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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...
12.03.02  Expand sub section  Oropharyngeal anti-infective drugs
12.03.02  Expand sub section  Oropharyngeal Fungal infections
Nystatin 
(oral suspension)
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First Choice
Green
  • Always prescribe by BRANDNAME in primary care to get most cost-effective version.
  • 100,000 units/ml 30ml bottle
  • Dose:  ADULT and CHILD over 2 years, 100 000 units 4 times daily
  • Due to the high sucrose content of nystatin suspension, 500mg/1ml, ensure that diabetic patients are aware of this.
  • Nystatin is the first line choice, however miconazole may be considered due to the differing formulations.
 
Miconazole 
(oral gel)
View adult BNF View SPC online
Formulary
Green
  • Oral gel 20mg/g 15g/80g
 
Link  MHRA DSU Sept 2017 Miconazole (Daktarin): over-the-counter oral gel contraindicated in patients taking warfarin
   
12.03.02  Expand sub section  Oropharyngeal Viral infections
 ....
 Non Formulary Items
Amphotericin Lozenges
(Fungilin)

View adult BNF View SPC online
Non Formulary
 
Miconazole (Loramyc)

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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
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Link to adult BNF
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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

Red

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Amber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Amber 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.  

Green

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Self

Suitable for patient to be directed to buy themselves  

Grey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Black

(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.   

Red 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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