netFormulary
 Report : A-Z of formulary items 06/10/2024 00:45:18
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Section Name Details
04.08.01 Carbamazepine Tegretol®

Tablets 100mg, 200mg, 400mg
M/R tablets (Tegretol® Retard) 200mg, 400mg
Chewable tablets (Tegretol® Chewtabs) 100mg, 200mg
Liquid 100mg/5mL
Suppositories 125mg, 250mg

Note: 125mg suppositories are approximately equivalent in therapeutic effect to 100mg tablets (plasma concentration monitoring is recommended

 

Category 1 - Doctors are advised to ensure that their patient is maintained on a specific manufacturer's product

Different preparations may vary in bioavailability and are therefore not interchangeable, prescriptions should include the brand name.

 

13.05.01 Ichthammol with Zinc oxide   Ichthopaste bandage® 7.5cm x 6m
13.08.01 5-aminolevulinic acid Alacare ®

Medicated plaster 8mg - Each medicated plaster of 4 cm2 contains 8 mg 5-aminolevulinic acid, 2 mg per cm2

Alacare plasters are only recommended for single-use treatment of mild actinic keratoses lesions with a maximum diameter of 1.8cm on the face and scalp (hairless areas)

10.01.03 Abatacept Orencia®

Intravenous infusion 250mg
S/C injection 125mg prefilled syringe pre-filled pen 

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

13.05.03 Abrocitinib Cibinqo ®

Tablets 50mg - for treating moderate to severe atopic dermatitis

Tablets 100mg - for treating moderate to severe atopic dermatitis

Tablets 200mg - for treating moderate to severe atopic dermatitis

04.10.01 Acamprosate 

Tablets 333mg

SPECIALIST INITIATION

06.01.02.03 Acarbose 

Patients may remain on acarbose but not recommended in new patients.

02.08.02 Acenocoumarol Sinthrome®

Tablets 1mg

Second line vitamin K antagonist

11.06 Acetazolamide 

Tablets 250mg
M/R capsules 250mg
 

11.06 Acetazolamide 

Injection 500mg

11.08.02 Acetylcholine Chloride Miochol-E® Intra-occular irrigation 1%
03.07 Acetylcysteine 

Capsules

11.08.01 Acetylcysteine 5% with Hypromellose 0.35% Ilube®

Eye drops

Restricted Item For treatment of filamentary keratitis only

12.03.02 Aciclovir  Cream 5%
13.10.03 Aciclovir 5%  Cream 2g, 10g
13.05.02 Acitretin Neotigason®

Capsules 10mg, 25mg

Consultant dermatologist or specialist initiation only

Pregnancy must be excluded before initiation and before each repeat prescription.
Prescriptions for women are limited to 28 days treatment

03.01.02 Aclidinium 

Eklira Genuair® inhalation powder 322micrograms/metered inhalation

03.01.04 Aclidinium/ Formoterol 

Duaklir Genuair inhalation powder 340/12

Licensed for COPD only

06.01.01.01 Actrapid® Insulin 10mL vial

01.05.03 Adalimumab 

Prevention of recurrence of ulcerative colitis following surgery

01.05.03 Adalimumab 

Pre-filled syringe or pen

Crohn's disease - NICE TA187

Ulcerative colitis - NICE TA329

High risk patients for prevention of recurrence or upon recurrence of Crohn's Disease following surgery

10.01.03 Adalimumab Biosimilars avaliable

S/C injection 40mg prefilled syringe and pen

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

11.10 Adalimumab 

Solution for injection

13.05.03 Adalimumab Biosimilars avaliable

S/C injection 40mg pre-filled syringe, pre-filled pen

Consultant dermatologist or specilaist initiation only

Tertiary centre only for hidradenitis suppurativa

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

13.06.01 Adapalene 0.1% Differin®

Cream 45g

13.06.01 Adapalene 0.1% / Benzoyl Peroxide 2.5% Epiduo® Gel 45g

02.03.02 Adenosine  Injection 6mg/2mL
03.04.03 Adrenaline 

Emerade® 150mg, solution for injection in pre-filled pen, 300mcg solution for injection in pre-filled pen, 500mcg soultion for injection in pre-filled pen. Epipen®,0.15mg auto-injector, 0.3mg auto-injector.

Jext®150mcg soultion for injection in pre-filled pen, 300mcgsolution for injection in pre-filled pen

When prescribing for a patient 'just in case' then the prescription should be based on weight. Any child over 30kg should be prescribed  the 300mcg strength pen. It is recommended that 2 adrenaline auto-injectors are prescribed, which patients should carry at all times.

03.04.03 Adrenaline 

Injection 1 in 1000 1mg/1mL

03.04.03 Adrenaline 

1 in 10,000 injection

02.07.03 Adrenaline / Epinephrine   Injection 1mg/10mL amp, 1mg/10mL pre-filled syringe
11.08.02 Aflibercept Eylea®

Solution for intravitreal injection pre-filled syringe 40mg/mL
 

04.03.04 Agomelatine 

Red with prior approval. LSCFT to approve all applications to use - patients currently on treatment can continue.

02.03.02 Ajmaline 

injection 

Ventricular arrythmias where other options have failed.
Cardiology/ICU use only.

06.06.02 Alendronic Acid 

70mg tablets are once weekly.

First line for osteoporosis.

06.06.02 Alendronic Acid with colecalciferol Fosavance
09.06.04 Alfacalcidol One-Alpha®

Capsules 250 nanograms, 1 microgram
Oral drops 2 micrograms/mL (1 drop = 100 nanograms)

For severe renal impairment

Prescribers initiating treatment should indicate monitoring requirements.

07.04.01 Alfuzosin 

Tablets 2.5mg
M/R tablets 10mg

Urinary retention.

02.12 Alirocumab Praluent®

Pre-filled pen 75mg, 150mg


02.05.05.03 Aliskiren 
13.05.01 Alitretinoin Toctino®

Capsules 10mg, 30mg

Consultant dermatologist or specialist only

Pregnancy must be excluded before initiation and before each repeat prescription.
prescriptions for women are limited to 28 days treatment

REQUIRES BLUETEQ APPROVAL

10.01.04 Allopurinol  Tablets 100mg, 300mg
06.01.02.03 Alogliptin Vipidia®

Tablets 6.25mg, 12.5mg, 25mg
 
First line gliptin on LSCMMG pathway

09.06.05 Alpha Tocopheryl Acetate 

Suspension 500mg/5mL

Other preparations may be available but are unlicensed - contact pharmacy for advice

04.01.02 Alprazolam 
07.04.05 Alprostadil 3mg/g cream Vitaros®

Alprostadil 3 mg per 1 gram

Amber 0 Erectile Dysfunction in patients who have not responded to at least 2 other PDE5 inhibitors

Green Restricted Erectile Dysfunction in patients who are intolerant to or have a contra-indication to PDE5 inhibitors

07.04.05 Alprostadil intracavernosal injection Caverject®

Injection 10 microgram, 20 microgram

Erectile Dysfunction.

07.04.05 Alprostadil Urethral application MUSE®

Urethral sticks 500microgram, 1000microgram

Erectile Dysfunction.

02.10.02 Alteplase 

Acute ischaemic stroke (NICE TA264)

Follow local policy

01.02 Alverine Citrate 

Capsules 60mg

04.09.01 Amantadine 

Capsules 100mg
Liquid 50mg/5mL

02.02.03 Amiloride Hydrochloride  Tablets 5mg
Liquid 5mg/5mL
13.08 Aminolevulinic acid  Ameluz®

gel 78mg/g

03.01.03 Aminophylline Phyllocontin Continus®

M/R tablets 225mg

03.01.03 Aminophylline IV  Injection 250mg/10ML
02.03.02 Amiodarone 

Injection 150mg/3mL
Injection 300mg/10mL pre-filled syringe

 

02.03.02 Amiodarone 

Tablets 100mg, 200mg

On advice of cardiology only

04.02.01 Amisulpride 

Tablets 50mg, 200mg, 400mg
Liquid 100mg/mL

04.03.01 Amitriptyline 

Tablets 10mg, 25mg, 50mg
Liquid 25mg/5mL

Sugar Free oral solution 50mg/5mL

04.07.03 Amitriptyline 
04.07.04.02 Amitriptyline  See section 4.3.1

Unlicensed indication
21 Amitriptyline 

Palliative care

Neuropathic pain

02.06.02 Amlodipine 

Tablets 5mg, 10mg


First line dihydropyridine

11.03.02 Amphotericin B 

Eye drops 0.15% preservative free

Unlicensed - Specialist use only

09.01.04 Anagrelide Xagrid®

Capsules 500 micrograms

Consultant haemtologist only

10.01.03 Anakinra Kineret®

Solution for injection pre-filled syringes  100mg/0.67mL

02.08.02 Andexanet alfa Ondexxya ®

Powder for solution for infusion 200mg

 

01.01.01 Antacid with Oxetacaine 

unlicensed Unlicensed special for treatment of painful swallowing, during/following radiotherapy to the head, neck and chest areas

01.07.01 Anusol® 

Cream, Ointment, Suppositories

Consider OTC/Self care

01.07.02 Anusol-HC 

Ointment, benzyl benzoate 1.25%, bismuth oxide 0.875%, bismuth subgallate 2.25%, hydrocortisone acetate 0.25%, Peru balsam 1.875%, zinc oxide 10.75%.

Do not use for longer than 7 days

06.01.01.01 Apidra® Insulin Glulisine 10mL vial
3mL cartridge for OptiPen® Pro 1
3mL prefilled disposable pen SoloSTAR
02.08.02 Apixaban 

Tablets 2.5mg, 5mg

Green Traffic Light  Apixaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation (NICE TA275)


Red Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults (NICE TA245)

Amber 0 Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism (NICE TA341)

04.09.01 Apomorphine APO-go ®, Dacepton®

Injection 50mg/5mL

Pre-filled pen 30mg/3mL

11.06 Apraclonidine Iopidine®

Eye drops 0.5% 

*under review*

11.08.02 Apraclonidine Iopidine®

Unit dose eye drops 1% - perioperative use only

*under review*

10.01.03 Apremilast 

Tablets 10mg, 20mg, 30mg

13.05.03 Apremilast Otezla®

Tablets 10mg, 20mg, 30mg

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

04.06 Aprepitant Emend® Capsules 80mg, 125mg
01.06.03 Arachis Oil 

Enema 130mL

Contains nuts - contraindicated in patients with hypersensitivity to nuts

02.08.01 Argatroban 

50mg/50ml vials for infusion

250mg/2.5ml concentrate vials for infusion

04.02.01 Aripiprazole Abilify®

Tablets 5mg,10mg,15mg, 30mg
Dispersible tablets 10mg,15mg
Liquid 1mg/mL

Consultant psychiatrist initiation only

04.02.02 Aripiprazole Abilify Maintena®

Prolonged release suspension for injection 400mg

LSCFT initiation only.

12.03.05 AS saliva Orthana®  Oral spray
09.06.03 Ascorbic Acid 

Tablets 50mg, 100mg, 200mg & 500mg
Effervescent tablets 1g with zinc

Only to be used for prophylaxis and treatment of scurvy

09.08.01 Asfotase alfa Strensiq®

Tertiary Centre

Solution for injection

100mg/ml, 40mg/ml

02.09 Aspirin tablets (antiplatelet) 

Dispersible tablets 75mg, 300mg


The use of enteric coated aspirin 75mg is not recommended

10.02 Ataluren Translarna ®

Granules for oral suspension 1000mg, 125mg, 250mg

Ataluren for treating Duchenne muscular dystrphy with a nonsense mutation in the dystrophin gene (replaces HST3) - likely to be tertiary centre only

02.04 Atenolol  Injection 5mg/10mL

02.04 Atenolol  Tablets 25mg, 50mg, 100mg
Liquid 25mg/5mL


04.06 Atogepant Aquipta®
04.04 Atomoxetine Strattera®

Capsules 10mg, 18mg, 25mg, 40mg, 60mg

Restricted Item Restricted to initiation by child or adolescent psychiatrists or paediatricians
experienced in the management of ADHD.

02.12 Atorvastatin 

Tablets 10mg, 20mg, 40mg, 80mg


First line

07.01.03 Atosiban 

Injection 6.75 mg/0.9mL, concentrate for infusion 37.5 mg/5mL 

Uncomplicated premature labour

Second line option when other options have failed or are unsuitable.

11.05 Atropine 

Eye drops 1% 

11.05 Atropine Sulphate single use Minims® Atropine Sulphate

Minims® 1%

09.08.01 Avalglucosidase alfa Nexviadyme ®

Powder for concentrate for solution for infusion 100mg - for treating Pompe disease - see link below

07.04.05 Avanafil Spedra®

Tablets 50mg, 100mg, 200mg

Erectile Dysfunction.

Treatment of erectile dysfunction in adult men who are unable to tolerate sildenafil and tadalafil.

09.01.04 Avatrombopag Doptelet®

Tablets 20mg

 

Red  NICE TA853 for treating primary chronic immune thrombocytopenia - see link below

01.05.03 Azathioprine 

Tablets 25mg, 50mg

10.01.03 Azathioprine 

Tablets 25mg, 50mg

13.05.03 Azathioprine 

Tablets 25mg, 50mg
Unlicensed indication
Consultant dermatologist or specilaist initiation only
See section 10.1.3

13.06.01 Azelaic Acid 15% Finacae® Gel 30g
13.06.01 Azelaic Acid 20% Skinoren® Cream
12.02.01 Azelastine 0.15% Nasal Spray Azelair®

Symptomatic treatment of allergic rhinitis in adults, adolescents and children 6 years and older.

12.02.01 Azelastine Hydrochloride Rhinolast®

nasal spray 140 microgram per 1 actuation

After tertiary referral only

Green in East Lancashire

10.02.02 Baclofen  Tablets 10mg
Liquid 5mg/5mL
11.08.02 Balanced Salt Solution  Sterile irrigation solution 15mL, 500mL
01.05.01 Balsalazide Sodium 

Capsules 750mg

10.01.03 Baricitinib Olumiant®

Tablets 2mg, 4mg

13.05.03 Baricitinib 

Film-coated tablets 2mg, 4mg

Red Treatment of atopic dermatitis

Do Not Prescribe Treatment of alopecia areata

06.04.01.01 Bazedoxifene & conjugated oestrogens 
03.02 Beclometasone / formoterol 

Fostair® / Luforbec® 100mcg beclometasone/6mcg formoterol metered dose inhalation (asthma and COPD)
Fostair® / Luforbec® 200mcg beclometasone/6mcg formoterol metered dose inhalation (asthma only)
Fostair / Luforbec are not recommended for children and young people under 18 years of age

Fostair NEXThaler®
Inhaler 100/6 micrograms per dose (asthma and COPD), 200/6 micrograms per dose (asthma only

03.02 Beclometasone / Formoterol / Glycopyrronium 

The LSCMMG adult asthma guidelines only recommend triple inhalers to be initiated by a clinical expert in primary / secondary care, in those patients who are not adequately controlled with a maintenance combination of a long-acting beta 2-agonist and a high dose (Trimbow 172/5/9) or medium dose (Trimbow 87/5/9) of an inhaled corticosteroid, who have experienced one or more asthma exacerbations in the previous year.

In COPD Trimbow is only recommended for maintenance treatment in adult patients with moderate to severe COPD who are not adequately treated by a combination of an inhaled long-acting beta 2-agonist and corticosteroid.     

Trimbow pMDI 87 micrograms beclometasone/5 micrograms formoterol/9 micrograms glycopyrronium pressurised inhalation, solution (asthma and COPD),

Trimbow pMDI 172 micrograms beclometasone/5 micrograms formoterol/9 micrograms glycopyrronium pressurised inhalation, solution (asthma only),

Trimbow NEXThaler (DPI) 88 micrograms beclometasone /5 micrograms formoterol /9 micrograms glycopyrronium per actuation inhalation powder (COPD only)

03.02 Beclometasone Dipropionate 

Clenil Modulite 50mcg per inhalation, 100mcg per inhalation, 200mcg per inhalation, 250mg per inhalation (asthma only)

Easyhaler 200mcg per inhalation (asthma only)

QVAR® beclometasone inhalers are approximately twice as potent as Clenil Modulite® at the same microgram doses. They are not interchangeable and should be prescribed by brand name. 

QVAR Easi-Breathe 50mg per inhalation, 100mcg per inhalation (asthma / over 12 years only)

QVAR Autohaler 50mcg per inhalation, 100mcg per inhalation (asthma / 5 years and over)

QVAR MDI 50mcg per inhalation, 100mcg per inhalation (asthma / 5years and over).  

Administration of doses above 1000 micrograms (500 micrograms twice daily) should be via a VOLUMATIC spacer device to help reduce side-effects in the mouth and throat.                                                

12.02.01 Beclometasone Dipropionate  Aqueous nasal spray 50micrograms/metered spray
10.01 Belimumab Benlysta®

Concentrate for solution for infusion 120mg, 400mg

Black RAG for NICE TA806: TA806 Belimumab for treating lupus nephritis (terminated appraisal) 

02.12 Bempedoic acid 

Tablets 180mg

As monotherapy for patients intolerant to ezetimibe

 

02.12 Bempedoic acid with Ezetimibe Nustendi®

Tablets 180mg/10mg

02.02.01 Bendroflumethiazide 

Tablets 2.5mg, 5mg

04.02.01 Benperidol 

LSCFT only. Consultant initiation only, primary care red for new patients.

03.04.02 Benralizumab Fasenra®

(Fasenra®) Solution for injection pre-filled syringes 30mg/1ml and solution for injection pre-filled pen 30mg /1ml

Severe eosinophilic asthma in adults (add-on therapy) - NICE TA565

 

04.09.02 Benzatropine 

Injection 2mg/2mL

**Under review**

13.06.01 Benzoyl Peroxide 5% Acnecide® Gel

13.06.01 Benzoyl Peroxide 5% with Clindamycin 1% Duac® Once Daily Gel 30g, 60g
12.03.01 Benzydamine Difflam® Oral rinse 0.15%
Spray 0.15%
03.04.03 Berotralstat dihydrochloride Orladeyo®

Capsules 150mg

04.06 Betahistine Dihydrochloride  Tablets 8mg, 16mg
12.03.01 Betamethasone Betnesol®

Soluble tablets 500micrograms

Unlicensed use

Amber 0  In East Lancashire

13.04 Betamethasone 0.1%  Scalp application 100mL
13.04 Betamethasone 0.1% Bettamousse® Foam 100g
12.01.01 Betamethasone 0.1% with Neomycin 0.5% ear drops Betnesol N®
11.04.01 Betamethasone 0.1% with Neomycin 0.5% eye drops 

Eye/ear/nose drops betamethasone 0.1%/ neomycin 0.5%

13.04 Betamethasone Dipropionate 0.05% with Salicylic Acid 2% Diprosalic® Scalp application 100mL
13.04 Betamethasone Dipropionate 0.05% with Salicylic Acid 3% Diprosalic® Ointment 100g
13.04 Betamethasone Dipropionate 0.064% with Clotrimazole 1% Lotriderm® Cream 30g
12.01.01 Betamethasone ear drops Betnesol ® betamethasone sodium phosphate 0.1%
11.04.01 Betamethasone eye drops 

Eye/ear/nose drops 0.1%

Green in East Lancashire

*under review*

06.03.02 Betamethasone injection 

Injection 4mg/1mL

12.02.01 Betamethasone nasal drops  Ear/eye/nose drops 0.1%
12.02.03 Betamethasone Sodium Phosphate 0.1% with Neomycin Sulphate 0.5%  Nasal drops Betamethasone Sodium Phosphate 0.1% with Neomycin Sulphate 0.5%
06.03.02 Betamethasone soluble tablets 

Soluble tablets 500micrograms

13.04 Betamethasone Valerate 0.025% Betnovate-RD® Cream 100g
Ointment 100g
13.04 Betamethasone Valerate 0.1% Betnovate® Cream 30g, 100g
Ointment 30g, 100g
13.04 Betamethasone Valerate 0.1% with Fucidic Acid 2% Fucibet® Cream 30g


Preparations containing fusidic acid should not be used in secondary care for in-patients
11.06 Betaxolol Betoptic®

Eye drops 0.25%, 0.5%

*under review*

Not listed on East Lancashire formulary

07.04.01 Bethanechol Chloride 

Tablets 10mg, 25mg

Urinary retention.

02.12 Bezafibrate 

Tablets 200mg
M/R tablets 400mg

11.06 Bimatoprost 

Eye drops 100micrograms/mL (0.01%)
Eye drops 300micrograms/mL (0.03%)
Eye drops - Preservative free 300micrograms/mL (0.03%) - only for patients with a documented allergy to preservatives

11.06 Bimatoprost with Timolol 

Eye drops bimatoprost 300micrograms/mL (0.03%)/timolol 5mg/mL (0.5%)
 Eye drops - preservative free bimatoprost 300micrograms/mL (0.03%)/timolol 5mg/mL (0.5%) - only for patients with a documented allergy to preservatives

10.01.03 Bimekizumab Bimzelx®

Pre-filled syringe/pen 160mg

 

ICB Commissioned

13.05.03 Bimekizumab Bimzelx ®

Pre-filled pen/syringe 160mg

Usually supplied to patients via a homecare delivery company

06.01.01.02 Biosimilar Insulin Glargine 

3mL cartridge 100units/mL
3mL prefilled disposable Pen 100units/mL

First choice in new users

12.03.05 Biotene Oralbalance® gel 

Oral gel

Reserved for use in patients with severe dry mouth as a result of an underlying condition or treatment, such as, progressive neurological conditions affecting swallowing (including but not exclusively Parkinson’s disease, Parkinson’s plus conditions, multiple sclerosis etc), Sjogren’s syndrome or after radiotherapy for head and neck cancer. It may also be suitable for end-of-life patients, anyone who is ‘nil by mouth’ or patients who are suffering from a dry mouth as a result of being on a fluid restriction due to cardiac issues. Non-pharmacological interventions should always be first-line

13.01 Birch bark extract Filsuvez Gel®

Gel 100mg/1g

01.06.02 Bisacodyl  Tablets 5mg
Suppositories 5mg, 10mg
21 Bisacodyl 

Palliative care

Constipation

01.03.03 Bismuth subsalicylate 

Chewable tablet 262.5mg

For H.pylori eradication therapy only, as part of a defined course

02.04 Bisoprolol 

Tablets 1.25mg, 2.5mg, 3.75mg, 5mg, 7.5mg, 10mg

First line

02.08.01 Bivalirudin 

Infusion 250mg

04.07.04.02 Botulinum Toxin Type A botox®

Powder for solution for injection

 

Specialist use only

04.09.03 Botulinum Toxin Type A Xeomin®

Injection 100 units

Preferred preparation

Consultant use only

Brands are not interchangeable

**under review**

04.09.03 Botulinum Toxin Type A Botox®

Injection 100units

For existing patients

Consultant use only

Brands are not interchangeable

**under review**

13.12 Botulinum toxin type A  

For treatment of primary idiopathic hyperhidrosis and secondary hyperhidrosis.

- as an option for the management of severe primary idiopathic hyperhidrosis of the axillae, which does not respond to self-care strategies and topical treatment, and where the cause is NOT due to social anxiety.

- as an option for the management of severe secondary hyperhidrosis of the axillae, which does not respond to self-care strategies and topical treatment, where the cause is NOT due to social anxiety and where the primary condition has been optimally managed as far as reasonable to alleviate the hyperhidrosis.

In order to reduce the potential for antibody formation which reduces the effectiveness of treatment, inject the lowest effective dose at the longest clinically indicated interval

13.06 Brimonidine Gel Mirvaso®

3mg/g gel brimonidine tartrate

 (Only for use in patients with moderate to severe, persistent facial erythema of rosacea)

11.06 Brimonidine Tartrate 

Eye drops 0.2%

11.06 Brimonidine Tartrate 0.2% with Timolol 0.5% 

Eye drops brimonidine 0.2%/timolol 0.5%

*under review*

Not on East Lancashire formulary

11.06 Brinzolamide 

Eye drops 10mg/mL (1%)

11.06 Brinzolamide 1% with Timolol 0.5%  Azarga®

Ophthalmic suspension brinzolamide 10mg/timolol 5mg/mL
 
 Second line carbonic anhydrase inhibitor with timolol

11.06 Brinzolamide 10mg/ml & brimonidine 2mg/ml Simbrinza®

Eye drops brinzolamide 10mg/mL/brimonidine 2mg/mL

04.08.01 Brivaracetam Briviact®

Tablets - all strengths

Oral solution

Category 3 - It is usually unecessary to ensure that patients are maintained on a specific manufacturer's product as therapeutic equivalence can be assumed

13.05.03 Brodalumab Kyntheum®

Solution for injection pre-filled syringes 210mg/1.5ml 

11.08.02 Brolucizumab  Beovu®

19.8mg/0.165ml solution for injection pre-filled syringes 

11.08.02 Bromfenac Yellox®

Eye drops 0.09%

06.07.01 Bromocriptine 

Tablets 2.5mg

Hyperprolactinaemic disorders.

Healthcare professionals are reminded that bromocriptine should only be used for prevention or suppression of postpartum lactation where medically indicated, in cases such as intrapartum loss, neonatal death, or a mother with HIV infection. It should not be used for routine suppression of lactation, or for relieving symptoms of postpartum breast pain and engorgement. Blood pressure should be carefully monitored, especially during the first days of treatment.

01.05.02 Budesonide Budenofalk®

e/c capsules 3mg
e/c granules 9mg/sachet
Foam enema

First line rectal treatment (foam enema)

01.05.02 Budesonide Kinpeygo®

Modified release capsules 4mg (targeted release)

For treating primary IgA nephropathy in accordance with NICE TA937

01.05.02 Budesonide Entocort®

Capsules 3mg, Enema

03.02 Budesonide 

 Easyhaler 100mcg per inhalation, 200mcg per inhalation, 400mcg per inhalation (asthma only)

Pulmicort® Turbohaler 100mcg per actuation, 200mcg per actuation, 400mcg per actuation (asthma only).                               

Pulmicort® respules 500mcg / 2ml, 1mg / 2ml (asthma / croup)

03.02 Budesonide / formoterol 

DuoResp Spiromax®  160 micrograms budesonide / 4.5 micrograms formoterol inhalation powder, 320 micrograms budesonide / 9mcg formoterol inhalation powder (asthma and COPD)

Fobumix Easyhaler® 80mcg budesonide / 4.5mcg formoterol per inhalation (asthma / over 18 years only), 160mcg budesonide / 4.5mcg formoterol per inhalation (asthma and COPD / over 18 years only), 320mcg budesonide / 9mcg formoterol per inhalation (asthma and COPD / over 18 years only)

Symbicort Turbohaler® 100mcg budesonide / 6mcg formoterol per inhalation (asthma only), 200mcg budesonide / 6mcg formoterol per inhalation (asthma and COPD), 400mcg budesonide / 12mcg formoterol per inhalation (asthma and COPD)

Symbicort® MDI 100mcg budesonide / 3mcg formoterol per actuation (asthma only), 200mcg budesonide / 6mcg formoterol per actuation (COPD only)

03.02 Budesonide / Formoterol / Glycopyrronium 

(Trixeo Aerosphere® )
MDI - Each single actuation (delivered dose, ex-actuator) contains 5 micrograms of formoterol fumarate dihydrate, glycopyrronium bromide 9 micrograms, equivalent to 7.2 micrograms of glycopyrronium, and budesonide 160 micrograms.

Restriction: Triple therapy should be reserved for patients who have failed to achieve or maintain an adequate response to an appropriate course of dual therapy.

01.05.02 Budesonide orodispersible tablets (Jorveza) 

Orodispersible tablets 1mg

01.05.02 Budesonide  Cortiment MMX®

Tablets, M/R 9 mg

02.02.02 Bumetanide 

Tablets 1mg, 5mg

 Second line treatment - Only if poor response to furosemide

04.07.02 Buprenorphine 

SEVEN day patches only to be prescribed (brands are interchangeable)

Hospital prescriber to prescribe generically and contract patches to be supplied

(To be prescribed as Sevodyne patches in Primary Care - 5,10,15 and 20mcg/hr)

Only for use in patients who are unable to take or tolerate oral medicine (including soluble tablets and liquids) OR where use of the low-dose buprenorphine patches may prevent administration problems for frail, elderly patients in the Community.

 

Transdermal preparations lack the flexibility required when treating patients with fluctuating or uncontrolled pain. Use should be reserved for patients with stable pain who are unable to take or tolerate oral medicines. Buprenorphine patches are several times more expensive than equivalent doses of oral analgesics, and inappropriate use of transdermal preparations has cost implications for commissioners. It is recommended that the reason for using a patch is documented on initiation and, if appropriate, patients are switched to oral formulations at the earliest opportunity.

**Under review**

04.07.02 Buprenorphine Temgesic®

s/l tablets 200micrograms

See section 4.10 for products used in opioid dependence

**under review**

04.10.03 Buprenorphine Subutex® Sublingual tablets 400micrograms, 2mg, 8mg
04.10.03 Buprenorphine and Naloxone Suboxone® Sublingual tablets (Suboxone®) 2mg/500micrograms, 8mg/2mg tablets
04.01.02 Buspirone 
03.04.03 C1 Esterase Inhibitor Berinert®

Berinert®500iu powder and solvent for solution for injection / infusion, 1500iu powder and solvent for solution for injection.

Cinryze®Black Triangle 500iu powder and solvent for solution for injection

Kept in Emergency Departments at RLI and FGH

06.07.01 Cabergoline 

Tablets 500micrograms, 1mg, 2mg

Hyperprolactinaemic disorders.

03.05.01 Caffeine citrate 

Liquid 50mg/5mL see BNFC
Injection 10mg/1mL see BNFC

For neonatal use

Caffeine citrate 2mg is equivalent to caffeine base 1mg

13.05.02 Calcipotriol  Ointment 120g
13.05.02 Calcipotriol 50micrograms/g with Betamethasone 0.05% Dovobet® Gel 60g
13.05.02 Calcipotriol 50micrograms/g with Betamethasone 0.5mg/g Enstilar® Cutaneous foam
06.06.01 Calcitonin (salmon) 

Injection 100units/1mL

09.06.04 Calcitriol Rocaltrol®

Capsules 250 nanograms

09.05.02.02 Calcium Acetate Renacet®

Tablets 475mg

09.05.02.02 Calcium Acetate Phosex®

Tablets 1g

09.05.01.01 Calcium Carbonate 

Chewable tablets 1.25g calcium 500mg (12.6mmol)

09.05.01.01 Calcium Chloride  Injection (calcium 10mmol/10mL) 10mL amp (unlicensed)
Injection 5mmol/5mL amp
Injection 1g in 10mL (calcium 9.1mmol/10mL) prefilled syringe
09.05.01.01 Calcium Gluconate  Injection 10% (calcium 2.26mmol/10mL)10mL amp
Injection 10% 50mL vial
09.05.02.02 Calcium Salts Osvaren®

Film coated tablets Calcium acetate, 435 mg equivalent to 110 mg calcium and Magnesium carbonate, heavy 235 mg equivalent to 60 mg magnesium

09.05.01.01 Calvive 1000® Effervescent Tablets 

Effervescent tablets calcium 1000mg (25mmol)

06.01.02.03 Canagliflozin Invokana®

Tablets 100mg, 300mg

First line gliflozin

06.01.02.03 Canagliflozin / metformin IR Vokanamet 
02.05.05.02 Candesartan 

Tablets 2mg, 4mg, 8mg, 16mg, 32mg


First line

04.08.01 Cannabidiol  Epidyolex®

Oral solution

100mg/mL

10.02.02 Cannabis extract Sativex®

Restricted to an initial 4-week trial for treatment of moderate to severe spasticity in adults with multiple sclerosis in line with NICE NG144. Treatment may be continued after the 4-week trial as long as the patient has had at least a 20% reduction in spasticity-related symptoms

 

Black  for Refractory neuropathic pain

13.09 Capasal®  Shampoo 250mL
09.01.04 Caplacizumab  Cablivi ®

10mg powder and solvent for solution for injection

10.03.02 Capsaicin Zacin ®

Cream 0.025%

10.03.02 Capsaicin Axsain®

Cream 0.075%

10.03.02 Capsaicin Qutenza®

Patch 179mg (8%)

Treatment of peripheral neuropathic pain in adults either alone or in combination with other medicinal products for the treatment of pain.

Restricted Item For specialist use only

04.02.03 Carbamazepine 

See section 4.8.1 for epilepsy indications

04.07.03 Carbamazepine  See section 4.8.1
07.01.01 Carbetocin 

100 microgram per 1 ml

Prevention of postpartum haemorrhage.

06.02.02 Carbimazole 

Tablets 5mg, 20mg

CSM warning: neutropenia and agranulocytosis

Manufacturer advises of the importance of recognising bone marrow suppression induced by carbimazole and the need to stop treatment promptly.

Warn patients that if a sore throat develops, in the first 6-8 weeks of therapy they should stop treatment and seek medical advice.

03.07 Carbocisteine 

250mg/5ml oral solution and 750mg/10ml oral solution in sachet

Restriction: only to be used for those with swallowing difficulties who can't take capsules.

03.07 Carbocisteine 

Capsules 375mg

11.08.01 Carbomer 980 eye drops 

Liquid gel eye drops 0.2%
Liquid gel unit dose eye drops 0.2%

07.01.01 Carboprost Hemabate®

Injection 250micrograms/1mL

Postpartum haemorrhage.

04.02.01 Cariprazine Reagila®

Tablets 1.5mg, 3mg, 4.5mg, 6mg

11.08.01 Carmellose 

Preservative free eye drops 0.5%, 1%

12.03.01 Carmellose Sodium Orabase® Protective paste carmellose 16.7%, pectin 16.7%, gelatin 16.7% in Plastibase®
12.04 Carnoy’s Solution 

Topical adjuvant for procedures for odontogenic keratocysts

unlicensed unlicensed

Specialist use only

02.04 Carvedilol 

Tablets 3.125mg, 6.25mg, 12.5mg, 25mg

Second line for heart failure

11.03.01 Cefuroxime   Eye drops 5%

Unlicensed - consultant ophthalmologist only
10.01.01 Celecoxib Celebrex® Capsules 100mg & 200mg
21 Celecoxib 

Palliative care

Pain: Anti-inflammatory

04.08.01 Cenobamate  Ontozry®

Tablets 12.5mg*, 25mg* (*initiation pack) 50mg, 100mg, 150mg, 200mg

Cenobamate is recommended as an option for treating focal onset seizures with or without secondary generalised seizures in adults with drug-resistant epilepsy that has not been adequately controlled with at least 2 antiseizure medicines. It is recommended only if:

  • it is used as an add-on treatment, after at least 1 other add-on treatment has not controlled seizures, and

  • treatment is started in a tertiary epilepsy service.

01.05.03 Certolizumab pegol 

Do not prescribed for Crohn's disease or ulcerative colitis

10.01.03 Certolizumab Pegol Cimzia®

S/C injection 200mg prefilled syringe pre-filled pen 

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

03.04.01 Cetirizine 

Tablets 10mg
Liquid 5mg/5mL

First line

04.01.01 Chloral Hydrate 500mg in 5mL 

Liquid 500mg/5mL

11.03.01 Chloramphenicol Minims®

Minims® 0.5% 

Follow local ophthalmology policies

11.03.01 Chloramphenicol 

Eye drops 0.5%

Eye drops 0.5% - preservative free (only for use in patients with a documented allergy to preservatives)

East Lancashire only - use as by ophthalmology when more than 5 days treatment required post op


Eye ointment 1%

Chloramphenicol eye drops 0.5% can be sold by a community pharmacy to the public  (for people over 2 years of age) for the treatment of acute bacterial conjunctivitis.

12.01.01 Chloramphenicol 

Ear drops 5%

Morecambe bay only

04.01.02 Chlordiazepoxide 

Capsules 5mg, 10mg

Chlordiazepoxide is also used in a reducing regime for the management of acute alcohol withdrawal. See trust Clinical Guidelines.

11.03.01 Chlorhexidine 0.02% eye drops 

Eye drops 0.02%

Unlicensed - Consultant ophthalmologist only. Morecambe bay only

* under review*

12.03.04 Chlorhexidine gluconate Corsodyl® Mouthwash 0.2%
Dental gel 1%
13.11.02 Chlorhexidine gluconate 4% Hibiscrub®

Cleansing solution, 250mL, 500mL
For use by dermatologists only

13.11.02 Chlorhexidine Gluconate Cream Hibitane Obstetric®

Cream 5%

12.02.03 Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5% Naseptin® Nasal cream Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5%
03.04.01 Chlorphenamine maleate 

Tablets 4mg
Liquid 2mg/5mL
Injection 10mg/1mL

04.02.01 Chlorpromazine 

Tablets 10mg, 25mg, 50mg, 100mg
Liquid 25mg/5mL, 100mg/5mL

 

Do Not Prescribe Injection

06.01.02.01 Chlorpropamide 
12.03.01 Choline Salicylate Bonjela® Adult Oral gel 8.7%

For adults and children over 16
03.02 Ciclesonide 

Alvesco® 80mcg per actuation, 160mcg per actuation (asthma / over 12 years only)

01.05.03 Ciclosporin 

Capsule

Severe ulcerative colitis

Specialist initiation only

unlicensed 

10.01.03 Ciclosporin 

Capsules 25mg, 50mg, 100mg

13.05.03 Ciclosporin 

Consultant dermatologist or specilaist initiation only

To be prescribed generically for dermatology patients

See section 10.1.3

11.11 Ciclosporin 0.1% eye drops Verkazia®

Unit dose eye drops 0.1% 0.3mL

 

For children and adolescents

11.11 Ciclosporin 0.1% eye drops Ikervis®

Unit dose eye drops 0.3mL

 For adults

01.05.03 Ciclosporin injection 

Severe ulcerative colitis

Specialist initiation only

unlicensed 

02.06.04 Cilostazol 
01.03.01 Cimetidine 

Tablets 200mg, 400mg

For use only when other options have proven ineffective. Not a first line option

09.05.01.02 Cinacalcet Mimpara® Tablets 30mg, 60mg

Consultant endocrinologist initiation only
04.06 Cinnarizine  Tablets 15mg
04.06 Cinnarizine and Dimenhydrinate  Arlevert®

Cinnarizine 20 mg, Dimenhydrinate 40 mg

Third line

**Under review**

11.03.01 Ciprofloxacin 

Eye drops 0.3%

*under review*

12.01.01 Ciprofloxacin 3mg and Dexamethasone 1mg ear drops Cilodex® Ear drops
04.03.03 Citalopram  Tablets (as hydrobromide) 10mg, 20mg
Oral drops (as hydrochloride) 40mg/mL (2mg/drop)

Note: 8mg(4drops) equivalent in therapeutic effect to 10mg citalopram tablet

Citalopram or Sertraline are the antidepressants of choice in epilepsy
07.04.06 Citalopram 

Tablets 10mg, 20mg

Premature ejaculation.

unlicensed Unlicensed indication

07.02.02 Clindamycin Dalacin®

Vaginal cream 2%

13.06.01 Clindamycin 1% Dalacin T®

Lotion 30mL, 60mL

13.06.01 Clindamycin 1% gel 

Gel 1%

For oncology patients only

13.06.01 Clindamycin 1%/ tretinoin 0.025% Treclin®

Gel 

04.08.01 Clobazam 

Tablets 10mg

 

Category 2 - Clinical judgement should be used when deciding whether to switch between different manufacturer's products

13.04 Clobetasol propionate  Etrivex®

Shampoo, clobetasol propionate 0.05% 125mL

13.04 Clobetasol propionate 0.05% Clarelux® Scalp application and shampoo
13.04 Clobetasol Propionate 0.05% Dermovate® Cream 30g, 100g
Ointment 30g, 100g
13.04 Clobetasone 0.05%/Nystatin 100,000u/g/Oxytetracycline 3% Trimovate® Cream 30g
13.04 Clobetasone Butyrate 0.05% Eumovate® Cream 30g
Ointment 30g
06.05.01 Clomifene Citrate  Tablets 50mg
04.03.01 Clomipramine  Capsules 10mg, 25mg, 50mg


04.02.03 Clonazepam 

Tablets 500micrograms, 2mg
Oral solution 500micrograms/5mL

Amber 0 for use in all forms of epilepsy and in the treatment of mood disorders

Green for the treatment of anxiety (off-label indication)

04.08.02 Clonazepam  Injection 1mg/1mL with 1mL water for injections
04.04 Clonidine  

Tablets 25 micrograms, 50 micrograms

**outstanding query**

02.05.02 Clonidine Hydrochloride 

Tablets 25 microgram 

Clonidine is considered less suitable for prescribing in hypertension

Green Restricted Vasomotor symptoms (VMS) associated with menopause

02.09 Clopidogrel  Tablets 75mg
07.02.02 Clotrimazole 

Pessary 500mg
Vaginal cream 10%
Cream 1%

Consider OTC purchase for some conditions.

12.01.01 Clotrimazole Canesten®

Clotrimazole 1% 20mL

labelled 'solution', not 'ear drops'

Red in East Lancashire

13.10.02 Clotrimazole 1%  Cream 20g
11.03.02 Clotrimazole drops 

1% drops

04.02.01 Clozapine 

Injection

LSCFT use only

unlicensed 

04.02.01 Clozapine Clozaril® Tablets 25mg, 100mg

Consultant psychiatrist initiation only

Patients must be registered with the Clozapine Patient Monitoring Service (CPMS)
04.02.01 Clozapine Denzapine® Liquid 100mg/5mL

Consultant psychiatrist initiation only

Patients must be registered with the Denzapine Patient Monitoring Service
13.05.02 Coal tar 1% with salicylic acid 2% and precipitated sulfur 4% Sebco® Scalp ointment 40g
13.05.02 Coal Tar 2% and Salicylic Acid Ointment 2% BP (Sloppy Tar) 

Not all coal tar products are routinely stocked by the pharmacy departments. If the product has to be obtained from a specials manufacturing unit there may be a delay of up to 4 weeks

13.05.02 Coal tar in emulsifying ointment 

1%, 2%, 5%, 10%, 15%, 20%, 25%, 30% 100g
Not all coal tar products are routinely stocked by the pharmacy departments. If the product has to be obtained from a specials manufacturing unit there may be a delay of up to 4 weeks.

13.05.02 Coal tar lotion 5% Exorex® Lotion 100mL
13.09 Coal Tar Shampoo 
02.02.04 Co-amilofruse   Tablets 2.5mg/20mg, 5mg/40mg
04.09.01 Co-Beneldopa Madopar®

Capsules 62.5mg (12.5/50), 125mg (25/100), 250mg (50/200)
Dispersible tablets 62.5mg (12.5/50), 125mg(25/100)
m/r capsules 125mg (25/100)

04.09.01 Co-Careldopa Sinemet®

Tablets 62.5mg (12.5/50), 110mg (10/100)
Tablets 125mg (25/100)
Tablets 250mg (50/200)
m/r tablets 125mg (25/100)
m/r tablets 250mg (50/200)

04.09.01 Co-Careldopa and Entacapone 

Tablets - all strengths available

13.06.02 Co-Cyprindiol  Tablets cyproterone 2mg / ethinylestradiol 35 micrograms

CSM advice: VTE risk - see BNF
21 Co-danthramer 

Palliative care

Constipation

Opiod-induced constipation

01.04.02 Codeine 

Tablets 15mg, 30mg
Liquid 25mg/5mL

Second line

04.07.02 Codeine Phosphate  Tablets 15mg, 30mg
Injection 60mg/1mL
Syrup 25mg/5mL
Linctus, BP 15mg/5mL
10.01.04 Colchicine 

Tablets 500 micrograms

09.06.04 Colecalciferol  

Follow local protocols

09.06.04 Colecalciferol 40000 unit  Plenachol® Capsules 40000 units

09.06.04 Colecalciferol and Calcium Carbonate 
01.09.02 Colesevelam 

Tablets 625mg

Off licence use for intractable diarrhoea secondary to bile salt malabsorption
Specialist initiation only by gastroenterology

02.12 Colesevelam Cholestagel®

Tablets 625 mg

Combination and monotherapy for familial hypercholesterolaemia 

01.09.02 Colestyramine  Powder,4 g/sachet
02.12 Colestyramine 

Powder 4g/sachet

Lipids

01.01.01 Co-magaldrox 

Oral suspension

06.04.01.01 Combined continuous HRT tablet Femoston Conti Tablets Estradiol 1mg/Dygesterone 5mg

Combined therapy for women with uterus or endometriosis post hysterectomy
06.04.01.01 Combined cyclical HRT tablet 
07.03.01 Combined Hormonal Contraceptives Evra 
07.03.01 Combined Hormonal Contraceptives oral 
09.02.02.01 Compound Sodium Lactate Intravenous Infusion Hartmann's ® 500mL & 1L
13.02.02 Conotrane® 

For community use only

13.03 Crotamiton 10% Eurax® Cream 30g
09.01.02 Cyanocobalamin Orobalin®

1mg Tablets

Green  for 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. 

Do Not Prescribe  for maintenance therapy of dietary related insufficiency cyanocobalamin remains designated 'Do not prescribe' and patients are advised to self-care by purchase of 50mcg tablets over the counter. 

04.06 Cyclizine Valoid®

injection 50mg/1mL

04.06 Cyclizine 

Tablets 50mg

21 Cyclizine 

Palliative care

Nausea and vomiting

Nausea and vomiting in the last days of life

Opioid-induced nausea and vomiting

11.05 Cyclopentolate  

Eye drops 0.5%, 1%

Red in East Lancashire

*under review*

11.05 Cyclopentolate Hydrochloride single use Minims® Cyclopentolate Hydrochloride

Minims® 0.5%, 1%

10.01.03 Cyclophosphamide  Tablets 50mg
Injection 200mg, 500mg, 1g

unlicensedunlicensed use
06.04.02 Cyproterone Acetate 

Tablets 50mg

For indications other than oncology

02.08.02 Dabigatran Pradaxa®

Capsules 110mg, 150mg

Green Traffic Light Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation (NICE TA249)

Red Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults (NICE TA157)

Amber 0  Dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism (NICE TA327)   (Green East Lancashire only, for this indication)

02.08.01 Dalteparin 

Refer to local guidance

Care when prescribing/selecting strength of syringes - Different strengths available. 

02.08.01 Danaparoid sodium injection 

Anticoagulation where standard options are contra-indicated.
Use only following haematologist advice.

10.02.02 Dantrolene 

Capsules 25mg

02.05.05 Dapagliflozin  Forxiga®

Tablets 5mg, 10mg

 

06.01.02.03 Dapagliflozin Forxiga®

Tablets 5mg, 10mg

First line gliflozin

Green ICB commissioned for NICE TA775 Dapagliflozin for treating chronic kidney disease 

09.01.03 Darbepoetin Alfa Aranesp® Injection prefilled syringe 10micrograms, 30micrograms, 50micrograms
Injection prefilled syringe and SureClick 20micrograms, 40micrograms, 60micrograms, 80micrograms, 100micrograms.

Consultant initiation only
04.01.01 Daridorexant 

Tablets 25mg, 50mg

Treatment of long-term insomnia

07.04.02 Darifenacin 

Modified-release tablets 7.5mg, 15mg

Urinary frequency, urgency, and incontinence.

09.01.03 Deferasirox Exjade®

Tablets 90mg, 180mg, 360mg

 

For specialist prescribing by haematologists

09.01.03 Deferiprone Ferriprox® Tablets 500mg

Consultant haematologist only
06.03.02 Deflazacort 

Should only be used for patients in whom oral prednisolone is not tolerated due to cushingoid side effects.

06.06.02 Denosumab Prolia®

Injection 60mg/mL pre-filled syringe

Licensed for treatment of postmenopausal osteoporosis in women at increased risk of fractures and for the treatment of bone loss associated with hormone ablation in men with prostate cancer. See NICE guideline TA204

Treatment of bone loss associated with long-term systemic glucocorticoid therapy in adult patients at increased risk of fracture

06.06.02 Denosumab XGEVA®

Injection 120mg vial

Injection 120mg/ml pre-filled syringe

13.02.01 Dermol® 

Cream 500g

Lotion 500mL

Also contains antimicrobials

09.01.03 Desferrioxamine Mesilate Desferal® Injection 500mg, 2g vials
03.04.01 Desloratadine 

Second line

06.05.02 Desmopressin injection 
06.05.02 Desmopressin tablets and spray 

Tablets 100micrograms, 200micrograms
Nasal spray 10micrograms/metered spray

In adults, 1st line tablets, 2nd line nasal/injection (choose most cost effective option), 3rd line desmomelts

07.03.02.01 Desogestrel  Tablets 75 micrograms
13.05.03 Deucravacitinib SOTYKTU

Film coated tablets 6mg

 

Red NICE TA907: Deucravacitinib for treating moderate to severe plaque psoriasis

 

 

06.03.02 Dexamethasone 

Tablets 500micrograms, 2mg
Liquid 2mg/5mL, 500micrograms/5mL, 10mg/5mL

21 Dexamethasone 

Palliative care

Bowel obstruction - reduction of tumour oedema associated with bowel obstruction

Breathlessness

Corticosteroids in palliative care - Anorexia, Adjuvant analgesic, Nausea and vomiting associated with chemotherapy, Obstructive syndromes, Raised intracranial pressure, Spinal cord compression

Nausea and vomiting - raised Intracranial Pressure

Palliative care emergencies - SVC obstruction AND Metastatic spinal cord compression

11.04.01 Dexamethasone eye drops Maxidex®

Eye drops 0.1%

Green in East Lancashire

*under review*

11.04.01 Dexamethasone eye drops 

Eye drops preservative free 0.1%

Green in East Lancashire

*under review*

 

11.04.01 Dexamethasone eye drops single use 

Single dose - preservative free drops 0.1% - for use in theatre or clinic before a procedure if a single dose is needed.

11.04.01 Dexamethasone intravitreal implant Ozurdex®

Intravitreal implant 700micrograms in disposable applicator

REQUIRES BLUETEQ APPROVAL

12.01.01 Dexamethasone with Antibacterial Otomize®
12.01.01 Dexamethasone with Antibacterial Sofradex® dexamethasone (as sodium metasulphobenzoate) 0.05%, framycetin sulfate 0.5%, gramicidin 0.005%
11.04.01 Dexamethasone with Neomycin and Polymyxin B sulphate Maxitrol®

Eye drops dexamethasone 0.1%, neomycin 3500u/g, polymixin B sulfate 6000units/g

Eye ointment dexamethasone 0.1%, neomycin 3500u/g, polymixin B sulfate 6000units/g

Green in East Lancashire

*under review*

11.04.01 Dexamethasone with Tobramycin Tobradex®

Eye drops -  dexamethasone 1mg/ml, tobramycin 3mg/ml

Restricted Item Restricted to post cataract surgery patients who are intolerant to Maxitrol

Morecambe bay only

04.04 Dexamfetamine 

Tablets 5mg, 10mg, 20mg

09.02.02.02 Dextran 40®  Intravenous infusion in glucose 5% 500mL & sodium chloride 0.9% 500mL
09.02.02.02 Dextran 70®  Intravenous infusion in glucose 5% 500mL & sodium chloride 0.9% 500mL
04.07.02 Diamorphine 

Injection 5mg, 10mg, 30mg, 100mg, 500mg

**under review**

04.01.02 Diazepam  Injection (solution) 10mg/2mL
Injection (emulsion) (Diazemuls®) 10mg/2mL

04.01.02 Diazepam 

Tablets 2mg, 5mg, 10mg
Liquid 2mg/5mL
Rectal tubes 2.5mg/1.25mL, 5mg/2.5mL, 10mg/2.5mL

04.08.02 Diazepam 

Injection (solution) 10mg/2mL
Injection (emulsion) (Diazemuls®)10mg/2mL

10.02.02 Diazepam  Tablets 2mg, 5mg, 10mg
Syrup 2mg/5mL
Injection 5mg/mL (2mL ampoules)
21 Diazepam 

Palliative care

Seizures

06.01.04 Diazoxide Eudemine®

Tablets 50mg

Chronic intractable hypoglycaemia.

10.01.01 Diclofenac 

Suppositories 12.5mg, 25mg, 50mg, 100mg

For short term treatment of post-op pain, renal colic and lithotripsy only

10.01.01 Diclofenac 

Tablets e/c 25mg, 50mg
Dispersible tablets 50mg
 
Restricted ItemFor short term use in breastfeeding mothers only

10.01.01 Diclofenac Akis®

Restricted ItemFor short term treatment of post-op pain (Akis®)
 

Injection 75mg/1mL

Morecambe bay only

11.08.02 Diclofenac Voltarol® Ophtha

Eye drops 0.1%
Unit dose eye drops 0.1%

*under review*

Amber 0 in East Lancashire

13.08.01 Diclofenac 3% Solaraze® Gel 25g
01.02 Dicycloverine 
13.03 Difelikefalin  Kapruvia®

Solution for injection 50micrograms/mL

NICE TA890 Difelikefalin for treating pruritus in people having haemodialysis

02.01.01 Digoxin injection 

Injection 500 micrograms/2mL 

Oral digoxin is the preferred route. Intravenous digoxin should only be used when oral route is unavailable. Digoxin has a narrow therapeutic index and can cause toxicity.

02.01.01 Digoxin oral 

Tablets 62.5 micrograms, 125 micrograms, 250 micrograms
Liquid 50 micrograms/1mL


02.01.01 Digoxin specific antibody fragments Digifab®

Intravenous infusion 40mg

04.07.02 Dihydrocodeine 

Tablets 30mg

For use only in patients who are breastfeeding or after initiation by the pain team.  For short term use only.

**under review**

01.07.04 Diltiazem 2% 

Cream, Ointment 

unlicensedunlicensed

02.06.02 Diltiazem oral 

Prescribe diltiazem modified-release preperations by brand name. Different hospital Trusts may stock different brands. Follow local Trust policy regarding brand switches.

13.05.02 Dimethyl Fumarate Skilarence®

Tablets 30mg, 120mg

07.04.04 Dimethyl sulfoxide (DMSO) installation 

Bladder instillation 50% 50mL

Interstitial cystitis.

unlicensed Unlicensed

13.10.04 Dimeticone Hedrin®

Lotion 4%

07.01.01 Dinoprostone 

Propess VDS 10mg
Prostin E2 vaginal gel 1mg, 2mg
Prostin E2 vaginal tabs 3mg

Induction of labour.

07.01.01.01 Dinoprostone 

Injection 1mg/mL 0.75mL

Maintaining patency of the ductus arteriosus.

unlicensed Unlicensed indication.

Under expert supervision.
This section is not included in the BNF. For the management of ductus arteriosus, see BNF for Children.

02.09 Dipyridamole 

Tablets 25mg, 100mg
M/R capsules 200mg


11.08.02 Disodium edetate 

Preservative free solution 0.37%

06.06.02 Disodium Pamidronate 

Intravenous infusion 30mg/10mL, 60mg/10mL, 90mg/10mL

First line for osteolytic lesions and bone pain

Treatment option for hypercalcaemia of malignancy

Paget's disease

02.03.02 Disopyramide 

Capsules 100mg, Tablets 250mg prolonged-release

On advice of cardiology only

04.10.01 Disulfiram Antabuse®

Tablets 200mg

13.05.02 Dithranol in Lassar’s Paste 

10%
(0.1%, 0.25%, 0.5%, 1%, 2%, 4%, 6%, 8% dilutions available from pharmacy)
Not all dithranol products are routinely stocked by the pharmacy departments. If the product has to be obtained from a specials manufacturing unit there may be a delay for up to 4 weeks.

02.07.01 Dobutamine 

Infusion

21 Docusate 

Palliative care

Constipation

Opioid-induced constipation

01.06.02 Docusate Sodium 

Capsules 100mg, Liquid 12.5mg/5ml (paeds), 50mg/5ml (adult)

01.02 Domperidone 
Tablets 10mg
Suspension 1mg/ml
 
Pro-kinetic agent unlicensed
 
To be commenced for this indication by GI and Critical Care specialists only.
Usually, the maximum treatment duration should not exceed one week.
04.06 Domperidone 

Tablets 10mg
Liquid 5mg/5mL
Suppositories 30mg
 
Amber in paediatrics

Domperidone is now authorised for the relief of symptoms of nausea and vomiting only in adults and adolescents 12 years of age or older and weighing 35kg or more. Consider alternative treatments to domperidone in children younger than 12 years of age who need relief of symptoms of nausea and vomiting.


MHRA/CHM advice
Domperidone is associated with a small increased risk of serious ventricular arrhythmia or sudden cardiac death, especially in patients over 60 years and on doses higher than 30mg/day. The European Medicines Agency and MHRA have restricted its indications, introduced new contra-indications and reduced the maximum dose and duration of use.

21 Domperidone 

Palliative care

Nausea and vomiting

04.11 Donepezil Aricept®

Tablets 5mg, 10mg

02.07.01 Dopamine 

Injection

03.07 Dornase Alfa 

Pulmozyme® 2500 U/ 2.5ml, nebuliser solution

11.06 Dorzolamide 2% with Timolol 0.5% 

Eye drops dorzolamide 2%/timolol 0.5%
 Eye drops - preservative free dorzolamide 2%/timolol 0.5% - only for patients with a documented allergy to preservatives.
 
 First line carbonic anhydrase inhibitor with timolol

11.06 Dorzolomide 

Eye drops 2%

Eye drops - preservative free 2% - only for patients with a documented allergy to preservatives

04.03.01 Dosulepin 

Tablets and Capsules

Dosulepin may continue to be prescribed for existing patients, RAG rating Amber 0 – please refer to the guideline below.  Patients should be regularly reviewed with a view to stopping or reducing doses due to the ongoing risk of cardiovascular events and risks associated with overdose. Elderly patients are particularly susceptible to many of these side-effects.

03.05.01 Doxapram 

100mg / 5ml solution for injection

02.05.04 Doxazosin 

Tablets 1mg, 2mg, 4mg

Doxazosin MR do not prescribe 

07.04.01 Doxazosin 

Tablets 1mg, 2mg, 4mg

Urinary retention.

04.03.01 Doxepin 

capsules 25mg, 50mg

13.06.02 Doxycycline  Capsules 100mg
04.06 Doxylamine and pyridoxine Xonvea®

Tablets Doxylamine succinate 10 mg, Pyridoxine hydrochloride 10 mg

02.03.02 Dronedarone 

Tablets 400mg

On advice of cardiology only

03.01.05 Drug Delivery Device AeroChamber Plus® Standard device (blue)
Child device with mask (yellow),
Infant device with mask (orange)

For use with any metered dose inhaler
03.01.05 Drug Delivery Device Easy Chamber®

First line spacer device in primary care for ADULTS

For ADULTS only, Paediatric patients should only be prescribed Aerochamber Plus Flow-vu or Volumatic spacers

 

03.01.05 Drug Delivery Device Volumatic® For use with Flixotide®, Seretide®, Serevent® and Ventolin® metered dose inhalers
03.01.05 Drug Delivery Device for paediatric use AeroChamber Plus Flow-Vu®

For use in Paediatric patients in primary and secondary care as a replacement for Aerochamber Plus spacer and in addition to Volumatic spacer

  • Small mask (orange)
  • Medium mask (yellow)
  • Youth mouthpiece (green)
  • Adult small mask (purple)


For use with any metered dose inhaler

06.01.02.03 Dulaglutide Trulicity ®

Pre-filled pen 0.75mg/0.5mL, 1.5mg/0.5mL

First line GLP-1 agonist

04.03.04 Duloxetine Cymbalta® Capsules 30mg, 60mg

Consultant psychiatrist initiation only

04.07.03 Duloxetine Cymbalta® See section 4.3.4
21 Duloxetine 

Palliative care

Neuropathic pain

13.05.03 Dupilumab Dupixent®

Pre-filled syringe 300mg/2ml solution for injection

Do Not Prescribe NICE TA648: Dupilumab for treating chronic rhinosinusitis with nasal polyps (terminated appraisal)

Do Not Prescribe NICE TA955: Dupilumab for treating moderate to severe prurigo nodularis

06.04.02 Dutasteride Avodart®

Dutasteride is restricted for a high risk patient group, used in combination with tamsulosin in patients with moderate to severe symptoms (IPSS>12) with larger prostates (>30cc) and elevated PSA (>1.5ng/mL).

02.08.02 Edoxaban 

tablets 15mg, 30mg, 60mg
 
Green Traffic Light Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation (NICE TA355)

Amber 0 Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism (NICE TA354)   (Green East Lancashire only, for this indication)

10.02.01 Edrophonium Chloride  Injection 10mg/1mL
09.08 Eladocagene exuparvovec Upstaza®

 Solution for infusion  2.8 x 10^11 Vector genomes/0.5mL

 

Tertiary Centre Only  HST26 Eladocagene exuparvovec for treating aromatic L-amino acid decarboxylase deficiency - See link below

09.01.04 Eltrombopag Revolade®

Tablets 25mg, 50mg

Consultant haematologist or specialist in hepatitis C therapy only

13.02.01 Emollient preparation containing Urea 25% Flexitol®

Heel balm 75g

Specific use only for diabetic patients

02.05.05 Empagliflozin 

Tablets 10mg, 25mg

06.01.02.03 Empagliflozin Jardiance®

Tablets 10mg, 25 mg

First line gliflozin

13.02.01 Emulsifying Ointment BP  500g

NB: fire hazard - see BNF
02.05.05.01 Enalapril  

Tablets 2.5mg, 5mg, 10mg, 20mg

Restricted Item Restricted to use in post natal women when used in line with NG133

02.08.01 Enoxaparin 

Refer to local guidance

Due to the differences in injectable device, all enoxaparin prescribing should be by brand name.
Switching between brands should be as a last resort after full training in the use of the new device has taken place.
Care when prescribing/selecting strength of syringes - Different strengths available.

02.01.02 Enoximone injection 

ICU use only.

04.09.01 Entacapone Comtess®
12.02.02 Ephedrine  Nasal drops 0.5%, 1%

If no strength is specified 0.5% drops will be supplied
13.02.01 Epimax ®  Cream 100g, 500g
13.02.01 Epimax ® ointment 

Ointment

MHRA Drug Safety Update, July 2024: Epimax Ointment and Epimax Paraffin-Free Ointment: reports of ocular surface toxicity and ocular chemical injury

13.02.01 Epimax Oatmeal® 

Cream 100g, 500g

02.02.03 Eplerenone 

Tablets 25mg, 50mg

Heart failure

09.01.03 Epoetin alfa Eprex® Injection prefilled syringe 10,000units, 40,000units

Consultant initiation only
02.06.04 Epoprostenol 

Injection 500micrograms

Restricted Item Restricted drug - specialist initiation only.
unlicensed  Unlicensed use.
NHSE commissioned for digital ulcers and pulmonary arterial hypertension

02.08.01 Epoprostenol 

Specialist use.
NHSE commissioned drug for digital ulcers and pulmonary arterial hypertension.

04.07.04.02 Eptinezumab Vyepti®

Concentrate for solution for infusion.

100mg

03.07 Erdosteine 
04.07.04.02 Erenumab Aimovig®

Pre-filled syringe 70mg, 140mg

Pre-filled pen 70mg, 140mg

09.06.04 Ergocalciferol RPH Pharmaceuticals

Injection 300,000 units

Consultant initiation only

Plastic syringes can be used 'off label' providing the injection is administered immediately after being drawn up into the syringe.

07.01.01 Ergometrine Maleate 

Injection 500micrograms/1mL

Postpartum haemorrhage.

07.01.01 Ergometrine Maleate and Oxytocin Syntometrine® Injection ergometrine 500micrograms, oxytocin 5 units/1mL
06.01.02.03 Ertugliflozin  Steglatro®

Tablets 5mg, 15mg

Restriction - only to be used as second line

 

01.02 Erythromycin 
E/C Tablets 250mg
Oral suspension 125mg/5ml, 250mg/5ml
Intravenous infusion 1g
 
Pro-kinetic agent unlicensed
 
To be commenced for this indication by GI and Critical Care specialists only.
Prescriptions should include a review date.
13.06.02 Erythromycin  Tablets 250mg
13.06.01 Erythromycin 40mg with Zinc Acetate 12mg/mL Zineryt®

Lotion 30mL, 90mL

04.03.03 Escitalopram 

Tablets 5mg, 10mg, 20mg

04.08.01 Eslicarbazepine Zebinix®

Tablets 800mg

 

Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products

02.04 Esmolol 

Injection 100mg/10mL
Infusion 2.5g in 250mL


01.03.05 Esomeprazole  

Green Capsules 20mg, 40mg

 Gastro-resistant granules sachets 10mg - for paediatric use only

Red Injection 40mg

 

07.03.01 Estradiol & Dienogest 
07.03.01 Estradiol & Nomegestrol 
06.04.01.01 Estradiol / progesterone  Bijuve

Bijuve® is an alternative when other HRT treatments have not been tolerated or when Femoston-Conti® is being considered OR
> Bijuve replaces HRT regimens where separate oestrogen and micronised progesterone are used (single hormone products used in combination are more expensive than Bijuve®).

06.04.01.01 Estradiol gel 

Oestrogel Pump 0.06% pack gel
Sandrena gel sachets 500mcg, 1mg


2nd line agent for patients with allergy/skin reactions to patches.

07.02.01 Estradiol vaginal 10 microgram tablet 

Vaginal tablets 10microgram

07.02.01 Estriol cream 

0.1% vaginal cream, 0.01% vaginal cream

Currently estriol vaginal cream can be prescribed in two forms:
 
· Estriol 0.1% (Ovestin®) cream which contains 0.5mg estriol per 0.5g application
· Estriol 0.01% (formerly Ortho-Gynest®) cream which contains 0.5mg estriol per 5ml application
 
Despite Ovestin® 0.1% cream being 10 times stronger, the amount of cream delivered per application is 10 times less than that of Estriol 0.01% cream, meaning that both creams deliver an identical amount of estriol per application, that being 0.5mg.
 
Contains nuts - contraindicated in patients with hypersensitivity to nuts
07.02.01 Estriol pessaries 

0.03mg  pessaries, 0.5mg pessaries

10.01.03 Etanercept Biosimilars avaliable

S/C injection 25mg, 50mg vial with diluent and prefilled syringe pre-filled pen 

usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

13.05.03 Etanercept Biosimilars avaliable

S/C injection 50mg pre-filled syringe, pre-filled pen

Consultant dermatologist or specilaist initiation only
Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

09.05.01.02 Etelcalcetide Parsabiv®

Injection

06.04.01.01 Ethinylestradiol 

Tablets 10micrograms, 50micrograms

04.08.01 Ethosuximide 

Capsules 250mg
Liquid 250mg/5mL

Category 3 - It is usually unecessary to ensure that patients are maintained on a specific manufacturer's product as therapeutic equivalence can be assumed

07.03.02.02 Etonorgestrel Nexplanon®

Implant 68mg

The doctor or nurse administering (or removing) the system should be fully trained in the technique.

10.01.01 Etoricoxib Arcoxia®

Tablets 60mg, 90mg, 120mg

Rheumatology initiation only

01.05.03 Etrasimod 

Tablets 2mg

For the treatment of ulcerative colitis in accordance with NICE TA956

02.12 Evolocumab Repatha®

Pre-filled pen 140mg

primary hypercholesterolaemia or mixed dyslipidaemia in adults as per NICE TA394

02.12 Evolocumab (Repatha®) 

Prevention of cardiac events in patients with CHD and a history of ACS, in combination with a statin

13.02.01 ExCetra® 

Liquid paraffin light 105 mg per 1 gram, White soft paraffin 132 mg per 1 gram

Cream 100g, 500g

06.01.02.03 Exenatide prolonged release Bydureon (BCise)®

prolonged-release suspension for injection in pre-filled pen (BCise) 2mg

Third line GLP-1 agonist

02.12 Ezetimibe 

Tablets 10mg

01.03.01 Famotidine 

Tablets 20mg, 40mg

11.08.02 Faricimab Vabysmo ®

Solution for injection 120 mg/mL 

10.01.04 Febuxostat Adenuric® Tablets f/c 80mg, 120mg

For patients who are intolerant of allopurinol or for whom allopurinol is contraindicated
02.06.02 Felodipine  M/R tablets 2.5mg
04.08.01 Fenfluramine  Fintepla®

Oral solution 2.2 mg/mL 

02.12 Fenofibrate 

Capsules (micronised) 200mg, 267mg
Tablets (micronised) 160mg

04.07.02 Fentanyl  Matrix patches 12, 25, 50, 75, 100micrograms/hour for 72hours
Sublingual tablets (Abstral®) 100microgram, 300 microgram, 400microgram, 600microgram, 800 microgram
21 Fentanyl 

Palliative care

Pain

09.01.01.02 Ferric Carboxymaltose Ferinject®

Injection 50mg/mL

First line choice
For use in patients with asthma or eczema
For use when total dose infusion is needed

09.01.01.01 Ferrous Fumarate Galfer® Liquid 140mg/5mL (equivalent to 45mg iron per 5mL)
09.01.01.01 Ferrous Fumarate Fersaday® f/c tablets 322mg (equivalent to 100mg iron)
09.01.01.01 Ferrous Sulphate  Tablets (equivalent to 65mg iron)
03.04.01 Fexofenadine 

Tablets 30mg, 120mg

First line

06.01.01.01 Fiasp® Insulin aspart

Injection 100 units/mL,
Penfill® cartridge for Fiasp® devices
Flextouch® prefilled disposable injection devices
Fiasp® and NovoRapid® are not interchangeable due to differences in bioavailability.

Must be commenced by a healthcare professional who is appropriately trained and experienced in the initiation of insulin.
Insulin Aspart (Fiasp®) is recommended for the treatment of diabetes mellitus in adults who are suitable for NovoRapid® and their diabetes cannot be adequately managed with alternative formulary choices and at least one of the following applies:
- where the prescriber believes a faster onset of action would be beneficial to the patient
- where a patient requires ‘tight’ control of blood sugar levels
- where a patient has rapid post meal increase in blood sugar levels

01.05.03 Filgotinib 

Tablet 100mg, 200mg

Moderately to severely active ulcerative colitis

10.01.03 Filgotinib  Jyseleca®

Tablets 100mg, 200mg

09.01.06 Filgrastim  Injection 12 million units in 0.2mL prefilled syringe, 30 million units & 48 million units in 0.5mL prefilled syringe
06.04.02 Finasteride  tablets 5mg
02.02.03 Finerenone 

Please see chapter 06.01.05

06.01.05 Finerenone 
02.03.02 Flecainide  Injection 150mg/15mL
02.03.02 Flecainide 

Tablets 50mg, 100mg

On advice of cardiology only

13.02.01 Flexitol® Cream, Hydromol® Intensive 

Flexitol is lower cost then Hydromol

13.04 Flucinolone Acetonide 0.025% Synalar® Gel 30g

For scalp use only
06.03.01 Fludrocortisone 

Tablets 100micrograms

Fludrocortisone has very high mineralocorticoid activity and insignificant glucocorticoid activity. A combination of hydrocortisone and fludrocortisone are needed in primary adrenal deficiency states.

13.04 Fludroxycortide  Haelan®

Tape 4 micrograms/cm2 7.5cm x 50cm x 200cm

Amber 0 In East Lancashire

12.01.01 Flumetasone 0.02% with Clioquinol 1% Locorten-Vioform®
04.07.04.02 Flunarizine 

Capsules 5mg

Specialist consultant use only

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

Cream & Ointment

Replaces Betnovate C cream & ointment

11.04.01 Fluocinolone intravitreal implant Iluvien®

Intravitreal implant 190micrograms in a disposable applicator

11.08.02 Fluorescein Sodium 

Minims® 1%, 2%

Injection 10% for WAMD clinic use only

Injection 20%

11.04.01 Fluorometholone FML®

Eye drops fluoromethalone 0.1%, polyvinyl alcohol 1.4%

Green in East Lancashire

*under review*

13.08.01 Fluorouracil 5% Efudix®

Cream 40g


 Green for actinic keratosis

 Red  for the treatment of small superficial basal-cell carcinomas in adults

Green treatment of superficial pre-malignant skin lesions

 

04.03.03 Fluoxetine  Capsules 20mg
Liquid 20mg/5mL
07.04.06 Fluoxetine 

Capsules 20mg

Premature ejaculation.

unlicensed Unlicensed indication

04.02.01 Flupentixol Depixol®

Tablets 500microgram, 1mg, 3mg

 For the treatment of schizophrenia and other psychoses

Do Not Prescribe for depression

04.02.02 Flupentixol Decanoate Depixol®

Injection 20mg/1mL, 40mg/2mL
Concentrate injection 50mg/0.5mL, 100mg/1mL

04.02.02 Fluphenazine Decanoate 

Injection 12.5mg/0.5mL, 25mg/1mL
Concentrate injection 100mg/1mL

03.02 Fluticasone 

Flixotide Evohaler®  50mcg per actuation, 125mcg per actuation, 250mcg per actuation.

Flixotide Accuhaler® 50mcg per actuation, 100mcg per actuation, 250mcg per actuation, 500mcg per actuation. 

The maximum licensed dose in children is 200 micrograms twice daily.

Administration of doses above 1000 micrograms (500 micrograms twice daily) should be via a spacer device to help reduce side-effects in the mouth and throat. 

03.02 Fluticasone / formoterol 

Flutiform® 50mcg fluticasone / 5mcg formoterol (asthma 5 years and above), 125 mcg fluticasone /5 mcg formoterol (asthma 12 years and above), 250mcg fluticasone / 10mcg formoterol per actuation (asthma adults only)

03.02 Fluticasone / vilanterol 

Relvar Ellipta® 92 micrograms fluticasone /22 micrograms vilanterol inhalation powder (asthma and COPD)

Relvar Ellipta® 184 micrograms fluticasone /22 micrograms vilanterol inhalation powder (asthma only)

03.02 Fluticasone / Vilanterol / Umeclidinium 

(Trelegy Elipta®) Dry powder inhaler - Fluticasone furoate 92 microgram per 1 dose, Umeclidinium bromide 65 microgram per 1 dose, Vilanterol (as Vilanterol trifenatate) 22 microgram per 1 dose

Restriction: Triple therapy should be reserved for patients who have failed to achieve or maintain an adequate response to an appropriate course of dual therapy. The restriction should be the same for all triple inhalers for use in COPD. 

03.02 Fluticasone and salmeterol 

AirFlu Sal Forspiro® 50mcg salmeterol / 500mcg fluticasone per actuation (asthma and COPD / adults only)

AirFluSal® MDI 25mcg salmeterol / 125mcg fluticasone per inhalation (asthma / adults only), 25mcg salmeterol / 250mcg fluticasone per inhalation (asthma / adults only)

Seretide Accuhaler® (asthma and COPD) 50mcg salmeterol / 100mcg fluticasone per actuation, 50mcg salmeterol / 250mcg fluticasone per actuation, 50mcg salmeterol / 500mcg fluticasone per actuation

Seretide Evohaler® (asthma only) 25mcg salmeterol / 50mcg fluticasone per actuation, 25mcg salmeterol / 125mcg fluticasone per actuation, 25mcg salmeterol / 250mcg fluticasoneper actuation

Sirdupla®  (asthma only) 25mcg salmeterol / 125mcg fluticasone per inhalation, 25mcg salmeterol / 250mcg fluticasone per inhalation 

12.02.01 Fluticasone furoate Avamys® Nasal spray 27.5micrograms/metered spray
12.02.01 Fluticasone Propionate Flixonase ®

Nasal spray 50microgram per dose

12.02.01 Fluticasone Propionate Flixonase Nasule®

Nasal drops 400micrograms/unit dose 
 
Consider alternative treatment if no improvement after 4–6 weeks

09.01.02 Folic Acid  Tablets 5mg, 400 microgram
Liquid 2.5mg/5mL
06.05.01 Follitropin 

Prescribe by brand.

02.08.01 Fondaparinux Arixtra®

Injection 1.5mg in 0.3mL, 2.5mg in 0.5mL, 5mg in 0.4mL, 7.5mg in 0.6mL, 10mg in 0.8mL


03.01.01.01 Formoterol  

Oxis 6 Turbohaler® 6micrograms/inhalation
Oxis 12 Turbohaler® 12micrograms/inhalation
Easyhaler® 12 micrograms/metered inhalation
Atimos Modulite® 12 micrograms/metered inhalation

To be used as 1st line LABA when used in combination with ICS for asthma (combination inhalers preferred)

04.09.01 Foslevodopa–Foscarbidopa Produodopa®

Solution for infusion 240mg/ml + 12mg/ml

09.01.04 Fostamatinib  TAVLESSE ®

Film coated tablets, 100mg, 150mg

04.07.04.02 Fremanezumab Ajovy®

Pre-filled pens/ pre-filled syringes 225mg/1.5ml solution for injection  

02.02.02 Furosemide 

Tablets 20mg, 40mg, 500mg
Liquid 20mg/5mL, 40mg/5mL, 50mg/5mL

First line treatment

 

Amber 0 Furosemide 500mg tablets in East Lancashire

02.02.02 Furosemide injection 

Injection 

11.03.01 Fusidic Acid 

Eye drops 1% in gel basis (liquefies on contact with eye)
 
Second line - Restricted use

13.10.01.02 Fusidic Acid 2% 

Cream 15g
Ointment 15g

04.07.03 Gabapentin 

See section 4.8.1

04.08.01 Gabapentin 

Capsules 100mg, 300mg, 400mg

 

Category 3 - It is usually unecessary to ensure that patients are maintained on a specific manufacturer's product as therapeutic equivalence can be assumed

21 Gabapentin 

Palliative care

Neuropathic pain

04.11 Galantamine 

m/r capsules 8mg, 16mg, 24mg
Oral liquid 4mg/1ml

04.07.04.02 Galcanezumab  Emgality®

Solution for injection pre-filled pens  120mg/1ml

Red For NICE TA659: Galcanezumab for preventing migraine

11.03.03 Ganciclovir 0.15% ophthalmic gel Virgan®

Eye gel 5g (1.5mg/g)

01.01.02 Gaviscon Advance 

Oral suspension

Reserved for hospital prescribing or reflux disease where Peptac liquid is not tolerated or ineffective.

01.01.02 Gaviscon Infant 

Oral powder sachets

For paediatric use only

09.02.02.02 Gelatin Gelofusine® Intravenous infusion 500mL
12.03.01 Gelclair® 

Sachets

Amber 0 in East Lancashire

12.03.01 GelX® 

Oral spray

11.03.01 Gentamicin 

Eye/ear drops 0.3%

12.01.01 Gentamicin Genticin® Gentamicin 0.3% 10 mL
11.03.01 Gentamicin Forte 

Preservative free eye drops 1.5%

Unlicensed - consultant ophthalmologist only

06.01.02.01 Gliclazide 

Tablets 80mg
M/R tablets 30mg

First choice

06.01.02.01 Glimepiride 

Tablets 1mg, 2mg, 3mg, 4mg

Second line

06.01.04 Glucagon GlucaGen® HypoKit Injection 1mg vial with prefilled syringe containing water for injection
06.01.04 Glucagon refill pen Ogluo

Prescribing of Ogluo devices should be reserved for patients for whom the preparation and administration of conventional glucagon kits presents a barrier to effective treatment of hypoglycaemia and a risk to patient welfare.

06.01.04 Glucose Glucotabs®

Tablets 4g

Consider OTC purchase

09.02.02.01 Glucose Intravenous  Injection 20% 20mL
Injection 50% 20mL, 50mL
Intravenous infusion 5% 100mL, 250mL, 500mL &1L
Intravenous infusion 10% 500mL & 1L
Intravenous infusion 15% 500mL
Intravenous infusion 20% 500mL
06.01.06 Glucose test strips 
13.07 Glutarol 10% solution 

Cutaneous solution 10%

For Primary care use only

01.06.02 Glycerol suppositories Glycerin

Suppositories 1g, 2g, 4g

02.06.01 Glyceryl Trinitrate 

Aerosol spray 400micrograms/dose
Patches 5mg/24h, 10mg/24h

Patches should only be considered in patients unable to comply with or tolerate oral isosorbide mononitrate.

02.06.01 Glyceryl Trinitrate 

Infusion

01.07.04 Glyceryl Trinitrate 0.4% Rectogesic®

Ointment

First Line

07.04.04 Glycine 

Irrigation solution 1.5%

Bladder irrigation.

03.01.02 Glycopyrronium Seebri breezhaler®

Hard capsule 44 micrograms per inhalation with Seebri Breezhaler® device

21 Glycopyrronium 

Palliative care

Bowel obstruction - colic associated with bowel obstruction AND GI secretions associated with bowel obstruction

Respiratory tract secretions in the last days of life

03.01.04 Glycopyrronium / Formoterol 

Bevespi Aerosphere 7.2 micrograms glycopyrronium /5 micrograms formoterol pressurised inhalation, suspension

Licensed for COPD only

03.01.04 Glycopyrronium / Indacaterol 

Ultibro Breezhaler 85 micrograms indacaterol /43 micrograms glycopyrronium inhalation powder hard capsules

Licensed for COPD only

01.02 Glycopyrronium Bromide 

Oral Liquid

Hypersalivation in adults and children with neurological conditions [Non-Parkinson's disease]
Use most cost-effective product. Care should be taken when prescribing as different strengths of liquid are available.

For Hypersalivation in adults with Parkinson's Disease, see chapter 4.

03.02 Glycopyrronium bromide and formoterol fumarate dihydrate Bevespi Aerosphere ®
01.05.03 Golimumab 

Pre-filled syringe or pen

Moderate to severe active ulcerative colitis

01.05.03 Golimumab 

Prevention of recurrence of ulcerative colitis following surgery

10.01.03 Golimumab Simponi®

S/C injection 50mg, 100mg, prefilled syringe pre-filled pen 

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

06.07.02 Goserelin 

Implant 3.6mg, 10.8mg

03.04.02 Grass pollen extract 
04.04 Guanfacine Intuniv®

M/R tablets 1mg, 2mg, 3mg, 4mg

For use in children and adolescents 6 - 17 years for whom stimulants are not suitable, not tolerated or have shown to be ineffective
 

10.01.03 Guselkumab Tremfya®

Solution for injection in pre-filled pen 100mg/1ml

13.05.03 Guselkumab Tremfya®

Solution for injection in pre-filled pen 100mg/1ml

04.02.01 Haloperidol 

Tablets 1.5mg, 5mg, 10mg
Capsules or tablets 500micrograms
Liquid 2mg/mL

04.02.01 Haloperidol  Injection 5mg/1mL
04.02.02 Haloperidol Haldol Decanoate®

Injection 50mg/1mL, 100mg/1mL

21 Haloperidol 

Palliative care

Care in the last weeks or days of life - Nausea and vomiting in the last days of life AND Agitation/terminal restlessness in the last days of life

Nausea and vomiting

Opioid-induced nausea and vomiting

01.03 Helicobacter pylori eradication 

The following information should be used in conjunction with NICE CG184 

*In January 2024, the MHRA published a Drug Safety Update on fluoroquinolone antibiotics. These must now only be prescribed when other commonly recommended antibiotics are inappropriate. NICE is assessing the impact of this warning on recommendations in this guideline.

All courses are 7 days.

First line (option 1)

 

 

 First line (option 2)

PPI BD (Prescribe most cost-effective PPI)

Clarithromycin 500mg BD

Amoxicillin 1g BD

 Or

PPI BD (Prescribe most cost-effective PPI)

Metronidazole 400mg BD

Amoxicillin 1g BD

Penicillin allergic (1st line)

 

 

 

Penicillin allergic (2nd line)

PPI BD (Prescribe most cost-effective PPI)

Metronidazole 400mg BD

Clarithromycin 500mg BD

 

PPI BD (Prescribe most cost-effective PPI)

Metronidazole 400mg BD

Levofloxacin 250mg BD*

Quadruple therapy

(Penicillin allergy + previous exposure to clarithromycin and/or fluoroquinolone)

PPI BD (Prescribe most cost-effective PPI)

Metronidazole 400mg BD

Bismuth subsalicylate 525mg QDS

Tetracycline 500mg QDS
Previous exposure to clarithromycin and metronidazole

PPI BD (Prescribe most cost-effective PPI)

Amoxicillin 1g BD

Tetracycline 500mg QDS OR

Levofloxacin 250mg BD*

 

02.08.01 Heparin 

Injection 1000units/1mL, 10 000units/10mL, 20 000units/20mL

02.08.01 Heparin flush 

Flush 50units/5mL

Arterial line patency. ICU use only.

12.03.04 Hexetidine Oraldene® Mouthwash 0.1%
13.01 HidraWear 

 Hidradenitis Suppurativa 

11.11 Holoclar 

79,000 - 316,000 cells/cm2 living tissue equivalent

06.01.01.01 Humalog® Insulin Lispro 10mL vial
3mL cartridge AutoPen® or HumaPen®
3mL prefilled disposable Humalog® KwikPen®
06.01.01.02 Humalog® Mix 25 Biphasic Insulin Lispro

3mL cartridge AutoPen® or HumaPen®
3mL prefilled disposable Humalog®Mix25 KwikPen®

Second line biphasic short-acting analogue insulin (Humalog Mix Kwikpen)

06.01.01.02 Humalog® Mix 50 Biphasic Insulin Lispro

3mL cartridge AutoPen® or HumaPen®
3mL prefilled disposable Humalog®Mix50 KwikPen®

Second line biphasic short-acting analogue insulin (Humalog Mix Kwikpen)

09.02.02.02 Human Albumin Solution  Intravenous infusion 4.5% 500mL, 20% 100mL
06.05.01 Human Chorionic Gonadotropin 5000 iu/mL 
06.05.01 Human Menopausal Gonadotrophins 

Injection 75units FSH/75units LH amp with solvent

06.01.01.02 Humulin® I Isophane Insulin

10mL vial
3mL cartridge for AutoPen® or HumaPen®
3mL prefilled disposable Humulin I® KwikPen®

First line isophane insulin (Humulin I Kwikpen)

06.01.01.02 Humulin® M3 Biphasic Isophane Insulin

10mL vial
3mL cartridge for AutoPen® or HumaPen®
3mL pre-filled disposable Humulin M3® KwikPen®

First line biphasic human insulin (Humulin M3 Kwikpen)

06.01.01.01 Humulin® S Insulin 10mL vial
3mL cartridge for AutoPen® or HumaPen®
10.03.01 Hyaluronidase Hyalase® Injection 1500 units
02.05.01 Hydralazine  Injection 20mg/2mL
02.05.01 Hydralazine 

Tablets 25mg, 50mg

Heart failure

Initiated in hospital or under specialist supervision.

02.05.01 Hydralazine 

Tablets 25mg, 50mg

Hypertension

11.08.01 Hydramed Night® 

Lubricating eye ointment 5g

06.03.02 Hydrocortisone Alkindi®

Granules in capsules for opening 0.5mg, 1mg, 2mg

For replacement therapy of adrenal insufficiency in children and adolescents (from birth to <18 years old)

12.03.01 Hydrocortisone Corlan® Pellets 2.5mg
13.04 Hydrocortisone 0.5%/ nystatin 100,000units/g /benzalkonium chloride 0.2%/ dimeticone '350' 10%  Timodine® Cream 30g
13.04 Hydrocortisone 1%  Cream 15g
Ointment 15g
13.04 Hydrocortisone 1% with Clotrimazole 1% Canesten HC® Cream 30g
13.04 Hydrocortisone Acetate 1% with Fusidic Acid 2% Fucidin H® Cream 30g, 60g

Preparations containing fusidic acid should not be used in secondary care for in-patients
12.01.01 Hydrocortisone Acetate 1% with Gentamicin 0.3% Gentisone® HC
06.03.02 Hydrocortisone MR capsules Efmody

Treatment of congenital adrenal hyperplasia (CAH) in adolescents aged 12 years and over and adults.

06.03.02 Hydrocortisone MR  Plenadren
06.03.02 Hydrocortisone sodium phosphate Efcortesol®

Injection 100mg/1mL

11.04.01 Hydrocortisone sodium phosphate 3.35 mg/ml eye drops Softacort

Red Eye drop - 2 week course only

1 ml eye drops, solution contains 3.35 mg of hydrocortisone sodium phosphate.

06.03.02 Hydrocortisone sodium succinate Solu-Cortef®

Injection 100mg vial

06.03.02 Hydrocortisone tablets 

Tablets 10mg, 20mg

12.03.04 Hydrogen Peroxide  Mouthwash 6%
13.11.06 Hydrogen Peroxide 1% Crystacide® Cream 25g
09.01.02 Hydroxocobalamin  Injection 1mg/1mL
10.01.03 Hydroxychloroquine 

Tablets 200mg, 300mg

03.04.01 Hydroxyzine hydrochloride 

Tablets 10mg, 25mg

11.08.01 Hylo-night ® 

Eye ointment preservative free

2nd line to Hydramed Night

01.02 Hyoscine Butylbromide Buscopan® Tablets 10mg
Injection 20mg/1mL
21 Hyoscine butylbromide 

Palliative care

Bowel obstruction - colic associated with bowel obstruction AND GI secretions associated with bowel obstruction

Respiratory tract secretions in the last days of life

04.06 Hyoscine Hydrobromide  Tablets 300micrograms
Patch (Scopoderm TTS®) 1mg/72hours
21 Hyoscine hydrobromide 

Palliative care

Respiratory tract secretions in the last days of life

11.08.01 Hypromellose 

Eye drops 0.3%

Preservative free eye drops 0.3%

06.06.02 Ibandronic Acid injection Bonviva®

Injection 3mg/3mL pre-filled syringe

06.06.02 Ibandronic Acid Tablets Bondronat®

(Bondronat®) Tablets 50mg: Oral alternative bisphosphonate for patients with breast cancer

06.06.02 Ibandronic Acid Tablets 

Alternative monthly bisphosphonate when alendronic acid is not appropriate.

07.01.01.01 Ibuprofen Pedea®

Injection 10mg/2ml

Closure of ductus arteriosus 

Under expert supervision.
This section is not included in the BNF. For the management of ductus arteriosus, see BNF for Children.

10.01.01 Ibuprofen 

Tablets 200mg, 400mg, 600mg
M/R tablets 800mg
Liquid 100mg/5mL

Red Solution for infusion 400mg/100mL

21 Ibuprofen 

Palltiave care

Pain: Anti-inflammatory

10.03.02 Ibuprofen 10% gel 

gel 10%

Primary Care only  - prescribe as Fenbid Forte gel

10.03.02 Ibuprofen 5 % gel 

gel 5%

In Primary Care prescribe as Fenbid gel

03.04.03 Icatibant 

30mg solution for injection in pre-filled syringe

Kept in Emergency Departments at RLI and FGH

02.12 Icosapent ethyl Vazkepa®

Soft capsules 998 mg 

02.08.02 Idarucizumab® Praxbind

Solution for injection/infusion 2.5 g/50 mL


Rapid reversal of anticoagulant effects of dabigatran  

02.06.04 Iloprost (IV) 

Raynauds

Specialist use only

02.06.04 Iloprost nebuliser solution 

Pulmonary hypertension

For use by specialist centres only.
NHSE commissioned

04.03.01 Imipramine  Tablets 10mg, 25mg
13.08.01 Imiquimod Aldara®

Cream 5%

Red for treatment of small superficial basal cell carcinoma in adults

13.07 Imiquimod 5% Aldara®

Cream

External genital warts and actinic keratosis

13.02.01 Imuderm® emollient 

emollient 500g

(Contains urea 5%)

02.12 Inclisiran  Leqvio®

Pre-filled syringe 284mg/1.5ml

 

02.02.01 Indapamide 

Tablets 2.5mg and 1.5mg MR
First line diuretic for hypertension

11.08.02 Indocyanine green  Injection 25mg (unlicensed)
10.01.01 Indometacin  Capsules 25mg
M/R capsules 75mg
Suppositories 100mg

Indometacin is usually only recommended for gout
01.05.03 Infliximab 

Intravenous infusion 100mg
Pre-filled pen 120 mg solution for injection
Pre-filled syringe 120 mg solution for injection

Use in high risk patients for prevention of recurrence or upon recurrence of Crohn's Disease following surgery.

Crohn's disease - NICE TA187

Acute exacerbations of Ulcerative Colitis - NICE TA163

Moderate to severe active ulcerative colitis - NICE TA329

 

01.05.03 Infliximab 

Prevention of recurrence of ulcerative colitis following surgery

10.01.03 Infliximab Biosimilars avaliable

Intravenous infusion 100mg, 120mg/ml pre-filled pen

REQUIRES BLUETEQ APPROVAL

13.05.03 Infliximab Biosimilars avaliable

Intravenous infusion 100mg

Consultant dermatologist or specilaist initiation only

REQUIRES BLUETEQ APPROVAL

06.01.01.02 Insulatard® Isophane Insulin

10mL vial
3mL cartridge for NovoPen®

Second line isophane insulin (Insulatard penfill)

06.01.02.03 Insulin glargine/lixisenatide 

100iu/mL  pre-filled pens

06.01.01.03 Insulin pumps 

For supply via secondary care only with Blueteq approval.

Classified as Red Red in secondary care and
Do Not Prescribe in Primary Care

07.03.02.03 Intrauterine-Progesterone Levonorgestrel IUD Mirena® Levosert®

Intra-uterine system 20 micrograms/24 hours

Mirena is effective for 5 years and Levosert is effective for 6 years when used for contraception and 5 years when used for menorrhagia.

07.03.02.03 Intrauterine-Progesterone Levonorgestrel IUD Jaydess®

Intra-uterine device system 13.5mg

06.02.02 Iodide with iodine 

Also known as Lugol's solution

Thyrotoxicosis (pre-operative).

06.02.02 Iodine containing preparations non-acute use
03.01.02 Ipratropium 

Nebuliser solution 250micrograms/1mL, 500micrograms/2mL
Metered dose inhaler 20micrograms/inhalation

12.02.02 Ipratropium Bromide Rinatec® Nasal spray 0.03% (21micrograms/metered spray)
09.01.03 Iptacopan 
Iptacopan is recommended, within its anticipated marketing authorisation, as an option for treating paroxysmal nocturnal haemoglobinuria (PNH) in adults with haemolytic anaemia.
Iptacopan will be available via the Innovative Medicines Fund (IMF) according to a set of treatment criteria which translates the NICE recommendation into a clinical guide as to use in practice. These treatment criteria can be found on the application form(s) on the Blueteq site.
NHS England will then routinely commission iptacopan in patients with PNH via commissioned centres.
02.05.05.02 Irbesartan 

Tablets 75mg, 150mg, 300mg

09.01.01.01 Iron and Folic Acid Pregaday® m/r tablets 322mg (equivalent to 100mg iron/350micrograms folic acid)
09.01.01.02 Iron Sucrose Venofer®

Injection 100mg/5mL

Second line after Ferinject


For intravenous use only

Do not use in patients with asthma or eczema

09.01.01.02 Iron(III) Isomaltoside  Diafer®

Injection 50mg/mL (2mL ampoule)

For use by renal unit only - preferred iron parenteral iron preparation for use by renal unit

13.02.01 Isomol gel ®  100g, 500g
02.07.01 Isoprenaline 

unlicensed unlicensed

02.06.01 Isosorbide Mononitrate 

Tablets 10mg, 20mg
M/R tablets 60mg
LA capsules 25mg, 50mg

12.02 Isotonic Aqueous Spray NASA-MIST®

Isotonic aqueous nasal spray

For use post-op follow local protocols

*under review*

13.06.02 Isotretinoin  Capsules 5mg, 20mg

Consultant dermatologist or specialist only

Pregnancy must be excluded before initiation and before each repeat prescription.
Prescriptions for women are limited to 28 days treatment
01.06.01 Ispaghula Husk 

Granules 3.5g

Consider OTC purchase for some conditions

02.06.03 Ivabradine 

Tablets 5mg, 7.5mg


03.07 Ivacaftor  Kalydeco®

Tablets 150mg
Granules sachets 13.4mg, 25mg, 50mg, 75mg

03.07 Ivacaftor–Tezacaftor–Elexacaftor Kaftrio®
13.10.04 Ivermectin 

Tablets 3mg

For hyperkeratotic (crusted or Norwegian) scabies unresponsive to topical treatment alone.

13.06 Ivermectin cream 1% Soolantra® Cream
10.01.03 Ixekizumab 

80mg solution for injection prefilled syringe; prefilled pen

13.05.02 Ixekizumab  Taltz®

80mg/1mL pre-filled pen

09.05.02.01 Joulies oral phosphate solution  Preservative free oral solution
Phosphate 0.98 mmol per 1mL
Sodium 0.76 mmol per 1mL
04.07.03 Ketamine oral solution 

Liquid 50mg/5mL

Unlicensed

For chronic pain - RED

Restricted Item For palliative care only AMBER - under review

06.07 Ketoconazole Ketoconazole HRA®

Tablets 200mg

Specilaist use only.

13.09 Ketoconazole 2%  Shampoo 120mL
11.08.02 Ketorolac 

Eye drops 0.5%

*under review*

Amber 0 in East Lancashire

11.04.02 Ketotifen Ketofall®

Eye drops (preservative free) 250micrograms/mL

Should only be prescribed when:

  • a patient has tried at least 2 alternative eye preparations for seasonal allergic conjunctivitis
  • and/or the patient is sensitive to preservatives

*under review*

Green Restricted in East Lancashire

02.04 Labetalol 

Tablets 100mg, 200mg

02.04 Labetalol  Injection 100mg/20mL

Hypertension in pregnancy and hypertensive crisis
02.06.02 Lacidipine 

A second line dihydropyridine calcium channel blocker when amlodipine is not tolerated (e.g. where patients develop significant ankle oedema).

For existing patients only

04.08.01 Lacosamide 

200mg/20ml solution for infusion - vials

04.08.01 Lacosamide  

Tablets 50mg, 100mg, 150mg, 200mg

 Oral solution 50mg/5ml

Category 3 - It is usually unecessary to ensure that patients are maintained on a specific manufacturer's product as therapeutic equivalence can be assumed

01.06.04 Lactulose 

Liquid 3.35g/5mL

Consider OTC purchase for some conditions

21 Lactulose 

Palliative care

Constipation

04.02.03 Lamotrigine 

Tablets, lamotrigine 25 mg, 100 mg, 200 mg

Dispersible tablets, lamotrigine 5 mg, 25 mg, 100 mg,

04.08.01 Lamotrigine 

Tablets 25mg 50mg, 100mg
Dispersible tablets 5mg, 25mg, 100mg

 

Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products



CSM advice: blood disorders - see BNF

03.04.03 Lanadelumab Takhzyro®

300mg solution for injection in pre-filled syringe

01.03.05 Lansoprazole 

Capsules 15mg, 30mg
Orodispersible tablets 15mg, 30mg

First line

Orodispersible tablets are for paediatric use and adults with swallowing difficulties only

Patients taking more than 30mg daily of lansoprazole are considered to be on high dose treatment. When reducing doses, please choose the lowest effective dose to
control symptoms.

09.05.02.02 Lanthanum Fosrenol ®

Tablets 250mg, 500mg, 750mg, 1000mg

06.01.01.02 Lantus® Insulin Glargine 

10mL vial
3mL cartridge for OptiPen® Pro 1
3mL prefilled disposable pen SoloSTAR®

Lantus® brand is not a preferred product in the LSCMMG antihyperglycaemics guideline. Biosimilars of Insulin glargine are also available for the treatment of NEW patients and patients assessed to need a medication change. Treatment should normally be started with the least expensive drug.

11.06 Latanoprost 
Eye drops 50micrograms/mL
Unit dose eye drops (preservative free)50micrograms/mL
Multidose eye drops (preservative free) 50micrograms/mL (Lotacryn)
 
The preservative free preparations are restricted to use in patients who have a proven sensitivity to benzalkonium chloride.
11.06 Latanoprost 0.005% with Timolol 0.5% 

Eye drops 50micrograms/mL (0.005%)/ timolol 0.5%

 

11.06 Latanoprost and timolol  Fixapost®

Unit dose eye drops 0.2mL Latanoprost 50micrograms/ml, Timolol 5mg/ml

This has been approved only for patients with documented preservative allergy.

09.08.01 L-Carnitine Carnitor®

Injection 1g in 5mL

Restricted Item Paediatric use only

10.01.03 Leflunomide 

Tablets 10mg, 20mg

02.06.02 Lercanidipine 

Tablets 10mg, 20mg

A second line dihydropyridine calcium channel blocker when amlodipine is not tolerated (e.g. where patients develop significant ankle oedema)

06.07.02 Leuprorelin Prostap® SR, Prostap® 3

Injection 3.75mg, 11.25mg vial with vehicle filled syringe

06.01.01.02 Levemir® Insulin Detemir 3mL cartridge for NovoPen®
3mL prefilled disposable FlexPen®
04.08.01 Levetiracetam 

Tablets 250mg, 500mg, 1g
Liquid 100mg/mL

 

Category 3 - It is usually unecessary to ensure that patients are maintained on a specific manufacturer's product as therapeutic equivalence can be assumed

11.06 Levobunolol Betagan®

Unit dose - preservative free eye drops levobunolol 0.5%/polyvinyl alcohol 1.4%

*under review*

Not listed on East Lancashire formulary

03.04.01 Levocetirizine 

Second line

04.09.01 Levodopa-Carbidopa- Entacapone Intestinal Gel (LECIG) 
Treatment with LECIG for Parkinson’s Disease may be delivered and managed through any acute provider trust which treats patients with Parkinson’s disease under either neurology or elderly care services. Eligibility must be determined through a specialist Parkinson’s clinician in an agreed networked approach with a specialist Parkinson's service in a regional specialised neurology centre. This may be through direct clinical assessment by clinicians with appropriate expertise within the network or through a Parkinson’s disease MDT arrangement managed through a specialised neurology centre.
04.09.01 Levodopa-Carbidopa Intestinal Gel (LCIG) 
Treatment with LCIG for Parkinson’s Disease may be delivered and managed through any acute provider trust which treats patients with Parkinson’s disease under either neurology or elderly care services. Eligibility must be determined through a specialist Parkinson’s clinician in an agreed networked approach with a specialist Parkinson's service in a regional specialised neurology centre. This may be through direct clinical assessment by clinicians with appropriate expertise within the network or through a Parkinson’s disease MDT arrangement managed through a specialised neurology centre.
11.03.01 Levofloxacin 

eye drops 0.5%

preservative-free eye drops 0.5% - reserved for patients with a documented allergy to preservatives or for intensive use

 *under review*

 

13.03 Levomenthol 0.5%, 1%, 5% cream 

Cream 500g

21 Levomepromazine 

Palliative care

Care in the last weeks or days of life - Nausea and vomiting in the last days of life AND Agitation/terminal restlessness in the last days of life

Nausea and vomiting

Opioid-induced nausea and vomiting

04.06 Levomepromazine (Methotrimeprazine)  

Tablets 25mg
Tablets 6mg 
Injection 25mg/1mL

For palliative care use only

Care in the last days or weeks of life - nausea and vomiting in the last days of life AND agitation/terminal restlessness in the last days of life 

Do Not Prescribe for schizophrenia (new patients)

07.03.02.01 Levonorgestrel 

Tablets 30 micrograms

07.03.05 Levonorgestrel 

Tablets 1.5mg

Emergency contraception.

06.02.01 Levothyroxine  Tablets 25micrograms, 50micrograms, 100micrograms
06.02.01 Levothyroxine Liquid 
02.03.02 Lidocaine 

Ventricular arrhythmias

For cardiology/ICU use only

04.07.03 Lidocaine  

5% Medicated Plasters

Post Herpetic Neuralgia

 

04.07.03 Lidocaine  

5% Medicated Plasters

Use outside of the license of post-herpetic neuralgia for the treatment of localised neuropathic pain with predominance of allodynia and/or hyperalgesia and dysesthesias unresponsive to other neuropathic agents.

 

12.03.01 Lidocaine 10% spray 

spray 10mg/metered dose

Morecambe bay only

12.03.01 Lidocaine 5% ointment  Ointment 5%
11.07 Lidocaine Hydrochloride 4% with Fluorescein 0.25% Minims® Minims® lidocaine 4%/fluorescein 0.25%
07.04.06 Lidocaine/Prilocaine 

Primary premature ejaculation in men.

01.06.07 Linaclotide Constella®

Capsules 290 micrograms

Prescribe in line with CG61. If no improvement in symptoms at follow up then discontinue

Green Restricted Green restricted in West Lancashire only

06.01.02.03 Linagliptin Trajenta®

Tablets 5mg

Second line gliptin on LSCMMG pathway for patients with renal impairment.
 
  

06.01.02.03 Linagliptin/ metformin Jentadueto 
06.02.01 Liothyronine 

Tablets 20micrograms

 
Do Not Prescribe  Liothyronine monotherapy for the management of chronic hypothyroidism – primary and secondary care.

Do Not Prescribe  Resistant depression

Do Not Prescribe  Liothyronine therapy commenced in the private sector

Red For the treatment of acute conditions where thyroid replacement is needed rapidly, for a limited period and/or where a drug with shorter half-life is required


Amber 0  Add-on treatment for refractory hypothyroidism – existing patient (RED RAG for Pennine only for this indication)

Amber 0  Add-on treatment for refractory hypothyroidism despite adequate replacement with levothyroxine – new patients (RED RAG for Pennine only for this indication)

06.02.01 Liothyronine (Triidothyronine) injection 
13.02.01 Liquid and White Soft Paraffin Ointment (50:50)  500g

NB: fire hazard - see BNF
04.05.01 Liraglutide Saxenda®

6mg/ml solution for injection 3ml pre-filled pens 

liraglutide is recommended as an option in overweight and obesity as long as it is prescribed in secondary care by a specialist multidisciplinary tier 3 weight management service

 

Do Not Prescribe for NICE TA749 Liraglutide for managing obesity in people aged 12 to 17 years (terminated appraisal)

06.01.02.03 Liraglutide Victoza®

Injection 6mg/mL pre-filled pen

Second line GLP-1 agonist, if daily administration preferred.
Prescribe by brand.

06.01.02.03 Liraglutide  Saxenda

Managing overweight and obesity.
Prescribe by brand.

04.04 Lisdexamfetamine Elvanse®

 Adult -  hard capsules 30mg, 50mg, 70mg

Under 16 years - hard capsules 20mg, 30mg, 40mg, 50mg, 60mg, 70mg
  

02.05.05.01 Lisinopril 

Tablets 2.5mg, 5mg, 10mg, 20mg

First line

04.02.03 Lithium Carbonate Camcolit®

M/R tablets 400mg

04.02.03 Lithium Carbonate Priadel®

M/R tablets 200mg, 400mg

04.02.03 Lithium Citrate Priadel®

Liquid 520mg/5mL

04.03.01 Lofepramine  Tablets 70mg
Liquid 70mg/5mL
04.10.03 Lofexidine BritLofex®

Tablets 200micrograms

**under review**

01.04.02 Loperamide 

Capsules 2mg

First line

03.04.01 Loratadine 

Tablets 10mg
Liquid 5mg/5mL

First line

04.01.02 Lorazepam 

Tablets 1mg

04.08.02 Lorazepam  Injection 4mg/1mL
21 Lorazepam 

Palliative care

Breathlessness

Breathlessness in the last days of life

02.05.05.02 Losartan 

Tablets 12.5mg, 25mg, 50mg, 100mg

First line

11.04.01 Loteprednol Lotemax®

Eye drops 0.5% (5mg/ml)

Restricted Item Restricted to second line use or if clinical condition warrants.

03.01.05 Low range peak flow meter Mini-Wright® Low range peak flow meter 30-400 litres/minute
03.07 Lumacaftor–Ivacaftor Orkambi®
10.01.04 Lumasiran Oxlumo ®

Solution for injection  94.5mg/0.5mL

Red Tertiary Centre only for NICE HST25 Lumasiran for treating primary hyperoxaluria type 1 - See link below

 

04.02.01 Lurasidone Latuda®

Tablets 18.5mg, 37mg, 74mg

LSCFT initiated only

09.01.04 Lusutrombopag Mulpleo®

Film coated tablets 3mg

13.06.02 Lymecycline  Capsules 408mg
06.01.01.01 Lyumjev® Insulin lispro

Injection 100 units/mL,

Solution for injection in vial

Solution for injection in cartridge

KwikPen® solution for injection in pre-filled pen

Junior KwikPen® solution for injection in pre-filled pen

 

Insulin Lispro (Lyumjev®) is recommended for the treatment of diabetes mellitus in adults who are suitable for Humalog® and their diabetes cannot be adequately managed with alternative formulary choices and at least one of the following applies:

-Where the prescriber believes a faster onset of action would be beneficial to the patient
- Where a patient requires ‘tight’ control of blood sugar levels
- Where a patient has rapid post-meal increase in blood sugar levels

01.06.04 Macrogols 

Powder for oral solution

Prescribe the most cost effective brand

01.06.05 Macrogols bowel cleansing

powder for oral solution

Prescribe by brand. Follow local protocols

09.05.01.03 Magnesium Aspartate 

Sachets 10mmol

Amber 0 In East Lancashire

09.05.01.03 Magnesium citrate 4mmol tablets 
09.05.01.03 Magnesium Glycerophosphate 

Tablets magnesium 4mmol
Liquid 1mmol/1mL - unlicensed-Unlicensed

09.05.01.03 Magnesium Sulphate  Injection 50% (magnesium 2mmol/mL) 2mL, 10mL amps
13.10.05 Magnesium Sulphate Paste BP  50g
13.10.04 Malathion 0.5% Derbac-M® Liquid in an aqueous basis 50mL, 200mL
02.02.05 Mannitol  Intravenous infusion 10%, 20%
03.07 Mannitol Bronchitol ®

Inhalation powder, hard capsule with device 40mg

01.02 Mebeverine Hydrochloride Colofac®

Tablets 135mg, MR capsules 200mg

13.02.02 Medi Derma-S 

Spray barrier film

For community use only

13.02.02 Medihoney®  

Second choice

Cream and sachet

For community use only

06.04.01.02 Medroxyprogesterone Acetate Provera®

Tablets 5mg, 10mg

07.03.02.02 Medroxyprogesterone Acetate 

Injection medroxyprogesterone acetate (Depo-Provera) 150mg/1mL prefilled syringe
Injection medroxyprogesterone acetate (Sayana Press) 104mg/0.65mL prefilled syringe

04.01.01 Melatonin 

Children with learning disabilities

Children with ADHD

Children and adolescents with Autism Spectrum Disorder (ASD) and / or Smith-Magenis syndrome

Cerebral palsy

Children with complex neurodevelopmental disorders that the specialist considers eligible

 

Initiation of melatonin must be by a specialist in the indication being prescribed for and have a clear plan for review.

Prescribing and review of melatonin in children must follow the principles outlined in the Melatonin Pathway (Children)

04.01.01 Melatonin 

For the Treatment of Rapid Eye Movement (REM) Sleep Behaviour Disorder (RBD) in Parkinson’s Disease and Lewy Body Dementia

Adults with learning disabilities

Sleep disturbance in adults with ADHD

Sleep disorders in the blind

Adults with complex neurodevelopmental disorders that the specialist considers eligible

 

Initiation of melatonin must be by a specialist in the indication being prescribed for and have a clear plan for review.

Prescribing and review of melatonin in adults must follow the principles outlined in the Melatonin Pathway (adults) **Under development**.

Melatonin is suitable for prescribing for the treatment of REM RBD in PD and LBD when clonazepam is not considered to be appropriate.

04.01.01 Melatonin 

Primary insomnia in those over 55

Sleep problems in patients with dementia associated with Alzheimer’s

Colonis liquid 1mg/ml and 3mg tablets for all indications, including insomnia and jet lag

10.01.01 Meloxicam  Tablets 7.5mg, 15mg
04.11 Memantine Ebixa®

Tablets 10mg
Oral drops 10mg/mL
Note: 5mg = 10 drops

Primary care prescribers may start treatment with memantine without taking advice from a specialist clinician where an AChEI is already prescribed.  Green as per LSCMMG guidance.

 

 

 

 

09.06.06 Menadiol Sodium Phosphate 

Tablets 10mg

water soluble preparation for patients with fat malabsorption

03.04.02 Mepolizumab  

(Nucala®) solution for injection pre-filled syringe 40mg / 0.4ml, 100mg powder for solution for injection, solution for injection pre-filled pen 100mg / 1ml, solution for injection in pre-filled syringe 100mg / 1ml

Severe eosinophilic asthma in adults - NICE TA671

03.04.02 Mepolizumab 

Eosinophilic granulomatosis with polyangiitis in people 6 years and over. Appraisal terminated NICE TA845

03.04.02 Mepolizumab 

Severe hypereosinophilic syndrome in adults. Appraisal terminated. NICE TA846

03.04.02 Mepolizumab 

Severe chronic rhinosinusitis with nasal polyps in adults. Appraisal terminated. NICE TA847

01.05.03 Mercaptopurine 

Tablets 50mg

01.05.01 Mesalazine (oral) 

Mesalazine products should be prescribed by brand.

First line – Octasa

Second line – Pentasa and Salofalk

First line for swallowing difficulties – Pentasa and Salofalk

Patients prescribed Asacol should be switched to Octasa. Patients who cannot tolerate Octasa may remain on Asacol. (Asacol 400mg MR discontinued)

Patients prescribed Mezavant may remain on this brand.

01.05.01 Mesalazine (rectal) 

Mesalazine products should be prescribed by brand.
Formulary options include:
Pentasa liquid enema and suppositories.
Salofalk foam enema and suppositories.
Octasa suppositories.

13.02.02 Metanium® Barrier preparation

Ointment
For paediatric use only

Tissue Viability Nurse authorisation required for use in adult patients

02.07.02 Metaraminol  Injection 2.5mg/5mL, 10mg/1mL
06.01.02.02 Metformin 

Tablets 500mg, 850mg

M/R tablets 500mg, 750mg, 1g

Only consider using modified release metformin if the patient cannot tolerate immediate release metformin.            

Treatment of type 2 diabetes mellitus, particularly in overweight patients, when dietary management and exercise alone does not result in adequate glycaemic control

Reduction in the risk or delay of the onset of type 2 diabetes mellitus in adult, overweight patients with implied Glucose Tolerance and/or increased HbA1C who are at high risk for developing overt type 2 diabetes mellitus and still progressing towards type 2 diabetes mellitus despite implementation of intensive lifestyle change for 3-6 months.

04.07.02 Methadone 

Tablets 5mg
Injection 10mg/1mL

Methadone, when used as an analgesic, should be initiated by specialists in palliative care only

see section 4.10 for products used in opioid dependence

**under review**

04.10.03 Methadone  Liquid 1mg/mL sugar free

CHM advice: QT interval prolongation - se BNF
01.05.03 Methotrexate 

2.5mg tablets, Prefilled syringes and pens (various strengths)

Crohn's disease.
Methotrexate should be prescribed once weekly as a single dose on the same day each week.
If oral methotrexate is prescribed only use the 2.5 mg strength

10.01.03 Methotrexate check local policy - branded generic available

Tablets 2.5mg

S/C 5mg, 7.5mg, 10mg, 12.5mg, 15mg, 17.5mg, 20mg, 22.5mg, 25mg and 30mg


Methotrexate should be prescribed once weekly as a single dose on the same day each week.
If oral methotrexate is prescribed only use the 2.5 mg strength.

See hospital policy for prescribing and supply of oral methotrexate

13.05.03 Methotrexate 

Consultant dermatologist or specialist initiation only


Methotrexate should be prescribed once weekly as a single dose on the same day each week. If oral methotrexate is prescribed only use the 2.5 mg strength

04.07 Methoxyflurane Penthrox ®

 Inhalation vapour 3ml bottles with device (Each bottle contains 3 ml of methoxyflurane 99.9%)

Use restricted to consultants/SAS doctors/Registrars in UHMB Emergency Departments and Urgent Treatment Centre only

13.05.02 Methoxypsoralen  Bath lotion 1.2%
Gel 0.005%
Tablets 10mg
13.08.01 Methyl-5-Aminolevulinate Metvix® Cream 2g
02.05.02 Methyldopa 

Tablets 125mg, 250mg, 500mg

01.06.06 Methylnaltrexone bromide 
04.04 Methylphenidate 

Tablets 5mg, 10mg, 20mg
M/R tablets 18mg, 27mg, 36mg, 54mg
M/R capsules 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, 60mg

All brands are formulary - choice of brand to made by specialist

For adult patients under the care of Psychiatry UK in South Cumbria, please prescribe as Xaggatin XL in primary care

10.01.02.02 Methylprednisolone Acetate Depo-Medrone®

Injection 80mg/2mL, 120mg/3ml, 40mg/ml 

10.01.02.02 Methylprednisolone Acetate with Lidocaine Depo-Medrone®

Injection
(Methylprednisolone 80mg/2mL with lidocaine 20mg/2mL)

01.02 Metoclopramide 
Tablets 10mg
Oral solution 5mg/5ml
 
Pro-kinetic agent unlicensed
 
To be commenced for this indication by GI and Critical Care specialists only.
Metoclopramide can induce acute dystonic reactions, these are more common in the young (especially girls and young women) and the very old.
Prescriptions should include a review date.
04.06 Metoclopramide  Tablets 10mg
Liquid 5mg/5ml
Injection 10mg/2mL

Metoclopramide may induce acute dystonic reactions and should be avoided in patients under 20 years – see BNF

Risk of neurological adverse effect – restricted dose and duration of use.

Maximum adult dose is 30mg daily. Should only be prescribed for short term us (up to 5 days)
NB/ advice does not apply to unlicensed uses of metoclopramide (e.g. palliative care).
21 Metoclopramide 

Palliative care

Nausea and vomiting

Opioid-induced nausea and vomiting

02.02.01 Metolazone 

Tablets 2.5mg, 5mg

Treatment of patients with chronic heart failure with resistant volume overload

Must be prescribed by brand

Use the licensed preparation for new patients

02.04 Metoprolol  Injection 5mg/5mL

02.04 Metoprolol 

Tablets 50mg

Not first line. Use when beta blocker with a short half life is required.

13.10.01.02 Metronidazole 0.75% gel  

Gel 30g

06.07 Metyrapone 

Capsules 250mg

02.03.02 Mexiletine 

50mg, 100mg, 200mg (as hydrochloride)

Treatment of documented ventricular arrhythmias which, in the judgement of the physician, are considered as life-threatening.
For use by specialists in treating arrhythmias only.

10.02.02 Mexiletine hydrochloride Namuscla ®

Capsules 167mg

12.03.02 Miconazole Daktarin® Oral gel 20mg/g
13.10.02 Miconazole 2%  Cream 30g
04.08.02 Midazolam Buccolam®

Oromucosal solution pre-filled oral syringes 2.5mg/0.5ml, 5mg/1ml, 7.5mg/1.5ml, 10mg/2ml

 

04.08.02 Midazolam Epistatus ®

Buccal liquid 10mg/1mL

21 Midazolam 

Palliative care

Breathlessness

Care in the last weeks or days of life - Breathlessness in the last days of life AND Agitation/terminal restlessness in the last days of life

Palliative care emergencies - Seizures AND Anixolytic following major blood loss

02.07.02 Midodrine 

Tablets 2.5mg, 5mg

Postural hypotension

07.01.02 Mifepristone 

Tablets 200mg

Termination of pregnancy.

Follow Trust policy on authorisation to prescribe and prescription requirements.

02.01.02 Milrinone 

Congestive cardiac failure.
ICU use only.

07.04.02 Mirabegron Betmiga®

Modified-release tablets 25mg, 50mg

Urinary frequency, urgency, and incontinence.

01.05.03 Mirikizumab 

100mg/ml  solution for injection pre-filled pen, 300mg/15ml concentrate for solution for infusion vials

For treatment of moderately to severely active ulcerative colitis

04.03.04 Mirtazapine  Tablets 15mg, 30mg, 45mg
Dispersible tablets 15mg, 30mg, 45mg(only for patients with swallowing difficulties)
07.01.01 Misoprostol 

Tablets 200micrograms

Induction of abortion.

unlicensed Unlicensed indication

04.03.02 Moclobemide 

Tablets 150mg

04.04 Modafinil Provigil®

Tablets 100mg

Specialist initiation only

03.02 Mometasone Asmanex®
03.02 Mometasone / Indacaterol 

Atectura Breezhaler 125 micrograms indacaterol /62.5 micrograms mometasone inhalation powder, hard capsules

Atectura Breezhaler 125 micrograms indacaterol /127.5 micrograms mometasone inhalation powder, hard capsules

Atectura Breezhaler 125 micrograms indacaterol /260 micrograms mometasone inhalation powder, hard capsules

03.02 Mometasone / Indacaterol / Glycopyrronium 

(Enerzair® Breezhaler® ) 114 micrograms/46 micrograms/136 micrograms inhalation powder, hard capsules 

The LSCMMG adult asthma guidelines only recommend triple inhalers to be initiated by a clinical expert in primary / secondary care, in those patients who are not adequately controlled with a maintenance combination of a long-acting beta 2-agonist and a high dose  of an inhaled corticosteroid, who have experienced one or more asthma exacerbations in the previous year

12.02.01 Mometasone Furoate Nasonex® Nasal spray 50micrograms/metered spray
13.04 Mometasone Furoate 0.1% Elocon®

Cream 30g
Ointment 30g

03.03.02 Montelukast 

Tablets 10mg (for patients over 15 years of age)

Chewable tablets 5mg (for patients 6-14 years of age)

Chewable tablets 4mg (for patients aged 2-5years of age)

Granules 4mg (for patients 6months to 5 years)

04.07.02 Morphine 

Check local guidance

21 Morphine 

Palliative care 

Breathlessness

Pain in the last weeks or days of life

Breathlessness in the last days of life

Pain

02.05.02 Moxonidine 

Tablets 200micrograms, 300micrograms, 400micrograms

Reserved for use in resistant hypertension, in line with NG 136

09.06.07 Multivitamin preparations Abidec® Vitamins A, B group, C and D

Oral drops
09.06.07 Multivitamin preparations Dalivit® Vitamins A, B group, C and D

Oral drops
12.02.03 Mupirocin 2% Bactroban Nasal® Nasal ointment Mupirocin 2%
13.10.01.01 Mupirocin 2% Bactroban® Cream 15g
09.06.07 Mutivitamin 
11.05 Mydrane 

Solution for injection - lidocaine hydrochloride 10mg/ml, phenylephrine hydrochloride 3.1mg/ml, tropicamide 200microgram/ml

11.05 Mydriasert 

Ophthalmic inserts - phenylephrine hydrochloride 5.4mg, Tropicamide 28mg

02.06.04 Naftidrofuryl oxalate 

Capsules 100mg

01.06.06 Naldemedine tosylate Rizmoic®

Tablets 200 micrograms

01.06.06 Naloxegol Moventig®

Tablets 12.5mg, 25mg

21 Naloxegol 

Palliative care

Opioid-induced constipation

04.10.03 Naltrexone Nalorex® Tablets 50mg
10.01.01 Naproxen 

Tablets 250mg, 500mg
Effervescent tablets 250mg

Evidence suggests that naproxen is aassociated with a lower cardiovascular risk than COX-2 inhibitors, diclofenac or high dose ibuprofen.
naproxen is the preferred option for patients requiring long-term treatment with a more potent NSAID than ibuprofen

21 Naproxen 

Palliative care

Pain: Anti-inflammatory

01.03.05 Naproxen & Esomeprazole Tablets 
02.04 Nebivolol 

Tablets 5mg


Not first line.
Note that strengths other than 5mg are significantly more expensive.

02.06.02 Nicardipine 

Injection 10mg/10mL

Specialist use only

02.06.03 Nicorandil 

Tablets 10mg, 20mg


Alternative following first line anti-anginal agents as per CG126 Stable angina: management

04.10 Nicotine 

NiQuitin®Patches 7mg/24hours, 14mg/24hours, 21mg/24hours
NiQuitin® mini lozenges 1.5mg, 4mg
Nicorette® inhalator 15mg plus 20 cartridges

Nicorette patches® 15mg/16 hours, 25mg/16 hours -for pregnant women only

Nicotine gum - for pregnant women only - * NOT liquorice flavour*

02.06.04 Nifedipine 
Capsules 5mg, 10mg, 20mg
 
M/R Tablets 10mg, 20mg
 
Raynauds syndrome (modified release preperations - unlicensed use).
 
Hypertension in pregnancy (Refer to the individual SPC for each preparation of nifedipine for further details on use in preganancy).
 
No longer recommended for the treatment angina or hypertension (refer to NG133 for hypertension in pregnancy).
 
Prescribe modified release preperations by brand.
07.01.03 Nifedipine 

Capsules 10mg

Uncomplicated premature labour

unlicensedunlicensed indication

02.06.02 Nimodipine Nimotop®

Tablets 30mg
Intravenous infusion 10mg/50mL

Prevention and treatment of ischaemia following subarachnoid haemorrhage

For use only within licensed indications following aneurysmal subarachnoid haemorrhage.

03.11 Nintedanib 

Ofev® 100mg soft capsule / 150mg soft capsules

Only Ofev brand is licensed for IPF

NICE TA379 - Nintedanib for treating idiopathic pulmonary fibrosis

NICE TA747 - Nintedanib for treating progressive fibrosing interstitial lung diseases

NICETA864 - Nintedanib for treating idiopathic pulmonary fibrosis when forced vital capacity is above 80% predicted

04.01.01 Nitrazepam  Tablets 5mg
Liquid 2.5mg/5mL

Stocked for patients admitted on these and for Mental Health patients
01.03.01 Nizatidine 

Capsules 150mg, 300mg

02.07.02 Noradrenaline (Norepinephrine) 

For theatre/ICU use only

06.04.01.02 Norethisterone Utovlan®

Tablets 5mg

07.03.02.01 Norethisterone 

Tablets 350 micrograms

Menstrual disorders.

04.03.01 Nortriptyline Allegron®

Tablets 10mg, 25mg

Use in line with LSCMMG pain guidance

04.07.03 Nortriptyline 
06.01.01.02 NovoMix® 30 Biphasic Insulin Aspart

3mL cartridge for Innovo® or NovoPen®
3mL prefilled disposable FlexPen®

First line biphasic short-acting analogue insulin (Novomix 30 Flexpen)

06.01.01.01 NovoRapid® Insulin Aspart

10mL vial
3mL cartridge for NovoPen®
3mL prefilled disposable FlexPen®

Biosimilars are first line

10.02 Nusinersen  Spinraza®

Solution for injection vials 12mg/5ml

12.03.02 Nystatin Nystan® Oral suspension 100,000 units/mL

Will be labelled in doses of 1mL unless alternative specifically requested
01.09.01 Obeticholic acid  Ocaliva®

Tablets 5mg, 10mg

Specialist use only
NHS England Commissioned

13.11 Octenisan® 
21 Octreotide 

Palliative care

Bowel obstruction - GI secretions associated with bowel obstruction. 

06.04.01.01 Oestrogen only HRT implant Estradiol

Implant 50mg

For patients who cannot tolerate other formulations.

06.04.01.01 Oestrogen only HRT tablet Elleste-Solo

Tablets 1mg, 2mg

Oestrogen only for women without a uterus

07.02.01 Oestrogens, Topical Estring®

Only used in patients who can't use gel or patches.

11.03.03 Ofloxacin eye drops  

0.3% drops

13.02.01 Oilatum®  Cream 50g, 500g
04.02.01 Olanzapine 

Tablets 2.5mg, 5mg, 7.5mg, 10mg, 15mg
Dispersible tablets (Velotabs®) 5mg, 10mg, 15mg, 20mg

04.02.01 Olanzapine  Injection 10mg/2mL

04.06 Olanzapine 

Off-label use for the treatment of post-chemotherapy nausea and vomiting.

* For Oncology use only *

**under review**

12.01.03 Olive Oil Ear Drops 
03.01.01.01 Olodaterol Striverdi Respimat®

2.5micrograms/dose solution for inhalation cartridge with device

11.04.02 Olopatadine Opatanol®

Eye drops 1mg/mL (0.1%)

03.04.02 Omalizumab 

 Xolair® 75mg solution for injection in pre-filled syringe, 150mg solution for injection in pre-filled syringe

Severe persistent allergic asthma in people aged 6 years and older (NICE TA278)

03.04.02 Omalizumab 

Xolair® 75mg solution for injection in pre-filled syringe, 150mg solution for injection in pre-filled syringe
 
Chronic rhinosinusitis with nasal polyps - NICE TA678 appraisal terminated

02.12 Omega-3 acid ethyl esters 
07.01 Omega-3-acid ethyl esters 

Capsules 1000mg

Preterm birth risk reduction.

01.03.05 Omeprazole 

Green Capsules 10mg, 20mg - Second line 
Patients taking more than 20mg daily of omeprazole are considered to be on high dose treatment. When reducing doses, please choose the lowest effective dose to control symptoms

Green Restricted Omeprazole (Losec MUPS) Dispersible tablets 10mg - For paediatric use only

Green Restricted Omeprazole oral suspension, 10mg/5ml, 20mg/5ml- For paediatric use only (for children 1 month and above), where dispersible tablets are not suitable

Red Omperazole IV

10.02 Onasemnogene abeparvovec Zolgensma®

 2 × 1013 vector genomes/mL solution for infusion

Tertiary centre

04.06 Ondansetron 

Tablets 8mg
Liquid 4mg/5mL
Injection 4mg/2mL, 8mg/4mL

MHRA warning – risk of prolongation of the QT interval. Maximum single dose of ondansetron injection for the management of chemotherapy-induced nausea and vomiting in adults is 16mg.

21 Ondansetron 

Palliative care

Bowel obstruction - nausea and vomiting associated with bowel obstruction

04.09.01 Opicapone Ongentys®

Capsules 50mg

09.02.01.02 Oral Rehydration Salts inc Dioralyte®

Sachets

04.05.01 Orlistat  Capsules 120mg
04.09.02 Orphenadrine  Tablets 50mg
Liquid 50mg/5mL
07.02 Ospemifene 

Vulvovaginal or vaginal atrophy in postmenopausal women.

12.01.02 Otigo 40 mg/10 mg/g ear drops, solution Otigo ®

Ear drops containing - Lidocaine hydrochloride 10 mg per 1 gram with Phenazone 40 mg per 1 gram, 15mL bottle.

04.01.02 Oxazepam 

Tablets 10mg, 15mg

Oxazepam should be reserved for in-patient alcohol detoxification of patients with significant hepatic impairment where a short-acting benzodiazepine would be preferred. It may also be used in older patients who have been taking it long-term where a switch or discontinuation could pose a risk to the patient

 

04.08.01 Oxcarbazepine Trileptal®

Tablets 150mg, 300mg
Liquid 30mg/5mL

 

Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products

11.07 Oxybuprocaine Hydrochloride Minims® Minims® 0.4%
07.04.02 Oxybutynin 

Tablets 2.5mg, 5mg
Liquid 2.5mg/5mL
M/R tablets 5mg, 10mg

Urinary frequency, urgency, and incontinence.

04.07.02 Oxycodone 

Check local guidance 

Oxycodone should be initiated by consultant physicians or specialists in palliative care only, it is indicated only for patients who do not tolerate morphine

 

**under review**

21 Oxycodone 

Palliative care

Breathlessness in the last days of life (on the advice of a specialist)

21 Oxygen 

Palliative care

Breathlessness

13.06.02 Oxytetracycline  Tablets 250mg
07.01.01 Oxytocin 

Injection 10 units/1mL, 5 units/1mL

01.05.03 Ozanimod 

Capsules 230microgram, 460microgram, 920 microgram

Moderately to severely active ulcerative colitis

03.04.02 Palforzia 

Oral powder in capsules for opening 0.5mg, 1mg, 10mg, 20mg, 100mg, 300mg

peanut protein as defatted powder of Arachis hypogaea L., semen (peanuts)

In view of concerns about the safety of desensitising vaccines, it is recommended that they are used by specialists and only for licensed indications.

Self-injectable adrenaline must be prescribed to patients receiving this medicinal product.

04.02.02 Paliperidone 

Pre-filled syringes 50mg, 75mg, 100mg, 150mg (Xeplion) - monthly injection

Pre-filled syringes 175mg, 263mg, 350mg, 525mg (Trevicta) - 3-monthly injection

 Pre-filled syringes 700mg, 1000mg (Byannli) - 6-monthly injection

LSCFT initiation only.

01.09.04 Pancreatin 

First line: Creon capsules 10 000, 25 000
Second line if Creon not tolerated or unavailable: Nutrizym 22 capsules
Swallowing difficulties/enteral tubes: Pancrex V powder
Paeds only: Creon micro granules

01.03.05 Pantoprazole 

Green Pantoprazole Tablets 20mg, 40mg - Second line 

Red Pantoprazole IV (Injection 40mg)

04.07.01 Paracetamol  Tablets 500mg
Dispersible tablets 500mg
Liquid 120mg/5mL, 250mg/5mL, 1g/10mL
Suppositories 60mg,120mg, 240mg, 500mg


04.07.01 Paracetamol  Intravenous infusion 1g/100mL
For short term treatment of moderate pain or fever when the oral route is not available
04.08.02 Paraldehyde  Rectal solution 50% in olive oil

Unlicensed
06.06.01 Parathyroid Hormone 
09.06 Paravit CF® 

Paravit-CF is a ‘Food for Special Medical Purposes’ for the dietary management of patients with cystic fibrosis and is reimbursable on FP10.
Paravit CF Capsules contain:
• Vitamin A 1.5 mg (=5,000IU)
• Vitamin D3 37.5 µg (=1,500IU)
• Vitamin E 100 µg (=150IU)
• Vitamin K 5 mg
Paravit CF capsules provide an alternative vitamin supplementation option for Cystic Fibrosis patients, which offers patients a decreased oral medication load whilst also being a cost-effective option.
Paravit CF liquid is only available as an option for patients with swallowing difficulties or young children.

09.03 Parenteral Nutrition (TPN or PN)  Peripheral or Central line
10g, 2500ml volume, Na+ 52.5mmol, K+ 40mmol, Ca2+ 5mmol, Mg2+ 5.5, PO4- 21.2mmol, 1500kcal

Central line only
14g, 2000ml volume, Na+ 70mmol, K+ 60mmol, Ca2+ 7mmol, Mg2+ 8, PO4- 30mmol, 1920kcal

18g, 2000ml volume, Na+ 70mmol, K+ 60mmol, Ca2+ 7mmol, Mg2+ 8, PO4- 30mmol, 1680kcal

Electrolyte free (apart from PO4)
18g electrolyte free, 2000ml volume, central line only, PO4- 6mmol, 1680kcal

Fat free
14g fat free, 2000ml volume, central line only, Na+ 70mmol, K+ 60mmol, Ca2+ 4.5mmol, Mg2+ 5, PO4- 30mmol, 1200kcal

04.03.03 Paroxetine  Tablets 20mg, 30mg
Liquid 10mg/5mL
09.02.01.01 Patiromer calcium  Veltassa®

Oral powder sachets 8.4g, 16.8g

09.01.06 Pegfilgrastim Neulasta® Injection 6mg in 0.6mL prefilled syringe
09.08.01 Pegunigalsidase alfa Elafbrio®

For treating Fabry disease

06.05 Pegvisomant 
09.08.01 Penicillamine 

Tablets 125mg

10.01.03 Penicillamine 

Tablets 125mg

07.04.03 Pentosan polysulfate sodium  

Capsules 100mg

Bladder pain syndrome.

02.06.04 Pentoxifylline 
01.02 Peppermint Oil 

e/c capsules 0.2mL


04.08.01 Perampanel Fycompa®

Tablets f/c 2mg,4mg, 6mg, 8mg, 10mg, 12mg

Suspension 500micrograms/1mL

 

Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products

02.05.05.01 Perindopril erbumine 

Tablets 2mg, 4mg, 8mg

Not first line

Perindopril ARGININE is considered ‘Not suitable for prescribing’ across the ICB.

13.10.04 Permethrin 5% Lyclear® Dermal Cream Dermal cream 30g
04.07.02 Pethidine  Injection 50mg/1mL
04.03.02 Phenelzine Nardil®

Tablets 15mg

04.08.01 Phenobarbital 

Tablets 15mg, 30mg
Liquid 15mg/5mL

Restricted Item  Stocked for patients admitted on this but not recommended for initiation

 

Category 1 - Doctors are advised to ensure that their patient is maintained on a specific manufacturer's product

Liquid 50mg/5mL (alcohol free) for paediatric use only

 

**under review**

01.07.03 Phenol 

phenol 5% in almond oil. 5-mL amp

Contains nuts - contraindicated in patients with hypersensitivity to nuts

02.05.04 Phenoxybenzamine Hydrochloride 

Capsules 10mg

02.05.04 Phentolamine 

Injection

unlicensed unlicensed

For theatre/ICU use only.

07.04.05 Phentolamine/ Aviptadil  Invicorp®

Injection, phentolamine 2 mg/0.35 ml; aviptadil 25 micrograms/0.35 ml

Symptomatic treatment of erectile dysfunction in adult males due to neurogenic, vasculogenic, psychogenic, or mixed aetiology.

Reserved for patients not responding or intolerant to Alprostadil, as an option before referral for surgical procedure.

10.01.01 Phenylbutazone  Tablets 100mg
Consultant rheumatologist only.
Reserved for ankylosing spondylitis not responsive to other NSAIDs
02.07.02 Phenylephrine 
11.05 Phenylephrine Hydrochloride Minims® Phenylephrine Hydrochloride

Minims® 2.5%, 10%

04.08.01 Phenytoin 

Capsules (Flynn Pharma®) 25mg, 50mg, 100mg (as phenytoin sodium)
Liquid (Epanutin®)30mg/5mL

 

Category 1 - Doctors are advised to ensure that the patient is maintained on a specific manufacturer's product

Phenytoin suspension 90mg in 15mL is approximately equivalent in therapeutic effect to capsules or tablets containing phenytoin sodium 100mg

**under review**

04.08.02 Phenytoin  Injection 250mg/5mL
09.05.02.01 Phosphate infusion 

Intravenous infusion (phosphate 50mmol/500mL) 500mL

09.05.02.01 Phosphate supplements Phosphate-Sandoz® Effervescent tablets 500mg (phosphate 16.1mmol)
01.06.04 Phosphates (Rectal) Fleet®

Ready to use enema 133mL

Cleen® [formally Fleet®] Ready-to-use Enema - prescribe by brand

09.06.06 Phytomenadione  Injection 10mg/1mL (Konakion MM®) for IV injection only, not for IM injection.
Injection 2mg/0.2mL (Konakion MM Paediatric®)

Konakion MM Paediatric® may be administered by mouth, by IM injection or by IV injection - see UHMB guideline for administration of vitamin k to neonates
11.06 Pilocarpine 

Minims® 2%

11.06 Pilocarpine 

Eye drops 1% 2%
 

12.03.05 Pilocarpine Salagen®

Tablets 5mg

Radiation-induced xerostomia, Sjogren’s syndrome 

When 1st line topical agents have not been effective

12.03.05 Pilocarpine Hydrochloride 

Approved for Sjogrens Syndrome for severe cases that are unresponsive to pastilles and/or artificial saliva spray - Specialist initiation

13.05.03 Pimecrolimus 1% Elidel®

Cream 30g, 60g, 100g

06.01.02.03 Pioglitazone 

Tablets 15mg, 30mg, 45mg

06.01.02.03 Pioglitazone & Metformin 
04.02.02 Pipotiazine Palmitate Piportil® Depot

Injection 50mg/1mL, 100mg/2mL

04.08.01 Piracetam Nootropil®

Tablets 800mg, 1200mg

Oral Solution 33% 

03.11 Pirfenidone 

267mg tablets / hard capsules, 534mg tablets, 801mg tablets

04.07.04.02 Pizotifen 

Tablets 500micrograms, 1.5mg

**Under review**

13.07 Podophyllotoxin 0.015% Warticon® Cream 5g
11.03.01 Polihexanide 

Eye drops 0.02%

Specialist use only for treatment of fusarium keratitis

Also known as polyhexamethylene biguanide (PHMB)

09.02.01.01 Polystyrene Sulphonate Resins Calcium Resonium®

Oral powder 300g
Enema kit 30g

Green In East Lancashire

11.08.01 Polyvinyl Alcohol Liquifilm Tears®

Eye drops 1.4%
Unit dose eye drops 1.4%

03.05.02 Poractant Alfa Curosurf®

120mg/ vial endotracheopulmonary instillation suspension, 240mg / vial endotracheopulmonary instillation suspension

11.08 Potassium ascorbate 

Eye drops 10%

*under review*
Not on East Lancashire formulary

09.02.01.01 Potassium Chloride Sando-K® Effervescent tablets potassium 12mmol
09.02.01.01 Potassium Chloride Kay-Cee-L® Liquid 1mmol/mL
09.02.01.01 Potassium Chloride Slow-K® m/r tablets potassium 8mmol

Avoid unless effervescent tablets or liquid preparations inappropriate
09.02.02.01 Potassium Chloride 50mmol in 50mL Sodium Chloride 0.9% prefilled syringe  Restricted ItemHigh strength intravenous infusion Prefilled syringe 7.5% (1mmol/L) 50mL

Restricted ItemRestricted use see UHMB Trust Potassium Policy
09.02.02.01 Potassium Chloride and Glucose Intravenous Infusion   Potassium chloride 0.15% (20mmol/litre)/glucose 5% 1L
Potassium chloride 0.3% (40mmol/litre)/glucose 5% 500mL & 1L
Potassium chloride 0.15% (20mmol/litre)/glucose 10% 500mL
Potassium chloride 0.3% (40mmol/litre)/glucose 10% 500mL
09.02.02.01 Potassium Chloride and Sodium Chloride Intravenous Infusion  Potassium chloride 0.15% (20mmol/litre)/sodium chloride 0.9% 1L
Potassium chloride 0.3% (40mmol/litre)/sodium chloride 0.9% 1L
Restricted ItemPotassium chloride 0.6% (80mmol/litre)/sodium chloride 0.9% 500mL & 1L

Restricted Item Restricted use - see UHMB Trust Potassium Policy
09.02.02.01 Potassium Chloride, Sodium Chloride and Glucose Intravenous Infusion  Potassium chloride 0.15% (20mmol/litre)/sodium chloride 0.18%/glucose 4% 1L
Potassium chloride 0.3% (40mmol/litre)/sodium chloride 0.18%/glucose 4% 1L
Potassium chloride 0.15% (20mmol/litre)/sodium chloride 0.45%/glucose 5% 500mL
Potassium chloride 0.3% (40mmol/litre)/sodium chloride 0.45%/glucose 5% 500mL
07.04.03 Potassium Citrate 

Effervescent tablets, 30% mixture BP

Alkalinisation of urine.

13.11.06 Potassium Permanganate Permitabs®

Solution tablets 400mg

Primary Care :  Potassium permanganate should always be prescribed for a named patient by a primary care prescriber, experienced in the treatment of dermatological conditions and use of potassium permanganate.
 
Secondary Care:- Potassium permanganate concentrate should always be prescribed for a named patient by a specialist in dermatology, a clinician working under the guidance of a dermatologist, or specialist tissue viability staff only.
 
Note:  A risk assessment must be completed if potassium permanganate is to be used in a patient's home
11.08.02 Povidone iodine 

Unit dose eye drops 5%

04.09.01 Pramipexole 

Tablets 88micrograms, 180micrograms, 350 micrograms, 700micrograms pramipexole base (equivalent to 125micrograms, 250micrograms, 500micrograms and 1mg pramipexole salt)
m/r tablets 260 micrograms, 520 micrograms 1.05mg, 2.1mg, 3.15mg base (equivalent to 375micrograms, 750micrograms, 1.5mg, 3mg, 4.5mg salt)

Pramipexole (first line) and ropinirole (second line) are Green Traffic Light  for moderate to severe restless legs syndrome - see prescribing guideline

07.02.01 Prasterone 

Vulvovaginal or vaginal atrophy in postmenopausal women having moderate to severe symptoms.

02.09 Prasugrel 

Tablets 5mg, 10mg


02.12 Pravastatin  

Tablets 10mg, 20mg, 40mg

Pravastatin is restricted to use in patients who cannot tolerate other statins.

06.03.02 Prednisolone 

Tablets 1mg, 5mg
e/c tablets 2.5mg

25mg tablets are classified as Do Not Prescribe


There is no evidence that e/c prednisolone reduces the risk of gastrointestinal side effects. Uncoated tablets should be prescribed first line together with a PPI if necessary.

11.04.01 Prednisolone Pred Forte®

Eye drops 1%

01.05.02 Prednisolone (oral) 

Tablets 1mg, 5mg
e/c tablets 2.5mg

First line oral corticosteroid treatment.

25mg tablets are classified as Do Not Prescribe.

There is no evidence that e/c prednisolone reduces the risk of gastrointestinal side effects. Uncoated 5mg tablets should be prescribed first line together with a PPI if necessary.

01.05.02 Prednisolone (rectal) 

Foam 20mg/metered application,
Retention enema 20mg/100mL,
Suppositories 5mg

Prednisolone rectal preparations are reserved for patients who do not respond to budesonide rectal.

11.04.01 Prednisolone eye drops 

Eye drops 0.5%

Unit dose eye drops preservative free 0.5% - only for patients with a documented allergy to preservatives

Green in East Lancashire

*under review*

04.01.02 Pregabalin 

Capsules

04.07.03 Pregabalin 

See section 4.8.1

04.08.01 Pregabalin 

Capsules 25mg, 50mg, 75mg, 100mg, 150mg, 300mg

 

Category 3 - It is usually unecessary to ensure that patients are maintained on a specific manufacturer's product as therapeutic equivalence can be assumed


A decision has been made and ratified by UHMB Drug & Therapeutics Committee and Morecambe Bay Area Prescribing Committee that generic pregabalin will be dispensed for all licensed and unlicensed indications

**under review**

21 Pregabalin 

Palliative care

Neuropathic pain

06.01.01.03 Prescribable CGM 

FreeStyle Libre, Dexcom

Red FreeStyle Libre® 3

04.08.01 Primidone 

Tablets 250mg

Restricted Item  Stocked for patients admitted on this but not recommended for initiation

 

Category 1 - Doctors are advised to ensure that their patient is maintained on a specific manufacturer's product

**under review**

04.09.03 Primidone  See section 4.8.1
04.06 Prochlorperazine  Tablets 5mg
Buccal tablets 3mg
Liquid 5mg/5mL
Suppositories 5mg
Injection 12.5mg/1mL
21 Prochlorperazine (buccal) 

Palliative care

Nausea and vomiting in the last days of life

04.09.02 Procyclidine  Injection 10mg/2mL

04.09.02 Procyclidine  Tablets 5mg
Liquid 5mg/5mL

06.04.01.02 Progesterone Cyclogest®

Pessaries 200mg, 400mg

Used in specialist pre-term birth clinic and for patients with recurring miscarriage following IVF.

06.04.01.02 Progesterone (micronised) Utrogestan ®

Capsules 100mg

06.04.01.02 Progestogen (micronised) vaginal capsules Utrogestan ®

Vaginal capsules 200mg

 Approved 'off label' for specialist use only as per NICE NG126: Ectopic pregnancy and miscarriage: diagnosis and initial management.

04.02.01 Promazine Hydrochloride  Tablets 25mg, 50mg
Liquid 25mg/5mL, 50mg/5mL
03.04.01 Promethazine Phenergan® Tablets 10mg, 25mg
Liquid 5mg/5mL
04.06 Promethazine Hydrochloride Phenergan See section 3.4.1
04.06 Promethazine Teoclate Avomine®

Tablets 25mg

02.03.02 Propafenone 

Tablets 150mg, 300mg

Requires specialist supervision

11.03.01 Propamidine Isetionate Brolene®

Eye drops 0.1%

Specialist use only for treatment of acanthamoeba keratitis

02.04 Propranolol 

Tablets 10mg, 40mg, 80mg
M/R capsules 80mg, 160mg

Not recommended for cardiac indications

04.07.04.02 Propranolol  See section 2.4
04.09.03 Propranolol 

See section 2.4

06.02.02 Propylthiouracil  Tablets 50mg
13.02.02 Proshield Plus®  Skin protectant ointment 115g
02.08.03 Protamine  

Injection 50mg/5mL

06.05 Protirelin TRH 

For diagnostic use

11.07 Proxymetacaine Hydrochloride Minims® Minims® 0.5%
01.06.07 Prucalopride Resolor ®

Tablets f/c 1mg, 2mg

10.02.01 Pyridostigmine Bromide 

Tablets 60mg

09.06.02 Pyridoxine Hydrochloride 

Tablets 10mg, 50mg

Green  in East Lancashire

04.02.01 Quetiapine 

Tablets 25mg, 100mg, 150mg, 200mg, 300mg


M/R tablets 50mg, 200mg, 300mg, 400mg (to be prescribed as Sondate XL in primary care)

LSCFT initiated only

06.07.01 Quinagolide 

Hyperprolactinaemic disorders.

Third line.

 

10.02.02 Quinine  Tablets 200mg, 300mg
06.04.01.01 Raloxifene Hydrochloride Evista®

Tablets 60mg

Green Traffic Light  Secondary prevention of osteoporosis (NICE TA161)

Do Not Prescribe   Primary prevention of osteoporosis in postmenopausal women - not recommended by NICE TA160 updated

02.05.05.01 Ramipril 

Capsules 1.25mg, 2.5mg, 5mg, 10mg

First line

11.08.02 Ranibizumab 

Solution for intravitreal injection 10mg/mL
 

Black For NICE TA637: Ranibizumab for treating diabetic retinopathy (terminated appraisal)

02.06.03 Ranolazine Ranexa®

M/R tablets 375mg, 500mg, 750mg

Restricted to use in line with NICE CG126 Stable angina: management

04.09.01 Rasagiline Azilect®

Tablets 1mg

Rasagiline is 2nd line in patients unable to tolerate selegiline tablets

10.01.04 Rasburicase Fasturtec® Intravenous infusion 7.5mg

Consultant haematologist only
09.01.03 Ravulizumab Ultomiris®

Concentrate for solution for infusion 300mg/3mL, 1,100mg/11mL, 300mg/30mL

Tertiary centres only

04.03.04 Reboxetine Edronex®

Tablets 4mg

Consultant psychiatrist initiation only

06.07.02 Relugolix–estradiol–norethisterone acetate Ryeqo ®

Tablets : Estradiol (as Estradiol hemihydrate) 1 mg, Norethisterone acetate 500 microgram, Relugolix 40 mg

09.06.07 Renavit® 

Dietary management of water-soluble vitamin deficiency in adults with renal failure on dialysis
For G.P prescribing

06.01.02.03 Repaglinide 

Tablets 500micrograms, 1mg, 2mg

First line to stimulate insulin release

03.04.02 Reslizumab 

(Cinqaero®) concentrate for solution for infusion 25mg/2.5ml, 100mg/10ml

Severe eosinophilic asthma  as per NICE TA479

04.09.03 Riluzole Rilutek®

Tablets 50mg

Suspension 5mg/1ml

Consultant neurologist initiation only

04.06 Rimegepant Vydura

75mg

 Prophylaxis of migraine (in patients who have at least 4 migraine days per month)

** North-West Pathway for Headache being developed **

01.05.03 Risankizumab Skyrizi®

solution for injection pre-filled syringes, solution for injection pre-filled pen 150mg/mL

Crohn's disease

10.01.03 Risankizumab Skyrizi®

solution for injection pre-filled syringes, solution for injection pre-filled pen 150mg/mL

13.05.03 Risankizumab Skyrizi®

solution for injection pre-filled syringes, solution for injection pre-filled pen 150mg/mL

Red BlueTeqNICE TA888 Risankizumab for previously treated moderately to severely active Crohn's disease - see link below

10.02 Risdiplam  Evrysdi®

Powder for oral solution 0.75mg/mL

06.06.02 Risedronate 

Second line for osteoporosis.

Alternative weekly preparation when alendronic acid is not appropriate.

04.02.01 Risperidone 

Tablets 500micrograms, 1mg, 2mg, 3mg
Dispersible tablets (Quicklets®) 1mg, 2mg
Liquid 1mg/mL

04.02.02 Risperidone Risperdal Consta®

Injection 25mg, 37.5mg, 50mg

Consultant psychiatrist initiation only
 
 

09.01.03 Rituximab 

Off-label use for the treatment of autoimmune haemolytic anaemia in adults (AIHA)

Rituximab is recommended as an alternative treatment for adults with AIHA where patients are contraindicated to or fail to respond to standard active treatments (e.g corticosteroids).

Treatment requires initiation and continuation by specilist haematology services.

 

 

09.01.04 Rituximab idiopathic thrombocytopenia in adults

Off-label use for the treatment of idiopathic thrombocytopenia in adults.

For use as an alternative 2nd line treatment in adults with ITP following failure of corticosteriod treatment or when corticosteroids and thrombopoietin receptor agonists are contraindicated

Treatment requires initiation and continuation and continuation by specialist haematology services

10.01.03 Rituximab (rheumatology) Biosimilars avaliable

Concentrate for intravenous infusion 500mg/50mL


REQUIRES BLUETEQ APPROVAL

02.08.02 Rivaroxaban Xarelto®

Tablets 2.5mg, 10mg, 15mg, 20mg

Green  Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation (NICE TA256)
 
Red Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults (NICE TA 170)


Amber 0 Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome (NICE TA335) (Green East Lancashire only, for this indication)

Amber 0 Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism (NICE TA261)  (Green East Lancashire only, for this indication)

Amber 0 Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism (NICE TA287)  (Green East Lancashire only, for this indication)

 

Amber 0 *10mg tablets* Treatment of DVT and PE, and extended prevention of recurrent DVT and PE in adults

02.08.02 Rivaroxaban with aspirin 

Tablets 2.5mg

Prevention of cardiac events in patients with coronary (CAD) or peripheral artery Disease (PAD)

 

Amber 0  East Lancashire only

04.11 Rivastigmine Exelon®

Tablets 1.5mg, 3mg, 4.5mg
Patches 4.6mg/24hours, 9.5mg/24hours, 13.3mg/24 hours
Liquid 2mg/mL

03.03.03 Roflumilast Daxas®

Tablets 250 microgram, 500 microgram

09.01.04 Romiplostim Nplate®

Injection 250 micrograms

Consultant haematologist only

06.06.02 Romosozumab  Evenity®

Solution for injection in pre-filled pen 105mg

04.09.01 Ropinirole 

Tablets 250micrograms, 1mg, 2mg, 5mg
m/r tablets 2mg, 4mg, 8mg

Please prescribe Ropinirole m/r 2mg, 4mg and 8mg as the branded generic Ipinnia XL® in primary care


Pramipexole (first line) and ropinirole standard release tablets (second line) are Green Traffic Light  for moderate to severe restless legs syndrome - see prescribing guideline

02.12 Rosuvastatin 

Tablets 5mg, 10mg, 20mg



04.09.01 Rotigotine 

Patch 2mg, 4mg, 6mg, 8mg

09.01.01 Roxadustat Evrenzo®

Tablets 20mg, 50mg, 70mg, 100mg, 150mg

10.03.02 Rubefacients 

Rubefacients (excluding topical NSAIDs and capsaicin) are classified as BLACK (Not to be prescribed) as per national guidelines on items which should not routinely be prescribed in primary care.

Examples include: Algisal, Deep Heat, Transvasin

 

In hospital Deep Heat cream may be used for aiding the collection of arterial blood gases.

04.08.01 Rufinamide Inovelon®

Tablets 100mg, 200mg

 

Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products



Consultant neurologist initiation only

02.05.05.02 Sacubitril/valsartan Entresto®

film-coated tablets
24.3 mg sacubitril and 25.7 mg valsartan (as sacubitril valsartan sodium salt complex).
48.6 mg sacubitril and 51.4 mg valsartan (as sacubitril valsartan sodium salt complex).
97.2 mg sacubitril and 102.8 mg valsartan (as sacubitril valsartan sodium salt complex).

Entresto® tablets and granules contain sacubitril and valsartan in the form x/y where x and y are the strength in milligrams of sacubitril and valsartan respectively. Doses in BNF Publications are expressed as the total of both drug strengths.

 
For Entresto® tablets, the 24/26 mg, 49/51 mg, 72/78 mg, and 97/103 mg strengths are referred to as 50 mg, 100 mg, 150 mg, and 200 mg, respectively.
 
See BNF for more detail.
03.01.01.01 Salbutamol  Injection 500micrograms/1mL
Solution for intravenous infusion 5mg/5mL
03.01.01.01 Salbutamol 

Nebuliser solution 2.5mg/2.5mL, 5mg/2.5mL
Metered dose inhaler 100micrograms/inhalation
Easyhaler® 100micrograms inhalation
Easyhaler® 200micrograms inhalation
Ventolin Accuhaler® 200micrograms/inhalation

Airomir 100µg / inhalation

Airomir 100µg  / inhalation Autohaler

 

First choice reliever in fixed dose regimen

21 Salbutamol 2.5mg nebules 

Palliative care

Breathlessness

07.01.03 Salbutamol injection 

Concentrate for intravenous infusion 5mg/5mL

Uncomplicated premature labour

03.01.01.01 Salbutamol SR tablets 
13.07 Salicylic Acid 16.7% with Lactic Acid 16.7% Salactol® Paint 10mL
13.07 Salicylic Acid 26% Occlusal® Solution
13.05.02 salicylic acid in emulsifying ointment 2%, 5%, 10%  Ointment 2%, 5%, 10%
12.03.05 Salivix®  Pastilles
03.01.01.01 Salmeterol Long acting

Serevent® metered dose inhaler 25micrograms/inhalation
Serevent Accuhaler® 50micrograms/inhalation

COPD and Asthma

10.01.03 Sarilumab Kevzara®

Pre-filled pen 150mg. 200mg
Pre-filled syringe 150mg, 200mg

01.07.02 Scheriproct (Cincochaine with prednisolone)  

Ointment and suppository

10.01.03 Secukinumab 

150mg/ml pre-filled pens/syringes

13.05.03 Secukinumab Cosentyx®

150mg pre-filled syringe

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

Approved as Red Traffic Light  for palmoplantar psoriasis - off-label use

04.09.01 Selegiline Hydrochloride 

Tablets 5mg, 10mg

04.09.01 Selegiline Hydrochloride Zelapar®

Oral lyophilisate 1.25mg
(for patients unable to tolerate ordinary tablets)

04.05.01 Semaglutide  Wegovy®

Solution for injection in pre filled pen

0.25mg, 0.5mg, 1mg, 1.7mg, 2.4mg

 

Only available via referral to a Tier 3 Weight Management Service (though not commercially available yet)

Do Not Prescribe for NICE TA910

06.01.02.03 Semaglutide Ozempic®

Solution for injection - pre-filled pen 0.25mg, 0.5mg, 1mg

First line GLP-1 agonist.

Prescribe by brand.

06.01.02.03 Semaglutide Wegovy®

Managing overweight and obesity.

Prescribe by brand.

06.01.02.03 Semaglutide Rybelsus®

Tablets 3mg, 7mg, 14mg

First line GLP-1 agonist.

Alternative GLP-1 receptor agonist for patients who are unable to use subcutaneous formulations or patients who prefer oral administration. 

01.06.02 Senna 

Tablets 7.5mg, Liquid 7.5mg/5mL

First line

Consider OTC purchase for some conditions

21 Senna 

Palliative care

Constipation

Opioid-induced constipation

04.03.03 Sertraline 

Tablets 50mg, 100mg

Citalopram or Sertraline are the antidepressants of choice in epilepsy

06.07 Setmelanotide  Imcivree ®

Tertiary Service Only

09.05.02.02 Sevelamer Carbonate 

Tablets 800mg

09.05.02.02 Sevelamer Carbonate Renvela®

Sachets 2.4g

02.05.01 Sildenafil 

Tablets 20mg

Tertiary centre only.
Sildenafil and bosentan are licensed for use in pulmonary arterial hypertension (PAH). Treatment of this condition is commissioned nationally through a small number of PAH centres based in hospitals across the UK.
All patients should be referred to one of these centres, who carry out all prescribing of these therapies.

02.06.04 Sildenafil 

Tablets 25mg

Digital ulceration

Unlicensed indication - Specialist initiation only

07.04.05 Sildenafil 

Tablets 25mg, 50mg, 100mg

Erectile dysfunction.

First line pharmacological therapy for erectile dysfunction.

13.07 Silver Nitrate 75%  AVOCA® Caustic applicator
13.10.01.01 Silver Sulfadiazine 1% Flamazine® Cream 50g
01.01.01 Simeticone (activated dimeticone) 

Endoscopy use only

02.12 Simvastatin 

Tablets 10mg, 20mg, 40mg

02.12 Simvastatin and Ezetimibe Inegy 
06.01.02.03 Sitagliptin 

Tablets 100mg
 
Second line gliptin on LSCMMG pathway

06.01.02.03 Sitagliptin & Metformin 
01.01.02 Sodium alginate, calcium carbonate & sodium bicarbonate Peptac liquid 

Oral suspension

In primary care use the most cost effective alginate preparation. E.g. Peptac liquid.
Alginates are considered low priority prescribing, for reflux disease only.
Dyspepsia should be treated using self care measures and OTC products.

Consider OTC purchase for some conditions: Over the Counter Items that Should not be Routinely Prescribed in Primary Care Policy

07.04.03 Sodium Bicarbonate 

Capsules 500mg

09.02.01.03 Sodium Bicarbonate  Capsules 500mg (6mmol)
09.02.02.01 Sodium Bicarbonate 

Injection 8.4% 10mL
Prefilled syringe injection 8.4% 10mL & 50mL
Intravenous infusion 1.26%, 1.4% 500mL Polyfusor®
Intravenous infusion 8.4% 200mL Polyfusor®

12.01.03 Sodium Bicarbonate  sodium bicarbonate 5% 10mL
03.01.05 Sodium Chloride 

Sodium chloride 0.9% nebuliser liquid 2.5ml unit dose containers

03.07 Sodium chloride 

Nebuliser solution 3%, 6%, 7%

Inhaled hypertonic sodium chloride for mucociliary clearance in the lower airways.

09.02.01.02 Sodium Chloride Slow Sodium® m/r tablets 600mg (10mmol)
11.08.01 Sodium Chloride 

Preservative free eye drops 5% (unlicensed)

*under review*


Amber 0 in East Lancashire
 

11.08.01 Sodium Chloride Minims® Saline

0.9% Minims®

07.04.04 Sodium Chloride 0.9% 

Catheter maintenance solution.

07.04.04 Sodium chloride 0.9% irrigation solution 

Irrigation solution 3L

Bladder irrigation.

21 Sodium chloride 0.9% nebules 

Palliative care

Breathlessness

03.07 Sodium chloride 3% (Hypertonic) MucoClear®

Nebuliser solution

03.07 Sodium chloride 7% (Hypertonic) Respease®

Nebuliser solution

09.02.02.01 Sodium Chloride and Glucose Intravenous Infusion  Sodium chloride 0.18% (30mmol/litre)/glucose 4% 500mL & 1L
Sodium chloride 0.18% (30mmol/litre)/glucose 10% 500mL & 1L
Sodium chloride 0.45% (75mmol/litre)/glucose 5% 500mL
09.02.02.01 Sodium Chloride Intravenous  Injection 0.9% 2mL, 5mL, 10mL
Injection 30% (3g/10mL) 10mL
Intravenous infusion 0.18% (30mmol/litre) 500mL Polyfusor®
Intravenous infusion 0.45% (75mmol/litre) 500mL
Intravenous infusion 0.9% (150mmol/litre) 50mL, 100mL, 250mL, 500mL & 1L
Intravenous infusion 1.8% (300mmol/litre) 500mL
Intravenous infusion 2.7% 500mL Polyfusor®
01.06.04 Sodium Citrate Micolette Micro-enema®

Micro-enema

01.01.02 Sodium citrate 0.3M 

Oral solution 0.3M

Maternity ward use only

06.06.02 Sodium Clodronate 

Capsules 400mg

Tablets 800mg

Oral alternative for patients with multiple myeloma

11.04.02 Sodium Cromoglicate 

Eye drops 2%

Can be sold to the public (maximum pack size 10mL) for the treatment of acute seasonal and perennial allergic conjunctivitis

12.02.01 Sodium Cromoglicate Rynacrom®

Nasal spray 4% (5.2mg/metered spray)

Morecambe bay only

11.04.02 Sodium cromoglicate preservative free 

Preservative free eyedrops 2%  - Only for patients with a document allergy to preservatives.

*under review*

09.01.01.01 Sodium Feredetate 

Liquid 190mg/5mL (equivalent to 27.5mg iron per 5mL)

Only for use in neonates (SCBU)

09.05.03 Sodium fluoride toothpaste 5000ppm Duraphat® (Toothpaste)

For treatment of head and neck cancer patients who have had surgery, radiotherapy and/or chemotherapy and are often left with severely dry mouths, restricted mouth opening, and reduced access for toothbrushing or professional dental care.

Should be prescribed on the advice of a secondary care specialist

 Red Prophylaxis of dental caries

 

07.04.04 Sodium Hyaluronate Hyacyst®

Bladder instillation 40mg/50ml

Consultant urologist only

11.08.01 Sodium Hyaluronate 

Eye drops 0.2%

Eye drops - preservative free 0.1% & 0.2%

 

11.08.02 Sodium hyaluronate 

Injection 1%
Injection prefilled syringe 15mg in 1mL
Injection prefilled syringe 14mg in 1mL (Haelonid GV®)
Irrigation 40mg/50mL

07.04.04 Sodium hyaluronate & Sodium chondroitin sulphate bladder instillation (iAluRil) 

Pain due to interstitial cystitis.

02.05.01 Sodium Nitroprusside 

Injection 50mg vials

 unlicensed unlicensed

For specialist use only.

04.01.01 Sodium Oxybate 

Oral solution 500mg/mL

For narcolespsy with cataplexy under expert supervision

01.06.02 Sodium Picosulfate  Liquid 5mg/5mL
01.06.05 Sodium picosulphate & magnesium citrate sachets 

Follow local protocol

02.13 Sodium Tetradecyl Sulphate Fibro-Vein®

3%, 1%, 0.5%, 0.2% Solution for Injection

04.02.03 Sodium valproate 

M/R tablets

See section 4.8.1

In November 2023, due to known significant risk of serious harm to a baby after exposure to valproate the MHRA has stipulated that new regulatory measures will be put in place in January 2024 for oral valproate medicines as follows:

  • Valproate must not be initiated in patients male or female under the age of 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment and any use of valproate in women of childbearing potential should be in accordance with the Pregnancy Prevention Programme.
  • At their next annual review females of childbearing potential will require the signature of a second specialist if valproate is to be continued

National Patient Safety Alert:  Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients https://assets.publishing.service.gov.uk/media/6565ddf162180b0012ce82fd/NatPSA-2023-013-MHRA.pdf

MHRA Drug Safety Update - Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met https://www.gov.uk/drug-safety-update/valproate-medicines-epilim-depakote-contraindicated-in-women-and-girls-of-childbearing-potential-unless-conditions-of-pregnancy-prevention-programme-are-met?utm_source=eshot&utm_medium=email&utm_campaign=DSUApril2018Split2

04.07.04.02 Sodium valproate 

See section 4.8.1

Unlicensed indication

In November 2023, due to known significant risk of serious harm to a baby after exposure to valproate the MHRA has stipulated that new regulatory measures will be put in place in January 2024 for oral valproate medicines as follows:

  • Valproate must not be initiated in patients male or female under the age of 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment and any use of valproate in women of childbearing potential should be in accordance with the Pregnancy Prevention Programme.
  • At their next annual review females of childbearing potential will require the signature of a second specialist if valproate is to be continued

National Patient Safety Alert:  Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients https://assets.publishing.service.gov.uk/media/6565ddf162180b0012ce82fd/NatPSA-2023-013-MHRA.pdf

MHRA Drug Safety Update - Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met https://www.gov.uk/drug-safety-update/valproate-medicines-epilim-depakote-contraindicated-in-women-and-girls-of-childbearing-potential-unless-conditions-of-pregnancy-prevention-programme-are-met?utm_source=eshot&utm_medium=email&utm_campaign=DSUApril2018Split2

**Under review**

04.08.01 Sodium Valproate Epilim®

Crushable tablets 100mg
e/c tablets 200mg, 500mg
Liquid 200mg/5mL

 Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products

Different preparations may vary in bioavailability and are therefore not interchangeable, prescriptions should include the brand name.

Counselling: hepatic & blood disorders - see BNF

In November 2023, due to known significant risk of serious harm to a baby after exposure to valproate the MHRA has stipulated that new regulatory measures will be put in place in January 2024 for oral valproate medicines as follows:

  • Valproate must not be initiated in patients male or female under the age of 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment and any use of valproate in women of childbearing potential should be in accordance with the Pregnancy Prevention Programme.
  • At their next annual review females of childbearing potential will require the signature of a second specialist if valproate is to be continued

National Patient Safety Alert:  Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients https://assets.publishing.service.gov.uk/media/6565ddf162180b0012ce82fd/NatPSA-2023-013-MHRA.pdf

MHRA Drug Safety Update - Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met https://www.gov.uk/drug-safety-update/valproate-medicines-epilim-depakote-contraindicated-in-women-and-girls-of-childbearing-potential-unless-conditions-of-pregnancy-prevention-programme-are-met?utm_source=eshot&utm_medium=email&utm_campaign=DSUApril2018Split2

**Under review**

04.08.01 Sodium Valproate Epilim® Intravenous

Injection 400mg with 4mL water for injections

Different preparations may vary in bioavailability and are therefore not interchangeable, prescriptions should include the brand name.

Counselling: hepatic & blood disorders - see BNF

In November 2023, due to known significant risk of serious harm to a baby after exposure to valproate the MHRA has stipulated that new regulatory measures will be put in place in January 2024 for oral valproate medicines as follows:

  • Valproate must not be initiated in patients male or female under the age of 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment and any use of valproate in women of childbearing potential should be in accordance with the Pregnancy Prevention Programme.
  • At their next annual review females of childbearing potential will require the signature of a second specialist if valproate is to be continued

National Patient Safety Alert:  Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients https://assets.publishing.service.gov.uk/media/6565ddf162180b0012ce82fd/NatPSA-2023-013-MHRA.pdf

MHRA Drug Safety Update - Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met https://www.gov.uk/drug-safety-update/valproate-medicines-epilim-depakote-contraindicated-in-women-and-girls-of-childbearing-potential-unless-conditions-of-pregnancy-prevention-programme-are-met?utm_source=eshot&utm_medium=email&utm_campaign=DSUApril2018Split2

**Under review**

04.08.01 Sodium Valproate Epilim® Chrono

m/r tablets 200mg, 300mg, 500mg

 Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products

Different preparations may vary in bioavailability and are therefore not interchangeable, prescriptions should include the brand name.

Counselling: hepatic & blood disorders - see BNF

In November 2023, due to known significant risk of serious harm to a baby after exposure to valproate the MHRA has stipulated that new regulatory measures will be put in place in January 2024 for oral valproate medicines as follows:

  • Valproate must not be initiated in patients male or female under the age of 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment and any use of valproate in women of childbearing potential should be in accordance with the Pregnancy Prevention Programme.
  • At their next annual review females of childbearing potential will require the signature of a second specialist if valproate is to be continued

National Patient Safety Alert:  Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients https://assets.publishing.service.gov.uk/media/6565ddf162180b0012ce82fd/NatPSA-2023-013-MHRA.pdf

MHRA Drug Safety Update - Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met https://www.gov.uk/drug-safety-update/valproate-medicines-epilim-depakote-contraindicated-in-women-and-girls-of-childbearing-potential-unless-conditions-of-pregnancy-prevention-programme-are-met?utm_source=eshot&utm_medium=email&utm_campaign=DSUApril2018Split2

**Under review**

04.08.01 Sodium Valproate Episenta®

m/r capsules 150mg, 300mg
m/r granules 50mg, 100mg, 250mg, 500mg,750mg,1g

 Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products

Different preparations may vary in bioavailability and are therefore not interchangeable, prescriptions should include the brand name.

Counselling: hepatic & blood disorders - see BNF

In November 2023, due to known significant risk of serious harm to a baby after exposure to valproate the MHRA has stipulated that new regulatory measures will be put in place in January 2024 for oral valproate medicines as follows:

  • Valproate must not be initiated in patients male or female under the age of 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment and any use of valproate in women of childbearing potential should be in accordance with the Pregnancy Prevention Programme.
  • At their next annual review females of childbearing potential will require the signature of a second specialist if valproate is to be continued

National Patient Safety Alert:  Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients https://assets.publishing.service.gov.uk/media/6565ddf162180b0012ce82fd/NatPSA-2023-013-MHRA.pdf

MHRA Drug Safety Update - Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met https://www.gov.uk/drug-safety-update/valproate-medicines-epilim-depakote-contraindicated-in-women-and-girls-of-childbearing-potential-unless-conditions-of-pregnancy-prevention-programme-are-met?utm_source=eshot&utm_medium=email&utm_campaign=DSUApril2018Split2

**Under review**

09.02.01.01 Sodium zirconium cyclosilicate Lokelma®

Oral powder sachets 5g, 10g

07.04.02 Solifenacin 

Tablets 5mg, 10mg

Urinary frequency, urgency, and incontinence.

First line pharmacological therapy for urinary frequency, urgency, incontinence in women.

04.04 Solriamfetol hydrochloride Sunosi®

Tablets 75mg, 150mg

 

Red for NICE TA758:  Solriamfetol for excessive daytime sleepiness caused by narcolepsy

Black for NICE TA777: Solriamfetol for treating excessive daytime sleepiness caused by obstructive sleep apnoea 

07.04.04 Solution G 

Catheter maintenance solution.

07.04.04 Solution R 

Catheter maintenance solution.

06.05.01 Somatrogon Ngenla®

24mg solution for injection for pre filled pen

60mg solution for injection for pre filled pen

06.05.01 Somatropin 

Prescribe by brand.

13.02.02 Sorbaderm®  Available from stores - not supplied from UHMB pharmacy
02.04 Sotalol 

Tablets 40mg, 80mg

For arrhythmias.
On advice of cardiology only

02.02.03 Spironolactone 

Tablets 25mg, 50mg, 100mg

Heart failure

06.07 Spironolactone 

Idiopathic hyperandrogenism and polycystic ovary syndrome

unlicensed (unlicensed)

03.01.05 Standard range peak flow meter Mini-Wright® Standard range peak flow meter 60-800 litres/minute
13.11.07 Sterile Larvae (Maggots) LarvE® Available to order for named patients
12.02 Sterimar® 

Microspray 100% natural sea water 50mL pack

Follow local protocols

*under review*

04.08.01 Stiripentol Diacomit®

Capsules 250mg, 500mg

Powder for oral suspension in sachet 250mg, 500mg

RED RAG (for all ages) for continuation of treatment of patients who have previously received the drug during childhood under the NHSE standard contract for paediatric neurosciences - neurology. Not to be newly initiated in adults

02.10.02 Streptokinase 

Follow local policy

06.06.02 Strontium Ranelate 

Granules 2g/sachet

Treatment of severe osteoporosis

- in postmenopausal women;

- in adult men

at high risk of fracture, for whom treatment with other medicinal products approved for the treatment of osteoporosis is not possible due to, for example, contraindications or intolerance. In postmenopausal women, strontium ranelate reduces the risk of vertebral and hip fractures.

The decision to prescribe strontium ranelate should be based on an assessment of the individual patient's overall risks

01.03.03 Sucralfate 

Suspension & Tablets 

- Specialist initiation only, by GI consultants or GI surgeons
- Recommended for bile acid gastritis
- Use for general chronic gastritis should only be as a result of endoscopic findings, following an appropriate trial of PPI or H2 antagonist
- Not recommended for the treatment of GORD
- Course length should be stipulated prior to primary care taking over prescribing responsibility

Red for radiation proctitis (unlicensed indication). Suspension may be used as an enema (unlicensed use) or there is a 2g/20ml enema available (unlicensed product).

13.02.02 Sudocrem® Barrier preparation

Cream 60g

For paediatric use only

01.05.01 Sulfasalazine 

Tablets 500mg
e/c tablets 500mg
Liquid 250mg/5mL

10.01.03 Sulfasalazine EC Salazopyrin EN-Tabs®

E/C tablets 500mg

Other dose forms of sulfasalazine - see section 1.5, non e/c tablets and liquid are not licensed for rheumatoid arthritis

04.02.01 Sulpiride  Tablets 200mg
Liquid 200mg/5mL
04.07.04.01 Sumatriptan 

Tablets 50mg
Nasal spray 20mg/0.1mL actuation, 2 unit-dose spray device
Injection 6mg/0.5mL, 2 x 0.5mL prefilled syringes and auto-injector

Injection 3mg/0.5ml solution for injection in pre-filled pen

13.08.01 Sunsense® Ultra 

Factor 50 lotion 50mL

Green for ACBS conditions only, otherwise self care

13.05.02 Tacalcitol 4micrograms/g Curatoderm® Ointment 100g
13.05.03 Tacrolimus  Protopic®

Ointment 0.03%, 0.1% 30g, 60g

Consultant dermatologist or specilaist initiation only

07.04.05 Tadalafil 

Tablets 10mg, 20mg

Erectile dysfunction

When required preparation

07.04.05 Tadalafil all preparations

Benign prostatic hyperplasia

07.04.05 Tadalafil once daily 

5mg Tablets 

Red Erectile Dysfunction - When supplied through Specialist Sexual Health Services

Green For the treatment of erectile dysfunction. 2.5mg tablets are restricted for when the 5mg daily dose is not tolerated.

Do Not Prescribe Erectile Dysfunction Post Prostatectomy

07.04.01 Tamsulosin 

M/R capsules 400 microgram

Urinary retention.

 First line for urinary retention in men.

04.07.02 Tapentadol Palexia®

M/R tablets 50mg, 100mg, 150mg, 200mg, 250mg
 
Amber 
for palliative care
 
Black 
 In Morecambe Bay for other indications

**under review**

01.04.02 Teduglutide  Revestive ®

Injection

Short bowel syndrome
NHS England commissioned drug

04.01.01 Temazepam 

Tablets 10mg
Liquid 10mg/5mL

02.10.02 Tenecteplase Metalyse®

Injection 

Acute myocardial infarction

Follow local policy

13.10.02 Terbinafine 1% cream  Cream 15g
03.01.01.01 Terbutaline  Bricanyl Turbohaler® 500micrograms/inhalation
07.01.03 Terbutaline injection 

Injection 500micrograms/1mL

Uncomplicated premature labour.

06.06.01 Teriparatide 

Injection 750micrograms/3mL prefilled pen

For specialist use only in accordance with NICE TA guidance (women) or NHS England commissioning policy (men).


Usually supplied to patients by a home delivery company

06.05.02 Terlipressin 

Injection 0.12mg/mL

06.04.02 Testosterone 

Consult LSCMMG shared guidance for advice on brand selection

06.04.02 Testosterone Gel Testim®

Female sexual dysfunction following oophorectomy or primary ovarian failure.

04.09.03 Tetrabenazine Xenazine® 25

Tablets 25mg

11.07 Tetracaine Hydrochloride Minims® Amethocaine Hydrochloride Minims® 1%
06.05.01 Tetracosactide Synacthen®

Injection 250micrograms

Diagnostic 30-minute test.

03.07 Tezacaftor–Ivacaftor Symkevi®
03.04.02 Tezepelumab 

Tezspire® 210mg solution for injection in pre-filled pen, 210mg soultion for injection in pre-filled syringe 

03.01.03 Theophylline 

M/R tablets Uniphyllin Continus® 200mg, 300mg, 400mg
 

Monitoring of plasma theophylline concentrations may be required when: higher dosages are prescribed; patients have co-morbidities resulting in impaired clearance; theophylline is co-administered with medication that reduces theophylline clearance.

09.06.02 Thiamine Pabrinex® High potency

Intravenous injection 10mL (2 amps)
Intramuscular injection 7mL (2 amps)

MHRA/CHM advice:serious allergic adverse reactions - see BNF
09.06.02 Thiamine  Tablets 50mg
06.02.01 Thyroid extracts (Unlicensed liothyronine and thyroid extract products)  
04.08.01 Tiagabine Gabitril®

Tablets 5mg, 10mg, 15mg

 

Category 3 - It is usually unecessary to ensure that patients are maintained on a specific manufacturer's product as therapeutic equivalence can be assumed

06.04.01.01 Tibolone Livial®
02.09 Ticagrelor 

Tablets 60mg, 90mg

13.05.03 Tildrakizumab Ilumetri®

Solution for injection pre-filled syringes 100mg/1ml

11.06 Timolol 

eye drops 0.25%, 0.5%
Preservative free eye drops 0.25%, 0.5% 
Long acting eye drops 0.25%, 0.5% (Timoptol LA®)

02.08.01 Tinzaparin 

Refer to local guidance

Care when prescribing/selecting strength of syringes - Different strengths available

07.04.03 Tiopronin 

Prescribing restricted to consultant urologists only.

unlicensed Unlicensed

03.01.02 Tiotropium 

COPD

Spiriva 18 microgram inhalation powder, hard capsule,

Spiriva Respimat 2.5 microgram, inhalation solution,

Tiotropium (Braltus) 10mcg Inhalation Powder

 Prescribe by brand

03.01.02 Tiotropium 

Asthma

Spiriva Respimat 2.5 microgram, inhalation solution

Only Respimat® device is licensed for asthma

03.01.04 Tiotropium bromide / Olodaterol 

Spiolto Respimat 2.5 microgram tiotropium /2.5 microgram olodaterol inhalation solution

Licensed for COPD only

13.08.01 Tirbanibulin Klisyri ®

Ointment 10 mg/g

Each sachet contains 2.5 mg of tirbanibulin in 250 mg ointment.

02.09 Tirofiban 
Used in some Trusts for emergency use in cath lab
Specialist use only, follow local protocol
06.01.02.03 Tirzepatide 

Type 2 Diabetes

Preference of agent should be decided based on the clinician’s judgement about patient characteristics. Local specialists have suggested the following: 

1. Semaglutide (or other available GLP-1 RAs) may be preferred in patients with lower BMIs e.g. < BMI 35 kg/m2 or patients who have established CVD or are at high risk of CV events and require an agent with proven CV benefit. 

2. Tirzepatide may be preferred in patients with higher BMIs e.g. > BMI 40 kg/m2 or who despite optimisation of all other therapies still require further glycaemic control.

Careful consideration MUST be given to stopping tirzepatide if ineffective or not tolerated (evidence of poor tolerance as dose escalates). Tirzepatide should be reviewed after 6 months, and the deprescribing of other agents, e.g. sulfonylureas and gliptins, should be considered where possible. 

As a minimum expectation, it is recommended that tirzepatide is only continued if the adult with type 2 diabetes has had a beneficial metabolic response (a reduction of at least 11 mmol/mol [1.0%] in HbA1c and weight loss of at least 3% of initial body weight in 6 months).

 

Do Not Prescribe Managing overweight and obesity

10.02.02 Tizanidine Zanaflex®

Tablets 2mg, 4mg

Consultant initiation only

10.01.03 Tocilizumab Biosimilars avaliable

Concentrate for intravenous infusion (20mg/mL) 80mg, 200mg, 400mg vials

Soution for injection in pre-filled syringe 162mg

Solution for injection in pre-filled pen 162mg


Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

01.05.03 Tofacitinib 

Tablets 5mg, 10mg, MR tablets 11mg

10.01.03 Tofacitinib Xeljanz®

Tablets 5mg

MR Tablets 11mg

   CCG commissioned for TA547

06.01.02.01 Tolbutamide 

Patients may remain on tolbutamide but not recommended in new patients

04.09.01 Tolcapone Tasmar®

Tablets 100mg

 

Third Line

07.04.02 Tolterodine 

Tablets 1mg, 2mg, Modified-release capsules 4mg

Urinary frequency, urgency, and incontinence.

06.05.02 Tolvaptan 

Tablets 15mg, 30mg

Prescribe by brand.

Tolvaptan (Jinarc): 

  • Autosomal dominant polycystic kidney disease (TA358) BlueTeq 

Tolvaptan (Samsca):

  • Treatment of hyponatremia in adults, secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) (No Blueteq form required).
  •  Treatment of SIADH in patients requiring cancer chemotherapy is NHS England commissioned BlueTeq 

 

04.07.04.02 Topiramate 

Tablets 25mg, 50mg, 100mg, 200mg

Topiramate is now contraindicated in pregnancy and in women of childbearing potential unless the conditions of a Pregnancy Prevention Programme are fulfilled. This follows a review by the MHRA which concluded that the use of topiramate during pregnancy is associated with significant harm to the unborn child. Harms included a higher risk of congenital malformation, low birth weight and a potential increased risk of intellectual disability, autistic spectrum disorder and attention deficit hyperactivity disorder in children of mothers taking topiramate during pregnancy.

04.08.01 Topiramate 

Tablets 25mg,50mg, 100mg, 200mg
Sprinkle capsules 15mg, 25mg

Topiramate oral suspension - Restricted for paediatric use only, when sprinkle capsules are unsuitable. Prescribers should be cautious when selecting the strength of suspension as multiple strengths are available.

Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products

Topiramate is now contraindicated in pregnancy and in women of childbearing potential unless the conditions of a Pregnancy Prevention Programme are fulfilled. This follows a review by the MHRA which concluded that the use of topiramate during pregnancy is associated with significant harm to the unborn child. Harms included a higher risk of congenital malformation, low birth weight and a potential increased risk of intellectual disability, autistic spectrum disorder and attention deficit hyperactivity disorder in children of mothers taking topiramate during pregnancy.

06.01.01.02 Toujeo® Insulin glargine

Pre-filled pen 300 units/mL

First line high strength long acting insulin (Toujeo Solostar)

Type 1 - in accordance with the recommendations in NICE NG17 and in those who experience an unacceptable frequency and/or severity of nocturnal hypoglycaemia on attempting to achieve better glycaemic control during treatment with first-line long-acting insulin analogues; or as a once daily insulin therapy for patients who require assistance with administering injections.

Type 2 - in accordance with the recommendations in NICE NG28 in those who suffer from symptomatic nocturnal hypoglycaemia whilst being treated with a first-line long-acting insulin analogue.

13.05.03 Tralokinumab Adtralza ®

Pre-filled syringe 150 mg solution for injection - for treating moderate to severe atopic dermatitis - see link below

04.07.02 Tramadol 

Capsules 50mg
Dispersible tablets 50mg
m/r tablets 100mg, 200mg

Red Injection 100mg/2mL

02.11 Tranexamic Acid  Tablets 500mg
02.11 Tranexamic Acid  Injection 500mg/5mL
11.06 Travoprost 

Eye drops 40micrograms/mL (0.004%)

*under review*

Not on East Lancashire formulary

11.06 Travoprost with Timolol 

Eye drops 40micrograms/mL (0.004%)/ timolol 0.5%

*under review*

Not on East Lancashire formulary

04.03.01 Trazodone  Capsules 50mg, 100mg
Liquid 50mg/5mL
06.01.01.02 Tresiba® Insulin degludec

100 units/ml 3ml cartridges
100units/ml pre-filled pens Flextouch
200units/ml pre-filled pens Flextouch

Must be commenced by a healthcare professional who is appropriately trained and experienced in the initiation of insulin
Specialists may exceptionally consider initiating insulin degludec if:
- Patient is experiencing poor glycaemic control or recurrent hypoglycaemic episodes with their existing long-acting insulin analogue or
- Patient is unable to take basal insulin at the same time each day

Second line high strength long-acting (Tresiba FlexTouch 200).
Third line long acting insulin analogue (Tresiba Flextouch 100).

06.03.02 Triamcinolone Kenalog®

Intra-articular/intramuscular injection 40mg/1mL

10.01.02.02 Triamcinolone Acetonide Adcortyl® Injection 10mg/1mL

Intra-articular/intra-dermal injection
10.01.02.02 Triamcinolone Acetonide Kenalog® Injection 40mg/1mL

Intra-articular/intramuscular injection
12.01.01 Triamcinolone acetonide, nystatin, gramicidin, neomycin Kenacomb Otic® Ointment 5g
10.01.02.02 Triamcinolone hexacetonide   Injection 20mg/mL

Second line to Kenalog®
13.06 Trifarotene 0.05% Cream Aklief®

For acne

04.02.01 Trifluoperazine 

Tablets 1mg
Liquid 1mg/5mL, 5mg/5mL

04.09.02 Trihexyphenidyl  Tablets 2mg, 5mg
Liquid 5mg/5mL
04.03.01 Trimipramine Surmontil® Tablets 10mg, 25mg
Capsules 50mg
06.07.02 Triptorelin Decapeptyl® SR

Injection, (powder for suspension), m/r, triptorelin (as acetate),3-mg vial (with diluent, 11.25-mg vial (with diluent), 22.5mg vial (with diluent)

Central precocious puberty (onset before 8 years in girls and 10 years in boys)

 

11.05 Tropicamide single use Minims® Tropicamide

Minims® 0.5%, 1%

Red in Morecambe Bay

*under review*

 

07.04.02 Trospium 

Tablets 20mg, Modified-release capsules 60mg

Urinary frequency, urgency, and incontinence.

06.01.01.01 Trurapi Insulin Aspart (Biosimilar)

First choice insulin aspart in new users

11.08.02 Trypan Blue Vision Blue®

Injection

For use in cataract surgery

04.03.04 Tryptophan 

Tablets 500mg

Consultant psychiatrist initiation only

06.04.01.02 Ulipristal Esmya®

Tablets 5mg
 

In accordance with NICE NG88, ulipristal should only be used for intermittent treatment of moderate to severe symptoms of uterine fibroids before menopause and when surgical procedures (including uterine fibroid embolisation) are not suitable or have failed.

07.03.05 Ulipristal 

Tablets 30 mg

Emergency contraception.

03.01.02 Umeclidinium Incruse Ellipta®

55micrograms/dose dry powder inhaler

03.01.04 Umeclidinium bromide / Vilanterol 

Anoro Ellipta 55 micrograms umeclidinium /22 micrograms vilanterol inhalation powder, pre-dispensed

Licensed for COPD only

01.05.03 Upadacitinib  Rinvoq ®

Prolonged release tablets 15mg, 30mg, 45mg

10.01.03 Upadacitinib  Rinvoq ®

Prolonged release tablets 15mg

Red For NICE TA665: upadacitinib for treating severe rheumatoid arthritis - see link below

Red For NICE TA768: Upadacitinib for treating active psoriatic arthritis after inadequate response to DMARDs - see link below

Red For NICE TA829: Upadacitinib for treating active ankylosing spondylitis - see link below 

Red For NICE TA861 Upadacitinib for treating active non-radiographic axial spondyloarthritis - see link below
 
 
 
13.05.03 Upadacitinib  Rinvoq ®

Prolonged release tablets 15mg

 

02.10.02 Urokinase 

Injection

Follow local policy

01.09.01 Ursodeoxycholic acid 

Tablets 150mg
Capsules 250mg
Liquid 250mg/5mL

01.05.03 Ustekinumab 

Concentrate for solution for infusion 130mg

Solution for injection 45mg

Pre-filled syringe 45mg, 90mg

10.01.03 Ustekinumab 

Subcutaneous injection 45mg, 90mg prefilled syringes and 45mg/0.5ml vials

13.05.03 Ustekinumab Stelara®

Injection 45mg, 90mg pre-filled syringe

Consultant dermatologist or specilaist initiation only
Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

07.02 Vaginal dilators Amielle Comfort

Sexual pain-penetration disorder (SPPD) in combination with pychosexual therapy.

04.02.03 Valproic Acid Depakote®

E/C tablets 250mg, 500mg

In November 2023, due to known significant risk of serious harm to a baby after exposure to valproate the MHRA has stipulated that new regulatory measures will be put in place in January 2024 for oral valproate medicines as follows:

  • Valproate must not be initiated in patients male or female under the age of 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment and any use of valproate in women of childbearing potential should be in accordance with the Pregnancy Prevention Programme.
  • At their next annual review females of childbearing potential will require the signature of a second specialist if valproate is to be continued

National Patient Safety Alert:  Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients https://assets.publishing.service.gov.uk/media/6565ddf162180b0012ce82fd/NatPSA-2023-013-MHRA.pdf

MHRA Drug Safety Update - Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met https://www.gov.uk/drug-safety-update/valproate-medicines-epilim-depakote-contraindicated-in-women-and-girls-of-childbearing-potential-unless-conditions-of-pregnancy-prevention-programme-are-met?utm_source=eshot&utm_medium=email&utm_campaign=DSUApril2018Split2

02.05.05.02 Valsartan 

tablets and capsules

Existing patients only

07.04.05 Vardenafil 

Erectile Dysfunction.

04.10.02 Varenicline Champix®

Tablets 0.5mg, 1mg

For community prescribing only

01.05.03 Vedolizumab 

Prevention of recurrence of ulcerative colitis following surgery

01.05.03 Vedolizumab Entyvio®

intravenous infusion 300mg vial, pre-filled pen 108mg solution for injection, pre-filled syringe 108mg solution for injection

Use in high risk patients for prevention of recurrence or upon recurrance of Crohn's Disease following surgery.

Moderately to severely active Crohn's disease - NICE TA352

Moderately to severely active ulcerative colitis - NICE TA342

04.03.04 Venlafaxine 

Tablets 37.5mg, 75mg
M/R capsules 75mg, 150mg

M/R capsules 225mg - to be prescribed as Vencarm XL in primary care
 
Immediate release tablets are first line

02.06.02 Verapamil  Injection 5mg/2mL
02.06.02 Verapamil 

Tablets 40mg, 80mg, 120mg
M/R tablets 120mg, 240mg
Liquid 40mg/5mL

11.08.02 Verteporfin injection 

15mg vial

04.08.01 Vigabatrin Sabril®

Tablets 500mg
Powder sachet 500mg

 

Category 3 - It is usually unecessary to ensure that patients are maintained on a specific manufacturer's product as therapeutic equivalence can be assumed

13.05.01 Viscopaste® bandages 

 Bandage 7.5cm x 6m

For community use only

09.06.07 Vitamin and mineral supplements Forceval, & Forceval Soluble®

Tablets

On dieticians request only for patients with swallowing difficulties or enteral feeding tubes

Amber 0 Post-surgery if gastric bypass

For use post bariatric surgery please consult link below

09.06.07 Vitamin and mineral supplements Ketovite® Tablets
Liquid
09.06.02 Vitamin B complex preparations Vigranon B®

Not to be prescribed on TTO

Not for use in alcohol dependence

09.06.02 Vitamin B Tablets, Compound Strong 

For refeeding and Post Bariatric Surgery only

Refer to local policies

Not for use in alcohol dependence - thiamine may be used

11.11 Voretigene neparvovex Luxturna®

Tertiary Centre only

04.03.03 Vortioxetine Brintellix®

Tablets 5mg, 10mg, 20mg

Vortioxetine is recommended as an option for treating major depressive episodes in adults whose condition has responded inadequately to 2 antidepressants within the current episode

09.01.03 Voxelotor 
09.08.01 Vutrisiran Amvuttra ®

25mg solution for injection in pre-filled syringe

Red for NICE TA868 Vutrisiran for treating hereditary transthyretin-related amyloidosis

02.08.02 Warfarin 

Tablets 1mg, 3mg, 5mg


Amber 0 Treatment of venous thromboembolism

Green Restricted Prevention of stroke and systemic embolism in non-valvular atrial fibrillation

09.02.02.01 Water for Injection  2mL, 5mL, 10mL, 20mL
06.01.01.02 Xultophy® Insulin degludec and liraglutide 
12.02.02 Xylometazoline Otrivine® Nasal drops 0.1%
Nasal spray 0.1%
Paediatric nasal drops 0.05%
13.02.01 ZeroAQS® Emollient preparation

Cream 500g,

Similar to aqueous cream but contains no sodium lauryl sulfate.

13.05.02 Zinc and Salicylic Acid Paste BP 

Zinc oxide 24% / salicylic acid 2% / starch 24% / white soft paraffin 50%

13.05.01 Zinc oxide 15% and Ichthammol 1% in yellow soft paraffin Special ointment No1

Ointment

09.05.04 Zinc Sulphate Solvazinc® Effervescent tablets 125mg
06.06.02 Zoledronic Acid 

(Aclasta®) Specialist use in osteoporosis

Second choice treatment in Paget's disease

(Zometa ®) Second line for osteolytic lesions and bone pain treatment option for hypercalcaemia of malignancy

04.01.01 Zolpidem  Tablets 5mg, 10mg

Stocked for patients admitted on these and for Mental Health patients
04.07.04.02 Zonisamide 

Capsules, 25mg. 50mg, 100mg

Approved for use in patients when at least 3 prior prophylactic treatments have failed and erenumab, galcanezumab and fremanezumab are being considered 

04.08.01 Zonisamide Zonegran®

Capsules 25mg, 50mg, 100mg

Category 2 - Doctors should use clinical judgement when deciding whether to switch between different manufacturer's products

04.01.01 Zopiclone  Tablets 3.75mg, 7.5mg

First choice hypnotic

CD status in UHMB hospitals
04.02.01 Zuclopenthixol Clopixol®

Tablets 2mg, 10mg, 25mg

Injection

04.02.01 Zuclopenthixol Acetate Clopixol Acuphase® Injection 50mg/1mL
04.02.02 Zuclopenthixol Decanoate Clopixol® Conc.

Injection 200mg/1mL
Concentrate injection 500mg/1mL

Lancashire and South Cumbria