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...

07.04.05

Drugs for erectile dysfunction

07.04.05

Alprostadil

Alprostadil (Caverject^®)

Formulary

10 microgram, 20 microgram, 40 microgram intracavernosal injection.
Please note patients will be taught, in clinic, how to administer the dual chamber system. If this form of Caverject is unavailable, patients should not be switched to other Caverject preparations, unless advised by a specialist, as they will need to be re-trained in how to use the new device.

Alprostadil (MUSE^®)

Formulary

125 microgram, 250 microgram, 500 microgram, 1000 microgram transurethral delivery system.

Alprostadil
(Viridal^® Duo)

Formulary

10 microgram, 20 microgram, 40 microgram intracavernosal injection.

Alprostadil (Vitaros^®)

Formulary

3mg/g cream for application to tip of penis.
GWH and SFT only
Non formulary at RUH

07.04.05

Phosphodiesterase type 5 inhibitors

Sildenafil

First Choice

25mg, 50mg, 100mg tablets.
Offer generic sildenafil on the NHS for all patients as first-line treatment for ED (SLS requirement removed 01/08/14 - private prescriptions no longer necessary).
For unlicensed use of sildenafil in connective tissue disorders see section 02.05.01

MHRA Drug Safety Update (Nov 2018): Sildenafil (Revatio and Viagra): reports of persistent pulmonary hypertension of the newborn (PPHN)

Tadalafil

Second Choice

10mg, 20mg tablets.
Prescribe generically on the NHS if patient meets SLS criteria. Full information on SLS is at Drug Tariff Part XVIIIB
Offer a private prescription if patient does not meet SLS.
NOTE - TADALAFIL ONCE DAILY HAS NOT BEEN INCLUDED ON THE FORMULARY

NICE TA273: Hyperplasia (benign prostatic) - tadalafil (terminated appraisal)

07.04.05

Papaverine and phentolamine

Aviptadil + phentolamine
(Invicorp^®)

Formulary

Solution for intracavernosal injection.
GWH and SFT only
Non formulary at RUH

Papaverine

Formulary

Injection 25mg, 80mg.
RUH only
Non formulary at SFT and GWH

....

Non Formulary Items

Avanafil

Non Formulary

Phentolamine
(erectile dysfunction)

Non Formulary

Vardenafil (Levitra^®)

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.