Formulary Chapter 9: Nutrition and blood - Full Chapter
|
|
Details... |
09.01 |
Anaemias and some other blood disorders |
|
|
|
09.01.01 |
Iron-deficiency anaemias |
|
|
|
|
Iron Salt
|
Dose & frequency
|
Amount of ferrous iron / day
|
Ferrous Sulphate Tablets
|
200mg three times daily
|
195mg
|
Ferrous Fumarate Tablets
|
210mg three times daily
|
204mg
|
Ferrous Fumarate Syrup
|
280mg (10ml) twice daily
|
180mg
|
Sodium Feredate Liquid
|
380mg (10ml) three times daily
|
165mg
|
|
|
Ferrous Fumarate
(Oral)
|
First Choice

|
- Tablets 322mg (equivalent to 100mg ferrous iron per tablet).
- Tablets 210mg (equivalent to 68mg ferrous iron per tablet).
- Oral solution 140mg/5ml (equivalent to 45mg ferrous iron per 5ml)
|
|
Ferrous Sulphate
(Oral)
|
First Choice

|
- Tablets 200mg (equivalent to 65mg ferrous iron per tablet).
|
|
Sodium Feredetate
(Sytron®)
(Liquid)
|
Formulary

|
|
|
09.01.01.01 |
Iron and folic acid |
|
|
Iron and Folic Acid
(Pregaday®)
(Oral)
|
Formulary

|
- Tablets containing ferrous fumarate 322mg (equivalent to 100mg of ferrous iron)and folic acid 0.35mg
|
|
09.01.01.01 |
Compound iron preparations |
|
|
09.01.01.02 |
Parenteral iron |
|
|
|
Ferric Carboxymaltose
(Ferinject®)
(Injection)
|
Formulary

|
- Please note Ferinject is considerably more expensive than Cosmofer.
- Treatment of iron-deficiency in patients with asthma, allergic eczema or other atopic allergy, when oral iron preparations are ineffective or cannot be used
- 50mg/ml for slow intravenous injection or intravenous infusion
- Anaphylactoid reactions can occur with parenteral administration of iron complexes. Facilities for cardio-pulmonary resuscitation must be at hand.
|
Ferric carboxymaltose: risk of symptomatic hypophosphataemia leading to osteomalacia and fractures
|
Iron Dextran
(CosmoFer®)
(Injection )
|
Formulary

|
- SFT and GWH only. Not on formulary at RUH
- 50mg/ml
- Anaphylactoid reactions can occur with parenteral administration of iron complexes. Facilities for cardio-pulmonary resuscitation must be at hand.
|
|
Iron Isomaltoside
(Monofer®)
(Injection )
|
Formulary

|
- Included on formulary for RUH only - Treatment of iron-deficiency when oral preparations are ineffective and cannot be used
- GWH/SFT - Not on formulary
- 100mg/ml for slow intravenous injection or intravenous infusion
- Anaphylactoid reactions can occur with parenteral administration of iron complexes. Facilities for cardio-pulmonary resuscitation must be at hand.
|
|
09.01.02 |
Drugs used in megaloblastic anaemias |
|
|
|
Hydroxocobalamin
(Vitamin B12 Injection)
|
Formulary

|
- 1mg in ml
- Intramuscular injection
COVID-19 - BSW medicines management teams support the BSH advice on B12 replacement during the Covid-19 pandemic. See link below.
|
BSW guidance on B12 supplements during COVID pandemic
BSW Investigation, treatment and review of Vitamin B12 (cobalamin) deficiency
|
Cyanocobalamin
(Oral Vitamin B12)
|
Formulary

|
- 50microgram, 100microgram, 1mg tablets
- For management of diet related Vit B12 deficiency, patients can be advised to purchase cyanocobalamin OTC in line with NHSE guidance.
COVID-19 pandemic - As per BSH advice for Vit B12 replacement there may be situations where oral B12 50-150 micrograms per day may be offered as an alternative to Vit B12 injection. See link below.
|
BSW guidance on B12 supplements during COVID pandemic
BSW Investigation, treatment and review of Vitamin B12 (cobalamin) deficiency
Oral vitamin B12 – SPS Q&A: What are the prescribing considerations and what formulations are available?
|
Folic Acid
(Oral)
|
Formulary

|
- Tablets: 5mg, 400 micrograms
- SF Oral solution: 2.5mg / 5ml
- Refer to BNF for guidance on the use of folic acid for use in pregnancy for the prevention of neural tube defects.
- Women with a BMI ≥30 wishing to become pregnant should be advised to take 5mg folic acid supplementation daily, starting at least one month before conception and continuing during the first trimester of pregnancy. (RCOG)
|
|
09.01.03 |
Drugs used in hypoplastic, haemolytic, and renal anaemias |
|
|
|
Recombinant human erythropoietins
(Non renal indications)
|
Formulary

|
- Non renal indications - Haematology / Oncology
- Prescriber must specify which epoetin is required
- For use in patients in accordance with NICE TA323
- Choice of agent dependent on Trust and procurement costs.
- Non Formulary at SFT for non renal indications (use darbeopoetin instead)
- NeoRecormon® Prefilled syringes – 500, 1000, 2000, 3000, 4000, 5000, 6000, 10,000, 20,000, 30,000iu
- Eprex® pre-filled syringes 1000/0.5ml, 2,000/0.5ml, 10,000/1ml, 3,000/0.3ml, 4,000/0.4ml, 5,000/0.5ml, 6,000/0.6ml, 8,000/0.8ml,20,000/0.5m,30,000/0.75ml, 40,000/1ml units
|
NICE TA323: Erythropoiesis‑stimulating agents during chemotherapy
|
Darbepoetin Alfa
( Non renal indications)
|
Formulary
|
 SFT and RUH
 GWH
- Non renal indications - Haematology / Oncology
- Aranesp®Prefilled syringes 10, 15, 20, 30, 40, 50, 60, 80, 100, 150, 130, 300, 500 micrograms
- SureClick® 20, 40, 60, 80, 100, 150, 300, 500 micrograms
|
NICE TA323 Nov 2014: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
|
Recombinant human erythropoietins
(Renal indications)
|
Formulary

|
 GWH
- Non Formulary at RUH for renal indication (NBT specialist centre)
- Non Formulary at SFT for renal indication (QAH specialist centre)
- Commissioned by NHS England (for dialysis-induced anaemia only including via outpatients and only as per NICE CG114 and NICE NG8)
- Prescriber must specify which epoetin is required
- Choice of agent dependent on Trust and procurement costs.
- NeoRecormon® Prefilled syringes – 500, 1000, 2000, 3000, 4000, 5000, 6000, 10,000, 20,000, 30,000iu
- Eprex pre-filled syringes 1000/0.5ml, 2,000/0.5ml, 10,000/1ml, 3,000/0.3ml, 4,000/0.4ml, 5,000/0.5ml, 6,000/0.6ml, 8,000/0.8ml,20,000/0.5m,30,000/0.75ml, 40,000/1ml units
|
NICE NG8 June 2015: Chronic kidney disease: managing anaemia
|
|
09.01.03 |
Iron overload |
|
|
Deferasirox
(Tablet)
|
Formulary



|
- 90mg,180mg,360mg
- Commissioned by NHS England for iron chelation in thalassaemia and sickle cell anaemia.
|
NHSE Clinical Commissioning policy August 2016: Treatment of iron overload for transfused and non transfused patients with chronic inherited anaemias
|
Desferrioxamine Mesilate
(Injection)
|
Formulary



|
- 500mg, 2g powder for solution for injection vials
- Commissioned by NHS England for iron chelation in thalassaemia and sickle cell anaemia.
|
NHSE Clinical Commissioning policy August 2016: Treatment of Iron overload for transfused and non-transfused patinets with chronic inherited anaemias.
|
09.01.04 |
Drugs used in autoimmune thrombocytopenic purpura |
|
|
Eltrombopag
(Tablet)
|
Third Choice




|
- 25mg, 50mg
- See MHRA Drug Safety Update July 18 for information on reports of interferance with bilirubin and creatinine
- Third line options can be considered for patients with symptoms lasting longer than 12 months in whom first and second line treatment options have failed and there are on-going complications from their thrombocytopenia OR where second-line options are contra-indicated.
|
BSW Treatment Pathway for adult patients with immune (idiopathic) thrombocytopaenia purpura (ITP) Nov 2018
MHRA July 18 Eltrombopag (Revolade): reports of interference with bilirubin and creatinine test results
NICE TA293: Eltrombopag for treating chronic ITP
|
Romiplostim
(Injection)
|
Third Choice




|
- 250microgram
- Third line options can be considered for patients with symptoms lasting longer than 12 months in whom first and second line treatment options have failed and there are on-going complications from their thrombocytopenia OR where second-line options are contra-indicated.
- The CCG needs to be notified of dose increases over 500 micrograms (2 vials) of romiplostim by submitting a new Blueteq form.
|
BSW Treatment pathway for adult patients with immune (idiopathic) thrombocytopenic purpura (ITP) Nov 2018
NICE TA221: Thrombocytopenic purpura - romiplostim
|
Lusutrombopag
(Tablets)
|
Formulary



|
- 3mg film-coated tablets
- Short-term use for treating severe thrombocytopenia in adults with chronic liver disease needing a planned invasive procedure following NICE TA617.
|
NICE TA617 Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure Jan 2020
|
Rituximab
(Truxima®)
|
Formulary


|
- 100mg/10ml and 500mg/50ml infusion
- Prescribe by Brand Biosimilar First Line
- Also for the treatment of ITP in accordance with the BSW ITP guidelines
|
BSW Treatment pathway for adult patients with immune (idiopathic) thrombocytopenic purpura (ITP) Nov 2018
|
Anagrelide
(Capsule)
|
Formulary

|
- 500 microgram
- For the treatment of essential thrombocythaemia
|
|
|
09.01.06 |
Drugs used in neutropenia |
|
|
Filgrastim
(Accofil®)
(Injection)
|
Formulary


|
- Pre-filled syring 30 million units (300 micrograms)/0.5 mL and 48 million units (480 micrograms)/0.5 mL
- Biosimilar GCSF
- Commissioned by NHS England for neutropenia according to Trust Guidelines.
|
MHRA - Filgrastim and pegfilgrastim: risk of capillary leak syndrome
|
Lenograstim
(Granocyte®)
(Injection)
|
Formulary


|
- SFT and RUH
- GWH - not on formulary
- Pre-filled syringe 13.4 million-unit (105 micrograms), 33.6 million-unit (263 micrograms)
- Recombinant human granulocyte-colony stimulating factor (rHuG-CSF)
- Commissioned by NHS England for neutropenia according to Trust Guidelines
- RUH Used for the mobilisation of STEM cells.
|
|
09.01.07 |
Drugs used to mobilise stem cells |
|
|
Plerixafor
(Injection)
|
Formulary


|
- RUH and SFT - For use in line with NHS England Policy B04/P/2 January2014
- GWH not on formulary
- 20mg/ml 1.2ml vial
|
NHSE Clinical Commissioning Policy: Use of Plerixafor for Stem Cell Mobilisation (Update) Jan 2015
|
09.02 |
Fluids and electrolytes |
|
|
09.02.01 |
Oral preparations for fluid and electrolyte imbalance |
|
|
09.02.01.01 |
Oral potassium |
|
|
Potassium Chloride
(Sando-K®)
(Tablet)
|
Formulary

|
- Effervescent tablets each containing Potassium chloride 600mg / Potassium bicarbonate 400mg (total potassium 12mmol) per tablet
|
|
Potassium Chloride
(Kay-Cee-L®)
(Liquid)
|
Formulary

|
- Potassium chloride 375mg/5ml oral solution sugar free (total potassium 1mmol per mL syrup)
- Contains sorbitol: May cause osmotic diarrhoea
|
|
09.02.01.01 |
Potassium removal |
|
|
Polystyrene Sulphonate Resins
(Calcium Resonium®)
(powder)
|
Formulary

|
- Powder calcium polystyrene sulphonate.
- Note: Calcium resonium can be taken orally mixed in water (not fruit juice or other potassium containing fluids) or rectally.
|
|
Sodium Zirconium Cyclosilicate
(Lokelma®)
|
Formulary

|
- 5g and 10g powder for oral suspension
- For use in line with NICE TA599
|
NICE TA599 Sodium zirconium cyclosilicate for treating hyperkalaemia
|
Patiromer Sorbitex Calcium
(Veltassa®)
|
Formulary

|
- 8.4g, 16.8g, 25.2g powder for oral suspension
- For use in line with NICE TA623
|
NICE TA623 Patiromer for treating hyperkalaemia
|
09.02.01.02 |
Oral sodium and water |
|
|
Sodium Chloride
(Slow Sodium®)
(Tablet)
|
Formulary

|
- Modified release tablets containing 600mg sodium chloride (equivalent to 10mmol Sodium)
|
|
09.02.01.02 |
Oral rehydration therapy (ORT) |
|
|
Oral Rehydration Salts
(Dioralyte® Electrolade®)
|
Formulary

|
|
|
09.02.01.03 |
Oral bicarbonate |
|
|
Sodium Bicarbonate
(oral)
|
Formulary

|
- Capsules: 500 mg (more cost effective) (approx. 6mmol each of sodium and bicarbonate)
- Tablets: 600mg
- Paediatric oral solution:
unlicensed. For Paediatric Consultant prescribing only.
|
|
09.02.02 |
Parenteral preparations for fluid and electrolyte imbalance |
|
|
09.02.02.01 |
Electrolytes and water |
|
|
09.02.02.01 |
Intravenous sodium |
|
|
Compound Sodium Lactate Intravenous Infusion
(Hartmann's solution )
|
Formulary

|
- Calcium chloride0.027%, Potassium chloride 0.04% Sodium chloride 0.06% and Sodium lactate 0.25%
|
|
Sodium Chloride and Glucose Intravenous Infusion
|
Formulary

|
- Sodium chloride 0.45% and glucose 2.5%
- Sodium chloride 0.18% and glucose 4%
|
|
Sodium Chloride Intravenous
|
Formulary

|
- IV infusion 0.9% 5ml, 10ml, 20ml ampoules, 50ml vials
- The terms "saline", "normal saline" and "NS" must not be used to describe sodium chloride 0.9%
Sodium chloride 0.18% |
500ml |
Sodium chloride 0.45% |
500ml |
Sodium chloride 0.9%
|
50ml, 100ml, 250ml, 500ml, 1 litre |
Sodium chloride 1.8% |
500ml |
|
|
09.02.02.01 |
Intravenous glucose |
|
|
Glucose Intravenous
|
Formulary

|
- Glucose 50%: 50ml Min-I-jet
Additional products for infusion available for use in secondary care |
Glucose 5% |
100ml, 250ml, 500ml, 1 litre |
Glucose 10% |
500ml, 1 litre |
Glucose 20% |
500ml |
Glucose 50% |
500ml |
|
|
09.02.02.01 |
Intravenous potassium |
|
|
Potassium Chloride
|
Formulary

|
- For the administration of IV Potassium infusions available in the Trust, refer to Trust Policy
- Pre-mixed infusion solutions should be used when possible.
- Medical errors involving Sterile Potassium Chloride Concentrate (20mmol/10ml {15%}) can be potentially fatal.
- The use of Sterile Potassium Chloride Concentrate (20mmol/10ml {15%}) is restricted to use in areas that require potassium-containing fluids not available as pre-mixed solutions.
|
NPSA patients safety alert IV potassium 2002
|
09.02.02.01 |
Bicarbonate and lactate |
|
|
Sodium Bicarbonate
(injection)
|
Formulary

|
- Also used for emergency treatment of poisoning
Products for infusion available for use in secondary care |
Sodium bicarbonate 1.26% |
Infusion 500ml |
Sodium bicarbonate 8.4% |
Infusion 200ml |
|
|
|
09.02.02.02 |
Plasma and plasma substitutes |
|
|
Albumin Solution
(Isotonic solutions)
|
Formulary

|
- GWH and SFT
- RUH - Non formulary
- 4.5% & 20% infusions
|
|
09.02.02.02 |
Plasma substitutes |
|
|
Gelatin
(Gelofusine®)
(Infusion)
|
Formulary

|
- GWH only - for endoscopy use only
- RUH/SFT not on formulary
- Gelofusine® Infusion 500ml, 1 litre
|
|
09.03 |
Intravenous nutrition |
|
|
|
Total parenteral nutrition (TPN) should only be prescribed by appropriately trained, healthcare professionals, in line with Trust policy.
Royal United Hospitals Foundation Trust (RUH) info on aseptic services within the trust can be found on the RUH intranet here
Great Western Hospitals NHS Foundation Trust (GWH):
- TPN should ONLY be prescribed by, or on the advice of, the GWH Parenteral Nutrition team, who can be contacted during normal working hours on 01793-605149.
- For adults, the decision to initiate intravenous nutrition should NOT be taken outside of normal working hours whilst, for neonates, the decision to initiate intravenous nutrition outside of normal working hours MUST be in line with Trust policy and procedures.
|
|
|
|
|
Nutilis Clear®
|
First Choice

|
|
BSW Guide to Prescribing Thickeners for Adults in Primary Care
|
Resource ThickenUP Clear®
|
Formulary

|
|
BSW Guide to Prescribing Thickeners for Adults in Primary Care
|
Thick & Easy Clear®
|
Formulary

|
|
BSW Guide to Prescribing Thickeners for Adults in Primary Care
|
|
|
BSW - COVID nutrition prescribing guidance
Prescribers are reminded that the Advisory Committee on Borderline Substances recommends products on the basis that they may be regarded as drugs for the treatment of specified conditions. Doctors should satisfy themselves that the products can be safely prescribed, that patients are adequately monitored and that, where necessary, expert hospital supervision is available. Prescriptions for products recommended by the Committee should be endorsed "ACBS". |
|
|
09.04.01 |
Foods for special diets |
|
|
|
9.4.1 Foods for special diets: Coeliacs.
The BSWFormulary only supports the prescribing of gluten free products listed in the Drug Tariff Part XV and in line with the notes below.
These are ACBS indications (Advisory Committee on Borderline Substances)
-
BaNES - only for patients who meet the following criteria:
-
- A child under 18 years age
- Vulnerable adult
- Patients with complex needs
-
Swindon and Wiltshire - those who have a diagnosis of Coeliac disease Dermatitis Herpetiformis or steatorrhea due to gluten sensitivity
-
Monthly Prescribing Quantities:
Age and Sex |
Suggested Monthly Units |
Child under 10 years |
8 |
Child 11-18 years |
12 |
Female 19 years or above |
8 |
Male 19 years or above |
12 |
1 unit is equivalent to |
400g bread or 400g rolls/bagettes |
2 units is equivalent to |
500g bread mix or flour mix |
- Please note this link may also be of use www.coeliac.org.uk.
|
|
09.04.02 |
Enteral nutrition |
|
|
|
Before prescribing ONS, it is advisable to screen a patient to assess requirements using the MUST tool. See community MUST screening or care home MUST screening.
When introducing ONS to patients for the first time prescribe a small number of assorted flavours or a starter pack as an acute prescription.
|
|
Foodlink Complete
(Powdered MILKSHAKE style ONS)
|
First Choice

|
- First line option
- 57g sachets
- To be mixed with 200ml full fat milk. Consider whether patient has access to milk and ability to make up the drink with milk. Consider cost to patient. Not suitable for those with lactose intolerance.
- See ONS guidance for full product details
|
|
Aymes Shake
(Powdered MILKSHAKE style ONS)
|
Formulary

|
- 57g sachets
- See ONS guidance for full product details (link at top)
|
|
Fortisip
(Ready to drink MILKSHAKE style ONS)
|
Formulary

|
- 200ml bottle
- See ONS guidance for full product details (link at top)
|
|
Ensure Plus
(Ready to drink MILKSHAKE style ONS)
|
Formulary

|
- 220ml bottles
- See ONS guidance for full product details (link at top)
|
|
Foodlink Complete Compact
(Powdered COMPACT style ONS.)
|
Formulary

|
- For those who require smaller volumes or with fluid restrictions
- 57g sachets
- See ONS guidance for full product details (link at top)
|
|
Fortisip Compact
(Ready to drink COMPACT style ONS.)
|
Formulary

|
- For those who require smaller volumes or with fluid restrictions
- 125ml bottle
- See ONS guidance for full product details (link at top)
|
|
Altraplen Compact
(Ready to drink COMPACT style ONS)
|
Formulary

|
- For those who require smaller volumes or with fluid restrictions
- 125ml bottle
- See ONS guidance for full product details (link at top)
|
|
Aymes ActaSolve Smoothie
(Juice style ONS)
|
Formulary

|
- Not suitable for people with diabetes, COPD and wounds - due to carbohydrate:protein ratio
- 66g sachet
- See ONS guidance for full product details (link at top)
|
|
Altrajuce
(JUICE style ONS )
|
Formulary

|
- Not suitable for people with diabetes, COPD and wounds due to carbohydrate:protein ratio
- 200ml bottle
- See ONS guidance for full product details (link at top)
|
|
Fortijuce
(JUICE style ONS)
|
Formulary

|
- Not suitable for people with diabetes, COPD and wounds due to carbohydrate:protein ratio
- 200ml bottle
- See ONS guidance for full product details (link at top)
|
|
Foodlink Complete Powder with Fibre
(Milkshake style PLUS FIBRE ONS)
|
Formulary

|
- Contains fibre, consider for those with constipation
- 63g sachet
- See ONS guidance for full product details (link at top)
|
|
Ensure Plus Fibre
(MILKSHAKE style PLUS FIBRE ONS)
|
Formulary

|
- Contains fibre, consider for those with constipation
- 200ml bottle
- See ONS guidance for full product details (link at top)
|
|
Aymes ActaGain 2.4 Maxi
(Ready to drink MILKSHAKE style HIGH Protein ONS)
|
Formulary

|
- 200ml bottle
- See ONS guidance for full product details (link at top)
|
|
Fresubin 3.2 kcal
(Ready to drink MILKSHAKE style HIGH Protein ONS)
|
Formulary

|
- 125ml bottle
- See ONS guidance for full product details (link at top)
|
|
Fortisip Compact Protein
(Ready to drink MILKSHAKE style HIGH Protein ONS)
|
Formulary

|
- 125ml bottle
- See ONS guidance for full product details (link at top)
|
|
Nutricrem
(For Dysphagia Level 4 ONS)
|
Formulary

|
- FIRST LINE for Dysphagia Level 4 ONS
- 125g pot
- See ONS guidance for full product details (link at top)
|
|
Nutilis Fruit Dessert Level 4
(For Dysphagia Level 4 ONS)
|
Formulary

|
- 150g pot
- See ONS guidance for full product details (link at top)
|
|
|
|
09.05.01 |
Calcium and magnesium |
|
|
09.05.01.01 |
Calcium supplements |
|
|
Adcal ®
(Oral)
|
Formulary

|
- Swindon only
- BaNES and Salisbury - not on formulary
- 1500mg chewable tablets, each containing 1.5g calcium carbonate.
|
|
Calcichew ®
(Tablet)
|
Formulary

|
- BaNES and Salisbury only
- Swindon - not on formulary
- 500mg chewable tablets, each containing 1.25g calcium carbonate.
|
|
Calcium 5.1mmol/10ml Syrup
(Alliance Calcium Syrup®)
|
Formulary

|
- Replaces Calcium Sandoz syrup (discontinued)
|
|
Calcium Carbonate with Calcium Lactate Gluconate
(Calvive-1000®)
(Effervescent Tablet)
|
Formulary

|
- Effervescent tablets containing calcium lactate gluconate & calcium carbonate, 1000mg calcium per tablet
- Rebranded April 2020, formerly Sandocal 1000 effervescent tablets. No change to drug composition.
|
|
Calcium Chloride
(Injection)
|
Formulary

|
- Parental preparation - Calcium Chloride Injection
- Min-I-jet 10ml
|
|
Calcium Gluconate 10%
(Injection)
|
Formulary

|
- 10ml ampoule
- Infusion 50ml
|
|
09.05.01.02 |
Hypercalcaemia and hypercalciuria |
|
|
Cinacalcet
(Tablet)
|
Formulary


|
- For initiation and follow-on prescribing by an Endocrinology Specialist for the treatment of complex primary hyperparathyroidism
- 30mg, 60mg, 90mg
|
|
Cinacalcet
(Tablet)
|
Formulary


|
- Renal Specialist use for the treatment of secondary hyperparathyroidism in patients with end-stage renal disease on dialysis, in line with NICE TA 117
- Non formulary at RUH for this indication
- Amber shared care at QAH Portsmouth for SFT patients.
- 30mg, 60mg, 90mg
|
NICE TA117 Cinacalcet for the treatment of secondary hyperparathyroidism in patients with end-stage renal disease on maintenance dialysis therapy
|
09.05.01.03 |
Magnesium |
|
|
Magnesium Aspartate
(Magnaspartate®)
(Sachet)
|
Formulary

|
- Magnaspartate Sachets each contain 10mmol magnesium (mix with water)
- Licensed for the treatment and prevention of magnesium deficiency, where clinically indicated in adults, adolescents and children aged 2 years and older.
|
|
Magnesium Glycerophosphate
(Neomag ®)
(Tablet)
|
Formulary
|
 SFT,GWH & RUH
- Licensed for the treatment of chronic magnesium loss or hyomagesaemia, where clinically indicated, in adults, adolescents and children aged 4 years and older
- Also licensed for adult patients with hypomagnesaemia due to the concomitant administration of loop and thiazide diuretics or other drugs which cause hypomagnesaemia.
|
|
Magnesium Sulphate
(Injection)
|
Formulary

|
- Injection 10%, 20%, 50% ampoules
- 20% pre-filled syringes (unlic) included on formulary for maternity use (GWH only)
|
MHRA Drug Safety Update (May 2019): Magnesium sulfate: risk of skeletal adverse effects in the neonate following prolonged or repeated use in pregnancy
|
|
09.05.02.01 |
Phosphate supplements |
|
|
Phosphate supplements
(Phosphate-Sandoz®)
(Oral)
|
Formulary

|
- Effervescent Tablets: 500mg containing the equivalent of 16.1mmol phosphate
|
|
Phosphate Polyfusor ®
(IV)
|
Formulary

|
- IV infusion 500ml (Polyfusor)
- National supply problem with Phosphate Polyfusor® which is anticipated to continue until at least October 2020. There is no direct replacement but Glycophos® can be used to provide parenteral phosphate replacement.
|
|
Sodium Glycerophosphate 21.6% Injection
(Glycophos®)
|
Formulary

|
- Used at SFT, GWH, RUH
- There is a national supply problem with Phosphate Polyfusor® which is anticipated to continue until at least October 2020. There is no direct replacement but Glycophos® can be used to provide parenteral phosphate replacement. Note high sodium content (40mmol/20mL).
|
|
09.05.02.02 |
Phosphate-binding agents |
|
|
Aluminium Hydroxide
(Alu-Cap®)
(Capsule)
|
Formulary
|
 Banes and Wiltshire
 Swindon
|
|
Calcium Acetate
(Tablet)
|
Formulary
|
 Swindon
 BaNES, Wiltshire
- Phosex Calcium acetate 1g tablets
- Each 1g tablet contains 250mg calcium or 6.2mmol Ca2+.
Usual dose 4-6 tablets daily according to phosphate levels.
- For use as a phosphate binder according to NICE CG 157
|
|
Calcium Carbonate
(Calcichew®)
(Tablet)
|
Formulary

|
- Salisbury and BaNES
- Calcichew chewable tablet containing 500mg calcium/12.5mmol Ca2+
|
|
Lanthanum
(Fosrenol®)
(Tablet)
|
Formulary

|
- Tablets (chewable) 500mg, 750mg, 1g
- For intiation by Renal team only (3rd line treatment) as per relevant SCA
|
Lanthanum SCA for BaNES patients seen at NBT
|
Sevelamer Carbonate
(Renvela®)
(Tablet)
|
Formulary

|
- 800mg tablets
- Prescribe generically as sevelamer carbonate 800mg (most cost effective choice). The originator brand Renagel® tablets (sevelamer hydrochloride 800mg) is for existing patients only as far less cost-effective.
- For initiation by Renal team only.
|
|
|
|
Fluoride Toothpaste
|
Formulary

|
- Suitable for self care in most instances.
- Where prescription is required, ONLY for initiation and follow-on prescribing by dentists. Not for GP prescribing - see link below.
|
BSW Dental Prescribing (including Fluoride) Statement
|
Fluoride Mouthwash
|
Formulary

|
- Suitable for self care in most instances.
- Where prescription is required, ONLY for initiation and follow-on prescribing by dentists. Not for GP prescribing - see link below.
|
BSW Dental Prescribing (including Fluoride) statement
|
09.05.04 |
Zinc |
|
|
Zinc Sulphate
(Tablet)
|
Formulary

|
- Effervescent tablets Zinc Sulphate Monohydrate 125mg (equivalent 45mg elemental zinc)
- Oral zinc only included on the formulary for treatment of proven zinc deficiency
|
|
|
|
|
Vitamins A and D capsules BPC
|
Formulary

|
- Vitamins should not be routinely prescribed in primary care due to limited evidence of clinical effectiveness.
- The only exception is medically diagnosed deficiency, including for those patients who may have a lifelong or chronic condition or have undergone surgery that results in malabsorption. Continuing need should however be reviewed on a regular basis
|
|
|
Pyridoxine Hydrochloride
(Tablet)
|
Formulary

|
- 10mg, 20mg, 50mg Tablets (Vitamin B6)
- Also used to treat the side effects from some chemotherapy regimes
|
|
Thiamine
( Tablet)
|
Formulary

|
- 50mg,100mg (vitamin B1) tablets
-
NICE CG 100 states:
Offer thiamine to people at high risk of developing, or with suspected, Wernicke's encephalopathy. Thiamine should be given in doses toward the upper end of the 'British National Formulary' range.
Offer prophylactic oral thiamine to harmful or dependent drinkers: if they are malnourished or at risk of malnourishment or, if they have decompensated liver disease or, if they are in acute withdrawal or, before and during a planned medically assisted alcohol withdrawal
Dose for Mild Deficiency - 25-100mg daily
Dose for Severe Deficiency - 200-300mg daily in divided doses
|
NICE CG100: Management of alcohol-related physical complications
NICE CG115: Alcohol dependence - diagnosis, assessment and management
|
Vitamin B & C
(Pabrinex®)
(Injection)
|
Formulary

|
- Injection I/M High potency
- Injection I/V High potency
|
NICE CG100: Management of alcohol-related physical complications
NICE CG115: Alcohol dependence - diagnosis, assessment and management
|
Nicotinamide
(Tablet / Capsules)
|
Unlicensed

|
- 50mg for dermatology use - see BSWformulary section 13.5.3
- Tablets 500mg (unlicensed) for oncology use (with radiotherapy & carbogen for bladder cancer) as per NICE NG2
|
|
09.06.02 |
Oral vitamin B complex preparations |
|
|
Vitamin B Tablets (Compound)
(Tablet)
|
Formulary

|
- ONLY for use in patients with enteral tubes where tablets need to be crushed and flushed down the tube.
Note: Formulary Traffic Light status for review (Dec 2020) see RMOC guidance
|
Regional Medicines Optimisation Committee (RMOC) Position Statement Oral vitamin B supplementation in alcoholism November 2019
|
Vitamin B Tablets, Compound Strong
( Tablet)
|
Formulary

|
- Nicotinamide 20mg, pyridoxine 2mg, riboflavine 2mg, thiamine 5mg
- Not indicated for the prevention of alcohol induced cognitive impairment- use thiamine instead.
- 10 day course for Refeeding Syndrome.
Note: Formulary Traffic Light status for review (Dec 2020) see RMOC guidance
|
Regional Medicines Optimisation Committee (RMOC) Position Statement Oral vitamin B supplementation in alcoholism November 2019
|
|
|
Ascorbic Acid
(Vitamin C)
(Tablet)
|
Formulary

|
- Salisbury not on formulary
- BaNES not on formulary and not stocked at RUH. Only ordered in for medically diagnosed deficiency (i.e. treatment and prevention of scurvy)
- Tablets 50mg, 100mg, 500mg. Effervescent 1g (Not prescribable on NHS)
- Notes: Deficiency is rare and ascorbic acid is not recommended
- Vitamins should not be routinely prescribed in primary care due to limited evidence of clinical effectiveness.
- The only exception is medically diagnosed deficiency, including for those patients who may have a lifelong or chronic condition or have undergone surgery that results in malabsorption. Continuing need should however be reviewed on a regular basis
|
|
Ascorbic Acid
(Vitamin C)
(Tablet)
|
Formulary
|
- GWH - For use in Ophthalmology for severe corneal burns.
- Non-formulary - SFT & RUH.
- Tablets: 500mg.
- Effervescent tablets 1g. (Not presribeable on the NHS).
|
|
|
|
At risk groups to receive Vit D Updated 19th Jan 2021 DHSC guidance for anyone who is CEV and/or in residential and nursing care homes, and has been offered a free supply of vit D supplements in England:
Healthcare professionals with queries concerning the guidance for care homes can email: BaNES- BSWCCG.banes.moch@nhs.net Swindon- BSWCCG.swindon.moch@nhs.net Wiltshire- BSWCCG.wiltshire.moch@nhs.net
The BSW Medicines Optimisation Team remind prescribers that vit D should only be prescribed for proven vit D deficiency and only for patients who are classified as high risk for prevention or maintenance of vit D deficiency. All other patients should purchase their vit D over the counter. Colecalciferol is available at most pharmacies, large supermarkets and health food shops.
Routine monitoring of serum vit D levels is also not recommended. Monitoring and prescribing advice can be found in the BSW vitamin D guidance: Treatment of vitamin D deficiency in adults
The British Dietetic Association has advised that you cannot boost your immune system and no specific food or supplement will prevent you catching COVID-19/Coronavirus here. Good hygiene practice remains the best means of avoiding infection. Patients should be advised to only take vit D as recommended by PHE https://www.gov.uk/government/news/phe-publishes-new-advice-on-vitamin-d.
SPS Which oral vitamin D products are suitable for people with vegetarian or vegan diets? |
|
Colecalciferol and calcium carbonate
(Accrete D3®)
(Tablet)
|
First Choice

|
- First line for primary care across BSW; Cost effective alternative to Calceos
- Film coated tablet - calcium carbonate 1.5 g (calcium 600 mg) and colecalciferol 10 micrograms (400 units) [Dose: 1 tablet twice daily]
- Chewable tablet - calcium carbonate 2.5 g (calcium 1000 mg) and colecalciferol 22 micrograms (880 units) [Dose: 1 tablet once daily]
|
|
Colecalciferol and calcium carbonate
(Adcal-D3®)
(Oral)
|
Formulary

|
- Caplets containing 300mg/ 7.5mmol calcium and 200 units/5micrograms of vitamin D (as vitamin D3/coleclciferol. Dose: 2 caplets twice daily
- Chewable tablets containing 600mg/15 mmol calcium and 400 units/ 10micrograms of Vitamin D (as vitamin D3/colecaciferol). Dose: 1 tablet twice daily.
- Dissolve, effervescent tablets containing 600mg calcium and 400 units of vitamin D (as vitamin D3). Dose: 1 tablet twice daily.
- Swindon: FIRST LINE IN SECONDARY CARE
|
|
Colecalciferol and calcium carbonate
(Calfovit D3®)
(Powder)
|
Formulary

|
- For patients unable to take chewable tablets or capsules.
- Powder- calcium phosphate (calcium 1.2g/ 30mmmol) and 800 units/20micrograms colecalciferol per sachet.
- For patients requiring calcium and vitamin D via enteral feeding. Calcium phosphate 1.2g or 30mmmol calcium and colecalciferol 20micrograms or 800 units per sachet.
- CALFOVIT D3 is indicated in adults and elderly. The safety and efficacy of CALFOVIT D3 in children has not been established; therefore, CALFOVIT D3 should not be used in this population. No data are available.
|
|
Colecalciferol and Calcium carbonate
(Calcichew-D3® Forte)
(Tablet)
|
Formulary

|
- Not on Swindon formulary
- Chewable tablets containing 500mg / 12.5mmol calcium and 400 units /10micrograms of vitamin D (as vitamin D3) Dose: 1 tablet twice a day
|
|
Colecalciferol and calcium carbonate
(Calceos®)
(Tablet)
|
Formulary

|
- Chewable tablets containing 500mg/12.5mmol calcium and 400 units/ 10micrograms of Vitamin D (as Vitamin D3/colecalciferol)
- Dose: 1 tablet twice daily.
|
|
Alfacalcidol
(One-Alpha®)
(Oral)
|
Formulary
|
 Salisbury
 Swindon and BaNES
- Capsules 250 nanograms, 500 nanograms, 1 microgram
- Oral drops- 2 micrograms/mL, one drop contains approximately 100 nanograms
- BaNES : Recommended brand - One- Alpha
- Note: Patients receiving alfacalcidol or calcitriol should have their plasma calcium levels checked regularly (at intervals recommended by specialist, usually evey 3-6 months)
|
BCAP,SFT,3Ts Alfacalcidol for the treatment of hypocalcaemia Shared Care Document
|
Calcitriol
(Capsule)
|
Formulary

|
- 250 nanograms, 500 nanograms
- For renal indication only.
- Note: Patients receiving alfacalcidol or calcitriol should have their plasma calcium levels checked regularly (at intervals recommended by specialist, usually every 3-6 months)
|
|
Colecalciferol
(Fultium D3®)
(capsule)
|
Formulary

|
- Note: These are not included in the BSW Vitamin D guidance but may be in use in acute trusts in line with hospital contract
- 20,000 unit, 3200 unit, 800 unit available
- Licensed for use in children 12-18 years old and adults.
- Please note capsules contain gelatin
|
|
Colecalciferol
(Stexerol D3®)
(Tablets)
|
Formulary

|
- 25,000 unit or 1,000 unit.
- Tablets containing 25,000 units vitamin D3 (625 micrograms) colecalciferol
- Loading Dose: TWO tablets (50,000 units) per week for 6 weeks
- Maintenance dose: ONE tablet (25,000 units) monthly (packs of 12)
- Tablets containing 1,000 units Vitamin D3 ( 25 micrograms) colecalciferol
- Maintenance dose: ONE tablet (1,000 units) daily
- Stexerol film-coated tablets are suitable for vegetarians, certified halal & kosher, peanut oil free, soya oil free, gelatine free, & gluten free. The tablets can be crushed or swallowed whole and can be taken with food. The vitamin D is derived from sheep’s wool so they may not be suitable for vegans but they are suitable for vegetarians.
- Use as per local vitamin D guidance above.
|
|
Colecalciferol 25,000 unit
(Invita D3)
(Liquid)
|
Formulary

|
- Licensed for use in children 0-18 years old and adults with swallowing difficulties.
- May be mixed with a small amount of cold or lukewarm food immediately before administration.
- Use as per local vitamin D guidance above.
|
|
|
Alpha Tocopheryl Acetate
(Vitamin E Oral)
|
Formulary
|
 SFT
 GWH
 RUH
unlicensed tablets 100mg - Available on a names patient basis only and therefore are considerably more expensive than the suspension.
- Suspension 500mg in 5ml
|
|
09.06.06 |
Vitamin K |
|
|
Phytomenadione
(Konakion® MM)
(Injection)
|
Formulary

|
- Injection 10mg in 1 ml
- Fat soluble formula (not malabsorption)
- Can be given orally for patients on warfarin at risk of bleeding with high INR. See reversal guidance in chapter 2.8.3
|
|
Phytomenadione
(Konakion® MM Paediatric)
(Injection)
|
Formulary

|
- Paediatric preparation
- 2mg in 0.2ml
- Fat soluble formula (not malabsorption)
- Can be given orally for patients on warfarin at risk of bleeding with high INR. See reversal guidance in chapter 2.8.3
|
|
Menadiol Sodium Phosphate
(Tablet)
|
Formulary

|
- 10mg
- Menadiol sodium phosphate is water soluble and is included for use where patients have fat malabsorption.
- Water soluble and should be used to prevent vitamin k deficiency in malabsorption syndromes. Not licensed to reverse over anticoagulation with oral anticoagulants.
|
|
Phytomenadione
(Tablet)
|
Unlicensed

|
- 10mg tablets
- Note added June 2020: The licensed 10mg tablets have been discontinued by the manufacturer. Unlicensed forms including tablets and casules may be available from special-order manufacturers. Prescribing of these for new patients should be retained by secondary care. Advice for existing patients on phytomenadione in primary care can be discussed with BSW medicines optimisation team bswccg.prescribing@nhs.net
|
|
09.06.07 |
Multivitamin preparations |
|
|
Valupak OAD Multivitamin & Minerals
(Oral)
|
First Choice

|
- Tablets
- Contains minerals and vitamins
- First choice multivitamin and mineral product
- Do not confuse with Valupak multivitamin tablets (without minerals)
|
|
Multivitamin preparations
(Abidec®)
(drops )
|
Formulary

|
- Contains less vitamin A than Dalivit®.
- For neo-nates prescribe as per SCBU guidelines.
- Substitute with Dalivit® if Abidec® unavailable - Dalivit® dose should not exceed 0.3ml daily in neo-nates.
|
|
Multivitamin preparations
(Dalivit®)
(drops)
|
Formulary

|
- Used for cystic fibrosis patients and adults, as Abidec® is not suitable for anyone > 12years.
|
|
Vitamins A C and D
(Healthy start children’s vitamin drops)
|
Formulary

|
- Oral drops vitamin A 5000 units, vitamin D 2000 units, ascorbic acid 150mg/ml
- Notes:
- Available direct to the public from maternity and child health clinics.
- Healthy Start products are available free of charge to pregnant women and children under 4 years of age in families receiving income support or income based job seekers allowance under the 'Healthy Start' scheme. See www.healthystart.nhs.uk for full details.
|
|
Vitamins C, D and folic acid
(Healthy start vitamins for women)
|
Formulary

|
- Tablets vitamin C 70mg, vitamin D3 10 micrograms, folic acid 400 micrograms
- Notes:
- Available direct to the public from maternity and child health clinics.
- Healthy Start products are available free of charge to pregnant women and children under 4 years of age in families receiving income support or income based job seekers allowance under the 'Healthy Start' scheme. See www.healthystart.nhs.uk for full details.
|
|
Paravit CF
(Oral)
|
Formulary

|
- For Cystic Fibrosis patients only
- Softgel capsules or liquid.
- Paravit-CF is a ‘Food for Special Medical Purposes’ containing vitamins A, D, E and K for the dietary management of patients with CF on the specific recommendation of a specialist in CF.
Paravit CF capsules provide an alternative vitamin supplementation option for CF patients, which offers patients a decreased oral medication load whilst also being a cost-effective option. Paravit CF liquid is only available as an option for patients with swallowing difficulties or young children.
|
|
DEKAs Plus
(Multivitamin containing vitamins A, D, E and K for patients with CF)
(Oral liquid, softgel capsules, chewable tablets)
|
Formulary

|
- For Cystic Fibrosis patients only
- Multivitamin containing vitamins A, D, E and K for the dietary management of patients with CF on the specific recommendation of a specialist in CF.
- 1-4yrs DEKAs liquid
- 5-8yrs DEKAs liquid or softgel capsules or chewable tablets
- >9yrs DEKAs softgel capsules or chewable tablets
|
|
Mutivitamin tablets
|
Formulary

|
|
|
09.06.07 |
Vitamin and mineral supplements and adjuncts to synthetic diets |
|
|
Multivitamin
(Renavit®)
(Tablet)
|
Formulary

|
- Tablets containing vitamins B1, B2, B3, B5, B6, B8, B9, B12
- For BaNES patients seen by renal specialist team at NBT as per SCA.
- Vitamin deficiencies are common in patients with renal disease due to dietary restrictions, changes to metabolism and vitamin loss during dialysis.
- Renavit® should only be initiated by a renal dietician- ongoing prescribing in primary care is acceptable.
- Haemodialysis: 1 tablet post dialysis 3 times a week Peritoneal Dialysis: 1 tablet daily
|
BCAP -Renavit initiated by Renal Dietician Shared Care
|
Vitamin and mineral supplements
(Forceval Soluble®)
(Tablet)
|
Formulary

|
- Forceval® soluble is taken in 125- 200ml of water.
- Take after food.
- Forceval Soluble is suitable for adults and children over 12 years of age.
- Contains both fat and water-soluble vitamins and minerals. The resulting solution may therefore be cloudy, this is perfectly normal.
|
|
Vitamin and mineral supplements
(Forceval®)
(Capsule)
|
Formulary

|
- Capsules
- Contains minerals and vitamins
- Forceval® is for use only if there is concern about the adequacy of micronutrient intake.
- Capsules contain soya bean oil. Patients allergic to peanut or soya should therefore not take this medicine (EMC Nov 14)
|
|
Vitamin and mineral supplements
(Ketovite®)
(Oral)
|
Formulary

|
- As a therapeutic supplement for the prevention of vitamin deficiency in conditions such as galactosaemia, disaccharide intolerance, phenylketonuria and other disorders of carbohydrate or amino acid metabolism, as well as in patients who are on restricted, specialised or synthetic diets.
- In order to achieve complete vitamin supplementation Ketovite Tablets should be used in conjunction with Ketovite Liquid.
|
|
Vitamin and mineral supplements
(Sanatogen A-Z Complete®)
|
Formulary

|
- Salisbury only
- BaNES or Swindon Non formulary
|
|
|
09.08 |
Metabolic disorders |
|
|
09.08.01 |
Drugs used in metabolic disorders |
|
|
Biotin
(Injection,Tablet)
|
Restricted

|
unlicensed GWH only
- SFT and RUH Non formulary
- Tablets: 5mg
- Injection: 5mg/ml
- Restricted - to prescribing by Consultant Paediatricians on the recommendation of tertiary Paediatric Specialists only.
|
|
|
09.08.01 |
Carnitine deficiency |
|
|
Carnitine
(Liquid)
|
Formulary

|
- GWH only
- RUH and SFT non formulary
- 100mg / ml (10 x 10ml single dose)
- Commissioned by NHS England for carnitine deficiency when supplied in secondary care, as per NHS England service specification. For initiation by specialist centres only.
|
|
|
09.08.01 |
Gaucher's disease |
|
|
09.08.01 |
Mucopolysaccharidosis I |
|
|
|
09.08.01 |
Nephropathic cystinosis |
|
|
09.08.01 |
Urea cycle disorders |
|
|
Arginine
(Oral, Injection)
|
Restricted

|
- GWH and RUH only
unlicensed
- SFT - non formulary
- Tablets: 500 mg
- Oral solution: 50mg/ml
- Powder:100g
- Injection: 500mg/ml
- For paediatric prescribing only.
- Restricted - to initiation by Consultant Paediatricians for the treatment of metabolic disorders on the advice of tertiary centres in accordance with NHS England commissioning of highly specialised metabolic disorder services.
|
|
Sodium Benzoate
(Oral)
|
Restricted

|
- GWH and RUH only
unlicensed
- SFT - non formulary
- Tablets: 500 mg
- Capsules: 50mg, 250mg, 400mg, 500mg
- Oral solution: 100mg/ml, 200mg/ml, 300mg/ml
- For paediatric consultant prescribing only
- Restricted - to initiation by Consultant Paediatricians for the treatment of metabolic disorders on the advice of tertiary centres in accordance with NHS England commissioning of highly specialised metabolic disorder services.
|
|
Sodium Phenylbutyrate
(Injection/Oral)
|
Restricted

|
- GWH and RUH only
unlicensed
- SFT - non formulary
- 200mg/ml 5ml ampoules
- 500mg tablet (Ammonaps®)
- Restricted - to initiation by Consultant Paediatricians for the treatment of metabolic disorders on the advice of tertiary centres in accordance with NHS England commissioning of highly specialised metabolic disorder services.
|
|
09.08.02 |
Acute porphyrias |
|
|
09.08.02 |
Drugs unsafe for use in acute porphyrias |
|
|
.... |
Non Formulary Items |
Antithymocyte Immunoglobulin (Equine)

|
Non Formulary
|
|
|
Compound iron preparations
(Ferrograd C®)

|
Non Formulary
|
|
|
Compound iron preparations
(Givitol®)

|
Non Formulary
|
|
|
Deferiprone
(Ferriprox®)

|
Non Formulary
|
|
NHSE Clinical commissioning policy August 2016: Treatment of iron overload for transfused and non-transfused patients with chronic inherited anaemias
|
Dextran 70 ®

|
Non Formulary
|
|
|
Eculizumab

|
Non Formulary
|
|
|
Etelcalcetide
(Injection)

|
Non Formulary


|
Commissioned by NHS England in line with NICE TA448 for treating secondary hyperparathyroidism via specialist centres only. For initiation and follow-on prescribing by a Renal specialist for the treatment of secondary hyperparathyroidism in adults with chronic kidney disease on haemodialysis, in line with NICE TA448. Used if cinacalcet is not suitable. |
NICE TA448 June 2017: Etelcalcetide for treating secondary hyperparathyroidism
|
Ferric maltol
(Ferracru®)

|
Non Formulary
|
|
|
Ferrous Gluconate

|
Non Formulary
|
|
|
Haem Arginate
(Normasang)
(Human Hemin Infusion)

|
Non Formulary
|
Commissioned by NHS England (for hepatic porphyria) according to NHS England Service Specification. For highly specialised criteria only. |
|
Hydroxycarbamide
(Siklos®)

|
Non Formulary
|
|
|
Iron and Folic Acide
(Fefol®)

|
Non Formulary
|
|
|
Iron Sucrose
(Venofer®)

|
Non Formulary
|
|
|
Lipegfilgrastim
(Lonquex®)

|
Non Formulary
|
- Not routinely commissioned by NHS England (for neutropenia). As per IFR approval
|
|
Mercaptamine
(Cystagon)
(Oral)

|
Non Formulary
|
Commissioned by NHS England (for nephropathic cystinosis) as per NHS England Service Specification according to highly specialised criteria. |
|
Multivitamins and dietary supplements for AMD

|
Non Formulary
|
Prescribing of nutritional supplements for age-related macular degeneration is not recommended by BSWCCG and these products are non-formulary.
This includes brands such as ICaps, Macushield, Ocuvite, Viteyes, MaculEH light, PreserVision, Vitalux
There is currently insufficient evidence to recommend the use of nutritional supplements in the primary prevention of macular degeneration.
If patients wish to purchase preparations they should note that not all products available contain the same amount of ingredients and these are not licensed medicines.
- Preservision or Viteyes original capsules closely match the formulation used in the AREDS study. These are not suitable for smokers or recent ex-smokers.
- Viteyes2 closely matches the AREDS2 formulation (no betacarotene).
|
|
Oxymetholone

|
Non Formulary
|
|
|
Pegfilgrastim
(Neulasta®)

|
Non Formulary
|
- Not routinely commissioned by NHS England (for neutropenia). As per IFR approval
|
|
Plasma-lyte 148

|
Non Formulary
|
|
|
Polysaccharide Iron Complex
(Miferex®)

|
Non Formulary
|
|
|
Polystyrene Sulphonate Resins
(Resonium A®)
(Powder)

|
Non Formulary
|
|
|
Riboflavin 50mg tabs
|
Unlicensed
|
SELF PURCHASE ONLY
March 2020 - Please note Some UK Guidelines advise that riboflavin 400mg OD may be useful in preventing migraines. This recommendation refers to self-purchase only from reputable health food shops. There is no licensed riboflavin product in the UK and prescribing on FP10 may incur costs of up to £500 per item. Larger, robust trials are required to conclusively establish its role in migraine prevention. |
|
Trientine Dihydrochloride

|
Non Formulary

|
Commissioned by NHS England and therefore should be issued by specialist care, specifically for Trientine. It should only be prescribed by local hospitals in agreement with specialist centres and in line with national policy.https://www.england.nhs.uk/wp-content/uploads/2018/12/Trientine-for-Wilson-disease-all-ages-1.pdf |
|
|
Key |
|
|
Cytotoxic Drug
|
|
Controlled Drug
|
|
High Cost Medicine
|
|
Cancer Drugs Fund
|
|
NHS England |
|
Homecare |
|
CCG |
|
High Cost Drug Approval System |
|
Traffic Light Status Information
|
|
|