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

Search

Formulary Chapter 16: Paediatrics - Full Chapter

Notes:

*** WORK WILL BE TAKING PLACE ON THIS CHAPTER w/c 24/01/21***

PLEASE NOTE: THIS CHAPTER IS STILL UNDER CONSTRUCTION

Where medicines are included in the BSWformulary (for any indication) and are in the BNF for Children (BNF-C), they can be prescribed for a licensed indication within the manufactrer's recommendations using any formulation.

Where medicines are not included and therefore non-formulary (despite being in the BNF-C) they must be approved for use by the local Formulary team by submitting a Non-Formulary Medicine Request Form or an IFR application for individual patient requests where exceptionality can be shown.

Paediatric drugs are frequently used outside of the SPC since many manufacturers fail to conduct the relevant trials needed to secure licensed use in paediatrics. Prescribers take full responsibility for prescribing products outside the license. However all prescribing should be carried out in the best interest of the child irrespective of license status.

Traffic Light Status Information for Paediatric Chapter

Red Traffic Light

In BNF-C but outside indications or dose range
Not in BNF-C
Off label use of drug (as per BNFC definition Guidance on prescribing: BNF for Children and marketing authorisation)
Unlicensed drug

Amber with Shared Care Agreement (SCA)

In BNF-C within indication and dose range
Unlicensed or Off label use of drug (as per BNF-C definition Guidance on prescribing: BNFC and marketing authorisation)
Require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP detailed in SCA

Amber No Shared Care Agreement (SCA) needed

In BNF-C within indication and dose range
Considered suitable for GP prescribing following specialist initiation or recommendation.

Green Traffic Light

In BNF-C within indication and dose range
Considered suitable for initiation in both primary and secondary care.

Useful resources

RCPCH and NPPG joint position statement -using standardised strengths of unlicensed liquid medicines

RCPCH and NPPG joint position statement - choosing an oral liquid medicine for children

Details...

16.11

Eye (paediatric)

Ciclosporin (Verkazia^®)
(Ophthalmic drops)

Formulary

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.

NICE TA369: Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears

....

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.