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NHS Bath and North East Somerset, Swindon and Wiltshire CCG
Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
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 Formulary Chapter 1: Gastro-intestinal system - Full Chapter
Notes:

Gastroenterology-related Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Gastroenterology-related Shared Care Agreements

Please see our Shared Care Agreements page for all shared care agreements (SCAs) relating to this chapter.

Self-care

Many of the products in this chapter are available for purchase over-the-counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to

https://www.england.nhs.uk/publication/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed-in-primary-care-guidance-for-ccgs/

 Details...
01.01  Expand sub section  Dyspepsia and gastro-oesophageal reflux disease
 note 

Self-care of indigestion & heartburn

Many of the products in this section are available to purchase over-the- counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to NHS England: Conditions for which over-the-counter items should not be routinely prescribed in primary care 2018

01.01.01  Expand sub section  Antacids and simeticone
01.01.01  Expand sub section  Aluminium and magnesium containing antacids
Magnesium Trisilicate (Mixture)
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Formulary
traffic lightSelf
  • MixtureSF (Contains about 6mmol of sodium in 10ml).  
 
 
Co-magaldrox
(Suspension)
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Formulary
traffic lightSelf
  • SuspensionSF 195/220 (low sodium, bowel neutral). 
 
 
01.01.01  Expand sub section  Antacid preparations containing simeticone
Maalox Plus
(Suspension)
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Formulary
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  • Suspension containing aluminium hydroxide 35 mg & magnesium hydroxide 40 mg per 1 ml.
 
 
01.01.01  Expand sub section  Simeticine alone to top
Simeticone (Infacol)
(Suspension)
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Formulary
  • Red - GWH & SFT ONLY - For use during endoscopic procedures as a defoaming agent
  • Non-formulary - RUH
  •  40mg in 1ml suspension 
  • Please note: Infacol is also available for use in Paediatrics. Please refer to our Paediatric chapter
 
 
Simeticone (Carbex )
(Oral)
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Formulary
  • Red - RUH - For use during endoscopic procedures as a defoaming agent
  • Non-formulary - SFT and GWH
  • 2.8g sachet, containing simeticone 0.042g & sodium bicarbnate 1.26g, plus 10ml bottle of citric acid 1g in 10ml oral solution
 
 
01.01.02  Expand sub section  Compound alginates and proprietary indigestion preparations
01.01.02  Expand sub section  Compound alginate preparations
 note 

Please note Gaviscon Infant is also available for use in Paediatrics. Please refer to our Paediatric chapter.

Please note Antacid with Oxetacaine is also available for use in Palliative Care. Please refer to our Palliative Care chapter.

Peptac (Suspension)
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First Choice
traffic lightSelf
  • Suspension SF containing sodium alginate 250mg, sodium bicarbonate 133.5mg & calcium carbonate 80mg per 5ml, with equivalent of 6.2 mmol of sodium per 10ml.
  • Please note: Peptac is our first-line option, as it is more cost-effective than Gaviscon Advance.
 
Gaviscon Advance (Oral)
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Second Choice
traffic lightSelf
  • Liquid (Contains 4.6 mmol of sodium in 10ml, plus 2 mmol of potassium).
  • Tablets (Contains 2.25 mmol of sodium per tablet, plus 1 mmol of potassium).
  • Licensed for laryngopharyngeal reflux.
 
 
Sodium citrate
(Mixture)
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Formulary
traffic lightRed
  • Please note: Sodium citrate mixture is used to prevent aspiration of stomach acid in maternity services.
 
 
 ....
 Non Formulary Items
Acidex

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Non Formulary
 
Algicon

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Non Formulary
 
Altacite plus

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Non Formulary
 
Aluminium Hydroxide

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Non Formulary
 
Aluminium Only Preparations
(Alu-Cap®)

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Non Formulary
 
Asilone

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Non Formulary
 
Co-magaldrox (Maalox)

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Non Formulary
 
Co-magaldrox 1100

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Non Formulary
 
Gastrocote (trade)
(Extra)

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Non Formulary
 
Gaviscon (Oral)

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Non Formulary
  • Liquid containing calcium carbonate 16 mg, sodium alginate 50 mg & sodium bicarbonate 26.7 mg per 1 ml.
  • Tablets containing sodium alginate 250 mg, sodium hydrogen carbonate 133.5 mg & calcium carbonate 80 mg per tablet.

 

 
Gripe Mixture

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Non Formulary
 
Magnesium Carbonate

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Non Formulary
 
Renie Duo

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Non Formulary
 
Simeticone
(Dentinox®)

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Non Formulary
 
Topal (Topal)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Traffic LightRed

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Traffic LightAmber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Traffic LightAmber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Traffic LightGreen

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Traffic LightSelf

Suitable for patient to be directed to buy themselves  

Traffic LightGrey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Traffic LightBlack

(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.   

Traffic LightRed Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

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