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 20: Unlicensed Medicines / Significant off-label use - Full Chapter

Notes:

Where possible, we have indicated unlicensed medicines and significant off label use within the relevant clinical chapters of this formulary.

This chapter of the BSW Formulary contains entries for medicines which are not included in the current BNF, and which cannot be classified under the BNF chapter system.

Details...

Unlicensed Medicines

Acetic acid 5%

Unlicensed

GWH Obstetric and Gynae OP stock

Ajmaline

Unlicensed

For use within RUH
Approved for use in the diagnosis of Brugada syndrome (unlicensed) by Consultant Cardiologists (for diagnostic use only).

Biolon / Haelonid AV

Unlicensed

For use within SFT

Cyanoacrylate glue N-butyl-2-cyanoacrylate

Unlicensed

For use within the RUH
For treatment of gastric variceal bleeding

Fibrin Sealant
(Tisseel^®)

Unlicensed

For use within RUH and GWH only

Heavy Liquid (Perfluorodecalin)

Unlicensed

For use within GWH only

Indigo carmine solution

Unlicensed

For use within RUH
'Off label' use of solution for injection as replacement for unlicensed preparation in endoscopy

Indocyanine green Injection 25 mg, 50mg

Unlicensed

For use within the RUH

Monsels Ferris Subsulphate Solution

Unlicensed

GWH Obstetric and Gynae OP stock

....

Non Formulary Items

Dibotermin Alfa, rhBMP-2
(Inductos^®)

Non Formulary

Eptotermin Alfa
(Osigraft^®)

Non Formulary

Levamisole Tablets 50 mg

Unlicensed

Methylthioninium chloride
(methylene blue)
(visualisation / staining)

Unlicensed

Procainamide Capsules 250 mg

Unlicensed

Sodium Hyaluronate
(Hyacyst^®)

Non Formulary

St Johns Wort

Non Formulary

St Marks solution

Non Formulary

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.