Formulary


	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

Dyspepsia and gastro-oesophageal reflux disease

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

Antacids and simeticone

NICE CG184: Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management

01.01.01

Aluminium and magnesium containing antacids

Magnesium Trisilicate (Mixture)

Formulary

Mixture^SF (Contains about 6mmol of sodium in 10ml).

Co-magaldrox
(Suspension)

Formulary

Suspension^SF 195/220 (low sodium, bowel neutral).

01.01.01

Antacid preparations containing simeticone

Maalox Plus
(Suspension)

Formulary

Suspension containing aluminium hydroxide 35 mg & magnesium hydroxide 40 mg per 1 ml.

01.01.01

Simeticine alone

Simeticone (Infacol^®)
(Suspension)

Formulary

- 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)

Formulary

- 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

Compound alginates and proprietary indigestion preparations

NICE CG184: Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management

NICE CG61: Irritable Bowel Syndrome

01.01.02

Compound alginate preparations

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)

First Choice

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)

Second Choice

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)

Formulary

Please note: Sodium citrate mixture is used to prevent aspiration of stomach acid in maternity services.

....

Non Formulary Items

Acidex

Non Formulary

Algicon ^®

Non Formulary

Altacite plus

Non Formulary

Aluminium Hydroxide

Non Formulary

Aluminium Only Preparations
(Alu-Cap^®)

Non Formulary

Asilone

Non Formulary

Co-magaldrox (Maalox^®)

Non Formulary

Co-magaldrox 1100

Non Formulary

Gastrocote (trade^®)
(Extra)

Non Formulary

Gaviscon^® (Oral)

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

Non Formulary

Magnesium Carbonate

Non Formulary

Renie Duo

Non Formulary

Simeticone
(Dentinox^®)

Non Formulary

Topal (Topal^®)

Non Formulary

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG
	High Cost Drug Approval System

Traffic Light Status Information

Status	Description
	RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.
	Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.
	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.
	These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.
	Suitable for patient to be directed to buy themselves
	Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.
	(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.
	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.