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 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...

07.02.01

Preparations for vaginal and vulval changes

Notes: For further information on treatment of vaginal atrophy and for HRT preparations refer to Section 6.4.1 HRT guidance and treatment pathway.

07.02.01

Topical HRT

Oestrogens, Topical
(Estring^®)

Formulary

Vaginal ring, releasing estradiol approx. 7.5 micrograms/24 hours

Oestrogens, Topical
(Imvaggis^®)

Formulary

Vaginal pessaries containing 0.03 mg estriol
Local treatment of vaginal symptoms of estrogen deficiency in postmenopausal women. Manufacturer states not to be combined with systemic estrogen preparations.
BaNES and Wiltshire only - not currently included on formulary for Swindon.

Oestrogens, Topical
(Ovestin^®)

Formulary

Vaginal Cream 0.1% estriol. One applicator-dose is 0.5g cream containing 0.5 mg estriol.
Licensed for Hormone Replacement Therapy (HRT) for treatment of atrophic vaginitis (due to estrogen deficiency) in peri- and post-menopausal women and
Licensed as pre-surgery therapy for vaginal operations and during subsequent convalescence.

Oestrogens, Topical
(Vagifem^®)

Formulary

Vaginal tablets containing estradiol hemihydrate equivalent to estradiol 10 micrograms.

....

Non Formulary Items

Oestrogens, Topical
(Gynest^®)

Non Formulary

Vaginal Cream 0.01% estriol
Licensed for Hormone Replacement Therapy (HRT) for treatment of atrophic vaginitis and kraurosis in post-menopausal women and
Licensed for treatment of pruritis vulvae and dyspareunia associated with atrophic vaginal epithelium.
Note: Gynest^®has arachis oil as an excipient

May 2019 No longer included in BSWformulary - patients should be switched where appropriate from Estriol to Ovestin cream, they look like very different products as the strengths are recorded differently but each applicator gives the same dose of Estriol: Estriol 0.01% 5ml of cream contains 0.5mg estriol = £24.98 Ovestin 1mg cream as each application contains 0.5mg Estriol = £4.45”

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.