Please note: Lactulose takes up to 48 hours to work, making it unlikely to produce immediate relief, but is often prescribed “when required”. It can be unpleasant to take and compliance may be a problem. Its main clinical benefit is in the management of hepatic encephalopathy.
Please note: Macrogol use is restricted to faecal impaction, or chronic cases where other laxatives have been ineffective or are unsuitable. It may cause electrolyte disturbances, and there is insufficient evidence to support its routine use before well-established, less expensive drugs.
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.