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 9: Nutrition and blood - Full Chapter

Notes:

Nutrition/Blood related Prescribing Guidance

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

Nutrition/Blood related Shared Care Agreements

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

Self-care

Many of the products in this chapter are available for purchase over-the-counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/

Details...

09.06.04

Vitamin D

At risk groups to receive Vit D Updated 19^th 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:

· Vitamin D and clinically extremely vulnerable (CEV) guidance

· Vitamin D and care homes guidance

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
Tablet 1.5g (equiv to calcium 600mg)/400iu Dose: 1 tablet twice daily
Tablet chewable 2.5g (equiv to calcium 1g)/880iu Dose: 1 tablet once daily
Cost effective alternative to Calceos

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.

....

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.