• BaNES - not on formulary

• Tablets containing ferrous fumarate 322mg (equivalent to 100mg of ferrous iron)and folic acid 0.35mg

• 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.

• 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.

• 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.

• 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. 

• 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. 

• 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) 

• 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 

•  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

•  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 

• 90mg,180mg,360mg
• Commissioned by NHS England for iron chelation in thalassaemia and sickle cell anaemia.

• 500mg, 2g powder for solution for injection vials
• Commissioned by NHS England for iron chelation in thalassaemia and sickle cell anaemia.   

• 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.

• 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.

• 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.

• 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

• 500 microgram
• For the treatment of essential thrombocythaemia

• 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. 

• 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.

• RUH and SFT - For use in line with NHS England Policy B04/P/2 January2014 
• GWH not on formulary
•  20mg/ml 1.2ml vial

   

• Effervescent tablets each containing Potassium chloride 600mg / Potassium bicarbonate 400mg (total potassium 12mmol) per tablet  

• Potassium chloride 375mg/5ml oral solution sugar free (total potassium 1mmol per mL syrup)
• Contains sorbitol: May cause osmotic diarrhoea
  

• Powder calcium polystyrene sulphonate. 
• Note: Calcium resonium can be taken orally mixed in water (not fruit juice or other potassium containing fluids) or rectally.       

• 5g and 10g powder for oral suspension
• For use in line with NICE TA599

• 8.4g, 16.8g, 25.2g powder for oral suspension
• For use in line with NICE TA623

• Modified release tablets containing 600mg sodium chloride (equivalent to 10mmol Sodium)

• Oral Powder Sachets

   

• Capsules: 500 mg (more cost effective) (approx. 6mmol each of sodium and bicarbonate)
• Tablets: 600mg
• Paediatric oral solution:  unlicensed. For Paediatric Consultant prescribing only. 

• Calcium chloride0.027%, Potassium chloride 0.04% Sodium chloride 0.06% and Sodium lactate 0.25%

• Sodium chloride 0.45% and glucose 2.5% 
• Sodium chloride 0.18% and glucose 4%  

• 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%

• Note - IV infusion 5ml, 10ml, 20ml ampoules, 50ml vials in BaNES.

   

• Glucose 50%: 50ml Min-I-jet

• 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.

• Also used for emergency treatment of poisoning

• GWH and SFT
• RUH - Non formulary
• 4.5% & 20% infusions

• GWH only - for endoscopy use only 
• RUH/SFT not on formulary
• Gelofusine^® Infusion 500ml, 1 litre            

• 127g tub

• 126g tub

• 57g sachets
• See ONS guidance for full product details (link at top)

• 200ml bottle
• See ONS guidance for full product details (link at top)

• 220ml bottles
• See ONS guidance for full product details (link at top)

• For those who require smaller volumes or with fluid restrictions
• 57g sachets
• See ONS guidance for full product details (link at top)

• For those who require smaller volumes or with fluid restrictions
• 125ml bottle
• See ONS guidance for full product details (link at top)

• For those who require smaller volumes or with fluid restrictions
• 125ml bottle
• See ONS guidance for full product details (link at top)

• 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)

• 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)

• 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)

• Contains fibre, consider for those with constipation
• 63g sachet
• See ONS guidance for full product details (link at top)

• Contains fibre, consider for those with constipation
• 200ml bottle
• See ONS guidance for full product details (link at top)

• 200ml bottle
• See ONS guidance for full product details (link at top)

• 125ml bottle
• See ONS guidance for full product details (link at top)

• 125ml bottle
• See ONS guidance for full product details (link at top)

• FIRST LINE for Dysphagia Level 4 ONS
• 125g pot 
• See ONS guidance for full product details (link at top)

• 150g pot 
• See ONS guidance for full product details (link at top)

• Swindon only
• BaNES and Salisbury - not on formulary 
•  1500mg chewable tablets, each containing 1.5g calcium carbonate.

• BaNES and Salisbury only
• Swindon - not on formulary
• 500mg chewable tablets, each containing 1.25g calcium carbonate.  

• Replaces Calcium Sandoz syrup (discontinued)

• 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.

• Parental preparation - Calcium Chloride Injection
•  Min-I-jet 10ml           

• 10ml ampoule
• Infusion 50ml         

• For initiation and follow-on prescribing by an Endocrinology Specialist for the treatment of complex primary hyperparathyroidism
• 30mg, 60mg, 90mg

• 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

• 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. 

•  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.

•   BaNES  - short term use
• Chewable tablets 4mmol (97mg)
• See prescribing guidelines Sept 2017 

• Injection 10%, 20%, 50% ampoules
• 20% pre-filled syringes (unlic) included on formulary for maternity use (GWH only) 

• Effervescent Tablets: 500mg containing the equivalent of 16.1mmol phosphate

• 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.

• 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).

 Banes and Wiltshire

 Swindon 

• 475mg capsules

 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

• Salisbury and BaNES
• Calcichew chewable tablet containing 500mg calcium/12.5mmol Ca2+

• Tablets (chewable) 500mg, 750mg, 1g
• For intiation by Renal team only (3rd line treatment) as per relevant SCA

• 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.

• 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.

• 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.

• Effervescent tablets Zinc Sulphate Monohydrate 125mg (equivalent 45mg elemental zinc) 
• Oral zinc only included on the formulary for treatment of proven zinc deficiency

• 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

• 10mg, 20mg, 50mg Tablets (Vitamin B6)
• Also used to treat the side effects from some chemotherapy regimes

• 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 

• Injection I/M High potency
• Injection I/V High potency       

• 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

• 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

• 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

• 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

•   - GWH - For use in Ophthalmology for severe corneal burns.
•  Non-formulary - SFT & RUH.
•  Tablets: 500mg.
•  Effervescent tablets 1g. (Not presribeable on the NHS).

• 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

• 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.

• 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

• Chewable tablets containing 500mg/12.5mmol calcium and 400 units/ 10micrograms of Vitamin D (as Vitamin D3/colecalciferol)
• Dose: 1 tablet twice daily. 

•   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)

• 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)

• 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

• 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.

• 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.

•   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

• 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

• 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

• 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.

• 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

• 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.   

• Used for cystic fibrosis patients and adults, as Abidec® is not suitable for anyone > 12years.   

• 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. 

• 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. 

• 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.

• 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

• GWH only

• 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

• 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.

• 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)

• 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.

• Salisbury only
• BaNES or Swindon Non formulary

•  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. 

• 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.

• 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. 

• 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. 

• 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.