netFormulary NHS
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
 Search
 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...
01.02  Expand sub section  Antispasmodics and other drugs altering gut motility
 note 

Whilst the medicines in this section are frequently prescribed for functional bowel symptoms, such as irritable bowel syndrome, their value in clinical trials has not been proved.

Lifestyle changes and identifying food triggers are the mainstay of treating functional gut symptoms.

01.02  Expand sub section  Antimuscarinics
 note 

Please note atropine and hyoscine hydrobromide are not routinely used for gastrointestinal problems. See Chapter 4 (CNS) and our Palliative Care chapter for other indications.

Dicycloverine is NOT recommended for use, as it is prohibitively expensive.

Hyoscine Butylbromide
(Tablet & Injection)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 10mg tablets. 
  • 20mg/ml injection (Salisbury & Swindon only).
  • Please note: Hyoscine butylbromide injection is also available for use in Palliative Care. Please refer to our Palliative Care chapter.
 
Link  MHRA Drug Safety Update (Feb 2017): Hyoscine butylbromide injection & risk of serious adverse effects in patients with underlying cardiac disease
 
Propantheline bromide (Tablet)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 15mg tablets.
  • Please note: This is ONLY for use in patients with Myasthenia gravis to reduce the antimuscarinic side effects of anticholinesterase inhibitors.
 
Link  Anticholinergic medicines (information leaflet for patients)
 
01.02  Expand sub section  Other antispasmodics
Mebeverine
(Tablet)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 135mg tablets.
  • Please note: Modified-release preparations are NOT included on our formulary.
 
 
Peppermint Oil
(Capsule)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 0.2ml gastro-resistant capsules.
  • Please note: Gastro-resistant capsules are more cost effective than MR capsules.
  • Please prescribe most cost-effective brand of gastro-resistant capsules BY BRAND. Mintec® or Apercap® are cost-effective brands in primary care.
 
 
Peppermint water
(Oral Solution)
View adult BNF View SPC online
Formulary
traffic lightRed
  • Oral solution.

 

 
 
01.02  Expand sub section  Motility stimulants
Metoclopramide
(Oral)
View adult BNF View SPC online
Formulary
  • Green - For short-term use.
  • Amber - For long-term use (off-label).
  • 10mg tablets.
  • 5mg in 5ml SF oral solution (Salisbury & Swindon ONLY).
  • Please note: Metoclopramide should be used with caution in patients under 20 years of age due to the risk of extrapyramidal effects. 
  • Metoclopramide is also available for prevention or treatment of nausea and vomiting. Please refer to Chapter 4 (CNS).
 
 
 ....
 Non Formulary Items
Acidex

View adult BNF View SPC online
Non Formulary
 
Algicon

View adult BNF View SPC online
Non Formulary
 
Alverine citrate

View adult BNF View SPC online
Non Formulary
 
Atropine
(tablets)

View adult BNF View SPC online
Non Formulary
 
Dicycloverine

View adult BNF View SPC online
Non Formulary

***This is NOT recommended for use as it is prohibitively expensive***

 
Gastrocote (trade)
(Extra)

View adult BNF View SPC online
Non Formulary
 
Gaviscon (Oral)

View adult BNF View SPC online
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.

 

 
Mebeverine (Colofac MR)

View adult BNF View SPC online
Non Formulary
 
Mebeverine
(Fybogel Mebeverine)

View adult BNF View SPC online
Non Formulary
 
Peppermint Oil
(Colpermin)

View adult BNF View SPC online
Non Formulary
 
Renie Duo

View adult BNF View SPC online
Non Formulary
 
Topal (Topal)

View adult BNF View SPC online
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
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
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.  

netFormulary