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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...
01.04.02  Expand sub section  Antimotility drugs
Loperamide
(Oral)
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Formulary
traffic lightSelf
  • 2mg capsules.
  • 1mg in 5ml oral syrupSF.
  • 2mg tablets (RUH only) Loperamide tablets are restricted to use in patients with feeding tubes, where loperamide liquid has been unsuitable due to hypertonicity. Tablets can be crushed and administered via feeding tube without risk of blocking the tube. 
  • Please note: The maximum total daily dose of loperamide is 16mg in routine use, although stoma patients may require higher doses.
 
Link  MHRA Drug Safety Update (Sept 2017): Loperamide: reports of serious cardiac adverse reactions with high doses of loperamide associated with abuse or misuse
 
Codeine phosphate
(Tablet)
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Formulary
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  • 15mg & 30mg tablets.
  • 60mg tablets (Salisbury & Swindon ONLY).
  • Please note: Codeine can cause sedation and constipation, and there is a risk of dependence with long term use. It should be reserved for short courses, and is best avoided in stoma patients.
 
 
 ....
 Non Formulary Items
Co-Phenotrope (Lomotil)

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Non Formulary
 
Eluxadoline (Truberzi) Black Triangle
(Tablet)

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Non Formulary

***This product has been discontinued***

 
Kaolin and Morphine Mixture

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Non Formulary
 
Loperamide
(Imodium Plus)

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Non Formulary
 
Teduglutide (Revestive)

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Non Formulary
High Cost Medicine
 
  
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.  

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