• Primary Care:  at NHS expense for patients in accordance with the national immunisation programme. Adults over 65 years and at risk groups, as listed in the Green Book, chapter 25.
• Use practice stock and claim on FP34 appendix form. 

•  600 mg of abacavir (as sulfate) and 300 mg lamivudine

• GWH and SFT only
• Non formulary at RUH
• 10mg in 5ml
• Adjunct in percutaneous coronary intervention

• Tablets e/c 333mg
• Use only in the context of supervised withdrawal regime with psychosocial recovery programme. For maintenance of abstinence in alcohol dependent patients.
• See shared care guidelines below for maintenance of abstinence.
• Acamprosate is supported by NICE (CG115) following assisted withdrawal or for harmful drinkers and people with mild alcohol dependence who have requested a pharmacological intervention in combination with an individual psychological intervention.

•  Bath and Salisbury for glaucoma
•  Swindon for glaucoma
• 250mg tablets and 250mg MR capsules (NB capsules more costly)
• Note: at RUH and GWH, acetazolamide is included on the formulary for idiopathic intracranial hypertension as Unlicensed indication
• Note - Private prescription only for prophylaxis of mountain sickness. Not licensed and NOT for prescribing on NHS. For further information see link below 

• Please note: Patients should self-care in the first instance

• 600mg Tablets (unlicensed)
• 200mg/1ml 10ml ampoules Infusion (Also used for treatment of poisoning)
• Interstitial pneumonia (unlicensed)/ Idiopathic Pulmonary Fibrosis (unlicensed)
• Renal protection before CT scan with contrast agent
• NHS England Specialised Commissioning - Respiratory Interstital Lung Disease Adults

•  
• 200mg
• 400mg
• 800mg
• During Varicella Zoster Immunoglobulin Shortage (Aug 2018):
  •  "off label" use during the shortage of Varicella Zoster Immunoglobulin (VZIG)in patients who are 20+ weeks pregnant.Only to be used as AMBER on specialist advice.
  •  Dose 800mg four times a day from day 7 to 14 after exposure

• 3% eye ointment

• Capsules 10mg, 25mg
• Consultant Dermatologist Only
• For severe resistant or complicated psoriasis,- not recommended in women of child bearing age.
• Pregnancy Prevention Scheme applies if prescribed in women of child bearing age. Acitretin is highly teratogenic and must not be used by women who are pregnant. The same applies to women of childbearing potential unless strict contraception is practiced 4 weeks before, during and for 3 years after treatment 

• Combination of Formoterol fumarate / Aclidinium (as bromide)
• Breath actuated dry powder MDI 12/340 Genuair device

• Injection 40mg prefilled syringe, prefilled pen
• Prescribe by brand. Biosimilar first-line option.  Imraldi^® first line biosimilar across BSW
• For rheumatoid arthritis in accordance with NICE TA375.

• Commissioned by NHS England From Specialist Centres Only for:
  • Juvenile idiopathic arthritis in line with NICE TA373.
  • Paediatric indications where an adult NICE TA is available
• Check Trust contracting arrangements.

• Cream 0.1% 45g
• Gel 0.1% 45g
• For the prevention of relapse.

Swindon only

Bath and Salisbury - not on formulary 

• Caplets containing 300mg / 7.5mmol calcium and 200 units/5micrograms of vitamin D (as vitamin D3 /colecalciferol). 
• Chewable tablets containing 600mg/15mmol calcium and 400 units /10micrograms of vitamin D (as vitamin D3 /colecaciferol). 
• Dissolve, effervescent tablets containing 600mg calcium and 400 units of vitamin D (as vitamin D3) 

• 6mg in 2ml

• Slow IV inj reserved for severely ill patients where there is doubt about adequacy of the circulation and absorption from the IM site with ECG monitoring.
• Ensure that the correct strength of adrenaline injection is used. 

• 20mg, 30mg, 40mg and 50mg tablets

• Eskazole 400mg tablets (Imported (France)
• Zentel 200mg chewable tablets (Imported (Australia)
• Zentel 400mg chewable tablets (Imported (United States)
• Dermatology use for cutaneous larva migrans

• 12mg/1.2ml infusion

 Green Salisbury 

 Amber SCA Swindon and Bath

• Capsules 250 nanograms, 500 nanograms, 1 microgram
• Oral drops- 2 micrograms/mL, one drop contains approximately 100 nanograms
• Bath: Recommended brand - One- Alpha
• Note: Patients receiving alfacalcidol or calcitriol should have their plasma calcium levels checked regularly (at intervals recommended by specialist, usually every 3-6 months)

• Tablets 2.5mg
• Modified-release tablets 10mg

• Oral alitretinoin is licensed for the treatment of severe chronic hand eczema unresponsive to potent topical corticosteroids, in adults.
• Alitretinoin should ONLY be prescribed by dermatologists.
• Prescriptions of alitretinoin for women of childbearing potential should be limited to 30 days of treatment and continuation of treatment requires a new prescription. Ideally, pregnancy testing, issuing a prescription and dispensing of alitretinoin should occur on the same day. Dispensing of alitretinoin should occur within a maximum of 7 days of the prescription.
• Pregnancy is an absolute contraindication to treatment with alitretinoin.
• A treatment course of alitretinoin may be given for 12 to 24 weeks depending on response.
• Discontinuation of therapy should be considered for patients who still have severe disease after the initial 12 weeks of treatment. In the event of relapse, patients may benefit from further treatment courses of alitretinoin. Patients should still be advised to use daily emollients during therapy and once the eczema has cleared.
• Capsules 10mg; 30mg
• Please see links below to risk materials on generic and branded alitretinoin forms
• Use for other indications is via IFR application only to CCG
  

• 3Ts formulary only
• 12.5mg tablets
• The maximum recommended dose is two doses in 24 hours.

Salisbury

Swindon

Bath

• unlicensed tablets 100mg - Available on a names patient basis only and therefore are considerably more expensive than the suspension.  
• Suspension 500mg in 5ml

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

• 10 microgram, 20 microgram, 40 microgram intracavernosal injection.

• Vial 20mg, 50mg

• Ready to drink COMPACT MILKSHAKE style ONS.
• For those who require smaller volumes or with fluid restrictions
• 125ml bottle
• Flavours: Hazel-chocolate, strawberry, vanilla, banana
• 300 kcals 12 g protein 125ml fluid
• Contains lactose 
• IDDSI level  2

120 ml bottle

28 day supply = 28 bottles, 3360 ml

420 kcal, 6 g protein

Recommended dose = 4 x 30 ml / day

IDDSI level 2  - Mildly thick

• 20% aluminium chloride hexahydrate in an alcoholic basis
• Anhydrol Forte^®, 60ml         
• Driclor^® 60ml, 75ml
• Notes: Aluminium chloride is a potent antiperspirant used in the treatment of severe hyperhidrosis.

• GWH only. For treatment of Acanthamoeba keratitis.
• Non formulary at RUH and Salisbury

• Tablets 5mg
• Note: Amiloride is a weak diuretic, but is useful for potassium conservation and is the most appropriate alternative to potassium supplements

• Aminophylline Injection 250 mg/10ml
• For selected patients with acute severe asthma or severe exacerbations of COPD.

• Tablets 100mg, 200mg
• A Shared Care Document is in the process of being written for BSW in line with NHSE guidance (June 2019) that prescribers should not initiate amiodarone in primary care for any new patient and that if, in exceptional circumstances, there is a clinical need for amiodarone to be prescribed, this should be undertaken in a cooperation arrangement with a multi-disciplinary team and/or other healthcare professional. 

• Tablets 10mg, 25mg, 50mg
• Oral solution 25mg in 5ml
• Not recommended for the treatment of depression – see BNF. A sedating TCA with a high incidence of side-effects and can be fatal in overdose.  Low dose useful for neuropathic pain.

• Tablet 10mg, 25mg, 50mg
• Notes: Initial dose 10mg nocte gradually increasing up to 75mg nocte if necessary (max 150mg nocte).
• N.B. Not included in NICE CG150, but local neurologists recommend this option first-line.
• Useful if migraine co-exists with depression, disturbed sleep, chronic pain condition or troublesome tension-type headache.
• Trial at maximum tolerated dose for 6-8 weeks.

• Nail lacquer 5%  5ml ,  3ml
• Apply once or twice a week to affected nail for 6 months for fingernails and 12 months for toenails.

• 250mg
• 500mg
• 1g

•  Infusion 50mg
• The National Patient Safety Agency has advised all healthcare staff involved in the use of intravenous amphotericin of the potentially lethal results if non-lipid and lipid formulations of the drug are confused. Caution: double check.

•  Infusion 50mg.
• The National Patient Safety Agency has advised all healthcare staff involved in the use of intravenous amphotericin of the potentially lethal results if non-lipid and lipid formulations of the drug are confused. Caution: double check.

• 500 microgram
• For the treatment of essential thrombocythaemia

• 100mg powder for concentrate for solution for IV infusion
• Treatment of invasive candidiasis in adult non-neutropaenic patients who are unable to tolerate fluconazole or have invasive candidiasis that is resistant to fluconazole as per acute trust guidance.

• Oral suspension: Each 5ml contains 10mg Oxetacaine, Aluminium hydroxide equivalent to 200mg aluminium oxide + 100mg magnesium hydroxide 150ml bottle.
• Not on formulary in Swindon and Salisbury.
• BaNES only - Antacid and anaesthetic relief of oesophageal pain in palliative care patients (unlicensed)

 GWH and SFT

 Bath

• Ointment & suppositories.

• Tablets 2.5mg, 5mg
• For prevention of VTE after total hip or knee replacement in adults.
• Following total hip replacement 2.5mg twice daily for 28 days post op, then stop.
• Following knee replacement 2.5mg twice daily for 14 days post op then stop.

• 0.1% solution

• Titration pack, tablets, f/c, 14-day starter pack of apremilast 4 x 10 mg (pink) with 4 x 20 mg (brown) and 19 x 30 mg (beige).  Otelza
• Tablet, f/c, apremilast 30 mg (beige) x 56 Otelza

VERY LIGHT MOISTURISER FOR VERY SENSITIVE MILD DRY SKIN, IF ISOMOL GEL HAS BEEN TRIED AND FAILED.

• Branded generic version of Aveeno (cheaper than Aveeno) 
• Patients requiring an emollient who are using medical oxygen therapy should use Aproderm Colloidal as this is a non-paraffin based emollient.

'1' from birth, '2' from 6 months

• 130ml enema.
• Avoid the use of arachis oil in patients with a known nut allergy.

GWH and RUH only  unlicensed

• Tablets: 500 mg
• Oral solution: 50mg/ml
• Powder:100g
• Injection: 500mg/ml
• For paediatric prescribing only. 
• SFT - non formulary
• 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. 

• 10mg/10ml infusion

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

• 150mg
• 200mg
• 300mg

• Tablets 25mg, 50mg, 100mg
• Syrup^SF 25mg/5ml

• Tablets 25mg, 50mg, 100mg
• Syrup^SF 25mg/5ml
• Note: Atenolol 25mg once daily increasing to 50mg once daily (unlicensed for this indication, atenolol may be better tolerated than propranolol. Not included in NICE CG150)

• Capsules 10mg, 18mg, 25mg, 40mg, 60mg 

 Note: SCA for Adults link below. SCA for Paeds see Chapter 16

• 10mg, 20mg, 40mg, 80mg
• Primary Prevention: New patients offer atorvastatin 20 mg for the primary prevention of CVD to people who have a 10% or greater 10 year risk of developing CVD. Estimate the level of risk using the QRISK2 assessment tool as per NICE CG below.
• Secondary Prevention: New patients start statin treatment in people with CVD with atorvastatin 80 mg^. Use a lower dose of atorvastatin if any of the following apply: potential drug interactions, high risk of adverse effects, patient preference as per NICE CG below.
• Primary prevention for people with type 1 diabetes as per NICE CG below, start treatment for adults with type 1 diabetes with atorvastatin 20 mg.
• Primary prevention for people with type 2 diabetes as per NICE CG below, Offer atorvastatin 20 mg to people who have a 10% or greater 10?year risk of developing CVD using the QRISK2 assessment tool

• GWH use for the treatment of PJP (Pneumocystis jirovecii pneumonia)

• 25mg in 2.5ml amp
• 50mg in 5ml amp
• 250mg in 25ml vial

• 1% single use minims

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

• Powdered MILKSHAKE style ONS (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.
• Flavours: Banana, chocolate, neutral, strawberry, vanilla
• 57g sachets
• 316 kcal 12.6 g protein 125 ml fluid
• Contains lactoset
• IDDSI level  1

• Not suitable for people with diabetes, COPD and wounds - due to carbohydrate:protein ratio
• Flavours: Pineapple, mango, peach, strawberry, cranberry 
• 66g sachet
• 297 kcals 10.7g protein 150 ml fluid
• Residual lactose
• IDDSI level  2

•  - Bath, Salisbury & Swindon (except Swindon patients monitored via the DAWN system and provided with prescriptions by GWH).
•  - GWH - Swindon DAWN patients.
• 25mg & 50mg tablets.
• Please refer to our DMARD Shared Care and Monitoring Guidance for your respective locality for further information.

•   - Bath, Salisbury & Swindon (except Swindon patients monitored via the DAWN system and provided with prescriptions by GWH)
•   - Swindon DAWN patients
• Please refer to our DMARD Shared Care and Monitoring Guidance for your respective locality for further information
• 25mg and 50mg tablets

• Non-antibiotic treatment option for rosacea (adults only) and mild to moderate papular-pustular acne of the facial area (age 12 upwards).
• Gel 15% 30g
• Apply twice daily discontinue if no improvement  after 1 month (acne) or 2 months (rosacea) 

• Tablets 250mg
• Oral suspension 200mg/5ml
• Included for primary care use only as an option for the treatment of chlamydia, travellers diarrhoea (private prescription) and certain types of Lyme diease.
• See primary care antibiotic guidance for further advice.
•  For COPD prophylaxis (off-label use), the decision to start azithromycin for several months at a time should be initiated by secondary care once the diagnosis of COPD has been confirmed and all the necessary preliminary investigations (eg CT and sputum cultures) has been done. NOT to be initiated by GPs without specialist input.

• 500mg
• 1g
• 2g

• 750mg capsules.
• Please note: Balsalazide is indicated for the treatment of mild to moderate ulcerative colitis and maintenace of remission, but should ONLY be prescribed for patients not responding to other aminosalicylates. 

• Use within GWH ONLY, not for use by primary care

• Bacillus calmette-guerin vaccine
• The BCG vaccine (which stands for Bacillus Calmette-Guérin vaccine) is not given as part of the routine NHS vaccination schedule. It's given on the NHS only when a child or adult is thought to have an increased risk of coming into contact with TB

• Prescribe by brand name
• MDI 50mcg and 100mcg
• Clenil^® and Kelhale^® /Qvar^® are first line pMDI low dose ICS for asthma.

• First choice ICS/LABA pMDI for asthma and COPD and the only licensed pMDI for COPD. 
• Aerosol inhalation MDI 120 dose unit beclometasone 100 micrograms, formoterol 6 micrograms dose and beclometasone 200 micrograms, formoterol 6 micrograms dose 
• Adults over 18 years only. (dose = 1-2 puffs twice daily, max 4 puffs twice daily) 

• 200 dose nasal spray, 50 micrograms per spray     
• Beclomethasone is licensed for the prophylaxis and treatment of allergic and vasomotor rhinitis.    
• First line for treatment of allergic rhinits  . OTC for over 18 years.

• 25mg and 100mg infusion
• Also available from NHS England Cancer Drugs Fund

• Aqueous gel 2.5%, 5%, 10% 40g    
• Cream: 5%, 10% 40g      

• oral rinse 0.15% 300ml
• oromucosal spray 0.15% 30ml

• GWH use to treat syphilis in HIV patients by the sexual health team.
• RUH sexual health specialists use this as well for syphilis
• A long acting form of benzylpenicillin administered by deep intramuscular injection. It is usually given as a single dose or weekly for the treatment of syphilis depending on the disease stage and guidelines used.
• 600,000 units or 1.2 MU Injection

•  Salisbury (tablets only)
•  RUH (tablets/injection)
•  SFT - injection for prophylactic treatment of neonatal respiratory distress syndrome
•  GWH (tablets only) used as a mouthwash. Dissolve a 500mg tablet in 10ml of water and used as a mouthbath up to five times a day.
• Injection 4mg in 1ml
• Soluble tablets (as sodium phosphate) 500 microgram   

• Potent steroid for scalps with salicylic acid
• Scalp Application Betamethasone valerate 0.05% & Salicylic Acid 3% 100ml
• For very scaly scalps.

• Potent steroid
• Cream, Ointment 0.1%  30g, 100g

• Potent steroid
• Cream, Betamethasone 0.1%, fusidic acid 2% 30g, 60g

• Potent steroid
• Cream Betamethasone diproprionate 0.05%, clotrimazole 1% 30g

• Potent steroid
• 100g

• Ear drops 0.1%  
• Prolonged use of topical corticosteroids should be avoided.
• Betamethasone products for use in nasal allergy please refer to 12.2.1

• Updated commissioning policies to be added once agreed across BSW

• 50mg and 150mg tablets

• 100microgram/ml ophthalmic drops
• 300microgram/ml preservative free single use eyedrops available where indicated as per BSW glaucoma guidance

• Saliva replacement oral gel
• 50g
• ACBS

 Salisbury

 Bath and Swindon

• Type 2 diabetes only

• Type 2 diabetes only
• NOTE - Insuman Comb 15 cartridge is being discontinued.
• NOTE - Insuman Comb 25 vial is being discontinued.

• 5mg tablets.
• 5mg & 10mg suppositories.
• Please note: Bisacodyl tablets are much more cost-effective than senna tablets in primary care, where all new patients should be commenced on bisacodyl tablets or, if necessary, senna liquid.

•  - Salisbury & Swindon.
• Non-formulary - Bath.
• 262.5mg chewable tablets.
• Please note: This is ONLY included for use as part of H.pylori eradication therapy, as described above in Section 01.03 Helicobacter pylori infection.
• When used as the bismuth element of H. pylori eradication therapy, the dose of bismuth subsalicylate is 525mg four times daily (prescribe generically).

• Injection, powder for reconstitution 250mg vial
• Anticoagulation during PCI

• 15mg tablets
• Also available from NHS England Cancer Drugs Fund

• 3.5mg infusion
• Also available from NHS England Cancer Drugs Fund

• 100mg, 400mg and 500mf tablets
• Also available from NHS England Cancer Drugs Fund

• Dysport^® injection 300 or 500 unit vial
• Botox^® Injection powder for reconstitution 50 unit vial, 100 unit vial, 200 unit vial
• Xeomin^® Injection powder for reconstitution 50 unit vial, 100 unit vial, 200 unit vial.
• See BSW CCG Botulinum commissioning policy for approved indications on the link below.
• Botox can also be used for migraine in accordance with recommendations of NICE TA 260.
• Xeomin® may be used for chronic sialorrhoea associated with chronic neurological conditions in line with licences and with NICE TA605
• Preparations are not interchangeable and should be used under specialist supervision.
• Commissioned by NHS England for use in focal spasticity in children according to set criteria.

• See BSW CCG Botulinum commissioning policy for approved indications:
• Management of bladder dysfunction in adults not adequately managed with anticholinergics for: Overactive bladder with symptoms of urinary incontinence, urgency and frequency.
• Neurogenic detrusor over-activity with urinary incontinence due to sub-cervical spinal cord injury or MS.

• 30mg, 90mg and 180mg

• 1% eye drops

• ophthalmic drops containing 10 mg/mL of brinzolamide and 2 mg/mL of brimonidine tartrate equivalent to 1.3 mg of brimonidine.

BaNES/Wilts - For use as per Glaucoma guidance 
Swindon - Not on formulary

• 210 mg solution for injection in pre-filled syringe
• Use as per NICE TA

• - RUH & Salisbury - For treatment of eosinophlic oesophagitis.
• Non- formulary - Swindon - Awaiting NICE TA publication.
• 1mg oro-dispersible tablets.
• Please prescribe BY BRAND.

• 3mg gastro-resistant capsules.
• Please note: Budenofalk capsules are available for use for their licensed indications of:
  • induction of remission in patients with mild to moderate Crohn's disease affecting the ileum and/or ascending colon,
  • induction of remmission in patients with active collagenous colitis,
  • autoimmune hepatitis (Swindon ONLY).
• Please prescribe BY BRAND. 

• Prescribe by brand name
• Easyhaler dry powder for inhalation MDI 100 micrograms/dose, 200 micrograms/dose, 400 micrograms/dose
• Turbohaler dry powder inhaler MDI 100 microgram/dose, 200 micrograms/dose, 400 micrograms/dose
• Easyhaler Budesonide^® and Pulmicort^® are the first line DPI low dose ICS for asthma. 

• No new prescribing. Existing patients only.
• Can be used in a MART regime. 
• Prescribe by brand.
• Combination of budesonide and formoterol
• Turbohaler dry powder inhaler DPI 100/6; 200/6; 400/12
• Notes: Symbicort Turbohaler is licensed for both asthma and COPD;

• First choice ICS/LABA DPI for asthma.
• Can be used in a MART regime.
• Prescribe by brand
• Combination of budesonide and formoterol fumarate dihydrate
• Breath-actuated dry powder inhaler 80 micrograms/4.5 micrograms, 160 micrograms/ 4.5 micrograms and 320 micrograms/9 micrograms
• For the treatment of asthma and COPD within product licence
• Most cost effective option July 2018

• Tablets 1mg, 5mg
• Bumetanide is significantly more expensive than Furosemide in primary care.

• 25mg in 10ml (0.25%) amp
• 50mg in 10ml (0.5%) amp
• 75mg in 10ml (0.75%) amp
• GWH only: 0.1% and 0.125% epidural infusion bags used.

• 7 day patch of choice for consistency and safety
• Patch 5 microgram/hour for 7 days 
• Patch 10 microgram/hour for 7 days
• Patch 15 micrograms/hour for 7 days
• Patch 20 microgram/hour for 7 days
• Only to be used in patients with cognitive deficit or swallowing difficulties, after a trial of soluble/liquid medication. Zomorph capsules can be opened up for ease of swallowing.
• Buprenorphine patches are NOT suitable, or licensed, for management of acute / intermittent pain.
• Patients and/or their carers neeed to be aware that these patches need to be applied at appropriate seven-day intervals. Remember to remove the old patch before application of new patch. Avoid use of multiple patches.

• For BaNES CCG 
• Swindon/North Wilts: Under review
• Sublingual Tablets 400micrograms, 2mg, 8mg
• For treatment of substance misuse 
• See BaNES CCG shared care for substance misuse on link above
• The recommended criteria for generalist prescribers to prescribe in the field of opioid dependence is that they have completed the RCGP Certificate in the Management of Drug Misuse (part one) and be part of the Local Enhanced Service (LES) for substance misuse
• GPs with Specialist Interest (GPwSI) in substance misuse and specialist prescribers in the field of substance misuse (not LES prescribers) are "secondary care prescribers" for the purpose of these guidelines.
• Supervised Consumption through an accredited pharmacy should be undertaken for a minimum of twelve weeks at the start of methadone and buprenorphine treatment in line with DOH and NICE

• For fertility treatment
• 150 micrograms / metered spray

• Tablets 5mg
• No withdrawal effects but response to treatment may take up to 2 weeks

• 60mg/10ml infusion

• 60mg/1.5ml infusion

• 20mg, 40mg and 60mg tablets
• 20mg and 80mg capsules
• Also available from NHS England Cancer Drugs Fund

Bath and Salisbury only

Swindon - not on formulary

• Chewable tablets containing 500mg / 12.5mmol calcium and 400 units /10micrograms of vitamin D (as vitamin D3) 

• Ointment Calcipotriol 50mcg/g betamethasone diproprionate 500mcg/g 120g  
• Contains a potent steroid which may destabilise psoriasis and increase its severity due to rebound pustulation and inflammation.
• Usual max duration of treatment is 4 weeks. 
• Max 15g daily to no more than 30% of body surface area; max 100g weekly; 75g weekly (child >12 yrs)

• One gram of cutaneous foam contains 50 micrograms of calcipotriol (as monohydrate) and 0.5 mg of betamethasone (as dipropionate).
• Contains a potent steroid which may destabilise psoriasis and increase its severity due to rebound pustulation and inflammation.
• Usual max duration of treatment is 4 weeks. 
• Max 15g daily to no more than 30% of body surface area; max 100g weekly; 75g weekly (child >12 yrs)

• 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)

• Salisbury only
• Bath and Swindon not on formulary
• Replaces Calcium Sandoz syrup (discontinued)

Salisbury and Bath

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

• Folinic acid (as Calcium folinate) 7.5mg per 1ml
• Chemotherapy induced mucositis and myelosuppression

•  
•  IN COMBINATION WITH INSULIN IN TYPE 2 DIABETES FOLLOWING NICE GUIDANCE ONLY
• 100mg,300mg
• Renal Impairment: See SPC for patients with eGFR <60mL/minute/1.73m²

• Coal tar distilled 10 mg per 1 gram
• Coconut oil 10 mg per 1 gram
• Salicylic acid 5 mg per 1 gram
• 250ml

• GWH only: Restricted for use in patients undergoing autologous stem cell transplant only. Consultant haematologist prescription only.

• Swindon only - for painful diabetic peripheral polyneuropathy (off-label)
• Cream containing 0.025% capsaicin (Zacin^®)
• For symptomatic relief in osteoarthritis. It may need to be used for 1-2 weeks before pain is relieved

• Swindon only - for painful diabetic peripheral polyneuropathy.
• Cream containing 0.075% capsaicin (Axsain^®)
• For treatment of post herpetic neuralgia (after lesions have healed) & painful diabetic peripheral neuropathy

• Tablet 100mg, 200mg, 400mg
• Tegretol^® m/r tablet 200mg, 400mg.  Prescribe M/R tablet by brand
• Chewable tablet 100mg, 200mg
• Liquid^SF 100mg/ml
• Suppository 125mg, 250mg
• Prescribe generically for non epilepsy indications.
• Carbamazepine may be used for the prophylaxis of bipolar disorder in patients unresponsive to lithium; it seems to be particularly more effective in patients with rapid cycling manic-depressive illness (4 or more episodes per year).

• Tablet 100mg, 200mg, 400mg
• Tegretol^® m/r tablet 200mg, 400mg.  Prescribe M/R tablet by brand (Category 1 MHRA)
• Chewable tablet 100mg, 200mg
• Liquid^SF 100mg/ml
• Suppository 125mg, 250mg
• Prescribe generically for non epilepsy indications.

• Capsules 375mg
• Oral liquid 250mg/5ml
• Sachets 750mg/10ml Sugar free oral solution
• Note: liquid must still be used in patients with feeding tubes

• 0.2% gel 10g
• Suitable for contact lense wearers

• 250micrograms/1ml solution for injection ampoules 
• Indicated for postpartum haemorrhage due to uterine atony in patients unresponsive to ergometrine and oxytocin.

• 10mg, 30mg and 60mg infusion

• Please note: Patients should self-care in the first instance

• Tablets 3.125mg,6.25mg,12.5mg,25mg

 SFT and RUH

 Swindon

• Cetrimide 100 mg per 1 ml
• Phenylethyl alcohol 75 mg per 1 ml
• Undecenoic acid 10 mg per 1ml
• 150ml,500ml

•   for meningococcal disease for Penicillin allergic patients
•  for all other indications 
• 500mg
• 1g
• 2g

•  for use in acute trusts
•  for use in primary care as follows:
  • for treatment of cellulitis in the community in BaNES via Virgin Care primary care services 
  • 1g IM STAT used for treatment of pelvic inflammatory disease with high risk of gonococcal infection in conjunction with oral antibiotics as per local primary care antibiotic guidance.
• 250mg, 1g and 2g

• 5% eye drops

• Salisbury only
• Non formulary in Bath and Swindon
• 100mg and 200mg capsules

• 200mg pre-filled pen or syringe
• For people whose psoriasis has partially responded to the lowest licensed maintenance dose, increasing to the highest licensed dose (400 mg) is not cost effective compared with switching to an alternative biological treatment. Hence only the 200mg maintenance dose has been approved by NICE.

•  Self Care Medicine for primary care.
• Tablets 10mg
• Oral solution^SF 5mg in 5ml

• 143mg/5ml oral solution
• GWH: Paediatric use only
• SFT: used for pre-procedure sedation only.
• Short-term use only. License is for severe insomnia which is interfering with normal daily life and where other therapies have failed. 
• Not to be initiated in primary care.

• 0.5% ophthalmic drops
• 0.5% minims available for patients allergic to preservatives, administering more than 6 times a day, undergoing eye surgery
• Eye drops available OTC for adults and children over 2 years

• Capsule 5mg, 10mg
• Use only in the context of supervised withdrawal regime over a period of 5-10 days, with psychosocial recovery programme.

• GWH ICU only

•  300ml or 600ml bottles

• Treatment of non-falciparum malaria is available on the NHS.
• Patients requiring Malaria prevention must acquire this on a private prescription or can buy it OTC
• Tablets 250mg (equivalent to 155mg chloroquine base)
• Syrup 68mg/5ml (equivalent to 50mg chloroquine base per 5ml)

•  Self Care Medicine for primary care.
• Tablets 4mg
• Injection 10mg/ml

• RUH only
• Non formulary at GWH and Salisbury
• 1% eye ointment

• Please note: Patients should self-care in the first instance
• 8.7% dental gel 15g

• Not on formulary RUH
• 5000 I.U. powder for solution for injection.

•  - Salisbury.
• - Swindon (except Swindon patients monitored via the DAWN system and provided with prescriptions by GWH).
•  - GWH - Swindon DAWN patients.
•  - RUH.
• 10mg, 25mg, 50mg & 100mg capsules.
• 250mg in 5ml ampoules for intravenous infusion.
• Please refer to our DMARD Shared Care and Monitoring Guidance for your respective locality for further information.

• 25mg, 50mg and 100mg capsules
• For SOLID organ transplant patients continue on brand specifed by the specialist.
• Preparations are not interchangeable.
• NHSE commissioner when ciclosporin used for solid organ transplants. Available from Specialist Centres ONLY.

•  in BaNES and for Swindon DAWN patients
•  in Swindon (except Swindon patients monitored via the DAWN system and provided with prescriptions by GWH)
•  in Salisbury for rheumatology indications
• 10mg, 25mg, 50mg and 100mg capsules

• 0.1% drops (1 mg/mL eye drops, emulsion)
• Note - Ensure correct product is prescribed; available products have different licensing information and TLS. 
• Ikervis ® is licensed for the treatment of severe keratitis in adult patients with dry eye disease, which has not improved despite treatment with tear substitutes.
• Verkazia®  is licensed for the treatment of severe vernal keratoconjunctivitis (VKC) in children from 4 years of age and adolescents. See here

• 0.1% drops (1 mg/mL eye drops, emulsion)
• SFT only. 
• Not on formulary at RUH or GWH
• Note - Ensure correct product is prescribed; available products have different licensing information and TLS. 
• Verkazia®  is licensed for the treatment of severe vernal keratoconjunctivitis (VKC) in children from 4 years of age and adolescents. 
• Ikervis® is not licensed in paediatrics.

For initiation and follow-on prescribing by an Endocrinology Specialist for the treatment of complex primary hyperparathyroidism

• 30mg, 60mg, 90mg

• Tablet 15mg 

• The EMA’s Pharmacovigilence Risk Assessment Committee has recommended restricting fluoroquinolones following a review of disabling & potentially long-lasting side-effects. See link above for further information. 
• IV infusion 100mg/50ml, 200mg/100ml, 400mg/200ml

• 2 mg/ml ear drops solution in single-dose container
• Licensed for the treatment of acute otitis externa in adults and children older than 1 year with an intact tympanic membrane
• The ampoule contents should be used immediately after opening the single dose ampoule.
• Each pack contains 15 ampoules
• Used at SFT only

• SFT only
• 2mg/ml or 5mg/ml

• Tablets 10mg, 20mg, 40mg
• Oral drops^SF 40mg in 1ml–8mg (4 drops may be considered equivalent to 10mg tablet)
• Note: Fewer drug interactions than fluoxetine or paroxetine. 
• For citalopram, new restrictions on the maximum daily doses now apply:
  • 40 mg for adults;
  • 20 mg for patients older than 65 years;
  • 20 mg for those with hepatic impairment.

• 10mg/10ml infusion
• For the treatment of hairy cell leukaemia in accordance with cancer network guidelines

•  IV infusion -used by BaNES community IV service

•  600mg/4ml
• GWH use as part of treatment protocol for PCP (Pneumocystis jirovecii pneumonia)

• 2% vaginal cream  

• Gel Tretinoin 0.025% and Clindamycin 1% 30g

• Very potent steroid
• 125ml shampoo 500mcg/g

• Very potent steroid
• SFT and GWH only
• NOT for primary care use.
• £87 a pack in primary care (Feb 2020)
• Only available generically. Dermovate NN has been discontinued.

• 20mg/20ml infusion
• ONLY Approved for use in acute myeloblastic leukaemia in accordance with the criteria set out by the NHS England Cancer Drugs Fund

• Capsule 10mg, 25mg, 50mg
• Note: Also used in phobic and obsessional states

• 1mg/ml or infusion of 1mg 
• Discontinued in the UK however an unlicensed import is used by acute trusts. 

• 1% cream 20g
• 10% vaginal cream 5g 
• 500mg pessary 
• Patients should be advised that clotrimazole products might damage latex condoms and diaphragms.

• Cream 1% 20g  

• Coal Tar solution 10% in a water-miscible basis 100g

• Coal Tar solution 5% emulsion 100ml, 250ml
• Useful for guttate psoriasis. Dilute with water to form an emulsion. Apply a thin layer twice or three times a day. Also useful applied to scaly scalps overnight.

• 2.5mg /25mg (amiloride /hydroclorothiazide)
• Note: Combination diuretics are not generally recommended, as the individual components cannot be adjusted independently. Restrict use to patients at risk of hypokalaemia, or if compliance problems.  
• Note: BaNES only - Co-amilozide included for ENT indications relating to balance e.g Menieres

• Tablets 250/125, 500/125.
• Oral suspension (SF) 125/31 in 5ml, 250/62 in 5ml.
• Do not prescribe with metronidazole, unless very significant faecal contamination of abdominal cavity identified during surgery.
• Cholestatic jaundice can occur either during or shortly after use of
  co-amoxiclav. The risk of acute liver toxicity was about 6 times greater
  with co-amoxiclav than wth amoxicillin. Cholestatic jaundice is more
  common in patients above the age of 65 years and in men.
• The duration of treatment should not usually exceed 14 days.

• GWH A&E only 

• Sinemet-62.5^,  Sinemet 110 (10/100) Sinemet Plus (25/100), Sinemet-275 tablet
• Half Sinemet CR m/r tablet 25/100
• Sinemet CR m/r tablet 50/200.

• Coal tar solution 120 mg per 1 gram
• Salicylic acid 20 mg per 1 gram
• Sulfur precipitated 40 mg per 1 gram
• 40g,100g

• 15mg & 30mg tablets.
• 60mg tablets (Salisbury & Swindon ONLY).
• Please note: Codeine can cause sedation and constipation, and there is a risk of dependence with long term use. It should be reserved for short courses, and is best avoided in stoma patients.

• 500 microgram tablets
• The dose of colchicine in acute gout is 1mg initially followed by 500 micrograms every 2-3 hours until relief of pain is obtained or vomiting or diarrhoea occurs or until a total dose of 6mg (12 tablets) has been reached. The course should not be repeated within 3 days.

• Non formulary Bath.
• 20,000 unit, 3200 unit, 800 unit available 
• Licensed for use in children 12-18 years old and adults.
• Please note capsules contain gelatin

• Bath and Swindon - first line for primary care
• Salisbury - non formulary
• 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

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

• 5g sachet.

SUPPLY ISSUES WITH COLESTYRAMINE 

Jan 2020 - BaNES, West Wilts and Swindon patients - Temporary change in TLS from AMBER to GREEN While Colestyramine is unavailable, RUH gastroenterologists have provided interim advice and guidance for local GPs to prescribe suitable alternatives in primary care for patients with bile acid malabsorption disorders.  Gastroenterology recommends GPs consider prescribing one of the two following options:

- Colesevelam 625mg tablets - One tablet OD or

- Colestipol 5g sachet - 1 sachet OD

as per BNF instructions, particularly around timings of other medications. Then increase the dose incrementally at weekly intervals to control symptoms up to the maximum dose as recommended in the BNF. If the alternatives aren’t effective, then GP should consider prescribing Loperamide and consider alternative diagnoses +/- secondary care referral where appropriate.

• Powder 4g sachet (Note: The sugar free sachet is less cost effective)
• Should only be used for lipid-lowering in exceptional circumstances and be initiated by a consultant. It remains useful in the small number of patients for whom statins cannot be used.

•  Dry powder for inhaler and hard capsule 1.66 million units/capsule

• 900microgram injection

FEB 2020 - PLEASE NOTE - NICE HAVE WITHDRAWN TA459 - collagenase clostridium histolyticum (Xiapex) is no longer available in the UK.

• 2mg estradiol and 1mg norethisterone
• 1 prescription charge. 

• 1mg estradiol + 5mg dydrogesterone
• 0.5mg estradiol + 2.5mg dydrogesterone (low dose)

• Patches 50 micrograms estradiol 170 micrograms norethisterone
• Change Twice a week

• Tablets estradiol (1mg, 2mg) with 1mg norethisterone acetate
• 2 prescription charges

• Transdermal patch containing 6 mg norelgestromin (NGMN) and 600 micrograms ethinyl estradiol (EE).
• Restricted for use in women who are likely to comply poorly with combined oral contraceptives.

• Tablets containing ethinylestradiol 30 micrograms and levonorgestrel 150 micrograms (21 beige tabs); lactose (7 white tabs) 3 x 28 £2.99 December 2018.

• 100g, 500g
• Benzalkonium chloride, cetrimide
• Nappy rash or for use in elderly in nursing homes

• 480mg/5ml
• 960mg/10ml

• 480mg/5ml
• 960mg/10ml

• 200mg and 250mg tablets
• Also available from NHS England Cancer Drugs Fund

Swindon and Salisbury - not on formulary

 Bath only

NOTE: Care must be taken if low dose oral cyanacobalamin is used as this risks suboptimal treatment of latent and emerging pernicious anaemia with possible inadequate treatment of neurological features.

Only use where indicated on BCAP 'Investigation and treatment of Vitamin B12 (cobalamin) deficiency in primary care' guidance.

• For nausea and vomiting
• Can be used in syringe drivers
• See page 89/90 Wessex Palliative Care Handbook (link at start of chapter)

• 0.5% and 1% ophthalmic drops
• 0.5% and 1% minims

• 50mg tablets

• 50mg

• 110mg, 150mg
• For primary or secondary prevention of stroke or systemic embolism in patients with non-valvular atrial fibrillation (AF), in accordance with NICE TA below.
• For the treatment and secondary prevention of DVT and/or PE. In accordance with NICE TA below. 

• 50mg and 75mg capsules

•  Tablets 30mg/60mg

• Note - variation in TLS across trusts and also according to indication. See individual prescribing policies.
• Pre filled syringes 2,500iu/0.2ml, 5000iu/0.2ml, 7,500iu/0.3ml, 10,000iu/0.4ml, 12,500iu/0.5ml, 15,000iu/0.6ml, 18,000iu/0.72ml for subcutaneous injection

• 100mg,200mg

•  20mg vial

•  for the treatment of dermatitis herpetiformis for stable patients.
•  for unlicensed indications.
• GWH use for the treatment of PCP (Pneumocystis jirovecii pneumonia)
• 50mg
• 100mg
• Needs monitoring as per DMARD shared care agreement on link below

• Use with microbiology advice only
• GWH/RUH only

Swindon 

• Non Formulary at RUH for renal indication (NBT specialist centre)
• Non Formulary at SFT for renal indication (QAH specialist centre)

• 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

• 400mg
• 600mg
• 800mg

•  Tablets 250mg

• 20mg infusion

GWH only

Non formulary RUH and SFT

• Tablets 500mg,1000mg
• Solution 100mg/ml
• Commissioned by NHS England for iron chelation in thalassaemia and sickle cell anaemia.

• 80mg and 120mg infusion

• Capsules 150mg      
• Used in the treatment of hyponatraemia resulting from inappropriate secretion of antidiuretic hormone (SIADH). Requires specialist initiation.

• Each vial contains 120 mg of denosumab in 1.7 mL of solution (70 mg/mL).
• Indication on formulary: Prevention of skeletal related events (pathological fracture, radiation to bone, spinal cord compression or surgery to bone) in adults with advanced malignancies involving bone.
• Not to be prescribed in primary care. 
• New monitoring - Monitoring of calcium levels should be conducted (i) prior to the initial dose of XGEVA, (ii) within two weeks after the initial dose, (iii) if suspected symptoms of hypocalcaemia occur Additional monitoring of calcium level should be considered during therapy in patients with risk factors for hypocalcaemia, or if otherwise indicated based on the clinical condition of the patient.

• Camouflage Cream and Fixing Powder

• Benzalkonium chloride 0.5% 250ml 

•   Commissioned by NHS England for iron chelation in thalassaemia and sickle cell anaemia.   

• SFT only - for the treatment of mild haemophilia A or von Willebrand's disease. Consultant haematologist use only.
• Non formulary at RUH and GWH
• For non-haematology indications, please see chapter 6.5.2

• Nasal spray 10 micrograms per metered spray 60 dose unit
• Nasal spray no longer licensed for primary nocturnal enuresis (bed wetting) due to adverse drug reactions including hyponatraemia.
• DDAVP^®/Desmopressin Intranasal Solution is indicated for:
• The diagnosis and treatment of vasopressin-sensitive cranial diabetes insipidus.
• The treatment of nocturia associated with multiple sclerosis where other treatments have failed.
• Establishing renal concentration capacity.

• For specific indications
• Tablets 500 microgram, 2mg
• Oral solution 2mg/5ml
• 3.32 mg of dexamethasone (dexamethasone base) in 1 ml solution for injection
• 6.64 mg of dexamethasone (dexamethasone base) in 2 ml solution for injection
• Injection  (BCAP only) Each ml of solution for injection contains 4.00 mg of dexamethasone phosphate (as 4.37 mg dexamethasone sodium phosphate) equivalent to 3.32 mg of dexamethasone base.

•  Bath 
• GWH - For post-operative use only
• Non formulary in Salisbury
• 0.1% eye drops 0.5ml unit dose 

• 3.32 mg of dexamethasone (dexamethasone base) in 1 ml solution for injection which is equivalent to 4 mg dexamethasone phosphate (or 4.3 mg dexamethasone sodium phosphate)
• For use in syringe pumps following advice from palliative care specialists
• See page 89/90 Wessex Palliative Care Handbook (link at start of chapter)

• Salisbury only
• Non formulary in Bath and Swindon
• Dexamethasone 1 mg per 1 ml, tobramycin 3 mg per 1 ml

• Dexamethasone 0.1%, hypromellose 0.5%, neomycin 0.35%, polymixin B sulphate 6000 units/ml in 5ml container

• GWH ICU/theatres only 
• 100 micrograms/ml concentrate for solution for infusion, various ampoule sizes

• Injection 5mg, 10mg, 30mg, 100mg, 500mg 
• For use in Palliative Care see chapter 20

• Community Just In Case Boxes
• For pain

• 2.5mg, 5mg, 10mg

• 2mg, 5mg and 10mg tablets
• 10mg/2ml injection
• 2mg/5ml oral suspension
• 2.5mg, 5mg and 10mg rectal tubes
• For short term use only

• Injection (emulsion - Diazemuls^®) 10mg in 2ml
• Injection 5mg/ml

• 12.5mg, 25mg, 50mg and 100mg suppositories
• 75mg in 3ml injection
• Cardiovascular risk is higher with diclofenac than other non-selective NSAIDs and similar to selective COX-2 inhibitors.
• Diclofenac should be used for short courses only.

• - Salisbury & Swindon.
• - Bath  - Oral diclofenac is only included on the formulary for maternity services for a short course of inpatient treatment post delivery.
• 25mg & 50mg gastro-resistant tablets
• Cardiovascular risk is higher with diclofenac than other non-selective NSAIDs and similar to selective COX-2 inhibitors.
• Oral diclofenac should be used for short courses only

• Gel 3% 50g, 100g Solaraze^®
• Prescribe by brand
• Apply thinly twice daily for 60-90 days, maximum 8g daily

• 1mg and 5mg tablets

• Tablets 62.5 micrograms, 125 micrograms, 250 micrograms
• Elixir 50 micrograms/ml

• 40mg powder for solution for infusion vials DigiFab^®
• Note: For reversal of life-threatening digoxin overdose

• Tablets 60mg
• Although the means of formulation has called for the strict designation ‘modified-release’ the duration of action corresponds to that of tablets requiring administration 3 times daily.

• 2% ointment.
• 2% cream.
• Please note: This is for use second- line for the treatment of chronic anal fissures, after GTN 0.4% ointment, prior to considering surgery, with maximum duration of use of 8 weeks. (Unlicensed).
• Please note: 2% ointment is more cost-effective in primary care, whilst 2% cream is more cost-effective in secondary care.

• Tablets 30mg, 120mg 
• NICE TA 475 guidance Dimethyl fumarate for treating moderate-to-severe plaque psoriasis (Sept 2017)
• The brand Fumaderm was previously used before the licensed product beccame available in the UK. There may still be some existing patients on this imported product, who will be reviewed by their specialist.

• Prostin E2^® dinoprostone 3mg vaginal tablets
• Prostin E2^®  dinoprostone 400micrograms per 1ml, 800micrograms per 1ml vaginal gel. 
  NB Prostin E2 vaginal tablets and vaginal gel are not bioequivalent. 
• Propess^® dinoprostone 10mg vaginal pessaries with retrieval device. 

• 20mg/4.5ml infusion

Checking if being used locally as specialist

• 100mg tablet
• 200mg MR capsule

• 15mg, 30mg, 60mg, 90mg 
• For multiple myeloma and treatment of hypercalcaemia.           

• 0.5ml,1.0ml

• Restricted: Specialist Prescribing Only. Various forms as per BAD specials list.
• See section 13.14 for BAD specials information

• 250mg in 20ml
• 250mg in 50ml

• 100mg capsules.
• 50mg in 5ml oral solution SF.
• 120mg micro enema.

• 50 mg dolutegravir (as sodium), 600 mg of abacavir (as sulfate) and 300 mg of lamivudine

• for short-term use/ 1 week
• for long-term use (off-label)
• Tablet 10mg
• Suspension 5mg in 5ml
• Suppository 30mg
• Domperidone is the antiemetic of choice in Parkinsons Disease
• Domperidone should be used at the lowest effective dose for the shortest possible duration (max. treatment duration should not normally exceed 1 week);

• 200mg in 5ml

• Nebuliser solution 2500 units in 2.5ml 

• Notes:

  • A Jet Nebuliser used exclusively for dornase alfa is required for administration
  • To improve pulmonary function in cystic fibrosis patients with a FVC of greater than 40% predicted.
  • Use on specialist respiratory advice only.
  • Requirement for dornase alfa should be reviewed every 3 days.

• 5ml ophthalmic drops

• 1mg, 2mg, 4mg
• Use only if diuretics, beta-blockers, CCBs and ACEI fail or are unsuitable.  
• Note: Doxazosin m/r is not included as it is less cost-effective

•  For eczema associated pruritis only
•  for off-label use
•  Cream (30g)
• Specialist use only for "off label" urticaria. Apply thin film three or four times a day. Maximum 3g per application

• 20mg/10ml and 50mg/25ml infusion
• Also available from NHS England Cancer Drugs Fund

• Capsules 100mg
• 100mg once a day for 3 months then review

• Tablets 400mg
• In line with NHSE guidance (June 2019) prescribers should not initiate dronedarone in primary care for any new patient. If there is a clinical need for dronedarone to be prescribed it must be in line with individual trust Shared Care Agreements - see links below.

• In combination with existing therapy (a sulphonylurea or prandial insulin). Amber specialist initiated.
• 0.75mg/0.5ml prefilled syringe, 1.5mg/0.5ml prefilled syringe
• Dose 0.75mg ONCE a week, increased to 1.5mg ONCE a WEEK
• Bath - existing patients only

• The starting and recommended maintenance dose is 60 mg once daily with or without food. 

• 300mg in 2ml solution for injection in a pre-filled syringe
• Use as per NICE TA

• Included on formulary as a diagnostic agent for myasthenia gravis.  

• SFT only
• Commissioning policy in development (August 2019)
• maximum supply of 30g per month
• Discontinue if no beneficial effects are noticed within four months of commencing therapy
• Hirsutism may be self-managed with mechanical and cosmetic means at no cost to the NHS
• It is important that the patient is properly assessed and underlying causes addressed as hirsutism can result from serious medical conditions or from medication.
• Eflornithine does not offer permanent hair removal, it slows hair growth such that users require less frequent hair removal by other methods (e.g. shaving, plucking, waxing). Hair removal will need to continue (regrowth occurs within 8 weeks).

• See MHRA Drug Safety Update July 18 for information on reports of interferance with bilirubin and creatinine 
• 25mg, 50mg
• 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.

• Capsules 200mg
• Oral solution 50mg/5ml

•  Emtriciciabine 200mg, rilpivirine 25mg, tenofovir 245mg

GREASY MOISTURISER FOR SEVERE DRY SKIN

•    Ointment 500g

• Injection 100mg in 20ml

220 ml bottle

Provides 330 kcal, 13.8 g protein, 220 ml fluid

IDDSI Level 0 - Thin fluids

• For those unable to use powdered milkshakes but can tolerate larger volumes. (220ml bottles)
• Flavours: Banana, chocolate, coffee, fruits of the forest, neutral, orange, peach, raspberry, strawberry, vanilla, blackcurrant, caramel 
• 330 kcals 13.8g protein 220 ml fluid
• Lactose free
• IDDSI level  0

• Not suitable for people with diabetes, COPD and wounds - due to carbohydrate:protein ratio
• Flavours: Apple, fruit punch, lemonlime, orange, peach, strawberry
• 330 kcals 10.6g protein, 71.9g carbohydrate, 220 ml fluid
• Lactose free
• 220ml bottle
• IDDSI level  1

•   500 micrograms
•   1mg

• Injection 30mg in 1ml
• Tablets 30mg for treatment of persistent (12 hours) and orthostatic hypotension, refractory to fluid bolus, during attempts to mobilise patients following spinal anaethesia for total hip or total knee arthroplasty

CREAM FOR MILD TO MODERATE DRY SKIN

• 500g flexi-dispenser which can be used by care homes. No pump pack available.
• Primary Care Diprobase^®alternative

• 10mg/5ml and 50mg/25ml injection
• 100mg/50ml, 200mg/100ml infusion

•  Powder for reconstitution 500 micrograms

• Salisbury- First line calcium and vitamin D product in primary care.
• Chewable tablets containing 500mg/12.5mmol calcium and 400 units/ 10micrograms of Vitamin D (as Vitamin D3/colecalciferol) Dose: 1 tablet twice daily. 
• For existing patients only.

• Injection containing ergometrine maleate 500 micrograms and oxytocin 5 units in 1ml

• 25mg, 100mg and 150mg tablets

•  
• 5mg,15mg
• Due to current lack of cardiovascular disease outcome data we would recommend ertugliflozin is only used in patients without established cardiovascular disease.
• If patients and their clinicians consider ertugliflozin to be one of a range of suitable treatments including canagliflozin, dapagliflozin and empagliflozin, the least expensive should be chosen, which is ertugliflozin.

• GWH only for suspected chlamydia in neonates on the advice of paediatrician
• Non formulary at RUH and Salisbury
• 0.5% eye ointment

• Topical lotion, powder for reconstitution, erythromycin 40mg/ml, Zinc acetate 12mg/ml 30ml, 90ml
• Apply twice daily
• Note that this product is not in local acne guidance due to high resistance levels. It was on the 3Ts and SFT formularies for children under 12 with acne only.

• Tablets 5mg, 10mg
• Drops 20mg/ml
• 20 mg for adults;
• 10 mg for patients older than 65 years;
• 10 mg for those with hepatic impairment

•  100mg/10ml, 2.5g/10ml

• 25mg or 50mg solution for injection in pre-filled syringe or pen
• Prescribe by BRAND. Biosimilar should be used 1st line. BENEPALI^® is the biosimilar brand used locally in BSW. First-line etanercept brand. 

Commissioned by CCG for:

• Rheumatoid arthritis in accordance with NICE TA 375 and local pathway.
• Ankylosing spondylitis in accordance with NICE TA383 and local pathway
• Psoriatic arthritis in accordance with NICE TA199 and local pathway

Commissioned by NHS England from specialist centres only for:

• Juvenile idiopathic arthritis in line with NICE TA373.
• Paediatric patients in line with adult NICE TAs.
• Check Trust contracting arrangements.

• GWH only.
• Non-Formulary RUH and SFT
• 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.
• 10mg/2ml ,2.5mg/0.5ml,5mg/1ml

 Bath

 Swindon and Salisbury 

• Tablets 10 micrograms, 50 micrograms, 1mg.
• 2 microgram strength is an  unlicensed special.
• Licensed for short term use for short term treatment of oestrogen deficiency, female hypogonadism and menstrual disorders.
• Also used for treatment of  gender dysphoria 

Note: Ethinylestradiol tablets are very expensive consider using estradiol where clinically appropriate as a more cost effective option.

• Tablets containing ethinylestradiol 20 micrograms and norethisterone acetate 1mg.
• Please note: Sept 2019 manufacturers confirmed this product is being discontinued with no further supplies of Loestrin 20 to the UK market.

• Tablets containing ethinylestradiol 20 micrograms and gestodene 75 micrograms.