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 13: Skin - Full Chapter

Notes:

Only high cost medicines to be supplied within our health economy are listed on BSW Formulary, but patients may also have access to more specialised, high cost medicines via other specialist centres, if eligible.

Dermatology-related Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Dermatology-related Shared Care Agreements

Please see our Shared Care Agreements page for all shared care agreements (SCAs) relating to this chapter.

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/

Dermatology Specials Approved List: see section 13.14

Please note that any specials listed in the BAD list are deemed to be RED on this formulary, so that specialists can prescribe them only.

Details...

13.12

Antiperspirants

Aluminium Salts
(Solution)

Formulary

20% aluminium chloride hexahydrate in an alcoholic basis
Anhydrol Forte^®, 60ml
Driclor^®60ml, 75ml
Notes: Aluminium chloride is a potent antiperspirant used in the treatment of severe hyperhidrosis.

Botulinum A toxin
(Antiperspirant)

Formulary

GWH.
A specific commissioning policy for the use of this for hyperhydrosis is under development (August 19). Current botulinum policy is found below.
Botulinum toxin units are not interchangeable from one product to another. Prescribe by brand as advised by hospital pharmacy department.

BSW CCG BOTULINUM TOXIN POLICIES

Glycopyrronium Bromide
(Hyperhidrosis)

Formulary

Various glycopyrronium products are used:
1mg and 2mg tablets
3g/5g/10g powder for solution for iontophoresis
unlicensed: Solution 0.05% 500mL and topical cream in various strengths (0.5%-4%) (both unlicensed preparation) for use in iontophoretic threatment of hyperhydrosis
A specific CCG commissioning policy for the use of this for hyperhydrosis is under development (February 2021).

Propantheline Bromide (Tablets)

Formulary

15mg tablets
Licensed for hyperhydrosis and used for gustatory sweating but only included on the formulary for this indication when initiated at GWH
Not on formulary for this indication at RUH or at SFT.
See Chapter 1.2 for other formulary indications

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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.