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 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter

Notes:

Prescribing Guidance

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

Shared Care Agreements

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

Details...

07.01

Drugs used in obstetrics

NICE CG55: Intrapartum care

07.01.01

Prostaglandins and oxytocics

Carboprost (Hemabate^®)

Formulary

250micrograms/1ml solution for injection ampoules
Indicated for postpartum haemorrhage due to uterine atony in patients unresponsive to ergometrine and oxytocin.

Dinoprostone

Formulary

Prostin E2^® dinoprostone 3mg vaginal tablets
Prostin E2^® dinoprostone 400micrograms per 1ml, 800micrograms per 1ml vaginal gel.
NB Prostin E2 vaginal tablets and vaginal gel are not bioequivalent.
Propess^®dinoprostone 10mg vaginal pessaries with retrieval device.

Ergometrine Maleate
(Ergometrine)

Formulary

Injection 500 micrograms in 1ml

Ergometrine Maleate and Oxytocin
(Syntometrine^®)

Formulary

Injection containing ergometrine maleate 500 micrograms and oxytocin 5 units in 1ml

Gemeprost

Formulary

Pessaries 1mg

Oxytocin (Syntocinon^®)

Formulary

Injection 5 units in 1ml, 10 units in 1ml

Misoprostol
(Gynae)

Unlicensed

Misoprostol 200micrograms tablets
Unlicensed indication/route of administration. Such use of misoprostol is supported by the Royal College of Obstetricians and Gynaecologists guideline development group.

NICE CG13: Caesarean section

NICE CG70: Induction of labour

07.01.01.01

Drugs affecting the ductus arteriosus

07.01.01.01

Maintenance of patency

Alprostadil
(Prostin VR^®)

Formulary

RUH only
Non formulary at GWH and SFT
500 micrograms/ml solution for infusion

Dinoprostone

Formulary

GWH and SFT
note - off label use

07.01.01.01

Closure of ductus arteriosus

Ibuprofen
(Pedea^® injection)

Formulary

GWH and SFT only
Non formulary at RUH

Indometacin
(Indocid PDA^®)

Formulary

GWH and RUH only
Non formulary SFT

07.01.02

Mifepristone

Mifepristone (Mifegyne^®)

Formulary

ONLY for consultant obstetrician and gynaecologist prescribing AND in accordance with RCOG guidelines.

07.01.03

Myometrial relaxants

Atosiban

Formulary

Injection 7.5mg/mL (6.75mg/0.9mL vial)
Concentrate for IV infusion 7.5mg/mL (37.5mg/5mL vial)

Nifedipine
(Oral)

Formulary

GWH only - For the initial management of preterm labour (off-label indication)
Non formulary at RUH and SFT
For use in hypertension or angina and note on supply problems see section 2.6.2

Terbutaline
(obstetrics)

Formulary

Injection 500 micrograms/ml

MHRA DSU Dec 2014: Short-acting â2 agonists: restricted use for tocolysis in premature labour

....

Non Formulary Items

Ritodrine (Yutopar^®)

Non Formulary

Salbutamol
(obstetrics)

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.