Formulary
This chapter of the formulary is under continual development, please let the team know if you have any comments about the contents: mlcsu.lscformulary@nhs.net.
For more information about the formulary development process, please see: https://www.lancsmmg.nhs.uk/lancashire-and-south-cumbria-icb-formulary-development/
| Hydroxocobalamin |
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Formulary
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Injection 1mg/1mL 1st line treatment in vitamin B12 deficiency.
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 MHRA: Vitamin B12 (hydroxocobalamin, cyanocobalamin): advise patients with known cobalt allergy to be vigilant for sensitivity reactions |
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Following gastric bypass or sleeve gastrectomy.| Cyanocobalamin |
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Formulary
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Tablets 1mg Treatment of non-dietary vitamin B12 deficiency when hydroxocobalamin injection is inappropriate or cannot be administered, and in dietary related deficiency only until B12 levels are replete, at which point patients are encouraged to self-care with 50-150mcg tablets daily purchased over the counter.
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 LSCMMG: Over the Counter Items that Should not be Routinely Prescribed in Primary Care Policy MHRA: Vitamin B12 (hydroxocobalamin, cyanocobalamin): advise patients with known cobalt allergy to be vigilant for sensitivity reactions |
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Maintenance therapy of dietary related insufficiency. Patients are advised to self-care by purchase of 50mcg tablets over the counter. | Folic Acid |
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Formulary
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Tablets 400 microgram, 5mg Should never be given alone for pernicious anaemia or other megaloblastic anaemias caused by vitamin B12 deficiency (may precipitate subacute combined degeneration of the spinal cord). |
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Medicines for children: Folic acid for megaloblastic anaemia caused by folate deficiency and haemolytic anaemia MHRA: Medicines in pregnancy and breastfeeding: new initiative for consistent guidance; report on optimising data for medicines used during pregnancy NICE NG247: Maternal and child nutrition: nutrition and weight management in pregnancy, and nutrition in children up to 5 years UK Chief Medical Officers Chief Nursing Officers and Chief Midwifery Officers - Folic Acid |
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Links
- LSCMMG: Bariatric surgery guidelines for prescribing of vitamins and nutritional supplements: Position Statement
- LSCMMG: Gluten-Free food products: Position Statement
- LSCMMG: Oral Nutritional Supplements in Primary Care
- LSCMMG: Over the Counter Items that Should not be Routinely Prescribed in Primary Care Policy
- LSCMMG: PKU - Prescribing of Multivitamins & Phenylalanine-free amino acid substitutes for adults and children
- Medicines for children: Folic acid for megaloblastic anaemia caused by folate deficiency and haemolytic anaemia
- MHRA: Medicines in pregnancy and breastfeeding: new initiative for consistent guidance; report on optimising data for medicines used during pregnancy
- MHRA: Vitamin B12 (hydroxocobalamin, cyanocobalamin): advise patients with known cobalt allergy to be vigilant for sensitivity reactions
- MHRA: Vitamin B12 (hydroxocobalamin, cyanocobalamin): advise patients with known cobalt allergy to be vigilant for sensitivity reactions
- NICE CG32: Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition
- NICE NG20: Coeliac disease: recognition, assessment and management
- NICE NG203: Chronic kidney disease: assessment and management
- NICE NG239: Vitamin B12 deficiency in over 16s: diagnosis and management
- NICE NG247: Maternal and child nutrition: nutrition and weight management in pregnancy, and nutrition in children up to 5 years
- NICE TA743: Crizanlizumab for preventing sickle cell crises in sickle cell disease
- UK Chief Medical Officers Chief Nursing Officers and Chief Midwifery Officers - Folic Acid