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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 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...
12.02.01  Expand sub section  Drugs used in nasal allergy
12.02.01  Expand sub section  Antihistamines
12.02.01  Expand sub section  Corticosteroids
Mometasone Furoate
(spray)
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First Choice
traffic lightGreen
  • 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)
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First Choice
traffic lightSelf
  • 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.

 

 

 

 
Budesonide (Nasal spray)
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Second Choice
traffic lightGreen
  • Budesonide nasal spray 64micrograms / spray 120 dose
  • Second line for the treatment of allergic rhinitis
  • Licensed for nasal polyps.

 

 
 
Fluticasone furoate (Nasal spray)
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Second Choice
traffic lightGreen
  • Fluticasone furoate nasal spray, 27.5 micrograms per spray
  • Second line for the treatment of allergic rhinitis

 

 

 

 
 
Fluticasone Propionate
(nasal drops)
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Third Choice
traffic lightGreen
  • Nasal drops 400 micrograms/unit dose  
  • Only for the treatment of nasal polyps and associated symptoms of nasal obstruction.
  • Only to be used 3rd line as per the Local allergic rhinitis guidance (see top of this section for guidance links) March 2018

 

 

 

 
 
Fluticasone + Azelastine
(Nasal spray)
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Third Choice
traffic lightGreen
  • Azelastine 137 micrograms and Fluticasone propionate 50 micrograms per actuation
  • Only to be used 3rd line as per the local allergic rhinitis guidance  
 
 
Betamethasone Sodium Phosphate 0.1%
(nasal drops)
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Formulary
traffic lightGreen
  •  5ml nasal drops

 

 
 
 ....
 Non Formulary Items
Flunisolide (Syntaris)

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Non Formulary
 
Fluticasone Propionate
(Nasofan®)

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Non Formulary
 
Triamcinolone Acetonide
(Nasacort)

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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.  

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