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
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.
Please see MHRA Drug Safety Update August 2017 for information and advice on the rare risk of central serous chorioretinopathy with local and systemic administration of corticosteroids.
Allergic rhinitis: short term treatment, start treatment 2-3 weeks before season starts. Many of the products are available for self-purchase and self-care.
Perennial rhinitis: long term therapy required.
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Drugs used in nasal allergy
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Antihistamines
Azelastine (Nasal spray)
Formulary
140micrograms/dose nasal spray 22ml
Useful option for patients who do not want to try a corticosteroid or have contra-indications to them
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Corticosteroids
Mometasone Furoate (spray)
First Choice
Nasal spray 50 micrograms per spray
First line for treatment of allergic rhinits (prescribe generically)
For ENT initiation only for the treatment of nasal polyps.
Beclometasone Dipropionate
(spray)
First Choice
200 dose nasal spray, 50 micrograms per spray
Beclomethasone is licensed for the prophylaxis and treatment of allergic and vasomotor rhinitis.
First line for treatment of allergic rhinits . OTC for over 18 years.
Contains arachis oil: Should be avoided in peanut or soya allergy
To avoid the development of resistance, the treatment course should not exceed 7 days and the course not repeated on more than one occasion
Mupirocin 2%
(Bactroban ®)
(Nasal ointment 3g)
Formulary
Mupirocin (Bactroban® nasal) is of value when the carriage of Staphlococcus aureus in the nose or ears has to be cleared.
To avoid the development of resistance, the treatment course should not exceed 7 days and the course not repeated on more than one occasion
Prontoderm (Nasal gel)
Formulary
30ml
As an alternative for decolonisation of MRSA
To avoid the development of resistance, the treatment course should not exceed 7 days and the course not repeated on more than one occasion
....
Non Formulary Items
Flunisolide
(Syntaris®)
Non Formulary
Fluticasone Propionate
(Nasofan®)
Non Formulary
Triamcinolone Acetonide
(Nasacort®)
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.
