. see Interferon beta
Betahistine, 42
Betaloc. see Metoprolol
Betamethasone

ear drops, 122


eye drops, 115
nasal drops, 123
skin preparations, 129, 130
systemic therapy, 70
with calcipotriol. See Dovobet

cream & ointment. see Betnovate N, 129


ear drops, 122
eye drops, 116

oral, 101

BiCNU. see Carmustine


Bile acid sequestrants, 28
Biltricide. see Praziquantel
Bimatoprost, 117
Bimatoprost and timolol. see Ganfort
Biobag. see Sterile larvae
BioGaia, 163
Bioglue, 136
Biopatch, 164
Biorphen. see Orphenadrine
Biotene oral balance, 126
Biotin, 165
BioXtra, 126
Biphasic insulin aspart, 67
BIPP. see Bismuth subnitrate & Iodoform,
124, 137
Bisacodyl, 12
Bismuth subnitrate and iodoform, 124, 137
Bisoprolol, 18
Bisphosphonates, 76
Bivalirudin, 24
Bladder instillations, 84
Bleomycin, 87
Blood Products, 27
BMP-2. See Dibotermin Alfa
BMP-7. See Eptotermin alfa
Boceprevir, 64
Bondronat. see Ibandronic acid
Bone Metabolism, drugs affecting, 75
Bonefos. see Sodium clodronate
Bonjela. see Choline salicylate, 124
Bonneys blue, 138
Bonviva. see Ibandronic acid
Bortezomib, 89
Bosentan, 18
Botox. see Botulinum A toxin
Botulinum A toxin

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

169

anal fissure, 14
dystonias, 53
hyperhidrosis, 139
Botulinum B toxin, 53
Botulinum toxin A

Dysport, 46

Botulinum toxin type A, 53


Botulism Antitoxin, 140
Bowel cleansing solutions, 13
Bramitob. See Tobramycin
Brevibloc. see Esmolol
Bricanyl. see Terbutaline
Bridion. See Sugammadex
Brilliant green and crystal violet paint. see
Bonneys blue
Brimonidine, 117
BritLofex. see Lofexidine
Brolene. see Propamidine isethionate
Bromocriptine

in endocrinology, 77
parkinsonism, 52

Bronchodilators, 29

antimuscarinic, 29
sympathomimetic, 29
Theophylline & Aminophylline, 30

Brufen. see Ibuprofen


Budenofalk
see budesonide, 11
Budesonide

asthma, 30
inflammatory bowel disease, 11

Budesonide and Eformoterol, 31


Bulk forming laxatives, 12
Bumetanide, 15
Bupivacaine, 148
Buprenorphine

analgesic, 44
opioid dependence, 54

Bupropion, 54
Burinex. see Bumetanide
Buscopan. see Hyoscine butylbromide
Buserelin, 78, 96
Busulfan, 86
Busulphan. see Busulfan, 86
Bydureon. See exenatide
Byetta. see Exenatide

C
Cabergoline

in endocrinology, 77

Caelyx. see Liposomal Doxorubicin


Caffeine citrate, 33
Calamine lotion, 129
Calcichew. see calcium carbonate
Calciferol. see Ergocalciferol, 105
Calcipotriol, 131

with betamethasone. See Dovobet

Calcitonin (Salmon), 75

bone metabolism, 75
hypercalcaemia, 103
Calcium & ergocalciferol tablets, 106
Calcium acetate, 104
Calcium carbonate

calcium supplement, 102


phosphate binding, 104
with Vitamin D, 105

Calcium channel blockers, 21


Calcium chloride, 102
Calcium folinate, 86
Calcium gluconate, 102
calcium hydroxylapatite. See Radiesse
Voice
Calcium leucovorin. see Calcium folinate
Calcium polystyrene sulphonate, 100
Calcium Resonium, 100
Calcium Sandoz, 102
Calcium supplements, 102
Calfovit D3, 105
Calmurid, 128
Calpol. see Paracetamol
Calsynar. see Calcitonin (Salmon)
Camcolit. see Lithium carbonate
Camouflaging preparations, 134
Campral. see Acamprosate
Campto. see Irinotecan
Canagliflozin, 69
Cancidas. see Caspofungin
Candesartan, 20
Canesten. see Clotrimazole
Canesten HC, 130
Capecitabine, 87
Caphosol, 124
Capsaicin, 45, 113
Captopril, 20
Carace. see Lisinopril
Carbamazepine

anti-epileptic, 48
mania, 38
trigeminal neuralgia, 45

Carbimazole, 70
Carbocisteine, 33
Carbomer 980, 119
Carbomix. see Activated charcoal
Carboplatin, 89
Carboprost, 79
Cardicor. see Bisoprolol
Cardiovascular system, 15
Cardura. see Doxazosin
Carmellose sodium, 119, 124
Carmustine, 86
Carnitine, 107
Carnitor. see Carnitine
Carvedilol, 18
Casodex. see Bicalutamide
Caspofungin, 61
Castellanis paint. see Magenta paint
Catapres. see Clonidine
Caustic pencils, 134
Caverject. see Alprostadil

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

170

CCNU. see Lomustine


Cefalexin, 57
Cefixime, 57
Cefotaxime, 57
Ceftaroline, 57
Ceftazidime, 57
Ceftriaxone, 57
Cefuroxime, 57

eye drops, 114

Celebrex. see Celecoxib


Celecoxib, 108
Celectol. see Celiprolol
Celevac. see Methylcellulose
Celiprolol, 18
Cellcept. see Mycophenolate mofetil
Celluvisc. see Carmellose sodium
Celsentri. see Maraviroc
Central Nervous System, 35
Cephalexin. see Cefalexin
Cephalosporins, 57
Ceporex. see Cefalexin
Cerazette, 82
Certolizumab pegol

ankylosing spondylitis, 110


psoriatic arthritis, 110
rheumatoid arthritis, 110

Cervarix. see Human papilloma virus


vaccine
Cetirizine, 32
Cetraben, 127
Cetrorelix, 78
Cetrotide. See cetrorelix
Cetuximab, 89
Cetylpyridinium chloride, 125
Champix. see Varenicline
Charcoal, activated, 150, 151
Chirocaine. see Levobupivacaine
Chloral hydrate, 35
Chlorambucil, 86
Chloramphenicol

ear drops, 122


eye preparations, 114
systemic, 59

Chlordiazepoxide

alcohol dependence, 53
anxiolytic, 36

Chlorhexidine

bladder irrigation, 84
dusting powder, 137
mouth infections, 125

Chlorhexidine Gluconate

skin preparations, 137

Chlorhexidine impregnated, 164


Chlorhexidine, Nystatin and
Hydrocortisone. see Nystaform HC
Chlormethiazole. see Clomethiazole, 35
Chloromycetin. see Chloramphenicol
Chloroquine, 65
Chlorothiazide, 15
Chlorothiazide and spironolactone, 16
Chlorphenamine, 32

Chlorpheniramine, 32
Chlorpromazine, 36
Cholestagel. see colesvelam
Cholestyramine

anti-diarrhoeal, 14
lipid lowering, 28

Choline salicylate, 124


Chorionic gonadotrophin

fertility, 74
hypogonadism, 74

Chronic bowel disorders, 10


Chronic migraine. See botulinum toxin A
Cialis. see Tadalafil
Ciclosporin, 92

eye preparations, 119


Sandimmun, 92
skin conditions, 132

Cidofovir, 64
Cidomycin. see Gentamicin
Cilest, 80
Cimetidine, 9
Cimzia. See Certolizumab pegol
Cinacalcet, 103
Cinnarizine, 41
Cipramil. see Citalopram
Ciprofloxacin, 60
Ciproxin. see Ciprofloxacin
Circadin. see Melatonin
Cisatracurium, 146
Cisplatin, 89
Citalopram, 39
Citanest. see Prilocaine
Citrasate, 163
Cladribine, 87
Claforan. see Cefotaxime
Clarithromycin, 58
Clarityn. see Loratadine
Clens 100, 121
Clexane. see Enoxaparin
Clindamycin

skin preparations, 133


systemic, 58
vaginal cream, 80

Clinitas, 119
Clini-wipes. see Alcohol impregnated
wipes, 137
Clobazam, 49
Clobetasol propionate, 129
Clobetasone butyrate, 130
Clobetasone butyrate, Oxytetracycline and
nystatin. see Trimovate
Clodronate, 103
Clomethiazole, 35
Clomid. see Clomifene
Clomifene, 74
Clomiphene. see Clomifene, 74
Clomipramine, 39
Clonazepam

epilepsy, 49
status epilepticus, 51

Clonidine

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

171

migraine prophylaxis, 46
other specialist uses, 19
Clopidogrel, 25
Clopixol Accuphase. see Zuclopentixol
Acetate, 38
Clopixol. see Zuclopentixol decanoate, 37
Clotrimazole

ear infections, 122


vaginal infections, 79

Clotrimazole & Hydrocortisone cream. see


Canesten HC, 130
Clozapine, 37
Clozaril. see Clozapine
Cluster headaches. See Lithium
Coal tar, 131
Coal tar & salicylic acid ointment, 131
Coal tar strong solution in emulsifying
ointment, 131
Co-amilofruse, 16
Co-amoxiclav, 56
Coban, 160
Coban 2 Lite, 160
Co-beneldopa, 51
Cocaine

local anaesthetic, 149

Co-careldopa, 51
Co-codamol, 43

migraine, 45

Cocois see Coconut compound ointment,


131
Coconut compound ointment (Sebco), 131
Co-cyprindiol

acne, 133
contraception, 80
hirsutism, 135

Co-danthramer, 12
Co-danthrusate, 12
Codeine Phosphate

cough, 34
diarrhoea, 10
pain, 43

Coenzyme Q10. See Ubiquinone


Colazide. see Balsalazide
Colchicine, 111
Colecalciferol, 105
Colesevelam

anti-diarrhoeal, 14
lipid lowering, 28

Colestyramine

anti-diarrhoeal, 14
lipid lowering, 28

Colifoam. see Hydrocortisone acetate


Colistimethate sodium. see Colistin
Colistin, 59
Collagenase, 113
Collodion, 136
Colobreathe. see Colistimethate sodium
Colofac. see Mebeverine
Colomycin. see Colistin
Colpermin. see Peppermint oil
Co-magaldrox, 8

Combivent nebuliser solution, 30


Combivir, 63
Comfeel Plus Transparent, 155
Comfi range, 159
Comprilan, 159
Comtess. see Entacapone
Concerta XL. see Methylphenidate
Constella. See linaclotide
Contraceptives

combined hormonal, 80
oral, 80
progestogen only, 82
spermicidal, 82

Copaxone. see Glatiramer


Co-phenylcaine Forte, 149
Co-phenylcaine, see Lidocaine and
phenylephrine, 149
Copper intrauterine devices, 82
Coracten. see Nifedipine
Cordarone-X. see Amiodarone
Cordilox. see Verapamil
Corgard. see Nadolol
Corlan. see Hydrocortisone lozenges
Coro-Nitro. see Glyceryl trinitrate
Corsodyl. see Chlorhexidine
Corticosteroids

dermatological preparations, 129


ear preparations, 122
eye drops, 115
inflammatory bowel disease, 11
local injections, 109
systemic, 70

Corticotrophins, 74
Co-simalcite, 8
Cosmofer. see Iron dextran
Cosopt, 118
Co-trimoxazole, 60

pneumocystis pneumonia, 66

Cough suppressants, 34
Coversyl. see Perindopril
Cozaar. see Losartan
Creon, 14
Crestor. see Rosuvastatin
Crisantaspase, 89
Crixivan. see Indinavir
Crotamiton, 129
Crotamiton and hydrocortisone. see Eurax
Hydrocortisone
CRRT. See PrimsOcal B22, See
Primsocitrate 18/0
Crystal violet, 139
Cubicin. see Daptomycin
Curosurf. see Poractant alfa
CX antiseptic powder, 137
Cyanide poisoning, 150
Cyclizine, 41
Cyclogest. see Progesterone
Cyclopentolate, 116
Cyclophosphamide, 86
Cyclosporin. see Ciclosporin, 92
Cyklokapron. see Tranexamic acid

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

172

Cymbalta. see Duloxetine


Cymevene. see Ganciclovir
Cyprostat. see Cyproterone acetate
Cyproterone acetate

male hypersexuality, 73
prostate cancer, 97

Cyproterone acetate and Ethinylestradiol.


see Co-cyprindiol
Cysticide. see Praziquantel
Cystistat

see Sodium hyaluronate bladder


instillation, 84

Cystrin. see Oxybutynin


Cytarabine, 87
Cytomegalovirus immunoglobulin, 143
Cytomegalovirus infections, 64
Cytosar. see Cytarabine
Cytotec. see Misoprostol
Cytotoxic drugs, 86
Cytotoxic immunosuppressants, 92

D
Dabigatran, 24
Dacarbazine, 90
Dactinomycin, 87
Daktacort, 130
Daktarin, 135
Dalacin. see Clindamycin
Dalacin T. see Clindamycin, skin
preparations
Dalivit, 106
Danaparoid, 23
Danazol, 78
Danol. see Danazol
Dantrium. see Dantrolene
Dantrolene

malignant hyperthermia, 147


muscle relaxation, 112

Dantron and docusate sodium. see Codanthrusate, 12


Dantron and poloxamer. see Codanthramer
Dapagliflozin, 69
Dapsone, 60
Daptomycin, 59
Daraprim. see Pyrimethamine
Darbepoetin, 99
Darunavir, 62
Daunorubicin, 87
DaunoXome. see Daunorubicin
DC Beads, 165
DDAVP. see Desmopressin
DDI. see Didanosine
Debrisoft, 161
Decadron. see Dexamethasone
Decapaptyl SR. see Triptorelin
Deegans Ointment, 128
Deferasirox, 99
Deferasirox:, 99

Degarelix, 96
Deltacortril. see Prednisolone
Demeclocycline, 57, 75
Dementia, 54
Denosumab, 77
Depakote. see Valproate semi sodium
Depixol. see Flupentixol
Depocyte. See cytarabine
Depo-Medrone with lidocaine, 109
Depo-Medrone. see Methylprednisolone
acetate depot injection, 109
Depo-Provera see Medroxyprogesterone
acetate, 82
Derbac M. see Malathion
Dermacolor, 134
Dermacool, see Menthol in aqueous
cream, 129
Dermol bath, 128
Dermovate NN, 129
Dermovate. see Clobetasol propionate, 129
Desferal. see Desferrioxamine
Desferrioxamine

iron overload, 99
iron poisoning, 150

Desflurane, 145
Desloratadine, 32
Desmopressin, 75

enuresis, 84

Desmospray. see Desmopressin


Desmotabs. see Desmopressin
Desogestrel, 82
Destolit. see Ursodeoxycholic acid
Dexamethasone

eye drops, 115


systemic therapy, 70

Dexamethasone implant, 116


Dexamfetamine, 40
Dexamphetamine

see Dexamfetamine, 40

Dexrazoxane, 86
Diacomit. see Stiripentol
Diamicron. see Gliclazide
Diamorphine, 43
Diamox. see Acetazolamide
Dianette, see Co-cyprindiol, 80, 133, 135
Diazepam

anxiolytic, 35
in anaesthetics, 145
muscle relaxation, 112
status epilepticus, 50

Diazoxide, 18, 69
Dibenyline. see Phenoxybenzamine
Dibotermin Alfa, 165
Diclofenac, 108

eye drops, 120


injection, 146

Diclomax. see Diclofenac


Dicobalt edetate, 150
Dicyclomine, 8
Dicycloverine, 8
Didanosine, 62

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

173

Diethylstilbestrol, 95
Difflam. see Benzydamine
Dificlir. See Fidaxomicin
Diflucan. see Fluconazole
Digibind. see Digoxin-specific antibody
Digoxin, 15
Digoxin-specific antibody, 15
Dihydrocodeine, 44
Diloxanide, 66
Diltiazem, 21

anal fissure, 14

Dilzem-XL. see Diltiazem, 21


Dimercaprol, 150
Dimeticone, 136

containing antacid, 8
cream, 128

Dinoprostone, 79
Dioctyl. see Docusate sodium
Dioralyte, 101
Diovan. see Valsartan
Diphtheria (low dose), tetanus, acellular
pertussis and inactivated polio vaccine,
140
Diphtheria, tetanus, acellular pertussis and
inactivated polio vaccine, 140
Diphtheria, tetanus, acellular pertussis,
inactivated polio and Haemophilus
influenzae type b vaccine, 140
Diprivan. see Propofol
Diprobase cream, 128
Diprosalic, 130
Dipyridamole, 26
Disipal. see Orphenadrine
Disodium edetate, 121
Disodium pamidronate, 76, 102
Disprol. see Paracetamol
Distamine. see Penicillamine
Disulfiram, 53
Dithranol

cream, 131
in Lassars paste, 131
with salicylic acid in emulsifying base,
131

Dithrocream, 131
Ditropan. see Oxybutynin
Diuretics, 15

combinations with potassium conserving,


16
loop, 15
osmotic, 16
potassium sparing, 16
thiazide, 15

Dixarit. see Clonidine


DLux. see Colecalciferol
Dobutamine, 22
Dobutrex. see Dobutamine
Docetaxel, 90
Docusate sodium, 12
Dolmatil. see Sulpiride
Domperidone

anti-emetic, 41

as gastro-intestinal prokinetic agent, 9


breastfeeding, 41
Donepezil, 54
Dopacard. see Dopexamine
Dopamine, 22
Dopaminergic drugs, 51
Dopexamine, 22
Dopram. see Doxapram
Doribax. see Doripenem
Doripenem, 57
Dornase alfa, 33
Dorzolamide, 117
Dorzolamide and Timolol. see Co-sopt
Dotarem, 162
Doublebase gel, 127
Dovobet, 132
Dovonex. see Calcipotriol
Doxapram, 33, 147
Doxazosin

hypertension, 19
urine retention, 83

Doxorubicin, 87
Doxycycline, 57

periodontitis, 124

Draina S, 157
Drapolene, 128, 136
Dressit, 158
Driclor, 139
Drogenil. see Flutamide
Dronedarone. See
DTIC. see Dacarbazine, 90
ductus arteriosus. See ibuprofen iv
Dulcolax. see Bisacodyl
Dulcolax Pico Liquid. see Sodium
picosulfate elixir
Duloxetine.

depression, 39
diabetic neuropathy, 69
neuropathic pain, 45
stress incontinence, 83

DuoDerm Extra Thin, 155


DuoDerm Signal, 155
Duolube, 119
Duovisc, 120
Dupuytren's contracture. See collagenase
Duraphat, 104

Duraphat . See
Durogesic. see Fentanyl patches
Dyloject. see Diclofenac
Dynastat. see Parecoxib
Dyspepsia and gastro-oesophageal reflux
disease, 8
Dysport. see Botulinum A toxin

E
E45, 127
Eakin, 157
Ear wax removal, 122
Ear, drugs acting on, 122

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

174

Ecalta. See Anidulafungin


Eclypse Adherent, 153
Econazole

eye drops, 115

Eczema, 130
Edronax. see Reboxetine
Edrophonium

enhancing neuromuscular transmission,


112
in anaesthetics, 147

Edurant. see Rilpivirine


Efavirenz, 63
Efavirenz, Emtricitabine & Tenofovir. see
Atripla
Efcortelan. see Hydrocortisone
Efexor. see Venlafaxine
Efient. see Prasugrel
Eflornithine, 135
Eformoterol, 29
Efudix. see Fluorouracil
Eklira Genuair. see Aclidinium Bromide
Elantan. see Isosorbide mononitrate
Eldepryl. see Selegiline
Eldisine. see Vindesine
Elidel. see Pimecrolimus
Elite, 121
EllaOne. see Ulipristall
Elleste duet, 71
Elleste Solo. see Estradiol
Eloxatin. see Oxaliplatin
Eltrombopag, 99
Eltroxin. see Thyroxine
Elvanse. see Lisdexamfetamine
Emend. see aprepitant
Emerade. see Adrenaline, allergic
emergencies, 33
Emetic, 150
EMLA, 149
Emollients, 127
Emtricitabine & Tenofovir. see Truvada
Emulsifying ointment BP, 127
Emulsifying ointment RVI formula. see
Hydromol ointment, 127
Enalapril, 20
Enbucrilate, 136
Endocrine system, 67
Endoxana. see Cyclophosphamide
Enfuvirtide, 63
Engerix B. see Hepatitis B vaccine
Enoxaparin, 23
Entacapone, 52
Entecavir, 64
Enterocort
see budesonide, 11
Entonox, 144
Enuresis, 83
eosinophilic oesophagitis, 30
Epaderm. see Hydromol ointment, 127
Epanutin. see Phenytoin
Ephedrine

nasal drops, 123

systemic, 29
vasocontrictor, 22
Ephynal. see Alpha tocopheryl acetate
Epiduo, 133
Epilim. see Sodium valproate
Epinephrine (adrenaline)

allergic emergencies, 33
CPR, 23

Epirubicin, 87
Episenta. see Sodium valproate
Epivir. see Lamivudine
Eplerenone, 16
Epoetin

alfa, 99
beta, 99

Epoprostenol, 24
Eprex. see Epoetin alfa
Eptotermin alfa, 165
Equasym XL. see Methylphenidate
Erbitux. see Cetuximab
Erectile dysfunction, 85
Ergocalciferol, 105
Ergometrine, 79
Erlotinib, 91
Ertapenem, 57
Erwinase. see Crisantaspase
Erythrocin. see Erythromycin
Erythromycin, 58

eye ointment, 114


skin preparations, 133

Erythromycin and zinc acetate. see Zineryt


Esbriet. see Pirfenidone
Eskazole. see Albendazole
Eslicarbazepine Acetate, 49
Esmeron. see Rocuronium
Esmolol, 18
Estracyt, 86
Estradiol

implants, 71, 73
tablets, 71, 73
transdermal patches, 71, 73
vaginal tablets for atrophic vaginitis, 79

Estramustine, 86
Estriol, 79
Etanercept

musculoskeletal, 110
psoriasis, 132

Ethambutol, 60
Ethanol 20% eye drops, 120
Ethanolamine oleate, 28
Ethinylestradiol, 71
Ethosuximide, 50
Ethyl chloride spray, 149
Ethynodiol acetate, 82
Etodolac, 108
Etomidate, 144
Etonogestrel, 82
Etoposide, 88
Etoricoxib, 108
Etravirine, 63

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

175

Eucardic. see Carvedilol


Eudemine. see Diazoxide
Euglucon. see Glibenclamide
Eumovate. see Clobetasone butyrate, 130
Eurax. see Crotamiton
Eurax Hydrocortisone, 130
European viper antivenom, 151
Eviplera, 63
Evista. see Raloxifene
Evorel. see Estradiol transdermal
Evorel Conti patches, 72
Evorel Sequi, 71
Evra, 81
Exelon. see Rivastigmine
Exemestane, 96
Exenatide, 68
Exjade. see Deferasirox
Exocin. see Ofloxacin
Exorex, 131
Extavia. see Interferon beta
Extencilline, 56
Eylea. see Aflibercept
Ezetimibe, 27
Ezetrol. see Ezetimibe

F
Faecal softeners, 12
Faslodex. see Fulvestrant
Fasturtec. see Rasburicase
Febuxostat, 111
Feldene. see Piroxicam
Female sex hormones, 71
Femara. see Letrozole
Femodene, 80
Femodette, 81
Femoston, 71
Femulen, 82
Fenofibrate, 28
Fentanyl

injections, 146
lozenges, 44
sublingual tablets, 44
transdermal patches, 44

Ferinject. see Ferric carboxymaltose


Ferric carboxymaltose, 98
Ferrous fumarate, 98
Ferrous gluconate, 98
Ferrous sulphate, 98
Fersamel. see Ferrous fumarate
Fesoterodine, 83
Feulvestrant, 96
Fexofenadine, 32
Fibric acid analogues, 28
Fibrinolytic drugs, 26
Fibro-vein. see Sodium tetradecyl sulphate
Fidaxomicin, 59
Filgrastim, 100
Finasteride, 73
Fingolimod, 95

Firazyr. see Icatibant, 33


Firmagon. See Degarelix
Fish oils, as lipid regulators, 28
FK-506. see Tacrolimus
Flagyl. see Metronidazole
Flamazine. see Silver sulfadiazine
Flaminal, 157
Flebogamma. see Human normal
immunoglobulin
Flecainide, 17
Fleet phospho-soda, 13
Flexible collodion, 136
Flixonase. see Fluticasone nasal spray,
see Fluticasone nasal spray
Flolan. see Epoprostenol
Flomax MR. see Tamsulosin
Florinef. see Fludrocortisone
Floseal matrix sealant, 136
Floxapen, 56
Fluanxol. see Flupentixol
Flucloxacillin, 56
Fluconazole, 61
Flucytosine, 61
Fludara. see Fludarabine
Fludarabine, 88
Fludrocortisone, 70
Fludroxycortide tape, 130
Fluenz nasal spray, 141
Fluids and electrolytes, 100
Flumazenil, 147
Fluocinolone acetonide

diabetic macular oedema, 116


topical corticosteroid, 129

Fluorescein

eye preparations, 119


injections, 119

Fluorets, 119
Fluorometholone eye drops, 115
Fluorouracil, 88

cream, sun damage, 134

Fluoxetine, 39
Flupenthixol. see Flupentixol
Flupenthixol decanoate. see Flupentixol
decanoate, 37
Flupentixol, 36
Flupentixol decanoate, 37
Fluphenazine decanoate, 37
Flurandrenolone. see Fludroxycortide, 130
Flutamide, 97
Fluticasone

nasal spray, 123

Fluticasone and formoterol. see Flutiform


Flutiform, 31
FML. see Fluorometholone
Folic acid, 98
Folinic acid. see calcium folinate, 86
Fomepizole, 151
Fondaparinux, 23
Forceval, 107

anorexia nervosa, 106

Formoterol, 29

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

176

Forsteo. see Teriparatide


Fortisip Compact, 152
Fortum. see Ceftazidime
Forxiga. see Dapagliflozin
Fosamax. see Alendronate sodium
Fosamprenavir, 62
Fosaprepitant, 42
Foscarnet, 64
Foscavir. see Foscarnet
Fosfomycin, 59
Fosrenol. see Lanthanum
Fostair, 31
Friars' Balsam. see Benzoin tincture,
compound
Frovatriptan, 46
Fru-Co. see Co-amilofruse
Frumil. see Co-amilofruse
Frusemide. see Furosemide, 15
Fucidin. see Fusidic acid
Fucithalmic. see Fusidic acid
Fulcin. see Griseofulvin
Full Clini range, 159
Full Marks. see Phenothrin, 136
Fulvestrant, 96
Fungillin. see Amphotericin
Fungizone. see Amphotericin
Furosemide, 15
Fusidic acid. see Sodium fusidate

eye drops, 114


skin preparations, 135

Fuzeon. see Enfuvirtide


Fybogel. see Ispaghula husk

G
Gabapentin. See diabetic neuropathy

anti-epileptic, 50
neuropathic pain, 45, 69

Gadobenate dimeglumine, 162


Gadobutrol, 162
Gadofosveset, 162
Gadovist, 162
Gadoxetic acid, 162
Galantamine, 55
Galenphol. see Pholcodine
Galfer. see Ferrous fumarate
Gamanil. see Lofepramine
Ganciclovir, 64
Ganfort, 117
Gargles, 125
Gastrografin, 162
Gaviscon Infant, 8
Gaviscon, see Peptac, 8
G-CSF, 100
Gedarel 30/150, 80

Gedarel 20/150, 81
Gefitinib, 91
Gelatin, plasma expander, 101
Gelofusine. see Succinylated gelatin
GelTears see Carbomer 980, 119

Gemcitabine, 88
Gemeprost, 79
Gemzar. see Gemcitabine
Gengigel, 124
Genotropin. see Somatropin
Gentafleece, 163
Gentamicin, 58

ear drops, 122


eye preparations, 114

Gentamicin and Hydrocortisone

ear drops, 122

Gentian violet. see Crystal violet


Genticin. see Gentamicin
Gentisone HC ear drops, 122
Gilenya. See fingolimod
Gilurytmal. See Ajmaline
Giotrif. see Afatinib
GIST. See imatinib
Glandosane, 125
Glatiramer, 95
Glaucoma treatment, 117
Glibenclamide, 68
Gliclazide, 68
Glimepiride, 68
Glivec. see Imatinib
Glucagon, 69
Glucobay. see Acarbose
Glucocorticoid therapy, 70
GlucoGel see glucose gel, 69
Glucophage. see Metformin
Glucose

hypoglycaemia treatment, 69

Glucose and Electrolyte powder. see


Dioralyte
Glutaraldehyde 10% paint, 133
Glutarol. see Glutaraldehyde paint, 133
Glycerin. see Glycerol
Glycerol

suppositories, 12

Glyceryl trinitrate

anal fissure, 14
angina, 21

Glycine, bladder irrigation, 84


Glycopyrrolate cream, 139
Glycopyrronium & neostigmine, 147
Glycopyrronium Bromide, 29

anaesthesia, 145

Glypressin. see Terlipressin


Glytrin. see Glyceryl trinitrate
Gold salts, 109
Golimumab, 110
Gonadorelin, 75
Gonadotrophins, 74
Gonapeptyl Depot. see Triptorelin
Goserelin

endometriosis, 73, 77
prostrate cancer, 96

gout. inra
Gout, 111
Granocyte. see Lenograstim
Grass pollen extract. see Grazax, 32

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

177

Grazax, 32
Griseofulvin, 61
Grisovin. see Griseofulvin
Growth Hormone, 74
Gygel, see Nonoxynol 9, 82

H
H2 receptor antagonists, 9
Haelan tape. see Fludroxycortide tape, 130
Haemophilus influenzae type b and
meningitis C vaccine, 141
Haemophilus influenzae type b and
meningococcal group C vaccine, 141
Haemorrhoids, 13
Haldol. see Haloperidol
Half strength Lassars paste, 132
Haloperidol

anti-emetic, 41
antipsychotic, 36

Haloperidol decanoate, 37
Halothane, 144
Hand rub gel, 137
Havrix. see Hepatitis A Vaccine
Haycrom. see Sodium cromoglicate
HBvaxPRO. see Hepatitis B vaccine
Heaf (multiple puncture) test, 140
Heaf test, 140
Healon GV. see Sodium hyaluronate, eye
Healonid 5. see Sodium hyaluronate, eye
Healthy Start Vitamins, 106
Heavy metal poisoning, 150
Hedrin. See Dimeticone
Helicobacter pylori eradication, 10
Hemabate. see Carboprost
Heminevrin. see Clomethiazole
Heparin, 23
Hepatitis A & B vaccine, 141
Hepatitis A vaccine, 141
Hepatitis B, 64

vaccine, 141
vaccine (High strength), 141

Hepsera. see Adefovir


Herceptin. see Trastuzumab
Hexachlorophene, powder, 138
Hexitidine, 125
Hiberix. see Haemophilus Influenzae type b
vaccine
High strength fluoride. See Duraphat
high strength fluoride toothpaste. See
Duraphat
Histoacryl Blue, 136
HMG-CoA reductase inhibitors, 27
Hormone antagonists

in malignant disease, 95

Hormone replacement therapy, 71


HRF. see Gonadorelin, see Gonadorelin
HRT. see Hormone replacement therapy,
71
Humalog mix, 67

Human immunodeficiency virus, 62


Human normal immunoglobulin, 143
Human papilloma virus vaccine, 141
Humulin insulins, 67
Hyalase. see Hyaluronidase
Hyalgan

see Hyaluronic acid, 113

Hyalofemme, 79
Hyaluronan, 124
Hyaluronic acid, 113
Hyaluronic Acid injection

ENT surgery, 164

Hyaluronidase, 113
Hycamtin. see Topotecan
Hydrafil Softline Max, 164
Hydralazine, 18
Hydrea. see Hydroxycarbamide
Hydrocortisone

for disease suppression, 70


lozenges/pellets, 124
replacement therapy, 70
skin preparations, 130

Hydrocortisone acetate

injection, 109
rectal foam, 12

Hydrocortisone butyrate, 129


Hydrocortisyl. see Hydrocortisone
Hydrogen peroxide

solutions, 138

Hydromol ointment, 127


Hydromorphone, 44
Hydrous ointment, 127
Hydroxocobalamin, 98
Hydroxycarbamide, 90
Hydroxychloroquine, 109
Hydroxypropylmethyl- cellulose HV (Oasis),
120
Hydroxyurea. see Hydroxycarbamide, 90
Hydroxyzine, 32
Hyoscine butylbromide, 8
Hyoscine hydrobromide

anti-emetic, 42
injection, 145

Hypafix, 158
Hypercalcaemia and hypercalciuria, 102
Hyperparathyroidism. see cinacalcet
Hypertension in pregnancy. See enalapril
Hypnomidate. see Etomidate
Hypnotics, 35
Hypnovel. see Midazolam
Hypoglycaemia, 69
Hypostop see glucose gel, 69
Hypothalamic and pituitary hormones, 73
Hypothalamic hormones, 75
Hypromellose eye drops, 118

I
Ialuril, 84
Ibandronic acid, 76

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

178

Ibuprofen

NSAID, 108
topical, 113

Ibuprofen IV, 28
Icatibant, 33
Ichthopaste. see Zinc Paste and
Ichthammol Bandage
Idarubicin, 87
Ifosfamide, 86
Ikorel. see Nicorandil
Iloprost, 18, 24
Iluvien. see Fluocinolone acetonide implant
Imatinib, 91
Imdur. see Isosorbide mononitrate
Imigran. see Sumatriptan
Imipramine

antidepressant, 39
enuresis, 84

Imiquimod, 134
ImmunCyst. see BCG Connaught
Immunoglobulins, 143

anti-D Anti D (Rho) Immunoglobulin


(Rho), 143
antithymocyte, 93
cytomegalovirus, 143
human normal, 143
tetanus, 143
varicella, 143

Immunological products and vaccines, 140


Immunosuppressants, 92
Imodium. see Loperamide
Imodium Instants. See loperamide
Impotence, 85
Imuran. see Azathioprine
Inadine, 156
Incivo. see Telaprevir
Incontinence, 83
Indapamide, 15
Inderal. see Propranolol
Indermil X-Fine, 136
Indigo Carmine, 165
Indinavir, 63
Indocid. see Indomethacin
Indocid PDA. see Indometacin: closure of
ductus arteriosus
Indocyanine green, 120
Indometacin, 108

Closure of ductus arteriosus, 28

Indomethacin. see Indometacin, 108


Inductos. See Dibotermin Alfa
Infacol, 8
Infanrix IPV + Hib. see
Diphtheria/tetanus/acellular
pertussis/inactivated polio
vaccine/Haemophilus influenzae type b
Infanrix-IPV. see Diphtheria, tetanus,
acellular pertussis & inactivated polio
vaccine
Infant Gaviscon, 8
Infatrini peptisorb, 152
Infections, treatment of, 56

Infliximab

inflammatory bowel disease, 11


psoriasis, 132
Rheumatoid arthritis etc., 110

Infloran, 163
Influenza vaccine, 141
Influenza Virus, 65
Innohep. see Tinzaparin
Inspra. see Eplerenone
Insulatard insulins, 67
Insulin detemir, 67
Insulin glargine, 67
Insulins, 67
Integuseal IS 100, 163
Intelence. see Etravirine
Interferon alfa, 94
Interferon beta, 94
u
Intranasal diamorphine , 43
Intranasal midazolam, 145
Intrasite Gel, 154
Intrauterine devices, 82
Intraval. see Thiopental sodium
Intravenous fluids, 101
Intravenous nutrition, 102
intravitreal, 116
Intron. see Interferon alfa
Invanz. see Ertapenem
Invirase. see Saquinavir
Invokana. see Canagliflozin
Iodine solution, aqueous, 70
Iodine, Lugols, 70
Iodoflex, 156
Iodosorb, 156
Iopanoic acid, 70
Iopidine. see apraclonidine
Ipecacuanha emetic mixture, 150
Ipilimumab, 92
Ipral. see Trimethoprim
Ipratropium

bronchodilator, 29
nasal spray, 123

Ipratropium and salbutamol. see


Combivent
Irbesartan, 20
Iressa. see gefitinib
Irinotecan, 90
Iron deficiency anaemia, 98
Iron dextran, 98
Iron overload, 99
Iron poisoning, 150
Iron preparations, 98
Iron sucrose, 98
Isentress. see Raltegravir
Ismo. see Isosorbide mononitrate
Isoflurane, 144
Isoniazid, 60
Isoplex, 101
Isoprenaline, 22
Isopropyl alcohol, 137
Isordil. see Isosorbide dinitrate
Isosorbide dinitrate, 21

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

179

Isosorbide mononitrate, 21
Isotretinoin, 133
Isotrex. see Isotretinoin
Ispaghula husk
diarrhoea etc., 10

laxative, 12

Istin. see Amlodipine


Itraconazole, 61
Ivabradine, 22
Ivemend. see Fosaprepitant

J
Januvia. See sitagliptin
Japanese Encephalitis Vaccine, 141
Jetrea. see Ocriplasmin
Jext Junior. see Adrenaline, allergic
emergencies, 33
Jext. see Adrenaline, allergic emergencies,
33
JIA. See infliximab
Juvederm Ultra 3, 164

Juvederm Ultra 4, 164


Juvenile dermatomyositis. See infliximab
juvenile idipathic arthritis. see abatacept

K
Kaletra. see Lopinavir & ritonavir, 62
Kaolin, 10
Kay-Cee-L. see Potassium chloride, 100
K-Band, 159
Kefadim. see Ceftazidime
Keflex. see Cefalexin
Kemadrin. see Procyclidine
Kenalog. see Triamcinolone acetonide
Keppra. see Levetiracetam
Kerramax, 153
Kerraped, 160
Ketalar. see Ketamine
Ketamine, 144
Ketoconazole

shampoo, 134
skin preparations, 135

Ketorolac trometamol

eye drops, 120


injection, 146

Kineret. see Anakinra


Kiovig. see Human normal immunoglobulin
Kivexa. see Abacavir & lamivudine
Klaricid. see Clarithromycin
Klean prep, 13
Kliofem, 72
Kliovance, 72
K-Lite, 159
Konakion. see Phytomenadione
K-Two, 160

L
Labetalol, 17
Lacosamide, 50
Lacri-lube, 118
Lactulose, 13
Lamisil. see Terbinafine
Lamivudine

Hepatitis B, 64
HIV infection, 62

Lamotrigine, 49
Lanoxin. see Digoxin
Lanreotide, 97
Lansoprazole, 10
Lanthanum, 104
Lantus. see Insulin glargine
Lanvis. see Tioguanine
Largactil. see Chlorpromazine
Lariam. see Mefloquine
Larvae300. see Sterile larvae
LarvE, 139
Lasix. see Furosemide
Lasoride. see Co-amilofruse
LAT gel, 148
Latanoprost, 117
Latanoprost and timolol. see Xalacom
Laxatives, 12

bowel cleansing solutions, 13


bulk forming, 12
faecal softeners, 12
osmotic, 12
stimulant, 12

Ledclair. see Sodium calcium edetate


Ledermycin. see Demeclocycline
Leflunomide, 109
leishmaniasis. See sodium stibogluconate
Lenalidomide, 95
Lenograstim, 100
Lercanidipine, 21
Letrozole, 96
Leukeran. see Chlorambucil
Leukotriene receptor antagonists, 31
Leuporelin, 73
Leuprorelin

endometriosis, 77
prostate cancer, 96

Leustat. see Cladribine


Levact. see Bendamustine
Levemir. see Insulin detemir
Levetiracetam, 50
Levobupivacaine, 148
Levocarnitine, 107
Levofloxacin, 61
Levomepromazine, 36

anti-emetic, 41

Levonelle 1500. see Levonorgestrel


Levonorgestrel, 82

emergency contraception, 81
intra-uterine system, 82

Levosimendan, 22

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

180

Levothyroxine, 69
Lichen sclerosis. See Dermovate NN
Lidocaine

anti-arrhythmic, 17
local anaesthetic, 148
neuropathic pain, 45
ointment, 129

Lidocaine 4% cream, 148


Lidocaine and fluorescein, 118
Lidocaine and phenylephrine, 149
Lidocaine and prilocaine. see EMLA
Lignocaine

antiarrhythmic, 17
local anaesthetic, 148
ointment, 129

Ligocaine

neuropathic pain, 45

Li-Liquid. see Lithium citrate


Limbo, 160
Linaclotide, 13

irritable bowel syndrome with


constipation, 13

Linezolid, 59
Lioresal. see Baclofen
Liothyronine, 69
Lipantil micro. see Fenofibrate
Lipid regulating drugs, 27
Lipitor. see Atorvastatin
Liposomal Doxorubicin, 87
Lipostat. see Pravastatin
Liquiband, 136
Liraglutide, 68
Lisdexamfetamine

ADHD, 40

Lisinopril, 20
Lissamine green, 120
Lithium carbonate, 38
Lithium Carbonate

cluster headaches, 47

Lithium citrate, 38
Lithium Citrate

cluster headaches, 47

Loop diuretics, 15
Loperamide, 10
Lopinavir & ritonavir, 62
Loratadine, 32
Lorazepam, 36, 146

status epilepticus, 51

Loron. see Sodium clodronate


Losartan, 20
Losec. see Omeprazole
Lotemax. See Loteprednol
Loteprednol etabonate

corticosteroid eye drops, 116

Lucentis. see Ranibizumab


Lumigan. see Bimatoprost
Lustral. see Sertraline
Lutrelef. see Gonadorelin
Lyclear. see Permethrin
Lymecycline, 57
Lyrica. see Pregabalin
Lysodren. See mitotane
Lyxumia. see Lixisenatide

M
Maalox. see Co-magaldrox
MabThera. see Rituximab
Macitentan, 19
Macrobid. see Nitrofurantoin
Macrodantin. see Nitrofurantoin
Macrolides. see Erythromycin & related
drugs, 58
Madopar. see Co-beneldopa
Magenta paint, 139
Magnesium aspartate, 103
Magnesium chloride, 103
Magnesium glycerophosphate, 103
Magnesium sulphate

magnesium supplement, 103


paste, 136

Magnesium supplements, 103


Magnesium with potassium IV infusion

see Magnesium chloride, 103

Livial. see Tibolone


Lixisenatide, 68
l-lysine 2.5%, l-arginine 2.5%, 165
L-Mesitran Border, 155
L-Mesitran Hydro:, 155
L-Mesitran Net, 156
L-Mesitran Soft Ointment, 156
LMX4, 148
Local anaesthetics, 148

Malarone, 65
Malathion, 136
Male sex hormones, 72
Malic acid pastilles, 126
Malignant disease, 86
Manerix. see Moclobemide
Mannitol.

Loceryl. see amorolfine


Locoid. see Hydrocortisone butyrate, 129
Lodine SR. see Etodolac
Loestrin 30, 80
Lofepramine, 38
Lofexidine, 54
Logynon, 81
Lomustine, 86
Loniten. see Minoxidil

Mantoux test, 140


Maraviroc, 63
Marcain. see Bupivacaine
Marvelon, 80
Maxidex. see Dexamethasone eye drops
Maxitrol, 116
Maxolon. see Metoclopramide
Measles, mumps & rubella vaccine, 141

Lidocaine ointment, 129

bronchial provocation testing, 33


cystic fibrosis, 33
diuretic, 16

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

181

Mebendazole, 66
Mebeverine, 9
Medi hosiery, 160
Mediscrub, 138
Medroxyprogesterone acetate, 72

contraceptive, 82
in malignant disease, 95

Mefenamic acid, 108


Mefix, 158
Mefloquine, 65
Megace. see Megestrol acetate
Megaloblastic anaemias, 98
Megestrol acetate, 96
Meglisorb, 155
Meglumine gadoterate, 162
Melatonin, 35
Meloxicam, 108
Melphalan, 86
Memantine, 53

dementia, 55

Menadiol sodium phosphate, 106


Menires Disease, 42
Meningococcal A, C, W135 & Y conjugate
Vaccine (Menveo), 142
Meningococcal A, C, W135 & Y Vaccine,
142
Meningococcal C conjugate vaccine, 142
Menitorix, see Haemophilus Influenzae
type b and meningitis C conjugate
vaccine, 141
Menopur. see Menotrophin
Menotrophin, 74
Mentadent P. see Triclosan toothpaste,
125
Menthol in aqueous cream, 129
Menveo, 142
Mepacrine, 66
Mepact. see Mifamurtide
Mepilex, 155

Border, 155

Mepilex Transfer, 155


Mepivacaine, 148
Mepore, 153
Merbentyl. see Dicycloverine
Mercaptamine, 107
Mercaptopurine, 88

inflammatory bowel disease, 11

Mercilon, 81
Merocaine, 125
Merocet. see cetylpyridinium chloride
Meronem. see Meropenem
Meropenem, 57
Mesalazine, 10, 11
Mesna, 86
Mesorb, 153
Mesren mr. see mesalazine
Mestinon. see Pyridostigmine
Metalyse. see Tenecteplase
Metanium, 128
Metaraminol, 22
Metformin, 68

Methadone

analgesia, 44
use in substance dependence, 54

Methionine, 150
Methotrexate

cancer, 88
inflammatory bowel disease, 11
rheumatoid arthritis, 109
skin conditions, 132

Methotrimeprazine. see Levomepromazine,


36, 41
Methoxsalen. see 8-Methoxypsoralen
Methoxy polyethylene glycol-epoetin beta,
99
Methoxypsoralen, 132
Methylated Spirit, 137
Methylcellulose
diarrhoea etc., 10

laxative, 12

Methyldopa, 19
Methylphenidate

ADHD, 40
narcolepsy, 40

Methylprednisolone

injections (depot), 109


injections (systemic), 70

Methylprednisolone acetate and Lidocaine,


109
Methylprednisolone acetate depot injection,
109
Methylthioninium Chloride, 165
Metoclopramide

anti-emetic, 41
as GI prokinetic agent, 9
migraine, 46

Metolazone, 15
Metoprolol, 17

migraine prophylaxis, 46

Metronidazole

amoebicide, 66
anaerobic infections, 60
antigiardial, 66
gel, 135
vaginal gel, 80

Metrotop. see Metronidazole gel


Metyrapone, 78
Mexiletine

neuropathic pain, 45

Miacalcic. see Calcitonin (Salmon)


Micafungin, 61
Miconazole

buccal infections, 125

Miconazole & hydrocortisone. see


Daktacort, 130
Miconazole Nitrate, 135
Microgynon 30, 80
Micronor, 82
Midamor. see Amiloride
Midazolam

anaesthetics, 145

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

182

epilepsy, 50
Midodrine, 22
Mifamurtide, 95
Mifegyne. see Mifepristone
Mifepristone, 79
Migard. see Frovatriptan
Migraine, 45
milk replacement

ProZero

, 152

Millinette 30/75, 80
Milrinone, 15
Milton. see Sodium hypochlorite, 138
Mimpara. see Cinacalcet
Minerals, 102
Mini TT380 Slimline, 82
Minims saline. see Sodium chloride
Miniversol, 137, 161
Minocin. see Minocycline
Minocycline

DMARD, 111
treatment of infections, 57

Minoxidil, 18
Miochol E. see Acetylcholine
Miotics, 117
Mirabegron, 84
Miraflow daily cleaner, 121
Mirapexin. see Pramipexole
Mircera, 99
Mirena. see Levonorgestrel intra-uterine
system, 82
Mirtazapine, 39
Misoprostol, 9
Mitomycin, 87

Moxonidine, 19
Mozobil. see Plerixafor, 100
MST. see Morphine
Mucaine. see Antacid with oxetacaine
Mucodyne. see Carbocisteine
Mucogel. see Co-magaldrox, 8
Mucolytics, 33
Multaq. See Dronaderone
Multihance, 162
Multiple carboxylase deficiency

Biotin, 165

Multivitamin capsules/tablets. see Vitamins


BPC capsules / tablets, 106
Multivitamin preparations, 106
Multivitamins. See Abidec
Mupirocin

nasal ointment, 124


ointment, 135

muscle relaxant. See Papaverine


Muscle relaxants (skeletal), 112
Muse. see Alprostadil
Myambutol. see Ethambutol
Mycamine. See micafungin
Mycobutin. see Rifabutin
Mycophenolate mofetil, 92
Mycophenolate sodium, 92
Mydriatics, 116
Mydricaine No 2, 116
Mydrilate. see Cyclopentolate
Myfortic. see Mycophenolate sodium
Myleran. see Busulphan
Myocrisin. see Sodium aurothiomalate
Myometrial relaxants, 79

bladder cancer, 87

Mitotane, 90
Mitoxana. see Ifosfamide
Mitoxantrone, 87
Mivacron. see Mivacurium
Mivacurium, 146
Mixtard insulins, 67
MMR II Vaccine, 141
Mobic. see Meloxicam
Moclobemide, 39
Modafinil, 40
Modecate. see Fluphenazine decanoate
Modified fluid gelatin see Succinylated
gelatin, 101
Molipaxin. see Trazodone
Mometasone nasal spray, 123
Monit. see Isosorbide mononitrate
Monoamine oxidase inhibitors, 39
Monotrim. see Trimethoprim
Montelukast, 31
Morphine, 43
Motilium. see Domperidone
Mouthwash solution tablets, 125
Mouthwashes, gargles and dentifrices, 125
Mouthwashes, Gargles and Dentifrices,
125
Movicol, 13
Moxifloxacin, 61

N
Nabilone

anti-emetic, 42
chronic pain, 43

Nabumetone, 108
N-Acetylcysteine, see acetylcysteine, 33
Nadolol, 18
Nafarelin, 78
Naftidrofuryl oxalate, 22

peripheral arterial disease, 22

Nalorex. see Naltrexone


Naloxone

in anaesthetics, 147
opioid poisoning, 150

Naltrexone, 54
Naprosyn. see Naproxen
Naproxen, 108
Narcan. see Naloxone
narcolepsy. see dexamfetamine
Nardil. see Phenelzine
Nasacort. see Triamcinolone acetonide
nasal spray
Nasal Allergy, 123
Nasal decongestants

systemic, 34

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

183

topical, 123
Naseptin, 124
Nasonex. see Mometasone
Natalizumab, 95
Natrilix. see Indapamide
Natulan. see Procarbazine
Navelbine. see Vinorelbine
Nebcin. see Tobramycin
Nebido. see Testosterone undecanoate
Nebilet. see Nebivolol
Nebivolol, 18
Nebulised Gentamicin, 58
Nebusal. See sodium chloride nebuliser
solution
Nefopam, 43
NeilMed Sinus Rinse, 124
Nelfinavir, 62
Neoclarityn. see Desloratadine
NeoKay. see Phytomenadione
Neo-Mercazole. see Carbimazole
Neomycin, 58
Neoral. see Ciclosporin
NeoRecormon. see Epoetin beta
Neostigmine, 147

myasthenia gravis, 112

Neotigason. see Acitretin


Neulasta. see Pegfilgrastim
Neupogen. see Filgrastim
Neupro. see Rotigotine
Neuroleptics. see Antipsychotics
Neuromuscular Disorders, 112
Neurontin. see Gabapentin
neuropathic pain. see mexiletine
Nevirapine, 63
New product request forms, 5
Nexplanon. See etonogestrel
Niacin slow release, 28
Niaspan. see Nicotinic acid slow release
Nicorandil, 22
Nicorette. see Nicotine
Nicorette Quickmist. See Nicotine
Nicotine, 53
Nicotinell. see Nicotine
Nicotinic acid slow release, 28
Nifedipine, 21
Nilotinib, 91
Nimbex. see Cisatracurium
Nimodipine, 21
Nimotop. see Nimodipine
NiQuitin. see Nicotine
Nitrates, 21
Nitrazepam, 35
Nitrofurantoin, 61
Nitrofurazone, 135
Nitrolingual. see Glyceryl trinitrate
Nitrous Oxide, 144
Nivaquine. see Chloroquine
Nizoral. see Ketoconazole
Nolvadex. see Tamoxifen
Non-formulary medicines, 5
initiating therapy with, 5

patients admitted on, 5


Non-nucleoside reverse transcriptase
inhibitors, 63
Nonoxynol 9, 82
Non-steroidal anti-inflammatory drugs, 108
Non-woven fabric swab, 158
Noradrenaline, 22
Norcuron. see Vecuronium
Norditropin. see Somatropin
Norepinephrine, 22
Norethisterone, 72

contraceptive, 82
in malignant disease, 96

Norgeston, 82
Normasol, 137
Norvir. see Ritonivir
Nova T 380, 82
Novantrone. see Mitozantrone
Novomix, 67
Novopen, 67
Novorapid, 67
Noxafil. see Posaconazole
Nozinan. see Levomepromazine
Nplate. see romiplostim
NSAIDs, 108

analgesia, 42

NSCLC. See gefitinib


Nucleoside reverse transcriptase inhibitors,
62
Nuelin. see Theophylline, 30
Nutrition

intravenous, 102

Nutrition and blood, 98, 152, 153


NuvaRing, 81
Nystaform HC, 130
Nystan. see Nystatin
Nystatin

oral, 62
oral suspension, 124
skin preparations. Discontinued

Nystatin pessaries, 62
Nystatin, benzalkonium chloride and
hydrocortisone. see Timodine

O
Obesity, treatment of, 40
Obstetrics, gynaecology and urinary-tract
disorders, 79
Ocriplasmin, 119
Octagam. see Human normal
immunoglobulin
Octanate

antihaemophila agent, 27

Octaplas & Octaplas LG, 27


Octasa MR. see Mesalazine
Octenidine. see Octenisan
Octenisan, 138
Octreotide, 97
Oculotect. see Povidone iodine

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

184

Oestradiol. see Estradiol


Oestriol. see Estriol, 79
Oestrogens, 71

in malignant disease, 95

Oestrogens, conjugated, 71
Ofloxacin, 61
Ofloxacin, eye drops, 114
Oilatum emollient, 127, 128
Oily cream. see Hydrous ointment, 127
Oily Phenol injection, 14
Olanzapine, 37
Olive oil ear drops, 122
Olopatadine, 116
Omalizumab, 32
Omega-3-acid ethyl esters, 28
Omeprazole, 9
Oncovin. see Vincristine
Ondansetron, 41
One-alpha. see Alfacalcidol
Opatanol. see Olopatadine
Ophthalin. see Sodium hyaluronate, eye
Opioid Dependence, 54
Opsite Flexifix, 154
Opsite plus, 154
Opsite Post Op, 154
Opsumit. see Macitentan
Opticrom. see Sodium cromoglicate
Optifree Express, 121
Orabase. see Carmellose sodium, 124
Oral contraceptives, 80
Oral ulceration and inflammation, 124
Oral viscous budesonide, 30
Oraldene. see Hexitidine
Oramorph. see Morphine
Orencia. see abatacept
Organophosphorus insecticide poisoning,
151
Orgaran. see Danaparoid
Orlistat, 40
Oropharynx, drugs acting on, 124
Orphenadrine, 52
Ortho-Gynest. see Estriol
Oseltamivir, 65
Osigraft. See Eptotermin alfa
Osmotic diuretics, 16
Osmotic laxatives, 12
Osvaren, 104
otitis externa. See triadcortyl
Otitis externa, 122
Otomize, 122
Otosporin, 122
Otrivine. see Xylometazoline
Otrivine-Antistin eye drops, 116
Ovarian cancer. See gemcitabine
Ovysmen, 80
Oxaliplatin, 91
Oxcarbazepine, 49
Oxetacaine. see Antacid with oxetacaine
Oxybuprocaine, 118
Oxybutynin, 83
Oxycodone, 44

OxyContin. see Oxycodone


Oxygen, 33
OxyNorm. see Oxycodone
Oxysept 1 step, 121
Oxytetracycline, 57
Oxytocin, 79
Ozurdex. see Dexamethasone implant

P
Pabrinex. see Vitamin B & C injection
Paclitaxel, 90
PAH. See tadalafil
Pain Cocktail. see Methadone:analgesia
Palexia. see Tapentadol
Palivizumab, 65
Palladone. see Hydromorphone
Palladone SR. see Hydromorphone
Palonosetron, 41
Pamidronate, 76, 102
Panadol. see Paracetamol
Pancreatic cancer. See fluouracil
Pancreatin, 14
Pancuronium, 146
Panoxyl Aquagel see Benzoyl peroxide,
133
Papaverine, 147
Papilloma virus vaccine, see Human
papilloma virus vaccine, 141
Paracetamol, 42

migraine, 45
poisoning, 150

Paracetamol and Codeine. see Cocodamol


Paraffin

soft white, 127


soft yellow, 127
sterile liquid, 127

Paraldehyde, 51
Paranet, 153
Paraplatin. see Carboplatin
Paraquat poisoning, 151
Parecoxib, 146
Paricalcitol, 103
Parkinsonism, 51
Parlodel. see Bromocriptine
Paroxetine, 39
Partobulin. see Anti D (Rho)
immunoglobulin
Parvolex. see Acetylcysteine
Patent Blue V Sodium, 165
Pavulon. see Pancuronium
Pazopanib, 91
Pedea. See Ibuprofen IV
Pediacel. see Diphtheria/tetanus/acellular
pertussis/inactivated polio
vaccine/Haemophilus influenzae type b
PEGAsparginase, 89
Pegasys. see Peginterferon
Pegfilgrastim, 100

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

185

Peginterferon, 94
pegzerepoetin alfa. see Methoxy
polyethylene glycol-epoetin beta
Pemetrexed, 88
Penicillamine

heavy metal poisoning, 150


rheumatoid arthritis, 109
Wilsons disease, 107

Penicillin G. see Benzylpenicillin, 56


Penicillin V. see Phenoxymethylpenicillin,
56
Penicillinase resistant penicillins, 56
Penicillins, 56

Antipseudomonal, 56

Penmate, 67
Pentacarinat. see Pentamidine
Pentamidine, 66
Pentasa. see Mesalazine
Pentasa sachets. see mesalazine
Pentosan polysulphate, 84
Peppermint oil, 9
Peptac, 8
Perampanel, 49
Perfalgan. see Paracetamol
Perindopril, 20
Periostat. see Doxycycline - periodontitis
Permethrin, 136
Perphenazine, 36
Persantin. see Dipyridamole
Personal Best Peak Flow Meter, 165
Pesticides, poisoning with, 151
Pethidine, 44
Pharmalgen, 32
Pharmorubicin. see Epirubicin
Phenelzine, 39
Phenergan. see Promethazine
Phenindione, 24
Phenobarbital, 48
Phenobarbitone see phenobarbital, 48
Phenol, oily injection, 14
Phenothrin, 136
Phenoxybenzamine, 19
Phenoxymethylpenicillin, 56
Phentolamine, 19
Phenylbutazone

ankylosing spondylitis, 108

Phenylephrine

eye drops, 116


injection, 22

Phenytoin

epilepsy, 48
neuropathic pain, 45
status epilepticus, 51

PHMB. see Polyhexamethylene biguanide


Pholcodine, 34
Phosex. see Calcium acetate
Phosphate Polyfusor, 103
Phosphate Sandoz, 103
Phosphate solution, 103
Phosphate supplements, 103
Phosphate-binding agents, 104

Phosphates enema, 13
Phospho-soda, 13
Phoxilium 1.2mmol/l phosphate, 102
Phyllocontin. see Aminophylline, 30
Physeptone. see Methadone
Physiotens. see Moxonidine
Physostigmine, 147
Phytomenadione, 106
Picibanil, 91
Pico, 158
Picolax, 13
Pilocarpine

for xerostomia, 126


glaucoma treatment, 117

Pimecrolimus, 133
Pioglitazone, 68
Piperacillin with tazobactam, 56
Piperazine phosphate. see Pripsen
Piportil. see Pipotiazine palmitate
Pipothiazine palmitate. see Pipotiazine
palmitate, 38
Pipotiazine palmitate, 38
Pirfenidone, 34
Piriton. see Chlorphenamine
Piroxicam

melt tablets, 108

Pituitary hormones, 74
Pivmecillinam, 56
Pixantrone, 87
Pixuvri. see Pixantrone
Pizotifen, 46
Plaquenil. see Hydroxychloroquine
Plasma substitutes, 101
Plasma-Lyte 148 and Plasma-Lyte & 5%
Glucose, 102
Plavix. see Clopidogrel
Plerixafor, 100
Pneumococcal conjugate vaccine, 142
Pneumococcal polysaccharide vaccine,
142
Pneumocystis Pneumonia, drugs for, 66
Pneumovax II, 142
Podophyllotoxin, 134
Poisoning, treatment of, 150
Poliomyelitis vaccine, 142
Pollinex Quattro, 32
Pollinex vaccines, 32
Polyacrylic acid. see Carbomer 980, 119
Polyfax ointment, 135
Polyfield Nitrile Patient Pack, 158
Polyhexamethylene biguanide, 115
Polymem, 155
Polytar liquid, 134
Ponstan. see Mefenamic acid
Poractant alfa, 33
Posaconazole, 61
Posterior pituitary hormones, 75
postmenopausal osteoporosis. See
Densoumab
Potassium

oral, 100

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

186

Potassium channel activators, 22


Potassium chloride

oral, 100

Potassium citrate, 84
Potassium iodate, 70
Potassium permanganate, 138
Potassium removal, 100
Potassium sparing diuretic combinations,
16
Potassium sparing diuretics, 16
Povidone iodine, 120

skin preparations, 138

Povidone Iodine

eye drops, 114

PR Freeze spray, 113, 149


Pradaxa. see Dabigatran
Pralidoxime mesylate, 151
Pramipexole, 52
Prasugrel, 25
Pravastatin, 27
Praziquantel, 66
Precortisyl. see Prednisolone
Predfoam. see Prednisolone, 11
Pred-forte. see Prednisolone acetate eye
drops
Prednisolone

ear drops, 122


eye drops, 115
inflammatory bowel disease, 11
inflammatory bowel disease rectal
preparations, 11
systemic therapy, 70

ProBanthine. see Propantheline


Probenecid, 112
Procainamide, 17
Procaine, 149
Procaine penicillin, 56
Pro-Cal Shot, 152
Procarbazine, 90
prochlorperazine. See Buccastem
Prochlorperazine

anti-emetic, 41

Procoralan. see Ivabradine


Procyclidine, 52
Profasi. see Chorionic gonadotrophin
Proflavine cream, 136
Profore, 160
Profore #1, 159
Profore Lite, 160
Progesterone, 72
Progestogen-only contraceptives, 82
Progestogens, 72

in malignant disease, 95

Prograf. see Tacrolimus


Proguanil, 65
Proguanil and atovaquone. see Malarone
Progynova TS. see Estradiol, 71, 73
Prolia. See Denosumab
Promethazine

allergy, 32
anti-emetic, 41
hypnotic, 35

Predsol. see Prednisolone


Predsol-N. see Prednisolone & Neomycin
Pregabalin, 50

Promogran Prisma Matrix, 157


Pronestyl. see Procainamide
Prontosan Irrigant, 157
Prontosan Wound Gel, 157
Propafenone, 17
Propamidine isethionate, 115
Propantheline, 9
Propofol, 144
Propofol Lipuro. see Propofol
Propranolol, 17

Pregnyl. see Chorionic gonadotrophin


Premarin, 71
Premique low -dose, 72
Prempak-C, 71
Prevenar, 142
Prezista. see Darunavir
Priadel. see Lithium carbonate
Prilocaine, 148
Prilocaine 2%, 148
Priloketal. See Prilocaine
Primacor. see Milrinone
Primaquine, 65
Primolut N. see Norethisterone
Primovist, see gadoxetic acid, 162
PrimsOcal B22, 163
Primsocitrate 18/0, 163
Prioderm. see Malathion
Pripsen, 66
Privigen. see Human normal
immunoglobulin

Propylthiouracil, 70
Proscar. see Finasteride, see Finasteride
Prostaglandins, 79
Prostap 3. see Leuprorelin
Prostap SR. see Leuprorelin
prostate cancer. See abiraterone
Prostin E2. see Dinoprostone
Protamine sulphate, 25
Protease inhibitors, 62
Protelos. see Strontium ranelate
Prothrombin complex concentrate. see
Beriplex-P
Protirelin, 75
Proton pump inhibitors, 9
Protopic. see Tacrolimus
Provera. see Medroxyprogesterone acetate
Provigil. see Modafinil
Proxymetacaine, 118
Prozac. see Fluoxetine

Prednisolone acetate

depot injection, 109


eye drops, 115

Prednisolone and Neomycin

eye drops, 116

neuropathic pain, 45

hyperthyroidism, 70
migraine prophylaxis, 46

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

187

ProZero

, 152
Prucalopride, 13

chronic constipation in women, 13

Pseudoephedrine, 34
Psoriasis, 131, 132
Pulmicort. see Budesonide
Pulmonary surfactants, 33
Pulmozyme. see Dornase alfa
Puri-Nethol. see Mercaptopurine
Pyrazinamide, 60
Pyridostigmine, 112
Pyridoxal phosphate, 105
Pyridoxine, 105
Pyrimethamine, 65

Q
Quellada M. see Malathion
Questran. see Colestyramine
Quetiapine, 37
Quinine

malaria treatment, 66
night cramps, 112

Quixil human fibrin glue, 136


QV cream, 127

R
Rabies vaccine, 142
Radiesse Voice, 164
Raloxifene, 72, 77
Raltegravir, 63
Ramipril, 20
Ranibizumab, 120
Ranitidine, 9
Ranolazine, 22
Rapamune. see Sirolimus
Rapifen. see Alfentanil
Rapilysin. see Reteplase
Rasagiline, 52
Rasburicase, 112
Rasilez. see Aliskiren
Rastinon. see Tolbutamide
Ratiograstim. see Filgrastim
Rebetol. see Ribavirin
Rebif. see Interferon beta
Reboxetine, 39
Reductil. see Sibutramine
Regurin. see Trospium chloride
Rehydration salts, 101
Relenza. see Zanamivir
Relifex. see Nabumetone
Remegel, 104
Remifentanil, 146
Reminyl. see Galantamine
Remodulin. see Treprostinil
Renasys Go, 158
Renavit, 107
Renin inhibitors, 20

Rennies, 104
Renvela. See sevelamer carbonate
Reopro. see Abciximab
Rephoren, see Rephoren, 104
Requip. see Ropinirole
Resolor. See prucalopride
Resonium A, 100
Resource Protein, 152
Respiratory stimulants, 33
Respiratory syncytial virus, 65
Respiratory system, 29
Reteplase, 26
Retigabine, 49
Retinol see Vitamin A, 104
Retrovir. see Zidovudine
Revatio. see Sildenafil
Revaxis. see Diphtheria (low dose),
tetanus, acellular pertussis & inactivated
polio vaccine
Revaxis. see Adsorbed Diphtheria (low
dose), Tetanus and Inactivated
Poliomyelitis Vaccine
Reverse transcriptase inhibitors, 62
Revlimid. see Lenalidomode
Revolade. see Eltrombopag
Reyataz. see Atazanavir
Rheumatic diseases and gout

drugs used in, 108

Rhinolast. see Azelastine


Rhophylac. see Anti D (Rho)
immunoglobulin
rHuG-CSF. see Lenograstim, 100
Ribavirin, 65
Rifabutin, 60
Rifadin. see Rifampicin
Rifampicin

non tuberculous infections, 59


tuberculosis, 60

Rifampicin and isoniazid, 60


Rifater, 60
Rifaximin, 59
Rifinah. see Rifampicin with Isoniazid
Rigevidon, 80
Rilpivirine, 63
Rilpivirine&Emtricitabine & Tenofovir. see
Eviplera
Rilutek. see Riluzole
Riluzole, 53
Rimactane. see Rifampicin
Rimactazid. see Rifampicin with Isoniazid
Rimexolone, 115
Rinatec. see Ipratropium nasal spray
Risedronate, 76
Risperdal Consta. see Risperidone longacting injection
Risperidone, 36

long-acting injection, 38

Ritalin. see Methylphenidate


Ritonavir, 63
Rituximab

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

188

lymphoma & lymphoproliferative


conditions, 93
rheumatoid arthritis and autoimmune
diseases, 111
Rivaroxaban, 25
Rivastigmine, 55
Rivotril. see Clonazepam
RoActemra. See Tocilizumab
Robinul. see Glycopyrronium
Robinul neostigmine. see
Glycopyrronium with neostigmine
Rocephin. see Ceftriaxone
Rocuronium, 146
Roferon. see Interferon alfa
Rogitine. see Phentolamine
Romiplostim, 99
Ropinirole, 51
Rosuvastatin, 27
Rotigotine

Parkinsons disease, 52
restless legs syndrome, 52

Rubefacients, 113

S
Saflutan. See tafluprost
Salactol paint, 133
Salagen. see Pilocarpine
Salamol. see Salbutamol
Salazopyrin. see Sulfasalazine
Salbutamol, 29

Easyhaler, 29

Salcatonin. see Calcitonin (salmon), 75,


103
Salette, 121
Salicylic acid, 132, 134
Salicylic acid and Lactic acid. see Salactol
Salicylic acid in emulsifying ointment, 132
Saliva Orthana, 125
Salivix. see Malic acid pastilles, 126
Salmeterol, 29
Salmeterol and fluticasone. see Seretide
Sandimmun. see Ciclosporin
Sandocal, 102
Sandoglobulin. see Human normal
immunoglobulin
Sando-K, 100
Sandostatin. see Octreotide
Sandrena. see Estradiol, transdermal, 71,
73
Sanomigran. see Pizotifen
Saquinavir, 63
Savene. See dexrazoxane
Scandonest. see Mepivacaine
Scanpore tape, 158
Schistosomicides, 66
Sclerosants

Local, 28

Scopoderm. see Hyoscine hydrobromide


Seal Tight, 161

Sebco see Coconut compound ointment,


131
Securon SR. see Verapamil
Seebri. see Glycopyrronium Bromide
Selective serotonin reuptake inhibitors, 39
Selegiline, 52
Selenium sulphide, 135
Selexid, 56
Selsun. see Selenium sulphide
Senna, 12
Senokot. see Senna
sentinel lymph node. See Patent Blue
Septrin. see Co-trimoxazole
Septrin Forte. See Co-trimoxazole
Serc. see Betahistine
Serenace. see Haloperidol
Seretide, 31
Serevent. see Salmeterol
Seroquel. see Quetiapine
Seroxat. see Paroxetine
Sertraline, 39
Settlers Tums, 104
Sevelamer Carbonate, 104
Sevoflurane, 144
Sex Hormones

in malignant disease, 95

Shampoos, 134
Sibutramine, 40
Sildenafil, 85

erectile dysfunction, 85
pulmonary hypertension, 19
Raynauds disease, 85

Silver nitrate

solutions, 138
sticks & applicators, 134

Silver sulfadiazine, 135


Silvercel, 157
simeticone. See Infacol
Simple linctus, 34
Simple Shampoo, 135
Simponi. See Golimumab
Simulect. see Basiliximab
Simvastatin, 27
Sinemet. see Co-careldopa
Singular. see Montelukast
Siopel. see Dimeticone cream
Sirolimus, 93
Sitagliptin, 68
Skin preparation swabs, 137
Skin, drugs acting on, 127
Skinsan. see triclosan
Slo-phyllin. see Theophylline, 30
Slow sodium. see Sodium chloride, 100
Slow-K. see Potassium chloride
Slow-Niacin. see Niacin slow release

Smofkabiven

TPN, 152

Smoking cessation, 53
Snakebite antiserum, 151
Sodium aurothiomalate, 109
Sodium bicarbonate

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

189

ear drops, 122


oral, 101
Sodium calcium edetate

heavy metal poisoning, 150

Sodium chloride, 119, 123

bladder irrigation (large volume, 84


bladder irrigation (small volume), 84
irrigation solution, 137
oral, 100

Sodium Chloride

Minoversol, 161
nebuliser solution, 33

Sodium citrate, 121

micro-enema, 13
solution, 147

Sodium clodronate, 76, 103


Sodium cromoglicate

eye drops, 116

Sodium dichloroisocyanurate, 138


Sodium feredetate, 98
Sodium fluoride mouthwash, 104
Sodium fusidate, 59
Sodium heparin, 23
Sodium hyaluronate. See Clinitas

bladder instillation, 84
eye, 120

Sodium hyaluronate (1.6%)/ Sodium


chondroitin. See Ialuril
Sodium hypochlorite, 138
Sodium ironedetate. see Sodium
feredetate, 98
Sodium nitrite, 150
Sodium nitroprusside, 18
Sodium phenylbutyrate, 107
Sodium picosulfate elixir, 12
Sodium picosulphate, in Picolax, 13
Sodium polystyrene sulphonate, 100
Sodium stibogluconate, 66
Sodium tetradecyl sulphate, 28
Sodium thiosulphate, 150
Sodium valproate

Sonovue, 162

diagnosing pancreatic cancer, 162


viualising blood vessels, 162

Sorbaderm, 161

Sorbaderm , 128
Sorbsan

Ribbon with Probe, 155

Sotacor. see Sotalol


Sotalol, 18
Spectinomycin, 58
Spermicidal contraceptives, 82
Spironolactone, 16, 73
Spironolactone & chlorothiazide, 16
Sporonox. see Itraconazole
Stalevo, 52
Starch based plasma substitutes, 101
Status epilepticus, 50
Stavudine, 62
STD. see Sodium tetradecyl sulphate
Stelara. See Ustekinumab
Stelazine. see Trifluoperazine
Stemetil. see Prochlorperazine
Sterets. see Skin preparation swabs, 137
Steriflex 165, 101
Sterile Gloves, 158
Sterile larvae, 161
Stimulant laxatives, 12
Stiripentol, 50
Strattera

see Atomoxetine, 40

Sodium Valproate, 49
Sodium, oral, 100
Sofosbuvir, 65
Sofradex ear drops, 122
Soft drape, 158
Soft paraffin

Streptase. see Streptokinase


Streptokinase, 26
Streptomycin, 60
Streptozocin, 90
Stribild, 63
Strontium ranelate, 76
Stugeron. see Cinnarizine
Subcuvia, 143
Sublimaze. see Fentanyl
Suboxone, 54
Subutex. see Buprenorphine, opioid
dependence
Suby G. see solution G, 84
Succinylated gelatin, 101
Sucralfate, 9
Sucrose 24% solution, 165
Sudafed. see Pseudoephedrine
Sudocrem, 128
Sugammadex, 147
Sulfasalazine

Solian. see Amisulpride


Solu-Cortef. see Hydrocortisone
Solu-Medrone. see Methylprednisolone
Solution G, 84
Solution R, 85
Solvaline N, 153
Solvazinc. see Zinc sulphate
Somatropin, 74
Somatuline. see Lanreotide

Sulphonylureas, 68
Sulpiride, 36
Sulpitil. see Sulpiride
Sumatriptan, 46
Sunitinib, 91
Sunscreening preparations, 134
Suprax. see Cefixime
Suprecur. see Buserelin
Suprefact. see Buserelin
Suscard Buccal. see Glyceryl trinitrate

anti-epileptic, 46, 49
bipolar disorder, 38

white, 127
yellow, 127

inflammatory bowel disease, 11

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

190

Sustanon, 73
Sustiva. see Efavirenz
Sutent. see Sunitinib
Suxamethonium, 146
Sweet-Ease. See Sucrose 24% solution
Symbicort, 31
Synacthen. see Tetracosactide
Synagis. see Palivizumab
Synalar. see Fluocinolone acetonide, 129
Synarel. see Nafarelin
Synkavit. see Menadiol sodium phosphate
Syntocinon. see Oxytocin
Syntometrine, 79
Systane, 119, 121
Sytron. see Sodium feredetate

T
TachoSil, 137
Tacrolimus

ointment, 133
systemic, 93

Tadalafil, 19, 85
Tafluprost, 117
Tagamet. see Cimetidine
Tambocor, 17, see Flecainide
Tamiflu. see Oseltamivir
Tamoxifen, 96
Tamsulosin, 83
Tapentadol, 44
Tar pomade, 131
Tarceva. see Erlotinib
Targocid. see Teicoplanin
Tarivid. see Ofloxacin
Tasigna. see Nilotinib
Tasmar. see Tolcapone
TauroHep, 24
Taurolidine, 24
Taurolidine 2% solution, 165
TauroLock, 24
Tavanic. see Levofloxacin
Taxol. see Paclitaxel
Taxotere. see Docetaxel
Teejel. see Choline salicylate, 124
Tegaderm, 154
Tegaderm Alginate Ag, 157
Tegafur with Uracil, 88
Tegretol. see Carbamazepine
Teicoplanin, 59
Telaprevir, 64
Telfa Clear, 154
Telfast. see Fexofenadine
Telzir. see Fosamprenavir
Temazepam, 35, 146
Temgesic. see buprenorphine
Temodal. see Temozolomide
Temozolomide, 91
Tenecteplase, 26
Tenofovir

hepatitis B, 64

HIV infection, 62
Tenofovir & Cobicistat & Elvitegravir &
Emtricitabine. see Stribild
Tenormin. see Atenolol
Terbinafine

skin preparations, 135


tablets, 62

Terbutaline, 29
Teriflunomide, 95
Teriparatide, 76
Terlipressin, 75
Tertroxin. see Liothyronine
Testim. See Testosterone gel
Testogel. see Testosterone, gel
Testosterone, 72
Testosterone undecanoate, 73
Testosterone, gel, 73
Tetanus immunoglobulin, 143
Tetanus vaccine adsorbed, 142
Tetrabenazine, 52
Tetracaine

eye drops, 118


gel for local anaesthesia, 148

Tetracosactide, 74
Tetracosactrin. see Tetracosactide, 74
Tetracyclines, 57
Tetralysal. See Lymecycline
Tetraspan, 101
Tetrastarch, 101
Thalidomide, 95
Theophylline, 30
Thiamine, 105
Thiamine compound strong. see Vitamin B
compound strong
Thiazide & related diuretics, 15
Thioguanine. see Tioguanine, 88
Thiopental, 144
Thiopentone see Thiopental, 144
Thiotepa, 86
Threadworms, 66
Thymoglobuline. see antithymocyte
immunoglobulin
Thyroid hormones, 69
Thyroxine, 69
Tibolone, 72
Tigecycline, 57
Tildiem. see Diltiazem
Timodine cream, 130
Timolol, 117
Timoptol. see Timolol
Tinzaparin, 23
Tioguanine, 88
Tiopronin, 107
Tirofiban, 26
Tisseel fibrin glue, 137

Tisseel Lyo Fibrin Glue

mesh fixation in hernia repair, 137

Tizanidine, 112
Tobi. see Tobramycin
TOBI Podhaler. See Tobramycin
Tobramycin, 58

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

191

Tocilizumab, 111
Tocino. See Alitretinoin
Tocopheryl acetate, 106
Toctino. See Alitretinoin
Tolbutamide, 68
Tolcapone, 52
Topical Negative Pressure, 158
Topiramate, 49
Topotecan, 92
Toviaz. see fesoterodine
t-PA. see Alteplase
Tracleer. see Bosentan
Tracrium. see Atracurium
Tractocile. see Atosiban
Tramadol

analgesia, 44
diabetic neuropathy, 69

Trandate. see Labetalol


Tranexamic acid, 26
Transiderm nitro. see Glyceryl trinitrate
Transpore tape, 159
Trastuzumab, 90
Trasylol. see Aprotinin
Trazodone, 38
Treosulfan, 87
Treprostinil, 19
Tretinoin

cancer, 90
eye drops, 121

TRH. see Protirelin, 75


Triadcortyl

otitis externa, 130

Triadcortyl

otitis externa, 130

Triamcinolone acetonide, 71

injection, 109
nasal spray, 123

Triamcinolone hexacetonide

injection, 109

Tribavirin. see Ribavirin, 65


Trichloroacetic acid, 134
Triclosan

skin cleanser, 138


toothpaste, 125

Tricotex, 153
Tricyclic and related antidepressants, 38
Trifluoperazine, 36
Trifluorothymidine eye drops, 115
Trigeminal neuralgia, 45
Trihexyphenidyl, 52
Triiodothyronine. see Liothyronine
Trileptal. see Oxcarbazepine
Trimeprazine

allergy, 32
in anaesthetics, 146

Trimethoprim, 59
Trimopan. see Trimethoprim
Trimovate, 130
Triptorelin

precocious puberty, 78
prostate cancer, 96

Tri-Regol, 81
Trisenox. see Arsenic Trioxide
Tritace. see Ramipril
Trizivir, 63
Trobalt. See retigabine
Tropicamide, 116
Trusopt. see Dorzolamide
Truvada, 63
Tryptizol. see Amitriptyline
T-Safe Cu380A, 82
Tsybari. Natalizumab
TT380 Slimline, 82
Tuberculin PPD, 140
Twinrix. see Hepatitis A and B vaccine
Tygasil. see Tigecycline
Typhim Vi. see Typhoid vaccine (vi
polysaccharide)
Typhoid vaccine (vi Polysaccharide), 142

U
Ubidecarenone. See Ubiquinone
Ubiquinone, 107
Uftoral. see Tegafur with uracil
Ukidan. see Urokinase
Ulcer healing drugs, 9
Ulipristal

emergency contraception, 81
uterine fibroids, 72

Ultiva. see Remifentanil


Uniphyllin. see Theophylline, 30
Urea cream. see Calmurid, 128
Urgotul, 154
Urgotul SSD, 157
Urinary frequency, 83
Urinary-tract infections, 61
Urine alkalinisation, 84
Urine retention, 83
Urokinase, 26
Urometexan. see Mesna
Urotainer Solution R. see Solution R, 85
Ursodeoxycholic acid, 14
Ursofalk. see Ursodeoxycholic acid
Ustekinumab, 132
Utovlan. see Norethisterone
Uvistat Ultrablock cream, 134

V
Vaccines, 140
Vagifem. see Estradiol vaginal tablets
Vaginal Atrophy, 79
Vaginal infections, 79
Valaciclovir, 64
Valcyte. see Valganciclovir
Valdoxan. see Agomelatine
Valganciclovir, 64
Valium. see Diazepam
Vallergan. see Alimemazine

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

192

Valoid. see Cyclizine


Valproate semi sodium, 38
Valsartan, 20
Valtrex. see Valaciclovir
Vancocin. see Vancomycin
Vancomycin, 59
Vaniqa. see Eflornithine
Varenicline, 54
Varicella zoster

vaccine, 142

Varicella zoster immunoglobulin, 143


Vasodilators

Peripheral and Cerebral, 22

Vasopressin. see Argipressin, 75


Vasovist, 162
Vecuronium, 147
Velbe. see Vinblastine
Velcade. see Bortezomib
Vemurafenib, 92
Venlafaxine, 39
Venofer. see Iron sucrose
Ventavis. see Iloprost
Ventolin. see Salbutamol
Vepesid. see Etoposide
Verapamil, 21
Vermox. see Mebendazole
Versatis medicated plasters. see Lidocaine,
neuropathic pain
Verteporfin, 121
Vesanoid. see Tretinoin
Vexol. see Rimexolone
Vfend. see Voriconazole
Vibramycin. see Doxycycline
Victoza. See liraglutide
Victrelis. see Boceprevir
Vidaza. See azacitidine
Videx. see Didanosine
Vigabatrin, 50
Vigam. see Human normal immunoglobulin
Vimpat. see Lacosamide
Vinblastine, 89
Vinca alkaloids, 88
Vincristine, 89
Vindesine, 89
Vinorelbine, 89
Viracept. see Nelfinavir
Viraferon. see Interferon alfa
Viraferon Peg. see Peginterferon
Viramune. see Nevirapine
Virazole. see Ribavirin
Viread, 64, see Tenofovir
Viridal Duo. see Alprostadil
Viscopaste PB7. see Zinc Paste Bandage
Viscotears see Carbomer 980, 119
Vistabel. see Botulinum A toxin
Vista-methasone. see Betamethasone
Vista-methasone N. see Betamethasone &
Neomycin
Vistide. see Cidofovir
Visudyne. see Verteporfin
Vitamin B & C injection, 105

Vitamin B compound strong, 105


Vitamin B1. see Thiamine
Vitamin B12. see Hydroxocobalamin, 98
Vitamin B6. see Pyridoxine
Vitamin C, 105
Vitamin D, 105
Vitamin E, 106
Vitamin K, 106
Vitamin K1. see Phytomenadione
Vitamins A, 104
Vitamins A & D, 104
Vitamins BPC, 106
Volibris. see Ambrisentan
Volmax. see Salbutamol
Volplex, 101
Voltarol. see Diclofenac
Voltarol-ophtha, 120
Volulyte, 101
Voriconazole, 62

eye drops, 115

VSL#3, 163

W
Warfarin, 24
Warticon. see Podophyllotoxin, 134
Warts and calluses, 133
Water for irrigation, 137
Water, bladder irrigation, 84
Welldorm. see Chloral betaine & hydrate
Wellferon. see Interferon alfa
Wellvone. see Atovaquone
White soft paraffin, 127
Whites Tar Paste see Zinc and coal tar
paste, 131
Wilsons disease, 107
WinRho. see Anti D (Rho)
immunoglobulin

X
Xagrid. see Anagrelide
Xalacom, 118
Xalatan. see Latanoprost
Xarelto. see Rivaroxaban
Xelma, 163
Xeloda, 87, see Capecitabine
Xenazine. see Tetrabenazine
Xenical. see Orlistat
Xolair. see Omalizumab, 32
Xylocaine. see Lidocaine
Xylometazoline, 123
Xyloproct, 14

Y
Yasmin, 80
Yellow fever vaccine, 142

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

193

Yellow soft paraffin, 127


Yentreve. see Duloxetine
Yervoy. see ipilimumab

Z
Zanaflex. see Tizanidine
Zanamivir, 65
Zanidip. see Lercanidipine
Zantac. see Ranitidine
Zarontin. see Ethosuximide
Zavedos. see Idarubicin
Zebinix. See Eslicarbazepine
Zeffix. see Lamivudine
Zelboraf. see Vemurafenib
Zerit. see Stavudine
Zerobase cream, 128
Zerodouble gel, 127
Zestril. see Lisinopril
Z-Hyalin. see Sodium hyaluronate, eye
Ziagen. see Abacavir
Zidoval. see Metronidazole vaginal gel
Zidovudine, 62
Zidovudine & lamivudine. see Combivir
Zinacef. see Cefuroxime
Zinamide. see Pyrazinamide
Zinc & coal tar & paste, 131
Zinc and castor oil, 128
Zinc and salicylic acid compound paste,
half strength, 132
Zinc Paste and Ichthammol Bandage

eczema, 130
medicated bandages, 160

Zinc Paste Bandage, 160


Zinc sulphate, 104
Zinc supplements, 104
Zineryt, 133
Zinforo. see Ceftaroline
Zipzoc, 160
Zirtec. see Cetirizine
Zispin. see Mirtazapine
Zithromax. see Azithromycin
Zocor. see Simvastatin
Zofran. see Ondansetron
Zoladex. see Goserelin
Zoledronic acid, 102

hypercalcaemia, 76
osteoporosis, 77
Pagets disease, 77

Zolmitriptan, 46
Zomacton. see Somatropin
Zometa. see Zoledronic
acid:hypercalcaemia
Zomig. see Zolmitriptan
Zonisamide, 49
Zopiclone, 35
Zoton. see Lansoprazole
Zovirax. see Aciclovir
Zuclopentixol Acetate, 38
Zuclopentixol decanoate, 37
Zyban. see Bupropion
Zydol. see Tramadol
Zyloric. see Allopurinol
Zyprexa. see Olanzapine
Zytiga. See abiraterone
Zyvox. see Linezolid

North of Tyne Area Prescribing Committee. Formulary - Version 5.2 March 2014

194