• Paediatric 12.5mg/5ml Oral Solution (licensed from age 6months)
• 50mg in 5ml oral solution SF (licensed from age 12years)
• 120mg micro enema (licensed from age 12years)
• 100mg capsules (licensed from age 12years)

• 10mg
• Licensed for Children 1 – 11 years with a bodyweight of ≥10 kg 
• Used locally for patients with enteral tubes or patients who have not tolerated MUPS

• 1 dose = half a dual sachet
• Prescribe as doses

• Note: 10mg strength tablets are unlicensed specials and prohibitively expensive when sourced in primary care. 
• Use by gastroenterology specialists.
• 10mg strength tablets are included on the formulary only when used in paediatric patients (alternate dosing using 50mg/100mg should be considered where daily doses between 50 and 100mgs are required for adults).
• Prescribing in paediatric patients should be retained by secondary care.

• Omeprazole 4mg/mL powder for oral suspension (Rosemont)
• RESTRICTED USE - Only for use following specialist recommendation for paediatric patients under 1 year of age or under 10kg whereby dispersible tabs/esomeprazole sachets are not appropriate (i.e. prescribed dose under 5mg or feeding tube in situ). 
• To support review process of infants receiving doses ≥5mg or those with feeding tubes in situ at 12 months to transition to more cost effective PPI alternatives see link below.
• Omeprazole suspension is NOT included on the formulary for use outside this cohort (see here).  

• 1 vial with powder contains: 2 mg alteplase (corresponding to 1,160,000 IU)
• Paediatric central venous catheter management

• 12.5mg, 25mg and 50mg
• 5mg/5ml and 25mg/5ml SF solution
• Swindon only
• Non-formulary in BaNES and Salisbury

• GWH only for treatment resistant ADHD and severe Tic disorder. Paediatric consultant only.
• Non-formulary at RUH/SFT
• 25mcg tablets
• 50mcg/5ml oral solution

• 2.5mg, 5mg, 10mg and 20mg

• Tablets 10mg, 40mg
• Liquid

• Only available as an unlicensed preparation for specialist initiation only.
• Swindon only
• Non-formulary in BaNES and Salisbury

• 10mg/5ml and 50mg/5ml (Note: RUH will be moving to standard solution strength in near future).

• 1million-units
• For use in paediatrics only following initiation by specialist

• 5mg
• For emergency treatment of Croup as per BNF-C

• 20mg, 30mg, 40mg, 50mg, 60mg and 70mg
• Once daily dosing

• Melatonin 5mg/5ml oral solution or suspension (alcohol free) Unlicensed only in line with melatonin policy see here - link to add - 22/02/2020

• 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg capsules
• 4mg/1ml oral solution

• 5mg
• Only for those whose ADHD symptoms are responding to lisdexamfetamine but who cannot tolerate the longer effect profile.

• 1.5mg patch
• Unlicensed indication
• Only licensed from 10 years for travel sickness.

• 250mg, 500mg, 750mg and 1g (category 3 MHRA)
• Oral solution SF 100mg/ml
• Granules in sachets 250mg, 500mg and 1000mg Desitrend (second line use only)

• 100mg/ml 5ml vial

• Epistatus^® Oromucosal solution prefilled single syringe 10mg/1ml  (licensed in adolescents from 10 years to less than 18 years) 
• unlicensed Epistatus^® Oromucosal solution 10mg/ml prefilled syringes: 2.5mg/0.25ml, 5mg/0.5ml, 7.5mg/0.75ml.  Individually wrapped in a pack of 4.
• Do not prescribe Oromucosal solution 10mg/ml multidose 5ml bottle. In primary care, all patients should use the pre-filled syringe format as this is what the specialist primary care nursing team can provide training on for carers/schools/nurseries/after-school clubs etc.
• Prescribe by BRAND (NB Buccolam brand is a different salt, STRENGTH and volume) 
• See Shared Care Guidelines: Use of Oromucosal Midazolam as an intervention for prolonged seizures and prevention od Status Epilepticus

Swindon only - when used for sedation and pre-med in theatres

• 500microgram tablet
• 1.5mg tablet
• Pizotifen is only included for prophylaxis of migraine in paediatrics. See Chapter 4.7.4.2 for BSWformulary choices for migraine in adults.

• Crushable tablets 100mg
• E/C tablets 200mg, 500mg
• M/R tablets 200mg, 300mg, 500mg 
• M/R capsules 150mg, 300mg
• Liquid^SF 200mg/5ml

COVID-19 MHRA have issued guidance - Valproate Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19)

• 400mg

COVID-19 MHRA have issued guidance - Valproate Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19)

• 2mg and 5mg tablets
• 5mg/5ml (200ml)
• Not licensed for this indication and 'Not Recommended' for children in the SPC but is listed in the BNF-C

• Use as per NICE NG87
• Offer guanfacine to children aged 5 years and over and young people if:
• they cannot tolerate methylphenidate or lisdexamfetamine or
• their symptoms have not responded to separate 6-week trials of lisdexamfetamine and methylphenidate, having considered alternative preparations and adequate doses.

• 50mg tablets

RUH ONLY - as adjunctive therapy in pharmaco-resistant paediatric epilepsy where other AEDs have failed at optimal doses.

• Swindon only
• 500mg/2ml
• Paediatric consultant/microbiology advice only
• Monitoring of drug levels required - NOT ROUTINELY STOCKED AT GWH
• Non-formulary at BaNES and Salisbury

• Capsules 250mg, 500mg 
• Suspension 125mg/5ml and 250mg/5ml

• 250mg and 500mg
• 200mg/5ml 

• 50mg and 100mg

• 100ml bottle
• Used as a diluent for dissolving some medicines e.g. omeprazole for oral/enteral use (unlicensed indication)
• BaNES only

• GWH - For Consultant prescribing only. 

•  at RUH and SFT
•  at GWH

• 250mg in 1ml

• 800micrograms/ml (4mg) vial
• Osteogenesis imperfecta and other low bone mass conditions as per the Bristol Childrens Hospital Guidelines
• Six monthly infusions

• ONLY to be initiated following specialist recommendation in people with diabetes who fit the NHSE criteria for funding (link below).
• Freestyle Libre should NOT be initiated by non-specialists in primary care.
• Freestyle Libre should not be initiated in people with Type 2 Diabetes (T2D) in line with NHSE policy. Exceptions are people with T2D on dialysis or with Cystic Fibrosis, and people with insulin treated T2D living with a learning disability which is recorded on the GPs learning disability register.
• Specialist teams must provide clinical oversight of a person’s use of Freestyle Libre. Including education for people initiated on Freestyle Libre , a prescribing contract, review of benefits after 6 months and ongoing follow up and review, alongside wider diabetes management.
• Continuing prescription for long-term use of Freestyle Libre post initial 6 months is contingent upon evidence of agreeing with NHSE conditions for use and that on-going use of Freestyle Libre is demonstrably improving an individual’s diabetes self-management. For example improvement of HbA1c or Time In Range; improvement in symptoms such as DKA or hypoglycaemia; or improvement in psycho-social wellbeing.
• A Freestyle Libre Sensor lasts for 2 weeks; one month’s supply is 2 sensors

Freestyle Libre 2 - Jan 2021 Update - NHSE link to follow when published

• The new Freestyle Libre 2 sensor has the added feature of real-time glucose alarms that notify people if glucose goes too low or too high.
• To manage workload & product supply, Freestyle Libre 2 will be offered to patients who meet the eligibility criteria for Flash at their next routine appointment with their specialist diabetic healthcare professional. In the current climate, we respectfully request that people wait until their next routine appointment with their specialist in 2021 to enquire about the FreeStyle Libre 2 system.
• Specialist diabetes teams will support people to use the new features included in Freestyle Libre 2 system to better manage their diabetes by supplying an information booklet and signposting to New Starter Clinic online education and support and will supply those using the old Freestyle Libre scanning device with a new Freestyle Libre 2 scanner. People using the Flash App should check that it is updated to the latest version (version 2.5 or above). Details on device compatibility can be found in the compatibility guide on the Abbott website.

• Note: 10mg strength tablets are unlicensed specials and prohibitively expensive when sourced in primary care. 
• Oncology specialist use.
• 10mg strength tablets are included on the formulary only when used in paediatric patients (alternate dosing using 50mg/100mg should be considered where daily doses between 50 and 100mgs are required for adults).
• Prescribing in paediatric patients should be retained by secondary care.

• Only to be prescibed in line with BSW CMPA guidance (below) 
• AAF are significantly more expensive that eHF. A small number of infants will need an AAF but this should usually be prescribed on the advice of a Consultant Paediatrician, allergy specialist or Paediatric Dietitian 
• SMA Alfamino (suitable from birth) is first line Amino Acid-based Formula (AAF) milk
• Neocate LCP, Neocate Junior, Neocate Syneo, Nutramigen Puramino and Elecare are alternative AAF options where SMA Alfamino is not tolerated or on the advice of a dietitian/ allergy specialist. 

• Swindon only.
• 20mg melts
• Third line in children unresponsive to or intolerant of Ibuprofen and Diclofenac.
• Non-formulary in BaNES and Salisbury

• Swindon only.
• 20mg/ml
• For intra-articular administration
• Non-formulary in BaNES and Salisbury

• 0.1% drops (1 mg/mL eye drops, emulsion)
• Verkazia®  is licensed for the treatment of severe vernal keratoconjunctivitis in children from 4 years of age and adolescents. 
• Ensure correct product is prescribed. Other ciclosporin eyedrops  are available but have different licensing information and TLS. Ikervis® contains the same ingredient but is not licensed in paediatrics. 

• Unlicensed named patient product
• Consultant Specialist initiation only
• For treatment of severe allergic rhinitis and severe allergic conjunctivitis not responding to standard treatment

• Swindon only
• 500microgram per 1 ml
• Non-formulary in BaNES and Salisbury

• 320micrograms/ml
• Licensed for symptomatic treatment of severe sialorrhoea (chronic pathological drooling) in children and adolescents aged 3 years and older with chronic neurological disorders
• For short term intermittent use

• Used in accident and emergency departments