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 12: Ear, nose and oropharynx - Full Chapter

Notes:

ENT related prescribing guidance

Please see our Prescribing Guidelines page for a full list of guidance available.

ENT Shared Care Agreements

There are no shared care agreements available for ENT.

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/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/

Details...

12.01

Drugs acting on the ear

12.01.01

Otitis externa

12.01.01

Astringent preparations

Acetic Acid 2%
(spray)

Formulary

Please note: Patients should self-care in the first instance

BSW Management of Infection Guidance for Primary Care

12.01.01

Anti-inflammatory preparations

For treatment of otitis externa in primary care see BSW Management of Infection Guidance for Primary Care

Betamethasone sodium phosphate drops 0.1%
(Ear drops )

Formulary

Ear drops 0.1%
Prolonged use of topical corticosteroids should be avoided.
Betamethasone products for use in nasal allergy please refer to 12.2.1

Prednisolone
(ear drops)

Formulary

Ear drops 0.5%

Dexamethasone with Antibacterial
(Otomize®)
(Ear spray)

Formulary

Dexamethasone 0.1%, neomycin sulfate 3250 units/ml, glacial acetic acid 2%

Dexamethasone with Antibacterials
(Sofradex^®)
(ear drops)

Formulary

Dexamethasone 0.05%, framycetin sulfate 0.5%, gramicidin 0.005%

Flumetasone 0.02% with Clioquinol 1%
(ear drops)

Formulary

Previously Locorten-Vioform^® (discontinued)

Hydrocortisone Acetate 1% with Gentamicin 0.3%
(ear drops)

Formulary

Previously Gentisone HC (discontinued)

Hydrocortisone with Antibacterial
(Otosporin^®)
(ear drops)

Formulary

Hydrocortisone 10 mg /Neomycin sulfate 3400 unit /Polymyxin B sulfate 10000 unit per 1 ml
10ml

Betamethasone 0.1% with Neomycin 0.5%
(Betnesol N^®)
(ear drops)

Formulary

12.01.01

Anti-infective preparations

Ciprofloxacin
(Ear drops)

Formulary

2 mg/ml ear drops solution in single-dose container
Licensed for the treatment of acute otitis externa in adults and children older than 1 year with an intact tympanic membrane
The ampoule contents should be used immediately after opening the single dose ampoule.
Each pack contains 15 ampoules
Salisbury only

Ciprofloxacin 0.3%
(eye drops)

Formulary

GWH ENT use eye drops in the ear (off-label)

Clotrimazole 1%
(solution)

Formulary

1% solution is licensed to be used as ear drops

Gentamicin 0.3%
(Ear Drops)

Formulary

Ear drop 0.3%

Ofloxacin 0.3%
(eye drops-off label use for ears)

Formulary

Eye drops 0.3% (off label use)
For chronic otitis media

12.01.01

Other aural preparations

12.01.02

Otitis media

For treatment of otitis media in primary care see BSW Management of Infection Guidance for Primary Care

12.01.03

Removal of ear wax

Olive Oil Ear Drops

Formulary

Please note: Patients should self-care in the first instance

Sodium Bicarbonate 5% (ear drps)

Formulary

Ear drops 5%
Please note: Patients should self-care in the first instance

....

Non Formulary Items

ACETIC ACID 5% solution in IMS

Non Formulary

Almond Oil

Non Formulary

Cerumol ^®

Non Formulary

Docusate 0.5% eardrops
(Waxsol^®)

Non Formulary

Exterol ^®

Non Formulary

Molcer ^®

Non Formulary

Neomycin Sulphate with corticosteroids
(Neo-Cortef^®)

Non Formulary

Neomycin Sulphate with corticosteroids
(Otosporin^®)

Non Formulary

Otex ^®

Non Formulary

Prednisolone 0.5% with Neomycin 0.5%
(Predsol-N^®)

Non Formulary

Triamcinolone with antibacterial
(Otocomb Otic^®)

Non Formulary

Triamcinolone with Antibacterial
(Tri-Adcortyl Otic^®)

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.