netFormulary
 Report : A-Z of formulary items 18/04/2019 20:04:52
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Section Name Details
12.01.01 Dexamethasone 0.05% with framycetin sulfate 0.5% and gramicidin 0.005% ear/eye drops Sofradex® with antibiotic
03.01.04 umeclidinium 55 micrograms, vilanterol (as trifenatate) 22 micrograms/inhalation (delivered dose) Anoro Ellipta® 55 micrograms/ 22 micrograms®

Prescribe as a step up from Umeclidinium inhaler

11.08.01 Yellow Soft Paraffin Simple Eye Ointment
05.03.01 Abacavir Ziagen® Life-threatening hypersensitivity reactions reported—most commonly characterised by fever or rash and possibly nausea, vomiting, diarrhoea, abdominal pain, dyspnoea, cough, lethargy, malaise, headache, and myalgia.

Symptoms usually appear in the first 6 weeks, but may occur at any time.

Discontinue immediately if any symptom of hypersensitivity develops and do not rechallenge (risk of more severe hypersensitivity reaction); discontinue if hypersensitivity cannot be ruled out, even when other diagnoses possible—if rechallenge necessary it must be carried out in hospital setting; if abacavir is stopped for any reason other than hypersensitivity, exclude hypersensitivity reaction as the cause and rechallenge only if medical assistance is readily available; care needed with concomitant use of drugs which cause skin toxicity.

Counselling
Patients should be told the importance of regular dosing (intermittent therapy may increase the risk of sensitisation), how to recognise signs of hypersensitivity, and advised to seek immediate medical attention if symptoms develop or before re-starting treatment; patients should be advised to keep Alert Card with them at all times (BNF)

05.03.01 Abacavir and Lamivudine Kivexa®

Life-threatening hypersensitivity reactions reported—most commonly characterised by fever or rash and possibly nausea, vomiting, diarrhoea, abdominal pain, dyspnoea, cough, lethargy, malaise, headache, and myalgia.

Symptoms usually appear in the first 6 weeks, but may occur at any time.

Discontinue immediately if any symptom of hypersensitivity develops and do not rechallenge (risk of more severe hypersensitivity reaction); discontinue if hypersensitivity cannot be ruled out, even when other diagnoses possible—if rechallenge necessary it must be carried out in hospital setting; if abacavir is stopped for any reason other than hypersensitivity, exclude hypersensitivity reaction as the cause and rechallenge only if medical assistance is readily available; care needed with concomitant use of drugs which cause skin toxicity.

Counselling
Patients should be told the importance of regular dosing (intermittent therapy may increase the risk of sensitisation), how to recognise signs of hypersensitivity, and advised to seek immediate medical attention if symptoms develop or before re-starting treatment; patients should be advised to keep Alert Card with them at all times (BNF)

05.03.01 Abacavir and Lamivudine and Zidovudine Trizivir®

Only for patients stabilised (for 6–8 weeks) on the individual components in the same proportions

Life-threatening hypersensitivity reactions reported—most commonly characterised by fever or rash and possibly nausea, vomiting, diarrhoea, abdominal pain, dyspnoea, cough, lethargy, malaise, headache, and myalgia.

Symptoms usually appear in the first 6 weeks, but may occur at any time.

Discontinue immediately if any symptom of hypersensitivity develops and do not rechallenge (risk of more severe hypersensitivity reaction); discontinue if hypersensitivity cannot be ruled out, even when other diagnoses possible—if rechallenge necessary it must be carried out in hospital setting; if abacavir is stopped for any reason other than hypersensitivity, exclude hypersensitivity reaction as the cause and rechallenge only if medical assistance is readily available; care needed with concomitant use of drugs which cause skin toxicity.

Counselling
Patients should be told the importance of regular dosing (intermittent therapy may increase the risk of sensitisation), how to recognise signs of hypersensitivity, and advised to seek immediate medical attention if symptoms develop or before re-starting treatment; patients should be advised to keep Alert Card with them at all times (BNF)

05.03.01 Abacavir with Dolutegravir and Lamivudine Triumeq
06.01.01.03 Abbott Thin Lancets 
04.10.01 Acamprosate Calcium Campral EC®
06.01.02.03 Acarbose Glucobay®
02.08.02 Acenocoumarol Tablets  For patients intolerant patients intolerant to Warfarin only
11.06 Acetazolamide M/R Capsules Diamox® SR First choice where systemic agent required


• Systemic use causes weak diuresis
• Not generally recommended for long term use though sometimes necessary for patients at high risk of surgery. Consultant initiation only.
• Contraindicated in patients with sulphonamide allergy or a history of renal stones. Side effects can include blood disorders, skin rashes (including Stevens-Johnson syndrome and toxic epidermal necrolysis) and electrolyte disturbances. (GMMMG)
11.06 Acetazolamide Tablets Diamox® First choice where systemic agent required


• Systemic use causes weak diuresis
• Not generally recommended for long term use though sometimes necessary for patients at high risk of surgery. Consultant initiation only.
• Contraindicated in patients with sulphonamide allergy or a history of renal stones. Side effects can include blood disorders, skin rashes (including Stevens-Johnson syndrome and toxic epidermal necrolysis) and electrolyte disturbances. (GMMMG)
13.10.01.01 Acetic Acid 5%  Colposcopy use only
18 Acetylcysteine Concentrate for intravenous infusion 200 mg/mL  Parvolex® The authorised posology in the treatment of paracetamol overdose is 3 consecutive intravenous infusions.

FIRST INFUSION: Initial loading dose of 150mg/kg over ONE hour.
SECOND INFUSION: 50mg/kg over the next FOUR hours
THIRD INFUSION: 100mg/kg over the next SIXTEEN hours

The patient should receive a total dose of 300mg/kg over a 21 hour period. A ceiling weight of 110kg should be used when calculating the dose for obese patients

Continued treatment (given at the dose and rate as used in the third infusion) may be necessary depending on the clinical evaluation of the individual patient.

(MHRA January 2017)
20 Acetylcysteine Tablets 600mg  Approved for:
Idiopthic Pulmonary Fibrosis - Respiratory Consultants only

Prophylaxis of Contrast Induced nephropathy

Unlicensed
05.03.02.01 Aciclovir  Available as tablets and injection

(Cream 5%: see skin chapter, eye Ointment 3%: see eye chapter)
11.03.03 Aciclovir 3% eye ointment Zovirax® Continue treatment for at least 3 days after
complete healing. (GMMMG)
13.10.03 Aciclovir 5% Cream 
13.05.02 Acitretin Neotigason® Consultant dermatologist only
03.01.02 Aclidinium 322 micrograms/dose dry powder inhaler Eklira Genuair®
03.01.04 Aclidinium 340 micrograms, formoterol 12 micrograms/inhalation (dry powder inhaler) Duaklir Genuair 340/12 inhalation powder Prescribe as a step up from Aclidinium inhaler (Elkira Genuair)
18 Activated Charcoal 50g Charcodote® 1 g/5 mL strength
01.05.03 Adalimumab Humira® GI Specialist only
10.01.03 Adalimumab Humira® Specialist use only
13.05.03 Adalimumab (biosimilar) Amgevita

Consultant Dematologist, Rheumatologist, and Gastroenterologist Use only

NICE guidance (TA146): Adalimumab for plaque psoriasis in adults (June 2008)
Adalimumab is recommended for the treatment of severe plaque psoriasis which has failed to respond to standard systemic treatments (including ciclosporin and methotrexate) and photochemotherapy, or when standard treatments cannot be used because of intolerance or contra-indications. Adalimumab should be withdrawn if the response is not adequate after 16 weeks. (BNF)

13.06.01 Adapalene 0.1% Differin® Available as:
- Cream
- Gel
05.03.03.01 Adefovir dipivoxil tablets 
02.03.02 Adenosine Adenoscan® Radiology use only
02.03.02 Adenosine 
02.07.03 Adrenaline / Epinephrine Adrenaline / Epinephrine 1 in 10000, dilute
03.04.03 Adrenaline / Epinephrine Emerade® Auto-injector 150, 300, 500 microgram dose (adrenaline)
03.04.03 Adrenaline / Epinephrine EpiPen® Auto-injector 300 microgram dose (adrenaline)
03.04.03 Adrenaline / Epinephrine Jext ® Auto-injector 300 microgram dose (adrenaline)
03.04.03 Adrenaline / Epinephrine 0.5ml, 1ml Adrenaline / Epinephrine 1 in 1000 Intramuscular injection for self-administration 1 in 1000 (0.5ml, 1ml)
14.04 Adsorbed Diphtheria [low dose], Tetanus and Inactivated Poliomyelitis Vaccine Revaxis® Used in A&E for Tetanus immunisation
Used for vaccination of pregnant women against pertussis
13.04 Alclometasone Dipropionate 0.05% Cream Modrasone®
13.04 Alclometasone Dipropionate 0.05% Ointment Modrasone®
17 Alcohol (Ethanol) Dehydrated Injection Absolute Alcohol
18 Alcohol (Ethanol) Dehydrated Injection Absolute Alcohol
06.06.02 Alendronic Acid 
09.06.04 Alfacalcidol 
15.01.04.03 Alfentanil 500micrograms/ml Injection 
15.01.04.03 Alfentanil 5mg/ml Injection  For Critical Care use only
07.04.01 Alfuzosin Hydrochloride Xatral® Not for initiation. Only for use in patient's already established on non-modified release preparation
07.04.01 Alfuzosin Hydrochloride Xatral® XL 10mg m/r tablets (also licensed for acute urine retention from the first day of catheterisation) (GMMMG)
02.12 Alirocumab solution for injection Praluent PCSK9 Inhibitor
Available as 75mg and 150mg solution for injection

Prescribed by Specialist in management of lipid disporders only

Supply by home care delivery only

Recommended in:

- Primary non-familial hypercholesterolemia: If patient at HIGH risk of CVD AND LDL-C concentration persistently above 4.0mmol/l, or at VERY HIGH risk of CVD and LDL-C concentration persistantly above 3.5mmol/L.

- Primary heterozygous - familial hypercholesterolaemia: If patient at HIGH or VERY HIGH risk of CVD and LDL-C concentration persistantly above 3.5mmol/L, or if LDL-C concentration is persistantly above 5.0mmol/L WITHOUT CVD. (NICE TA393)


13.05.01 Alitretinoin Toctino® Consultant Dermatologist only

Alitretinoin is recommended by NICE for the treatment of severe chronic hand eczema that has not responded to potent topical corticosteroids. Treatment should be stopped as soon as an adequate response has been achieved (hands clear or almost clear), or if the eczema remains severe after 12 weeks, or if an adequate response has not been achieved by 24 weeks.


Pregnancy prevention: In women of child-bearing potential, exclude pregnancy 1 month before treatment, up to 3 days before treatment, every month during treatment (unless there are compelling reasons to indicate that there is no risk of pregnancy), and 5 weeks after stopping treatment—perform pregnancy test in the first 3 days of the menstrual cycle. Women must practise effective contraception for at least 1 month before starting treatment, during treatment, and for at least 1 month after stopping treatment. Women should be advised to use at least 1 method of contraception but ideally they should use 2 methods of contraception. Oral progestogen-only contraceptives are not considered effective. Barrier methods should not be used alone but can be used in conjunction with other contraceptive methods. Each prescription for alitretinoin should be limited to a supply of up to 30 days' treatment and dispensed within 7 days of the date stated on the prescription. Women should be advised to discontinue treatment and to seek prompt medical attention if they become pregnant during treatment or within 1 month of stopping treatment (BNF)


13.05.01 Alitretinoin TOCTINO®
10.01.04 Allopurinol 
06.01.02.03 Alogliptin 
06.01.02.03 Alogliptin with Metformin Vipdomet® Only to be prescribed if genuine issue
with adherence to therapy
09.06.05 Alpha Tocopheryl Acetate 500ml/5ml syrup Vitamin E
07.01.01.01 Alprostadil Intravenous solution Prostin VR®
02.10.02 Alteplase Actilyse® Renal Unit Only
13.12 Aluminimum Chloride Hexahydrate 20% in Alcoholic Base Driclor®
13.12 Aluminimum Salts Anhydrol Forte®
09.05.02.02 Aluminium Hydroxide Alu-Cap®
01.02 Alverine Citrate Spasmonal®
04.09.01 Amantadine Hydrochloride Symmetrel®
02.02.03 Amiloride Hydrochloride 
03.01.03 Aminophylline Phyllocontin Continus® Modified release tablets 225mg, 350mg
03.01.03 Aminophylline Injection 250mg/10ml 
02.03.02 Amiodarone Hydrochloride  Specialist initiation only

Green Drug following specialist initiation
04.02.01 Amisulpride  Available as:
- Tablets
- Oral solution

AMBER status for all licensed indications and also unlicensed when recommeneded by NICE

RED status in dementia (for new patients only).

04.07.03 Amitriptyline 
04.07.03 Amitriptyline 
06.01.05 Amitriptyline  Unlicensed Indication
04.03.01 Amitriptyline Hydrochloride  Available as:
- Tablets
- Oral solution
02.06.02 Amlodipine  First choice DIHYDROPYRIDINE
13.10.02 Amorolfine 5% Nail lacquer 
05.02.03 Amphotericin AmBisome® Different preparations of intravenous amphotericin vary in their pharmacodynamics, pharmacokinetics, dosage, and administration; these preparations should not be considered interchangeable. To avoid confusion, prescribers should specify the brand to be dispensed. (BNF)

09.01.04 Anagrelide 500mcg capsules Xagrid® Consultant haematologist use only
08.03.04.01 Anastrozole Arimidex® Green Drug following specialist initiation
11.04.02 Antazoline Sulphate 0.5% with Xylometazoline HCl 0.05% eye drops Otrivine-Antistin® For allergic conjunctivitis
14.05.03 Anti-D (Rh0) Immunoglobulin  Available from pathology
01.07.01 Anusol®  Available as:
- Cream
- Suppositories
01.07.02 Anusol-HC® 
02.08.02 Apixaban Tablets Eliquis®
04.09.01 Apomorphine Hydrochloride 50mg/10ml Pre-filled Syringe APO-go® Amber Drug (following specialist initiation)

Patients receiving apomorphine and domperidone require an assessment of cardiac risk factors and ECG monitoring to reduce the risk of serious arrhythmia related to QT-prolongation.

(MHRA Drug Safety Alert, April 2016)
11.08.02 Apraclonidine 1% Ophthalmic solution SDU Iopidine® Opthalmic consultant initiation only

Preservative free

Apraclonidine 1% is licensed for control or prevention of postoperative elevation of intraocular pressure after anterior segment laser surgery
10.01.03 Apremilast Otezla Available as tablets

To be used strictly in accordance with NICE Guidance only.
04.02.01 Aripiprazole Abilify® Available as:
- Tablets
- Orodispersible Tablets
- 1mg/1ml Oral solution

AMBER status for all licensed indications and also unlicensed when recommeneded by NICE

RED status in dementia (for new patients only).

12.03.05 AS saliva Orthana® 
09.06.03 Ascorbic Acid tablets  Available strengths:
- 50mg
- 200mg
- 500mg
- 1g
02.09 Aspirin   Enteric-coated Aspirin tablets are not recommended. There is no convincing evidence that at a daily dose of 75 mg using enteric-coated rather than soluble Aspirin reduces the risk of gastrointestinal bleeding. (Ref: Drug Ther Bull Jan 1997 p7-8)
05.03.01 Atazanavir Reyataz® Rash
Mild to moderate rash occurs commonly, usually within the first 3 weeks of therapy. Severe rash occurs less frequently and may be accomapnied by systemic symptoms. Discontinue if severe rash develops. (BNF)
05.03.01 Atazanavir with Cobicistat Evotaz
02.04 Atenolol 
02.12 Atorvastatin 
07.01.03 Atosiban Tractocile®
15.01.05 Atracurium Besilate 
15.01.03 Atropine Sulphate 
11.05 Atropine Sulphate 1% eye drops  Duration of action up to 7 days. (GMMMG)
11.05 Atropine Sulphate 1% SDU Minims® Atropine Sulphate Preservative free

Duration of action up to 7 days. (GMMMG)
13.02.01 Aveeno® Cream 
01.05.03 Azathioprine  GI Specialist only
08.02.01 Azathioprine 
10.01.03 Azathioprine 
10.02.01 Azathioprine 
13.05.03 Azathioprine  Unlicensed indication

Specialist initiation only for Severe refractory eczema (GMMMG)
13.06.01 Azelaic Acid 20% Cream Skinoren®
11.04.02 Azelastine Hydrochloride Optilast®
09.06.02 B vitamins High potency Intramuscular injection Pabrinex®
09.06.02 B vitamins High potency Intravenous injection Pabrinex® First choice where parenteral preparation required
08.02.04 Bacillus Calmette-Guerin OncoTICE®
10.02.02 Baclofen 
13.02.01 Balneum® Plus Cream 
10.01.03 Baricitinib  For use strictly in accordance with NICE guidance only
17 Baritop 100 
17 Barium sulfate 94 % w/w powder for rectal suspension Polibar®
17 Barium Sulfate 96.3% Powder  177g cup
17 Barium Sulfate 96.84% Powder  340g cup
17 Barium Sulfate Powder  225ml
14.04 BCG vaccine diagnostic agent Tuberculline Purified Protein Derivative (PPD)
14.04 BCG vaccine Intradermal Bacillus Calmette-Guerin Vaccine
12.02.01 Beclometasone Dipropionate 50microgram/metered dose nasal spray  First Choice in adults > 16 years old

03.02.01 Beclometasone Dipropionate MDI Inhaler Clenil Modulite® First choice Corticosteroid Inhaler

MDI 50, 100, 200, 250 micrograms/dose
03.02.01 Beclometasone Dipropionate MDI Inhaler Qvar® First Choice Corticosteroid Inhaler

MDI 50, 100 microgram/dose

Easi-breathe or autohaler 50, 100 micrograms/dose
03.02.03 Beclometasone/formoterol Fostair® Not licensed for use in patients aged under 18 years

Available as:
- aerosol inhalation MDI (licensed for management of asthma and COPD)
- dry powder inhalation NEXThaler (licensed for regular treatment of asthma).
03.02.02 Beclometasone/formoterol DPI Fostair® NEXThaler



Not licensed for use in patients aged under 18 years

Available as 100/6 and 200/6 

 

Licensed for use in asthma.

 

03.02.03 Beclometasone/formoterol DPI Fostair® NEXThaler



Not licensed for use in patients aged under 18 years

Available as 100/6 and 200/6 

 

03.02.02 Beclometasone/formoterol MDI Fostair®

First choice for MDI inhaler
 
Not licensed for use in patients aged under 18 years


Licensed for management of asthma and COPD

Available as 100/6 and 200/6

03.02.03 Beclometasone/Formoterol/Glycopyrronium 87/5/9 MDI Trimbow
10.01.03 Belimumab Benlysta Available as solution for infusion

Recommended as an option as add-on treatment for active autoantibody-positive systemic lupus erythematosus in adults (NICE)
08.01.01 Bendamustine Levact® Consultant Haematologist prescribing only
02.02.01 Bendroflumethiazide 
13.06.01 Benzoyl Peroxide 10% Cream with antimcrobials  Quinoderm®
13.06.01 Benzoyl Peroxide 5% Gel Acnecide®
13.06.01 Benzoyl Peroxide 5% with Clindamycin 1% Gel Duac® Once Daily
12.03.01 Benzydamine Hydrochloride 0.15%  Difflam® Oral Rinse and spray
04.06 Betahistine Dihydrochloride 
06.03.02 Betamethasone  Obstetric use only
13.04 Betamethasone (as Dipropionate) 0.05% Cream Diprosone®
13.04 Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 2% Scalp Application Diprosalic®
13.04 Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 3% Ointment Diprosalic®
13.04 Betamethasone (as Valerate) 0.025% Cream Betnovate-RD®
13.04 Betamethasone (as Valerate) 0.025% Ointment Betnovate-RD®
13.04 Betamethasone (as valerate) 0.1% and Neomycin Sulfate 0.5% Cream Betnovate-N®
13.04 Betamethasone (as valerate) 0.1% and Neomycin Sulfate 0.5% Ointment Betnovate-N®
13.04 Betamethasone (as Valerate) 0.1% Scalp Application Betnovate®
13.04 Betamethasone (as Valerate) 0.1% with Fucidic Acid 2% Cream Fucibet®
11.04.01 Betamethasone 0.1% Ear/Eye/Nose Drops 
13.04 Betamethasone and Clioquinol Cream Betnovate-C®
13.04 Betamethasone and Clioquinol Ointment Betnovate-C®
12.02.01 Betamethasone Sodium Phosphate 0.1% Nose/Ear/Eye drops  Alternative in adults > 16 years old
12.01.01 Betamethasone Sodium Phosphate Eye/Ear/Nose drops 0.1% 
13.04 Betamethasone Valerate 0.1% Cream 
13.04 Betamethasone Valerate 0.1% Ointment 
11.06 Betaxolol Hydrochloride Eye Drops 0.5% 
11.06 Betaxolol Hydrochloride Ophthalmic suspension 0.25% Betoptic®
11.06 Betaxolol Hydrochloride SDU 0.25% Betoptic®
08.03.04.02 Bicalutamide  Bicalutamide is the only anti-androgen licensed as a single agent for monotherapy in a patient with locally advanced disease. The dosage of bicalutamide is 150mg once daily as a single agent, or 50mg once daily when given in conjunction with gonadorelin analogue injection therapy. Care should be taken to ensure correct choice of dose. (GMMMG)
11.06 Bimatoprost 100 micrograms/mL eye drops Lumigan®
11.06 Bimatoprost 300 micrograms/mL eye drops Lumigan®
11.06 Bimatoprost 300 micrograms/mL with Timolol 5 mg/mL eye drops Ganfort®
12.03.05 Biotène Oralbalance® 
12.03.05 BioXtra®  Available as Spray and Gel

Toothpaste and Mouth rinse listed on GMMMG Do not prescribe list: not a cost effective use of NHS resources
06.01.01.02 Biphasic Insulin Aspart NovoMix® 30

First choice Intermediate acting analogue mixture

Available as:
- 3ml Penfill® cartridge (via NovoPen 4 device)
- 3ml Flexpen® prefilled disposable injection device

06.01.01.02 Biphasic Insulin Lispro Humalog® Mix25

Available as:
- 10ml vial
- 3ml cartridge (via HumaPen Luxura device)
- 3ml Kwikpen

06.01.01.02 Biphasic Insulin Lispro Humalog® Mix50

Available as:
- 3ml cartridge (via HumaPen Luxura device)
- 3ml Kwikpen 

06.01.01.02 Biphasic Isophane Insulin Humulin® M3

First choice Soluble/Isophane Mixture

Available as:
- 10ml vial
- 3ml cartridge (via HumaPen Luxura device)
- 3ml Kwikpen

06.01.01.02 Biphasic Isophane Insulin Insuman® Comb 15

Available as 3ml cartridge (via ClikSTAR or Autopen 24 device)

06.01.01.02 Biphasic Isophane Insulin Insuman® Comb 25

Available as:
- 3ml cartridge (via ClikSTAR or Autopen 24 device)
- 3ml SoloStar® prefilled disposable injection device

06.01.01.02 Biphasic Isophane Insulin Insuman ®Comb 50

Available as 3ml cartridge (via ClikSTAR or Autopen 24 devices)

01.06.02 Bisacodyl 
12.02.03 Bismuth iodoform paraffin paste gauze BIPP Gauze
02.04 Bisoprolol Fumarate 
02.08.01 Bivalirudin Angiox®
13.08.01 Borderline Substances AntheliosXL SPF

Anthelios is fragrance and paraben free; better patient tolerability.  

08.01.05 Bortezomib Injection Velcade®
02.05.01 Bosentan Tracleer® Consultant Prescribing Only. Restricted to respiratory and rheumatology only.
04.07.04.02 Botulinum toxin type A  For use following NICE criteria only
04.09.03 Botulinum Toxin Type A Botox® Red Drug Intradermal for hyperhydrosis
Available as:
- 50 unit vial
- 100 unit vial
13.12 Botulinum Toxin Type A Botox® Red Drug Intradermal for hyperhydrosis
Available as:
- 50 unit vial
- 100 unit vial
04.09.03 Botulinum Toxin Type A 500 units Dysport® Red Drug Intradermal for hyperhydrosis
13.12 Botulinum Toxin Type A 500 units Dysport® Red Drug Intradermal for hyperhydrosis
11.06 Brimonidine Tartrate 0.2% eye drops 
11.06 Brinzolamide 10 mg/mL eye drops Azopt®
11.06 Brinzolamide 10ml/1ml with brimonidine tartrate 2mg/1ml eye drops Simbrinza Recommended to decrease elevated intraocular pressure (IOP) in adult patients with open angle glaucoma or ocular hypertension.
Recommended when the seperate constituent components (brinzolamide and brimonidine) of this combination would normally be recommended.
(GMMMG April 2015)
06.07.01 Bromocriptine  See section 4.9.1. for use in Parkinson’s disease
01.05.02 Budesonide 3mg CR Capsules Entocort®
03.02.02 Budesonide and Formoterol dry powder inhaler DuoResp Spiromax®



160/4.5, 320/9 micrograms dry powder inhaler

Only indicated in patients over the age of 18 years

03.02.02 Budesonide and Formoterol dry powder inhaler Fobumix Easyhaler

Available as 80/4.5, 160/4.5, and 320/9 dry powder inhaler

03.02.02 Budesonide and formoterol Turbohaler Symbicort® 100/6, 200/6, 400/12 Dry powder inhaler
03.02.01 Budesonide Inhaler  Dry powder inhalation 100, 200, 400 micrograms/dose (Easyhaler)
Dry powder inhalation 100, 200, 400 micrograms/dose (Pulmicort Turbohaler)
01.05.02 Budesonide M/R tablets Cortiment GI specialist initiation only
03.02.01 Budesonide Nebuliser liquid UDV  Available as 500 micrograms/2ml and 1mg/2mg UDV
02.02.02 Bumetanide 
15.02 Bupivacaine 0.1% with Fentanyl 500micrograms/250ml Epidural Infusion 
15.02 Bupivacaine 0.125% Epidural Infusion 
15.02 Bupivacaine 0.125% with Fentanyl 500micrograms/250ml Epidural Infusion 
15.02 Bupivacaine 0.25% Epidural Infusion 
15.02 Bupivacaine 0.25% Injection 
15.02 Bupivacaine 0.25% with Epinephrine (Adrenaline) 1 in 200,000 Injection 
15.02 Bupivacaine 0.5% Injection 
15.02 Bupivacaine 0.5% with Epinephrine (Adrenaline) 1 in 200,000 Injection 
15.02 Bupivacaine 20mg with Glucose 320mg/4ml Spinal Injection Marcain Heavy®
04.10.03 Buprenorphine Subutex®
04.07.02 Buprenorphine Patches Transtec® Remove after no longer than 96 hours and site replacement patch on a different area. (BNF)
04.07.02 Buprenorphine Patches BuTrans® Remove after 7 days and site replacement patch on a different area. (BNF)
04.07.02 Buprenorphine Sublingual Tablets Temgesic®
08.01.01 Busulfan Tablets Myleran®
03.04.03 C1 Esterase Inhibitor Berinert® Specialist Initiation Only
06.07.01 Cabergoline  See section 4.9.1. for use in Parkinson’s disease
04.09.01 Cabergoline Tablets  Green Drug (following specialist initiation)
03.05.01 Caffeine Citrate  For Neonatal apnoea only

When prescribing caffeine, all products should be named and prescribed as CAFFEINE CITRATE

Note Caffeine base 1 mg = caffeine citrate 2 mg

Available as:
- Caffeine citrate 10mg/ml oral solution
- Caffeine citrate 10ml/1ml solution for injection

13.03 Calamine Aqueous Cream 
13.03 Calamine Lotion 
13.05.02 Calcipotriol 50micrograms/g Ointment 
13.05.02 Calcipotriol 50micrograms/g with Betamethasone 0.05% Gel Dovobet®
13.05.02 Calcipotriol 50micrograms/ml Scalp solution 
06.06.01 Calcitonin (salmon) / Salcatonin Injection Miacalic®
09.06.04 Calcitriol 
09.05.02.02 Calcium Acetate 1g Tablets Phosex®
09.05.02.02 Calcium Acetate 667mg Capsules PhosLo®
09.05.01.01 Calcium Carbonate 1.25g (500mg Calcium ) Effervescent Tablets Cacit®
09.05.01.01 Calcium Carbonate 1.25g (500mg Calcium) Calcichew®
18 Calcium Chloride 10% Injection 
09.05.01.01 Calcium Chloride 10% Syringe 
09.05.01.01 Calcium Chloride 10mmol/10ml Injection 
09.05.01.01 Calcium Chloride 5mmol/5ml Injection 
08.01 Calcium Folinate  Available as:
- Tablets
- Injection
09.05.01.01 Calcium Gluconate 10% injection  The MHRA has advised that repeated or prolonged administration of calcium gluconate injection packaged in 10 mL glass containers is contra-indicated in children under 18 years and in patients with renal impairment owing to the risk of aluminium accumulation; in these patients the use of calcium gluconate injection packaged in plastic containers is recommended
(BNF)
18 Calcium Gluconate 10% Injection  The MHRA has advised that repeated or prolonged administration of calcium gluconate injection packaged in 10 mL glass containers is contra-indicated in children under 18 years and in patients with renal impairment owing to the risk of aluminium accumulation; in these patients the use of calcium gluconate injection packaged in plastic containers is recommended
(BNF)
09.05.02.02 Calcium Salts Calcichew® 500mg tablets
09.05.02.02 Calcium Salts Osvaren® Manufacturer advises that other drugs should be taken at least 2 hours before or 3 hours after Osvaren® to reduce possible interference with absorption of other drugs. (BNF)

09.05.01.01 Calcium-Sandoz® syrup (2.7mmol calcium/5ml) 
06.01.02.03 Canagliflozin Invokana® NICE TA315: - Canagliflozin in a dual therapy regimen in combination with metformin is recommended as an option for treating type 2 diabetes, only if:
•a sulfonylurea is contraindicated or not tolerated or
•the person is at significant risk of hypoglycaemia or its consequences.
Canagliflozin in a triple therapy regimen is recommended as an option for treating type 2 diabetes in combination with:
•metformin and a sulfonylurea or
•metformin and a thiazolidinedione.
Canagliflozin in combination with insulin with or without other antidiabetic drugs is recommended as an option for treating type 2 diabetes.
02.05.05.02 Candesartan Cilexetil 
13.09 Capasal® Shampoo 
08.01.03 Capecitabine Tablets Xeloda®
10.03.02 Capsaicin 0.025% Cream Zacin® Capsaicin 0.025% can be considered as an adjunct in hand or knee osteoarthritis. It may need to be used for 1–2 weeks before pain is relieved.
(BNF)
04.07.03 Capsaicin 0.075% Cream Axsain® See Section 10.3.2

Capsaicin 0.075% cream is licensed for the symptomatic relief of postherpetic neuralgia after lesions have healed, and for the relief of painful diabetic neuropathy (BNF)
10.03.02 Capsaicin 0.075% Cream Axsain® Capsaicin 0.075% cream is licensed for the symptomatic relief of postherpetic neuralgia after lesions have healed, and for the relief of painful diabetic neuropathy (BNF)
10.03.02 Capsaicin 179 mg Patch Qutenza® Restricted for use by pain team only

Restricted to the treatment of adults with post-herpetic neuralgia (PHN) who have not achieved adequate pain relief from, or who have not tolerated, convential first and second-line treatments only.
06.01.05 Capsaicin Cream 0.075% Axsain® See Section 10.3.2

Capsaicin 0.075% cream is licensed for the symptomatic relief of postherpetic neuralgia after lesions have healed, and for the relief of painful diabetic neuropathy (BNF)
04.02.03 Carbamazepine Tegretol® Second Choice antimanic drug

Available as:
- Tablets
- Chewable Tablets
- Oral suspension
- Suppositories
04.07.03 Carbamazepine Tegretol® Available as:
- Tablets
- Chewable Tablets
- Oral suspension
- Suppositories
04.07.03 Carbamazepine Tegretol® Available as:
- Tablets
- Chewable Tablets
- Oral suspension
- Suppositories
04.08.01 Carbamazepine Tegretol® Available as:
- Tablets
- Chewable Tablets
- Oral suspension
- Suppositories
04.02.03 Carbamazepine m/r Tablets Tegretol® Prolonged Release Second Choice antimanic drug
04.02.03 Carbamazepine m/r Tablets Carbagen® SR Second Choice antimanic drug
04.07.03 Carbamazepine m/r Tablets Tegretol® Prolonged Release
04.07.03 Carbamazepine m/r Tablets Carbagen® SR
04.07.03 Carbamazepine m/r Tablets Carbagen® SR
04.07.03 Carbamazepine m/r Tablets Tegretol® Prolonged Release
04.08.01 Carbamazepine m/r Tablets Carbagen® SR
04.08.01 Carbamazepine m/r Tablets Tegretol® Prolonged Release
04.02.03 Carbamazepine Tablets  Second Choice antimanic drug
04.07.03 Carbamazepine Tablets 
04.07.03 Carbamazepine Tablets 
04.08.01 Carbamazepine Tablets 
06.02.02 Carbimazole 
03.07 Carbocisteine Capsules 375mg, liquid 250mg/5ml 
11.08.01 Carbomer 980 0.2% liquid gel  
11.08.01 Carbomer 980 0.2% liquid gel SDU Viscotears® preservative free
07.01.01 Carboprost Hemabate®
11.08.01 Carmellose Sodium SDU Celluvisc® Available as:
- 0.5%
- 1%

All Preservative free
09.08.01 Carnitine (L-carnitine) Carnitor® Available as:
- Paediatric Solution
- Injection
11.06 Carteolol Hydrochloride eye drops Teoptic® Available as:
- 1%
- 2%
02.04 Carvedilol 
05.02.04 Caspofungin 
07.04.04 Catheter Patency Solutions Sodium Chloride 0.9%
13.02.02 Cavilon® Cream 
17 Cavilon® Cream 
13.02.02 Cavilon® Spray 
17 Cavilon® Spray 
13.02.02 Cavilon® Sticks 
17 Cavilon® Sticks 
10.01.03 Certolizumab Pegol Cimzia® Specialist use only
03.04.01 Cetirizine Hydrochloride Tablets 10mg, Oral solutionSF 5mg / 5mL  Tablets 10mg
Oral solution 5mg/5ml
13.02.01 Cetraben® Emollient Cream 
04.01.01 Chloral Hydrate Chloral Elixir®, Paediatric, BP 2000 Paediatric use only
08.01.01 Chlorambucil Tablets Leukeran®
11.03.01 Chloramphenicol 0.5% Eye Drops 
11.03.01 Chloramphenicol 0.5% SDU Minims ® Chloramphenicol
11.03.01 Chloramphenicol 1% eye ointment 
04.10.01 Chlordiazepoxide  For short term use in alcohol withdrawal
04.01.02 Chlordiazepoxide Hydrochloride  For use in alcohol withdrawal
13.11.02 Chlorhexidine 0.05% solution  Obstetrics only
13.11.02 Chlorhexidine acetate 1% Dusting Powder CX Antiseptic Dusting Powder® Obstetrics only
12.03.04 Chlorhexidine Gluconate 0.2% mouthwash 
13.11.02 Chlorhexidine gluconate 4% Hydrex® Surgical Scrub
13.11.02 Chlorhexidine gluconate solution 5% Hibitane Obstetric® Obstetrics only
12.02.03 Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5% Naseptin® cream
02.02.01 Chlorothiazide Oral Suspension  For Paediatric Use Only
03.04.01 Chlorphenamine Maleate  Tablets 4mg
Oral Solution 2mg/5ml
04.02.01 Chlorpromazine Hydrochloride 
02.02.01 Chlortalidone 
12.03.01 Choline Salicylate 8.7% Dental Gel Bonjela® Adult over 16 years only
08.02.02 Ciclosporin  Important
Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration. Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching. If it is necessary to switch a patient to a different brand of ciclosporin, the patient should be monitored closely for changes in blood-ciclosporin concentration, serum creatinine, blood pressure, and transplant function (if appropriate).
(BNF)

Deximune® is the brand of choice for patients newly initiated on Ciclosporin
10.01.03 Ciclosporin  Specialist initiation only

Important
Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration. Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching. If it is necessary to switch a patient to a different brand of ciclosporin, the patient should be monitored closely for changes in blood-ciclosporin concentration, serum creatinine, blood pressure, and transplant function (if appropriate).
(BNF)

Deximune® is the brand of choice for patients newly initiated on Ciclosporin
10.02.01 Ciclosporin  Unlicensed Indication

Important
Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration. Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching. If it is necessary to switch a patient to a different brand of ciclosporin, the patient should be monitored closely for changes in blood-ciclosporin concentration, serum creatinine, blood pressure, and transplant function (if appropriate). (BNF)

Deximune® is the brand of choice for patients newly initiated on Ciclosporin

13.05.03 Ciclosporin  Consultant Dermatologist initiation only

Important
Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration. Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching. If it is necessary to switch a patient to a different brand of ciclosporin, the patient should be monitored closely for changes in blood-ciclosporin concentration, serum creatinine, blood pressure, and transplant function (if appropriate). (BNF)

Deximune® is the brand of choice for patients newly initiated on Ciclosporin


11.08.01 Ciclosporin 0.1% eye drops Ikervis® FOr use in patients with severe dry eye disease that has not improved despite treatment with artificial tears
01.05.03 Ciclosporin IV Sandimmun® GI Specialist only
Unlicensed Indication

Important
Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration. Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching. If it is necessary to switch a patient to a different brand of ciclosporin, the patient should be monitored closely for changes in blood-ciclosporin concentration, serum creatinine, blood pressure, and transplant function (if appropriate).
(BNF)
08.02.02 Ciclosporin IV Sandimmun® Important
Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration. Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching. If it is necessary to switch a patient to a different brand of ciclosporin, the patient should be monitored closely for changes in blood-ciclosporin concentration, serum creatinine, blood pressure, and transplant function (if appropriate).
(BNF)
09.05.01.02 Cinacalcet Mimpara® For renal patients only

Red Drug for Secondary hyperparathyroidism (review after 12 months


Amber Drug for Primary hyperparathyroidism (transfer of prescribing to primary care only under a shared care guideline)
04.06 Cinnarizine 
11.03.01 Ciprofloxacin 0.3% Eye Drops Ciloxan® Quinolones must not be used for more than 10 days as resistance rapidly develops. (GMMMG)
15.01.05 Cistracurium Nimbex®
04.03.03 Citalopram  Available as:
- Tablets
- Oral Drops
01.06.05 Citrafleet® Oral Powder 
08.01.03 Cladribine Litak® Subcutaneous Injection
13.06.01 Clindamycin 1% Topical Solution Dalacin T®
07.02.02 Clindamycin 2% Cream Dalacin®
04.08.01 Clobazam 
13.04 Clobetasol Propionate 0.05% Cream Dermovate®
13.04 Clobetasol Propionate 0.05% Ointment Dermovate®
13.04 Clobetasol Propionate 0.05% Scalp application Dermovate®
13.04 Clobetasone Butyrate 0.05% Cream Eumovate®
13.04 Clobetasone Butyrate 0.05% Ointment Eumovate®
13.04 Clobetasone Butyrate 0.05%, Oxytetracycline 3%, Nystatin 100,000 units/g Cream Trimovate®
06.05.01 Clomifene Citrate  Note all drugs used for infertility are classed as Red Drugs
04.03.01 Clomipramine Hydrochloride 
04.08.01 Clonazepam 
04.08.01 Clonazepam Injection Rivotril®
02.05.02 Clonidine Hydrochloride  Available as:
- Tablets
- Injection (Radiology use only)
02.09 Clopidogrel  Tablets 75mg
07.02.02 Clotrimazole  Available as:
- 1% Cream
- 500mg pessary
13.10.02 Clotrimazole 1%  Available as:
- cream
- solution (for hairy areas)
12.01.01 Clotrimazole 1% solution Canesten® Antifungal
04.02.01 Clozapine Clozaril® Red Drug except selected approved mental health trust programs.
13.09 Coal Tar Extract 5% (Alcholic) Alphosyl 2 in 1®
13.05.02 Coal Tar Solution 5% Lotion Exorex®
02.02.04 Co-amilofruse (furosemide and amiloride)  Do not use combined preparations as first line treatment
04.09.01 Co-Beneldopa Madopar® Available as:
- capsules
- dispersible tablets
04.09.01 Co-Beneldopa m/r Madopar®CR
04.09.01 Co-Careldopa Sinemet®
04.09.01 Co-careldopa 
04.09.01 Co-Careldopa and Entacapone Stalevo®
04.09.01 Co-Careldopa m/r Caramet® CR
04.09.01 Co-Careldopa m/r 25/100 Half Sinemet ®CR
04.09.01 Co-Careldopa m/r 50/200 Sinemet® CR
13.05.02 Cocois® Scalp Ointment  Sebco® Scalp Ointment can be substituted as a generic alternative to this product
13.09 Cocois® Scalp Ointment  Sebco® Scalp Ointment can be substituted as a generic alternative to this product
13.06.02 Co-Cyprindiol 2000/35
(Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)
 Dianette®
13.09 Co-Cyprindiol 2000/35
(Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)
 Dianette®
01.06.02 Co-danthramer  Palliative Care only
01.06.02 Co-danthrusate  Palliative Care only
01.04.02 Codeine Linctus 15mg/5ml  For patients requiring a liquid preparation, use unlicensed codeine linctus 15mg/5ml. this allows ease of dosing in familiar 15mg increments.
01.04.02 Codeine Phosphate 
04.07.02 Codeine Phosphate 
04.07.02 Codeine Phosphate Codeine Linctus 15mg/5ml
10.01.04 Colchicine 
• Colchicine is an alternative in patients in whom NSAIDs are contra-indicated.
• The use of colchicine is limited by the development of toxicity at higher doses, but it is of value in patients with heart failure since, unlike NSAIDs, it does not induce fluid retention; moreover, it can be given to patients receiving anticoagulants.
• Colchicine may be used in low doses (500micrograms twice daily) for 3-6 months whilst optimising xanthine oxidase inhibitor doses.
• Max 6mg per course. Course not to be repeated within 3 days.
09.06.04 Colecalciferol 20,000units 
09.06.04 Colecalciferol and Calcium Carbonate Adcal-D3® Available as:
- Adcal-D3® Chewable
- Adcal-D3® Dissolve

Note that there is a dose difference between the caplet preparation and all other Adcal-D3® preparations. The caplet dose is usually double the dose of all other preparations. Care should therefore be taken when prescribing or switching between these different presentations. To avoid confusion, the caplet preparation is NOT first choice.
09.06.04 Colecalciferol and Calcium Carbonate Caplets Adcal-D3® Caplets Note that there is a dose difference between the caplet preparation and all other Adcal-D3® preparations. The caplet dose is usually double the dose of all other preparations. Care should therefore be taken when prescribing or switching between these different presentations.
09.06.04 Colecalciferol and Calcium Phosphate Calfovit D3® sachets
02.12 Colesevelam  Cholestagel Available as tablets

For diarrhoea associated with bile acid malabsorbtion (Unlicensed)
01.09.02 Colestyramine Questran Light®
02.12 Colestyramine 
05.01.07 Colistimethate injection for nebulisation Promixin

RED for new cystic fibrosis patient presenting to the service only

AMBER for existing cystic fibrosis patients only awaiting repatriation

AMBER when nebulised for non-cystic fibrosis patients

05.01.07 Colistimethate sodium dry powder inhalation capsules Colobreathe

An option for treating chronic pulmonary infection caused by P. aeruginosa in people with cystic fibrosis only if they do not tolerate it in its nebulised form and the manufacturer provides colimethate sodium DPI with the discount agreed as part of the patient access scheme to primary, secondary, and tertiary care in the NHS.

01.01.01 Co-magaldrox Mucogel®
07.03.01 Combined Hormonal Contraceptives Levest® Used as Microgynon 30/Ovranette alternative
07.03.01 Combined Hormonal Contraceptives Femodene® ED
Second choice Monophasic (every day) standard strength
07.03.01 Combined Hormonal Contraceptives Ovranette® First choice oral standard strength preparation (ethinylestradiol 30mcg)
07.03.01 Combined Hormonal Contraceptives Brevinor® First Choice Oral standard strength (ethinylestradiol 35mcg)
07.03.01 Combined Hormonal Contraceptives Loestrin 30®
Second choice oral standard strength preparation (ethinylestradiol 30mcg)
07.03.01 Combined Hormonal Contraceptives Norimin® First Choice Oral standard strength (ethinylestradiol 35mcg)
07.03.01 Combined Hormonal Contraceptives Ovysmen® First Choice Oral standard strength (ethinylestradiol 35mcg)
07.03.01 Combined Hormonal Contraceptives Cilest®
Second Choice Oral standard strength (ethinylestradiol 35mcg)
07.03.01 Combined Hormonal Contraceptives Loestrin 20® First choice oral low strength preparation (ethinylestradiol 20mcg)
07.03.01 Combined Hormonal Contraceptives Mercilon®
Second choice oral low strength preparation (ethinylestradiol 20mcg)
07.03.01 Combined Hormonal Contraceptives Evra® First Choice Transdermal (standard strength)preparation

Restricted for use in women who are likely to comply poorly with combined oral contraceptives.
07.03.01 Combined Hormonal Contraceptives Logynon® First Choice Tri-phasic
07.03.01 Combined Hormonal Contraceptives Microgynon 30® First choice oral standard strength preparation (ethinylestradiol 30mcg)
07.03.01 Combined Hormonal Contraceptives Microgynon 30 ED® First choice Monophasic (every day) standard strength
07.03.01 Combined Hormonal Contraceptives NuvaRing® First choice Vaginal (low strength) preparation
01.06.04 Compound Macrogol Oral Powder Laxido ® Caution: may cause electrolyte disturbances.

There is now sufficient evidence to support its use before well-established, less expensive drugs.
09.02.02.01 Compound Sodium Lactate Intravenous Infusion Hartmann's Solution Contains Na+ 131 mmol, K+ 5 mmol, Ca2+ 2 mmol, HCO3- (as lactate) 29 mmol, Cl- 111 mmol/litre

Available as:
- 500ml bag
- 1L bag
09.02.02.01 Compound Sodium Lactate Intravenous Infusion Hartmann's Solution Contains Na+ 131 mmol, K+ 5 mmol, Ca2+ 2 mmol, HCO3- (as lactate) 29 mmol, Cl- 111 mmol/litre

Available as:
- 500ml bag
- 1L bag
09.02.02.01 Compound Sodium Lactate Intravenous Infusion Hartmann's Solution Contains Na+ 131 mmol, K+ 5 mmol, Ca2+ 2 mmol, HCO3- (as lactate) 29 mmol, Cl- 111 mmol/litre

Available as:
- 500ml bag
- 1L bag
13.02.02 Conotrane® Cream 
05.04.08 Co-trimoxazole 
13.03 Crotamiton 10% Cream Eurax®
13.05.02 Crude Coal Tar in Yellow Soft Paraffin  Available in strengths of 5-30%
04.06 Cyclizine Hydrochloride 
11.05 Cyclopentolate Hydrochloride eye drops Mydrilate® Available as:
- 1%
- 0.5%

Duration of action 24 hours. (GMMMG)
11.05 Cyclopentolate Hydrochloride SDU Minims® Cyclopentolate Hydrochloride Available as:
- 1%
- 0.5%

Preservative free

Duration of action 24 hours. (GMMMG)
08.01.01 Cyclophosphamide  Available as:
- Tablets
- Injection
06.04.02 Cyproterone Acetate 
08.03.04.02 Cyproterone Acetate  Direct hepatic toxicity including jaundice, hepatitis and hepatic failure has been reported (usually after several months) in patients treated with cyproterone acetate 200-300 mg daily. Liver function tests should be performed before treatment and whenever symptoms suggestive of hepatotoxicity occur-if confirmed cyproterone should normally be withdrawn. Cyproterone is no longer recommended for long term use. (GMMMG)
02.08.02 Dabigatran Etexilate Capsules Pradaxa®
02.08.01 Dalteparin Sodium  Red/Amber/Green status dependent on indication. Shared Care protocols in place. Full list available via link below.
02.08.01 Danaparoid Sodium Orgaran® For patients with Heparin Induced Thrombocytopenia
06.07.02 Danazol 
15.01.08 Dantrolene Sodium Dantrium Intravenous® Available in all operating theatres
10.02.02 Dantrolene Sodium Capsules Dantrium® Intravenous Preparation available in all Theatres for treatment of malignant hyperthermia. See Section 15.01.08
06.01.02.03 Dapagliflozin Forxiga® Third line option following treatment with a gliptin
06.01.02.03 Dapagliflozin 10mg and Saxagliptin 5mg tablets Qtern 5mg/10mg

Resticted for use only in those patients already on this combination of medicines

05.01.10 Dapsone  Consultant Dermatologist use only

To be used following specialist initiation for leprosy and dermatitis herpetiformis

09.01.03 Darbepoetin Alfa Aranesp®
07.04.02 Darifenacin m/r Emselex® Darifenacin has a flat pricing structure, i.e. both strengths are the same price. Prescribe the 15mg strength if up-titrating the dose to 15mg od, do not double up on the 7.5mg strength. (GMMMG)
05.03.01 Darunavir Prezista® Rash
Mild to moderate rash occurs commonly, usually within the first 4 weeks of therapy and resolves without stopping treatment. Severe skin rash (including Stevens-Johnson syndrome and toxic epidermal necrolysis) occurs less frequently and may be accompanied by fever, malaise, arthralgia, myalgia, oral lesions, conjunctivitis, hepatitis, or eosinophilia; treatment should be stopped if severe rash develops. (BNF)

05.03.01 Darunavir with Cobicistat Rezolsta
08.01.05 Dasatinib Sprycel®
09.01.03 Deferasirox 125mg, 250mg, 500mg tabs Exjade®
06.05.02 Demeclocycline 
20 Demeclocycline  Unlicensed Indication

Demeclocycline may be used in the treatment of hyponatraemia resulting from inappropriate secretion of antidiuretic hormone.(GMMMG)
06.06.02 Denosumab Prolia® To be used in accordance with NICE guideline ; IPNTS recommendations and Shared Care Guideline ( attached)


06.06.02 Denosumab 70mg/ml Injection XGEVA® Denosumab is recommended by NICE as an option for preventing skeletal-related events (pathological fracture, radiation to bone, spinal cord compression or surgery to bone) in adults with bone metastases from breast cancer and from solid tumours other than prostate if:

•bisphosphonates would otherwise be prescribed and

•the manufacturer provides denosumab with the discount agreed in the patient access scheme.

1.2 Denosumab is not recommended for preventing skeletal-related events in adults with bone metastases from prostate cancer.

1.3 Adults with bone metastases from solid tumours currently receiving denosumab for the prevention of skeletal-related events that is not recommended according to 1.1 and 1.2 should be able to continue treatment until they and their clinician consider it appropriate to stop.

13.02.01.01 Dermol® 200 Shower Emollient 
13.02.01 Dermol® 500 Lotion 
13.02.01.01 Dermol® 600 Bath Emollient 
13.02.01 Dermol® Cream  
18 Desferrioxamine Mesilate 2g injection 
09.01.03 Desferrioxamine Mesilate 500mg, 2g injection 
15.01.02 Desflurane Suprane® For use as per anaesthetist guidelines
06.05.02 Desmopressin DDAVP®
06.05.02 Desmopressin Desmospray®
06.03.02 Dexamethasone  Dose equivalence between dexamethasone formulations is:

1mg dexamethasone tablets =
1.2mg dexamethasone phosphate (injections) =
1.3mg dexamethasone sodium phosphate (injections and oral solutions)

Take care when selecting dose of IV formulations of Dexamethasone as the strength printed on the pack is the strength of dexamethasone salt, rather than dexamethasone base. Refer to BNF dosing instructions for each individual product.
12.01.01 Dexamethasone 0.05%, framycetin sulfate 0.5% and gramicidin 0.005% ear/eye drops Sofradex® with steroid
11.04.01 Dexamethasone 0.1% Single Use Eye Drops Minims® Dexamethasone preservative free
11.04.01 Dexamethasone 0.1% with Neomycin 0.35% and Polymyxin B sulphate 6000 units/mL Maxitrol® Available as:
- Eye Drops
- Eye Ointment
12.01.01 Dexamethasone 0.1% with neomycin sulfate 3250 units/mL and glacial acetic acid 2%. Otomize® Ear Spray

with antibiotic
12.01.01 Dexamethasone 0.1% with neomycin sulfate 3250 units/mL and glacial acetic acid 2%. Otomize® with steroid
11.04.01 Dexamethasone 1% Eye Drops Maxidex®
10.01.02.02 Dexamethasone Sodium Phosphate 
04.07.02 Diamorphine Hydrochloride Injection 
04.07.02 Diamorphine Intranasal Spray  For use in A&E Paediatrics only

Unlicensed
20 Diamorphine Intranasal Spray  For use in A&E Paediatrics only

Unlicensed
04.01.02 Diazepam  Effective in short term, immediate management of anxiety states only. Do not use diazepam for chronic anxiety/ long term treatment or panic disorders. (GMMMG)

Available as:
- Tablets
- Oral solution (2mg/5ml and 5mg/5ml)
04.08.02 Diazepam  Available as:
- Solution for injection
- Emulsion for injection
- rectal tubes
10.02.02 Diazepam 
15.01.04.01 Diazepam  Available as:
- Oral Solution
- Tablets
- Solution for injection
- Emulsion for injection
18 Diazepam 
18 Diazepam 
06.01.04 Diazoxide Eudemine® Consultant recommendation only

50mg tablets
50mg/1ml Suspension (unlicensed)
10.03.02 Diclofenac diethylammonium salt 1.16% Gel Voltarol Emulgel® Equivalent to Diclofenac Sodium 1%
10.01.01 Diclofenac Sodium  Caution - Not to be used in patients with CV disease risk (GMMMG)
13.08.01 Diclofenac Sodium 3% gel Solaraze®
10.01.01 Diclofenac Suppositories  Caution - Not to be used in patients with CV disease risk (GMMMG)
18 Dicobalt Edetate 15mg/ml 
01.02 Dicycloverine Hydrochloride 
08.03.01 Diethylstilbestrol 
13.04 Diflucortolone Valerate 0.3% Oily Cream Nerisone Forte®
13.04 Diflucortolone Valerate 0.3% Ointment Nerisone Forte®
02.01.01 Digoxin  Available as:
- Tablets
- Liquid
- IV

Note that when converting from oral to IV Digoxin, the IV dose should be 70% of the oral dose.

Digoxin is not recommended first-line for rate control of atrial fibrillation in ambulant patients. (GMMMG)

For plasma concentration monitoring, blood should be taken at least 6 hours after a dose.

Monitor patient for signs of toxicity, especially in the elderly.

Hypokalaemia can dispose a patient to digitalis toxicity. Use extra caution when prescirbed with diuretics.

(GMMMG)

02.01.01 Digoxin-specific antibody DigiFab® See SPC within attached link for dosing information (SPC starts on page 50)
04.07.02 Dihydrocodeine Tartrate 
01.07.04 Diltiazem Gel 2%  Unlicensed
02.06.02 Diltiazem Hydrochloride modified release tablets/capsules  Prescribe by brand, not interchangable
18 Dimercaprol 100mg/2ml Injection 
08.02.04 Dimethyl fumarate Tecfidera®

Before starting dimethyl fumarate treatment
New advice:
• Perform a baseline cranial MRI scan as a reference, usually within 3 months of starting dimethyl fumarate treatment
Reminder of previous advice:
• Perform a full blood count including lymphocyte subsets
• Counsel patients and carers on the risk of progressive multifocal leukoencephalopathy (PML); advise them on symptoms to watch out for and to get medical help urgently if they occur
• If John Cunningham virus (JCV) testing is undertaken, consider that the influence of lymphopenia on the accuracy of the anti-JCV antibody test has not been studied in patients treated with dimethyl fumarate

MHRA Drug Safety Update (April 2016)

08.02.04 Dimethyl Fumarate tablets Skilarence

For use by Consultant Dermatologists Only, in accordance with NICE guidelines

07.04.04 Dimethyl sulfoxide 50% Rimso-50® Dimethyl sulfoxide may be used for symptomatic relief in patients with interstitial cystitis (Hunner’s ulcer). 50 mL of a 50% solution (Rimso-50®— (unlicensed) available from ‘special-order’ manufacturers or specialist importing companies is instilled into the bladder, retained for 15 minutes, and voided by the patient. Treatment is repeated at intervals of 2 weeks. Bladder spasm and hypersensitivity reactions may occur and long-term use requires ophthalmic, renal, and hepatic assessment at intervals of 6 months. (GMMMG)
20 Dimethyl sulfoxide 50% Rimso-50® Unlicensed

Dimethyl sulfoxide may be used for symptomatic relief in patients with interstitial cystitis (Hunner’s ulcer). 50 mL of a 50% solution (Rimso-50®— (unlicensed) available from ‘special-order’ manufacturers or specialist importing companies is instilled into the bladder, retained for 15 minutes, and voided by the patient. Treatment is repeated at intervals of 2 weeks. Bladder spasm and hypersensitivity reactions may occur and long-term use requires ophthalmic, renal, and hepatic assessment at intervals of 6 months. (GMMMG)
13.10.04 Dimeticone Hedrin®
07.01.01 Dinoprostone Prostin E2® Available as:
- Vaginal Tablets
- Extra-amniotic solution
07.01.01.01 Dinoprostone Intravenous solution Prostin® E2
14.04 Diphtheria, Tetanus, Pertussis (Acellular, Component), Poliomyelitis (Inactivated) and Haemophilus Type b Conjugate Vaccine (Adsorbed) Pediacel®
13.02.01 Diprobase® Cream 
13.02.01 Diprobase® Ointment 
02.09 Dipyridamole and Aspirin Modified Release Asasantin® Retard Modified release capsules 25mg/200mg
02.09 Dipyridamole Modified Release Persantin® Retard Modified release capsules 200mg
13.05.02 Dithranol in Lassar's Paste  Available in strengths of 0.1-6%
02.07.01 Dobutamine 
01.06.02 Docusate Sodium Dioctyl®
05.03.01 Dolutegravir 
01.02 Domperidone  Also Green Drug for inadequate lactation and on recommendation by secondary care (unlicensed indication).

Some epidemiological studies have shown that domperidone may be associated with an increased risk of serious ventricular arrhythmias or sudden cardiac death.
• These risks may be higher in patients older than 60 years and in patients who receive daily oral doses of more than 30 mg.
• Domperidone should be used at the lowest effective dose in adults and children.
• Patients should be advised to seek prompt medical attention if symptoms such as syncope or tachyarrhythmia appear during treatment.
• Domperidone should be avoided in patients who are taking concomitant medication known to cause QT prolongation (such as ketoconazole and erythromycin). (GMMMG)

Patients receiving apomorphine and domperidone require an assessment of cardiac risk factors and ECG monitoring to reduce the risk of serious arrhythmia related to QT-prolongation.
(MHRA Drug Safety Alert, April 2016)


*AMBER STATUS in paediatric RAG list*
04.06 Domperidone  Also Green Drug for inadequate lactation and on recommendation by secondary care (unlicensed indication).


Some epidemiological studies have shown that domperidone may be associated with an increased risk of serious ventricular arrhythmias or sudden cardiac death.
• These risks may be higher in patients older than 60 years and in patients who receive daily oral doses of more than 30 mg.
• Domperidone should be used at the lowest effective dose in adults and children.
• Patients should be advised to seek prompt medical attention if symptoms such as syncope or tachyarrhythmia appear during treatment.
• Domperidone should be avoided in patients who are taking concomitant medication known to cause QT prolongation (such as ketoconazole and erythromycin). (GMMMG)

Patients receiving apomorphine and domperidone require an assessment of cardiac risk factors and ECG monitoring to reduce the risk of serious arrhythmia related to QT-prolongation.
(MHRA Drug Safety Update, April 2016)

04.11 Donepezil Hydrochloride 
02.07.01 Dopamine Hydrochloride 
02.07.01 Dopexamine Hydrochloride Dopacard®
03.07 Dornase Alfa Nebuliser solution 2500units/2.5mL Pulmozyme® must only be initiated within hospital for the treatment of cystic fibrosis.
11.06 Dorzolamide 2% Eye drops 
11.06 Dorzolomide 2% with Timolol 0.5% eye drops  First choice where combination product required.

Only use combination products where patient has difficulty with compliance / administration.(GMMMG)
11.06 Dorzolomide 2% SDU Trusopt® preservative free
13.02.01 Doublebase® Gel 
03.05.01 Doxapram Hydrochloride Dopram® Critical Care only
02.05.04 Doxazosin  Note that the Modified Release preparation is NON FORMULARY and as such should NOT be used.

Doxazosin is a fourth-line hypertension management option.
07.04.01 Doxazosin  Consider where patient also requires alpha-blocker treatment for hypertension. Dose requires up titration. (GMMMG)
07.04.01 Doxazosin m/r 

Modified-release preperation listed on GMMMG Do Not Prescribe list. Immediate-release doxazosin should be considered in preference.

13.02.02 Drapolene® Cream 
02.03.02 Dronedarone Multaq® Only for use in accordance with NICE guidance below.
Specialist initiation only. Regular monitoring required.
04.06 Droperidol Xomolix® For use in line with Trust Anaesthetic Post-operative Nausea and Vomiting Guidelines
03.01.05 Drug Delivery Device Volumatic®
03.01.05 Drug Delivery Device AeroChamber Plus®
04.03.04 Duloxetine Cymbalta®
06.01.05 Duloxetine 60mg Capsules Cymbalta®
13.02.01 E45® Cream 
02.08.02 Edoxaban Lixiana®
10.02.01 Edrophonium Chloride 
05.03.01 Efavirenz 

Rash, usually in the first two weeks, is the most common side-effect; discontinue if severe rash with blistering, desquamation, mucosal involvement or fever; if rash mild or moderate, may continue without interruption - usually resolves within one month.

NOTE: The bioavailability of capsules and tablets is different to oral solution. and so the dose is not equivalent. (BNF)

05.03.01 Efavirenz with Emtricitabine and Tenofovir disoproxil Atripla®
13.09 Eflornithine 11.5% cream Vaniqa®
05.03.01 Elvitegravir with Cobicistat, Emtricitabine and Tenofovir alafenamide Genvoya
05.03.01 Elvitegravir with Cobicistat, Emtricitabine and Tenofovir disoproxil Stribild
06.01.02.03 Empagliflozin Jardiance® Sodium glucose cotransporter-2 (SGLT-2) inhibitor

Empagliflozin is licensed for use in type 2 diabetes as monotherapy (if metformin inappropriate), or in combination with insulin or other antidiabetic drugs (if existing treatment fails to achieve adequate glycaemic control).
05.03.01 Emtricitabine Emtriva®

For use in Maternity in line with TGH HIV in Pregnancy and Neonatal HIV protocol.

NOTE: 240mg oral solution equivalent to 200mg capsule

05.03.01 Emtricitabine with Rilpivirine and Tenofovir disoproxil Eviplera
05.03.01 Emtricitabine with Tenofovir disoproxil Truvada
13.02.01 Emulsifying Ointment BP 
02.05.05.01 Enalapril Meleate 
02.01.02 Enoximone Perfan® For use in Critical Care only
04.09.01 Entacapone Comtess®
05.03.03.01 Entecavir Baraclude®
08.03.04.02 Enzalutamide Xtandi 40mg Capsules
13.02.01 Epaderm® Ointment 
12.02.02 Ephedrine Hydrochloride Nasal Drops ( 0.5% or 1%)  First Choice Nasal Decongestant for those aged over 12 years only
02.07.02 Ephedrine Hydrocloride 
02.02.03 Eplerenone Inspra® Specialist Initiation Only
09.01.03 Epoetin alfa Binocrit® Renal Unit use only

This product is a Biosimilar medicine

A biosimilar medicine is a new biological product that is similar to a medicine that has already been authorised to be marketed (the biological reference medicine) in the European Union. The active substance of a biosimilar medicine is similar, but not identical, to the biological reference medicine. Biological products are different from standard chemical products in terms of their complexity and although theoretically there should be no important differences between the biosimilar and the biological reference medicine in terms of safety or efficacy, when prescribing biological products, it is good practice to use the brand name. This will ensure that substitution of a biosimilar medicine does not occur when the medicine is dispensed.

Biosimilar medicines have black triangle status at the time of initial marketing; however, in light of new EU legislation this will change, for latest information see www.mhra.gov.uk. It is important to report suspected adverse reactions to biosimilar medicines using the Yellow Card Scheme (see Adverse Reactions to Drugs). For biosimilar medicines, adverse reaction reports should clearly state the brand name and the batch number of the suspected medicine.
( BNF)

This is the product of choice when initiating treatment in new patients. Patients already established on the Eprex® brand should not be switched to Binocrit®
09.01.03 Epoetin alfa Eprex® Renal Unit use only

Only for use in existing patients.

When initiating treatment in new patients the Binocrit® brand should be used. Patients already established on the Eprex® brand should not be switched to Binocrit®
02.08.01 Epoprostenol Flolan®
02.09 Eptifibatide Integrilin®
17 Eptotermin Alfa Osigraft®
09.06.04 Ergocalciferol 
07.01.01 Ergometrine Maleate Ergometrine
07.01.01 Ergometrine Maleate and Oxytocin Syntometrine®
08.01.05 Erlotinib Tarceva®
01.02 Erythromycin 
02.04 Esmolol Hydrochloride Brevibloc® Critical Care Use Only
01.03.05 Esomeprazole  Consultant initiation only.

Esomeprazole may only be rarely used in some patients who fail on high doses of omeprazole, or have Barretts oesophagitis.

For treatment of Barrett’s a continual attempt to reduce dosage should be borne in mind.

Not for use in conjunction with Clopidogrel.
01.03.05 Esomeprazole IV  Reserved for patients with major peptic ulcer bleeding (active bleeding or non-bleeding visible vessel) following endoscopic haemostatic therapy.

Not for use in conjunction with Clopidogrel.

07.02.01 Estradiol 10 microgram film coated Vaginal tablets in disposable applicators Vagifem® No evidence of damage to latex condoms and diaphragms
(BNF)
07.02.01 Estriol 0.1% Intravaginal cream Ovestin® Effect on latex condoms and diaphragms not yet known
(BNF)
07.02.01 Estriol 500 microgram Pessaries Ortho-Gynest® Damages latex condoms and diaphragms
(BNF)
10.01.03 Etanercept Enbrel® Specialist use only
13.05.03 Etanercept Enbrel®

Consultant Dermatologist and Rheumatologist Use only

NICE Guidance: Etanercept and efalizumab for plaque psoriasis in adults (July 2006)
Etanercept is recommended for severe plaque psoriasis which has failed to respond to standard systemic treatments (including ciclosporin and methotrexate) and to photochemotherapy, or when standard treatments cannot be used because of intolerance or contra-indications. Etanercept should be withdrawn if the response is not adequate after 12 weeks.
(BNF)

06.06.01 Etelcalcetide Injection 
18 Ethanol 40%v/v Oral   Oral ethanol may be used as an alternative to Fomepizole or IV ethanol. A 40%v/v solution should be used. Absolut Vodka 40%v/v is available within the Trust for this indication.
06.04.01.01 Ethinylestradiol 
04.08.01 Ethosuximide 
15.02 Ethyl Chloride Cryogesic® Spray
15.01.01 Etomidate Hypnomidate®
07.03.02.02 Etonogestrel 68mg Implant Nexplanon®
05.03.01 Etravirine Intelence® Rash, usually in the second week, is the most common side-effect and appears more frequently in females. Life-threatening hypersensitivity reactions reported usually during week 3-6 of treatment and characterised by rash, eosinophilia, and systemic symptoms.

Discontinue permanently if hypersensitivity reaction or severe rash develops. If rash mild or moderate, may continue without interruption—usually resolves within two weeks.


Patients should be told how to recognise hypersensitivity reactions and advised to seek immediate medical attention if hypersensitivity reaction or severe rash develop.
(BNF)

02.12 Evolocumab solution for injection Repatha PCSK9 Inhibitor

Available as 140mg solution for injection

Prescribed by Specialist in management of lipid disporders only

Supply by home care delivery only


Recommended in:

- Primary non-familial hypercholesterolemia: If patient at HIGH risk of CVD AND LDL-C concentration persistently above 4.0mmol/l, or at VERY HIGH risk of CVD and LDL-C concentration persistantly above 3.5mmol/L.

- Primary heterozygous - familial hypercholesterolaemia: If patient at HIGH or VERY HIGH risk of CVD and LDL-C concentration persistantly above 3.5mmol/L, or if LDL-C concentration is persistantly above 5.0mmol/L WITHOUT CVD.
(NICE TA394)
08.03.04.01 Exemestane Aromasin® Green Drug following specialist initiation
06.01.02.03 Exenatide Byetta® Insulin and GLP-1 Agonist combination is classified as Green following specialist initiation or advice. This combination should not be initiated in primary care.


Recommended: 5 microgram injection s/c twice daily up to an hour before breakfast and evening meal for the first month. 10 microgram injection twice daily thereafter if untroubled by side effects.

• Exenatide is licensed for use in combination with:
o metformin, or
o a sulphonylurea, or
o thiazolidinedione, or
o metformin + a sulphonylurea, or
o metformin + thiazolidinedione
o BYETTA is also indicated as adjunctive therapy to basal insulin with or without metformin and/or pioglitazone in adults who have not achieved adequate glycaemic control with these agents
o Combinations should only be used when there is insufficient glycaemic control with maximum tolerated doses of the oral therapies
• Patients should be warned of the common side effects before starting the treatment – nausea, vomiting

• Patients who have had pancreatitis cannot use exenatide
• If patient the patient is prescribed antibiotics, they must be taken an hour apart from the exenatide injection
• Due to the increased risk of hypoglycaemia when exenatide is used in combination with sulphonylureas, drivers who are taking this combination are required to notify the DVLA
• If patients are prescribed sulphonylureas in combination with exenatide, the dose should be reduced initially due to the risk of hypoglycaemia
• Exenatide is contraindicated if eGFR < 30ml/min. For patient with renal impairment (eGFR 30-50ml/min) dose escalation should be undertaken more cautiously
• Exenatide slows gastric emptying. As a result it has several drug interactions consult SPC for most up-to-date information
• Patients prescribed warfarin should be monitored more closely as exenatide can cause an increase in INR (i.e. warfarin dose may need to be reduced)
(GMMMG)
06.01.02.03 Exenatide m/r Bydureon Diabetic consultant initiation only

Insulin and GLP-1 Agonist combination is classified as Green following specialist initiation or advice. This combination should not be initiated in primary care.

Recommended: 2mg injection s/c once weekly on the same day each week,
administered any time of the day, with or without meals.

• Exenatide is licensed for use in combination with:
o metformin, or
o a sulphonylurea, or
o thiazolidinedione, or
o metformin + a sulphonylurea, or
o metformin + thiazolidinedione
o Combinations should only be used when there is insufficient glycaemic control with maximum tolerated doses of the oral therapies
• Patients should be warned of the common side effects before starting the treatment – nausea, vomiting

• Patients who have had pancreatitis cannot use exenatide
• If patient the patient is prescribed antibiotics, they must be taken an hour apart from the exenatide injection
• Due to the increased risk of hypoglycaemia when exenatide is used in combination with sulphonylureas, drivers who are taking this combination are required to notify the DVLA
• If patients are prescribed sulphonylureas in combination with exenatide, the dose should be reduced initially due to the risk of hypoglycaemia
• Exenatide is contraindicated if eGFR < 30ml/min. For patient with renal impairment (eGFR 30-50ml/min) dose escalation should be undertaken more cautiously
• Exenatide slows gastric emptying. As a result it has several drug interactions consult SPC for most up-to-date information
• Patients prescribed warfarin should be monitored more closely as exenatide can cause an increase in INR (i.e. warfarin dose may need to be reduced)
(GMMMG)
02.12 Ezetimibe Ezetrol® Ezetimibe should be used as an option in those patients who are unable to take a statin, or are intolerant to statins, or for concomitant use in those patients unable to tolerate higher doses of statins (NICE TA132)
05.03.02.01 Famciclovir Famvir® For Sexual Health Clinic use only
10.01.04 Febuxostat Adenuric® NICE Guidance: Febuxostat for the management of hyperuricaemia in patients with gout (December 2008)
Febuxostat is recommended as an option for the management of chronic hyperuricaemia in gout only for patients who are intolerant of allopurinol or for whom allopurinol is contra-indicated.

For the purposes of this guidance, intolerance of allopurinol is defined as adverse effects that are sufficiently severe to warrant discontinuation, or to prevent full dose escalation for optimal effectiveness.
02.06.02 Felodipine M/R tablets 
02.12 Fenofibrate 

Available as:

 Capsules 67mg, 200mg, 267mg

Tablets 160mg

Do not offer routinely for the prevention of CVD to patients with CKD, type 1 or type 2 diabetes (NICE CG181)

15.01.04.03 Fentanyl 50 micrograms/mL Injection 
04.07.02 Fentanyl Injection 
04.07.02 Fentanyl Patches Matrifen® Remove after 72 hours and site replacement patch on a different area
04.07.02 Fentanyl Sublingual Tablets Abstral® For breakthrough cancer pain
09.01.01.02 Ferric Carboxymaltose Ferinject® Dose calculated according to body weight (for patients <90kg) and iron deficit - consult SPC for full prescribing and administration.

Not to be used in patients with known hypersensitivity to any other IV iron preparations.

(SPC)

NOTE: Ferinject can also be used in day case patients who require a total dose infusion of iron, and where the benefit of a fast infusion would assist with patient flow.
09.01.01.01 Ferric Maltol Capsules Feraccru To be prescribed by Consultant Gastroenterologist ONLY
Recommended as an alternative option to IV iron, in patients with MILD to MODERATE iron deficiency anaemia with IBD who have tried as least THREE oral ferrous salts, and have reported intolerance due to adverse effects after an adequate trial.
17 Ferric Subsulphate Monsel's Solution For colposcopy use only
09.01.01.01 Ferrous Fumarate 210 mg tablets  For use in Ferrous Sulphate intolerance only
09.01.01.01 Ferrous Fumarate 322mg tablets Fersaday®
09.01.01.01 Ferrous Fumarate syrup 140mg/5ml Galfer®
09.01.01.01 Ferrous Sulphate 200mg tablets 
07.04.02 Fesoterodine Fumarate m/r Toviaz® Fesoterodine has a flat pricing structure, i.e. both strengths are the same price. Prescribe the 8mg strength if up-titrating the dose to 8mg od, do not double up on the 4mg strength. (GMMMG)
03.04.01 Fexofenadine Hydrochloride Telfast®

Seasonal allergic rhinitis 120mg daily
Chronic idiopathic urticaria 180mg daily

Use if cetirizine and loratidine do not provide symptom relief

09.01.06 Filgrastim prefilled syringe  Available as:
- 30 million-units in 0.5ml
- 48 million-units in 0.8ml

This product is a Biosimilar medicine
A biosimilar medicine is a new biological product that is similar to a medicine that has already been authorised to be marketed (the biological reference medicine) in the European Union. The active substance of a biosimilar medicine is similar, but not identical, to the biological reference medicine. Biological products are different from standard chemical products in terms of their complexity and although theoretically there should be no important differences between the biosimilar and the biological reference medicine in terms of safety or efficacy, when prescribing biological products, it is good practice to use the brand name. This will ensure that substitution of a biosimilar medicine does not occur when the medicine is dispensed.

Biosimilar medicines have black triangle status at the time of initial marketing; however, in light of new EU legislation this will change, for latest information see www.mhra.gov.uk. It is important to report suspected adverse reactions to biosimilar medicines using the Yellow Card Scheme (see Adverse Reactions to Drugs). For biosimilar medicines, adverse reaction reports should clearly state the brand name and the batch number of the suspected medicine.
( BNF)
06.04.02 Finasteride 
08.02.04 Fingolimod Gilenya®
02.03.02 Flecainide Acetate  Specialist initiation only

Red Drug in paediatric patients, although unlicensed well established therapy and is in the children's BNF. Green Drug once patient is stablisied.
01.06.05 Fleet Phospho-soda® Oral Solution 
05.02.01 Fluconazole 
07.02.02 Fluconazole  Oral systemic treatment. See section 5.2
08.01.03 Fludarabine Phosphate Fludara® Available as:
- Tablets
- Injection
06.03.01 Fludrocortisone Acetate Florinef®
13.04 Fludroxycortide Tape Haelan®
15.01.07 Flumazenil 
18 Flumazenil 
12.01.01 Flumetasone Pivalate 0.02% with Clioquinol 1% Locorten-Vioform® Ear Drops

with steroid
12.01.01 Flumetasone Pivalate 0.02% with Clioquinol 1% Locorten-Vioform® Ear Drops
13.04 Fluocinolone Acetonide 0.0025% with Clioquinol 3% Cream Synalar C®
13.04 Fluocinolone Acetonide 0.0025% with Clioquinol 3% Ointment Synalar C®
13.04 Fluocinolone Acetonide 0.00625% Cream Synalar 1 in 4 Dilution®
13.04 Fluocinolone Acetonide 0.00625% Ointment Synalar 1 in 4 Dilution®
13.04 Fluocinolone Acetonide 0.025% Cream Synalar®
13.04 Fluocinolone Acetonide 0.025% Gel Synalar®
13.04 Fluocinolone Acetonide 0.025% Ointment Synalar®
13.04 Fluocinolone Acetonide 0.025% with Neomycin Sulfate 0.5% Cream Synalar N®
13.04 Fluocinolone Acetonide 0.025% with Neomycin Sulfate 0.5% Ointment Synalar N®
11.08.02 Fluorescein Sodium SDU Minims® Fluorescein Sodium Available as:
- 1%
- 2%

• Used in diagnostic procedures and for locating damaged areas of the cornea due to injury or disease. (GMMMG)

Also available with local anaesthetic. See section 11.7
09.05.03 Fluorides En-De-Kay® (Mouthwash)
11.04.01 Fluorometholone 0.1% with polyvinyl alcohol (Liquifilm®) 1.4%  FML® Opthalmic consultants only
13.08.01 Fluorouracil 5% Cream Efudix®
04.03.03 Fluoxetine  Available as:
- Capsules
- Liquid
04.02.01 Flupentixol Depixol®
04.02.02 Flupentixol Decanoate Depixol®
04.02.02 Flupentixol Decanoate Depixol® Conc.
08.03.04.02 Flutamide  Amber Drug for Prostate cancer
03.02.02 Fluticasone and salmeterol  Seretide® MDI 50, 125, 250 (Evohaler)
Dry Powder Inhaler 100, 250, 500 (Accuhaler)
12.02.01 Fluticasone furoate 27.5 micrograms/metered spray  First choice in children < 16 years old
12.02.01 Fluticasone Furoate 27.5 micrograms/metered spray  Alternative in adults > 16 years old
03.02.02 fluticasone furoate 92 micrograms, vilanterol (as trifenatate) 22 micrograms/inhalation (dry powder for inhalation) Relvar Ellipta® 92 micrograms/22 micrograms
03.02.03 fluticasone furoate 92 micrograms, vilanterol (as trifenatate) 22 micrograms/inhalation (dry powder for inhalation) Relvar Ellipta® 92 micrograms/22 micrograms

First choice for breath-actuated Dry Powder Inhaler

12.02.01 Fluticasone Propionate 400 micrograms/unit dose nose drops Flixonase Nasule®
12.02.01 Fluticasone propionate 50 micrograms / Azelastine hydrochloride 137 micrograms metered nasal spray Dymista GMMMG Grey List: Restricted for patients aged 12 years and over, where an intranasal antihistamine and a glucocorticoid are required, which would otherwise be individually be prescribed

(NTS)
03.02.01 Fluticasone Propionate Inhaler Flixotide® MDI 50, 125, 250 micrograms/dose (Flixotide evohaler)
Dry powder inhalation 50,100,250,500 micrograms/dose (Flixotide accuhaler)
03.02.01 Fluticasone Propionate Nebules  Available as 500micrograms/2ml and 2mg/2ml nebules
03.02.02 Fluticasone Propionate with Formoterol Fumarate Flutiform® 50/5, 125/5, 250/10 MDI (Flutiform)
03.02.03 Fluticasone/Umeclidinium/Vilanterol 92/55/22 DPI Trelegy
09.01.02 Folic Acid  400microgram and 5mg tablets, syrup 2.5mg/5ml
17 Fomepizole 
18 Fomepizole 
02.08.01 Fondaparinux Sodium Arixtra®
03.01.01.01 Formoterol Fumarate Dry Powder Inhaler  Available as 6micrograms and 12micrograms/dose
05.03.01 Fosamprenavir Telzir® Rash
Rash may occur, usually in the second week of therapy; discontinue permanently if severe rash with systemic or allergic symptoms or, mucosal involvement; if rash mild or moderate, may continue without interruption—usually resolves within 2 weeks and may respond to antihistamines. (BNF)

13.05.02 Fumaric Acid Esters Fumaderm® Tablets
Consultant Dermatologist Use Only
02.02.02 Furosemide 
11.03.01 Fusidic Acid 1% m/r eye drops Fucithalmic®
13.10.01.02 Fusidic Acid 2% Fucidin® Available as:
- Cream
- Ointment
04.07.03 Gabapentin 
04.08.01 Gabapentin 
06.01.05 Gabapentin 
17 Gadovist Injection  10ml
17 Gadovist Syringe  7.5ml
17 Gadovist Syringe  15ml
04.11 Galantamine Reminyl®
04.11 Galantamine Reminyl® XL
05.03.02.02 Ganciclovir Cymevene® Hospital use only
17 Gastromiro Solution 
01.01.02 Gaviscon Advance 
01.01.02 Gaviscon Infant  For Paediatric use only
09.02.02.02 Gelatin Geloplasma® 500ml
08.01.03 Gemcitabine Injection Gemzar®
12.01.01 Gentamicin 0.3% ear/eye drops Genticin®
11.03.01 Gentamicin 0.3% Eye/Ear Drops Genticin®
12.03.05 Glandosane® aerosol spray 
06.01.02.01 Gliclazide 

Immediate release 40mg and 80mg tablets

 

DO NOT PRESCRIBE modified-release preparation. Listed on GMMMG DNP list

06.01.02.01 Glimepiride 


 

06.01.04 Glucagon GlucaGen® HypoKit Family members can be taught to inject glucagon in emergencies where the patient becomes unconscious during a hypoglycaemic event.

Recommended: s/c or i/m injection of the full 1mg syringe
(GMMMG)
18 Glucagon GlucaGen® HypoKit
18 Glucagon GlucaGen® HypoKit
18 Glucagon GlucaGen® HypoKit
06.01.04 GlucoGel®  Only to be used in specific circumstances as
most patients will be able to take oral fast acting carbohydrate as detailed above.
(GMMMG)
06.01.01.03 GlucoRx 4mm Needles 
09.02.02.01 Glucose 10% with Sodium Chloride 0.18% Intravenous Infusion 500ml 
06.01.04 Glucose 10% 500ml Intravenous Infusion 
09.02.02.01 Glucose 10% Infusion  Available as:
- 1L bag
- 500ml bag
09.02.02.01 Glucose 10% Injection 10ml 
09.02.02.01 Glucose 20% Infusion 500ml 
09.02.02.01 Glucose 5% Infusion  Available as:
- 1L bag
- 500ml bag
- 250ml bag
09.02.02.01 Glucose 50% Infusion 500ml 
09.02.02.01 Glucose 50% Injection 50ml 
09.02.02.01 Glucose 50% Min-I-jet 50ml 
06.01.04 Glucose Powder 75g 
06.01.06 Glucose Powder 75g 
06.01.06 Glutole®  One 330ml bottle of Glutole contains 75g glucose, the dose recommended by WHO for adults in Glucose Tolerance Testing

01.06.02 Glycerol (Glycerin) 
02.06.01 Glyceryl Trinitrate Nitrolingual® Pumpspray When required for acute chest pain
01.07.04 Glyceryl Trinitrate 0.4% Rectogesic® Must be prescribed by brand
02.06.01 Glyceryl Trinitrate 2% Ointment Percutol®
02.06.01 Glyceryl Trinitrate Injection  When IV preparation required
02.06.01 Glyceryl Trinitrate Sublingual Tablets 
02.06.01 Glyceryl Trinitrate Transdermal Patches 
07.04.04 Glycine Irrigation Solution 
03.01.04 Glycopyrronium 85 micrograms, Indacaterol 43 micrograms powder for inhalation capsule Ultibro Breezhaler 85 micrograms/43 micrograms

Prescribe as a step up from Glycopyrronium inhaler

03.01.02 Glycopyrronium Bromide 55microgram Powder for Inhalation capsule Seebri Breezhaler®
15.01.03 Glycopyrronium Bromide Oral Solution 
13.12 Glycopyrronium Bromide Solution  Specialist use only

Unlicensed
10.01.03 Golimumab  Specialist use only
06.05.01 Gonadorelin HRF®
06.07.02 Goserelin Zoladex® Red Drug in precocious puberty and for testosterone castration in sex offenders (unlicensed)

Available as:
- 3.6mg Intradermal Implant (monthly) Zoladex®
- 10.8mg Intradermal Implant (3 monthly) Zoladex® LA
08.03.04.02 Goserelin Zoladex® Goserelin is the only licensed GnRH analogue for use in the treatment of breast cancer. It is also used in IVF and endometrial thinning before intra-uterine surgery. (GMMMG)
08.03.04.02 Goserelin Zoladex® LA Goserelin is the only licensed GnRH analogue for use in the treatment of breast cancer. It is also used in IVF and endometrial thinning before intra-uterine surgery. (GMMMG)

Where a luteinising hormone-releasing hormone agonist (LHRHa)is indicated , Leuprorelin 3 monthly injections are cheaper than Goserelin 3 monthly
08.03.04.01 Goserelin 3.6 mg Implant Zoladex® Goserelin is the only licensed GnRH analogue for use in the treatment of breast cancer. It is also used in IVF and endometrial thinning before intra-uterine surgery. (GMMMG)

Monthly administration
14.04 Haemophilus influenzae type B Combined Vaccine Menitorix®
01.07.01 Haemorrhoid Relief Cream 
04.02.01 Haloperidol  Available as:
- Tablets
- Oral solution
04.02.02 Haloperidol Haldol Decanoate®
04.09.03 Haloperidol 
02.08.01 Heparin Sodium 
02.08.01 Heparin Sodium IV Flush  Available as:

Heparin Sodium 10 unit per 1ml
Heparin Sodium 100 unit per 1ml
13.13 Heparinoid 0.3% Cream Hirudoid®
14.04 Hepatitis A vaccine Single Component Havrix Monodose®
14.04 Hepatitis A vaccine with Hepatitis B vaccine Twinrix®
14.05.02 Hepatitis B immunoglobulin  Available from public health virology laboratory. Prescriber needs to contact department in person to obtain.
14.04 Hepatitis B vaccine Single Component 20 micrograms Engerix B® Interchangeable with HBvaxPRO®, but note dose difference

Occupational health use only
14.04 Hepatitis B vaccine Single Component 10 micrograms HBvaxPRO® Interchangeable with Engerix B®, but note dose difference

Occupational health use only
09.02.02.02 Human Albumin Solution  Available for pathology laboratory. Not stocked in pharmacy.
10.03.01 Hyaluronidase Hyalase® For use in line with extravasation policy
02.05.01 Hydralazine Hydrochloride  Hydralazine may be used in combination with long acting nitrates (especially if the patient has moderate to severe heart failure NYHA class 3-4), in patients with heart failure who are still symptomatic despite the optimal therapy with ACE inhibitor and beta blocker. (NICE CG108)

01.05.02 Hydrocortisone Colifoam®
06.03.02 Hydrocortisone Efcortesol® For use as emergency rescue medication for patients with Addison's Disease
06.03.02 Hydrocortisone Solu-Cortef® 1st choice IV preparation

13.04 Hydrocortisone 0.1% Cream Dioderm®
13.04 Hydrocortisone 0.25% Crotamiton 10% Eurax-Hydrocortisone®
13.04 Hydrocortisone 0.5% Cream 
13.04 Hydrocortisone 0.5% Ointment 
13.04 Hydrocortisone 0.5%, Nystatin 100,000 units/g
and Chlorhexidine Acetate 1% Cream
 Nystaform-HC®
13.04 Hydrocortisone 0.5%, nystatin 100,000 units/g
Benzalkonium Chloride Solution 0.2%, Dimeticone '350' 10% Cream
 Timodine®
13.04 Hydrocortisone 1% Cream 
13.04 Hydrocortisone 1% Ointment 
13.04 Hydrocortisone 1% with Clotrimazole 1% Cream Canesten HC®
13.04 Hydrocortisone 1% with Miconazole Nitrate 2% Cream Daktacort®
13.04 Hydrocortisone 1% with Miconazole Nitrate 2% Ointment Daktacort®
13.04 Hydrocortisone 1% with Urea 10% Cream Hydromol® HC Intensive Cream
13.04 Hydrocortisone 1% with Urea 10% Cream Alphaderm®
13.04 Hydrocortisone 1%, Nystatin 100,000 units/g
and Chlorhexidine Acetate 1% Ointment
 Nystaform-HC®
12.03.01 Hydrocortisone 2.5mg Oromucosal Tablets 

Hydrocortisone muco-adhesive buccal tablets are indicated ONLY for local use in the mouth for aphthous ulceration and should not be used for treating adrenal insufficiency. Using buccal in this indication can result in insufficient cortisol absorption and, in stress situations, life-threatening adrenal crisis. (MHRA December 2018).

 

10.01.02.02 Hydrocortisone acetate Hydrocortistab®
13.04 Hydrocortisone Acetate 1% with Fusidic Acid 2% Cream Fucidin H®
12.01.01 Hydrocortisone Acetate 1% with Gentamicin 0.3% Gentisone® HC with antibiotic
13.04 Hydrocortisone Butyrate 0.1% Cream Locoid®
13.04 Hydrocortisone Butyrate 0.1% Ointment Locoid®
06.03.02 Hydrocortisone Tablets 
13.11.06 Hydrogen Peroxide Solution BP 3% (10 vols)
13.02.01 Hydromol® Ointment 
04.07.02 Hydromorphone Hydrochloride Palladone® Recommendation from Consultant in Palliative Medicine only
04.07.02 Hydromorphone Hydrochloride m/r Palladone® SR Recommendation from Consultant in Palliative Medicine only
09.01.02 Hydroxocobalamin 1mg/ml injection 
18 Hydroxocobalamin 5g Intravenous infusion Cyanokit® Note: Deep red colour of hydroxocobalamin may interfere with laboratory tests and haemodialysis. (BNF)
08.01.05 Hydroxycarbamide Capsules  Amber Drug in Essential thrombocythaemia or polycythaemia with high risk of complications and Sickle Cell Disease.

Red Drug in CML.
10.01.03 Hydroxychloroquine Sulphate Plaquenil®
11.08.01 Hydroxyethylcellulose Minims® Artificial Tears Contains hydroxyethylcellulose 0.44% & sodium chloride 0.35%
03.04.01 Hydroxyzine Hydrochloride  Tablets 10mg, 25mg
Oral solution 10mg/5ml

Favoured by the dermatologists for its anti-itch and sedating effects
01.02 Hyoscine Butylbromide Buscopan®
15.01.03 Hyoscine Hydrobromide (Scopolamine) 
04.06 Hyoscine Hydrobromide Patches Scopoderm® TTS
04.06 Hyoscine Hydrobromide Tablets Kwells®
03.07 Hypertonic sodium chloride for nebulisation 4ml MucoClear®

Available as:
- 3%
- 6%

Prescribe by brand to avoid unlicensed special use (GMMMG)

03.07 Hypertonic sodium chloride for nebulisation 7% 4ml Nebusal®

Prescribe by brand to avoid unlicensed special use (GMMMG)

11.08.01 Hypromellose 0.3% eye drops 
11.08.01 Hypromellose 0.3% SDU 
08.01.05 Ibrutinib Imbruvica Cancer Drugs Fund Approved

For Consultant Use Only
10.01.01 Ibuprofen  First Choice for musculoskeletal pain in A&E
Liquid formulation available
07.01.01.01 Ibuprofen 10 mg/2mL Intravenous solution Pedea ®
10.03.02 Ibuprofen 10% Gel 
10.03.02 Ibuprofen 5% Gel 
13.05.01 Ichthammol Zinc Paste and Ichthammol Bandage BP 1993 Ichthopaste bandage
02.08.02 Idarucizumab Praxbind Reversal agent for Dabigatran in adults, when rapid reversal of anticoagulant is required
Available as 2.5g/50ml solution for injection/infusion
Stored in TGH Pharmacy Emergency Drugs Room
18 Idarucizumab  Praxbind Reversal agent for Dabigatran in adults, when rapid reversal of anticoagulant is required

Available as Injection
Stored in TGH Pharmacy Emergency Drugs Room

02.05.01 Iloprost  Consultant Prescribing Only
Critical Care Only
08.01.05 Imatinib Gilvec®
04.03.01 Imipramine Hydrochloride 
13.07 Imiquimod Aldara®
02.02.01 Indapamide  Available as

- 2.5mg tablets
- 1.5mg M/R tablets
17 Indigo Carmine Injection 20mg/5ml (0.4 %) 
07.01.01.01 Indometacin Injection 
01.05.03 Infliximab Remicade® GI Specialist only
10.01.03 Infliximab Remicade® Specialist use only
13.05.03 Infliximab Remicade®
13.08.01 Ingenol mebutate 150 micrograms/g gel Picato® 0.47g single use tubes
03.01.05 Inhalation Aid Haleraid®
06.01.01.01 Insulin Actrapid® Available as 10ml vial

Not recommended for use in subcutaneous insulin infusion pumps—may precipitate in catheter or needle. (BNF)
06.01.01.01 Insulin Humulin® S

Available as:
- 10ml vial
- 3ml cartridge ( via Autopen classic or HumaPen)

06.01.01.01 Insulin Insuman® Rapid

Available as 3ml cartridge (via ClikSTAR or Autopen 24)


Not recommended for use in subcutaneous insulin infusion pumps (BNF)

06.01.01.01 Insulin Aspart NovoRapid®

Available as:
- 10ml vial
- 3ml Penfill® cartridge
- 3ml Flexpen® prefilled disposable injection device (via NovoPen devices)

- 1.6ml PumpCart (for infusion pumps)

06.01.01.01 Insulin Aspart Fiasp

Restristed for use in Type one patients as follows:

  • In patietns who have diabetes and are planning or are activaly pregnant
  • In patients who have post prandial glucose readings of >10mmol at two hours

It is NOT available for use in Type 2 diabetes patients

(GMMMG Formulary and Managed Entry Subgroup)

06.01.01.02 Insulin Detemir Levemir®

Available as:
- 3ml Penfill® cartridge (via NovoPen 4 device)
- 3ml Flexpen® prefilled disposable injection device
- InnoLet® prefilled disposable injection devices (for patients with manuel dexterity problems)

06.01.01.02 Insulin Glargine Lantus®

Available as:
- 100units/ml vial 10ml
- 100units/ml cartridge 3ml
- 100units/ml SoloStar® prefilled disposable pen 3ml
- 300units/ml Toujeo® prefilled disposable pen 1.5ml

06.01.01.02 Insulin glargine biosimilar (Eli Lilly) Abasaglar

Available as:

-3ml cartridge (via HumaPen Savvio device)

-3ml pre-filled disposable pen (FlexPen)

-Innolet (only for patients with manual dexterity problems)

06.01.01.02 Insulin glargine biosimilar (Mylan) Semglee

Available as:

-3ml disposable pen

06.01.01.01 Insulin Glulisine Apidra®

Available as:
- 3ml cartridge
- 3ml SoloStar® prefilled disposable injection device (via ClikSTAR or Autopen 24)
- 10ml vial

06.01.01.01 Insulin Lispro biosimilar (Sanofi) 

Available as:
- 10ml vial
- 3ml cartridge (via JunoirSTAR, Tactipen, AllStar, and AllStar PRO pens)
- 3ml Kwikpen

08.02.04 Interferon Alfa-2a Roferon-A®
08.02.04 Interferon Alfa-2b IntronA
08.02.04 Interferon Beta-1a Avonex®
08.02.04 Interferon Beta-1a Rebif®
08.02.04 Interferon Beta-1b Betaferon®
08.02.04 Interferon Beta-1b Extavia®
09.03 Intralipid® 20%  For use in management of local anaesthetic toxicity and in Pharmacy Aseptic Services for compounding of parenteral nutrition only

Available as:
- 100ml
- 500ml
07.03.04 Intra-uterine Contraceptive Devices Nova-T® 380
07.03.04 Intra-uterine Contraceptive Devices T-Safe® CU 380 A Quickload
07.03.04 Intra-uterine Contraceptive Devices GyneFix® Frameless coil
07.03.04 Intra-uterine Contraceptive Devices Mini TT 380® Slimline short coil for minimum uterine length 5cm
07.03.04 Intra-uterine Contraceptive Devices Multiload® Cu 375
07.03.02.03 Intra-uterine Progestogen Only System Mirena® The Mirena Intra-Uterine System is an option in the treatment of heavy menstrual bleeding.(GMMMG)
03.01.04 Ipratropium and Salbutamol nebuliser solution  Only for use with stable patients requiring a fixed dose.

In acute patients, salbutamol and ipratropium nebuliser solutions should be prescribed separately.
12.02.02 Ipratropium Bromide 0.03% Nasal Spray Rinatec® Second Choice Nasal Decongestant

Consider in allergic rhinitis where there is significant watery rhinorrhoea (GMMMG)
03.01.02 Ipratropium Bromide MDI 20 micrograms/dose  First Choice when a 'when required' short acting antimuscarinic bronchodilator is needed
03.01.02 Ipratropium Bromide Nebuliser solution Ipratropium Steri-Neb® First Choice where nebulised antimuscarinic bronchodilator required

250micrograms/1ml, 500micrograms/2ml
02.05.05.02 Irbesartan Aprovel ® First Choice for renal patients.
09.01.01.02 Iron Dextran CosmoFer® For use in maternity only.

CosmoFer can be given as a total-dose IV infusion

Dose calculated according to body weight (for patients <90kg) and iron deficit - consult SPC for full prescribing and administration.

Not to be used in patients with known hypersensitivity to any other IV iron preparations.

(SPC)

09.01.01.02 Iron Sucrose Venofer Dose calculated according to body weight (for patients <90kg) and iron deficit - consult SPC for full prescribing and administration.

Maximum dose of 200mg per administration. Cannot be given by total dose infusion.

Not to be used in patients with known hypersensitivity to any other IV iron preparations.

(SPC)
15.01.02 Isoflurane  For use as per anaesthetist guidelines
06.01.01.02 Isophane Insulin Insulatard®

Available as:
- 10ml vial
- 3ml Penfill® cartridge (via NovoPen 4 device)
- InnoLet® prefilled disposable injection devices

06.01.01.02 Isophane Insulin Humulin® I

Available as:
- 10ml vial
- 3ml cartridge (via HumaPen Luxura device)
- 3ml Kwikpen

06.01.01.02 Isophane Insulin Insuman® Basal

Available as:
- 5ml vial
- 3mL cartridge (via ClikSTAR or Autopen 24)
- Solostar® prefilled disposable injection device

02.07.01 Isoprenaline Sulphate  CCU use only
02.06.01 Isosorbide Dinitrate 
02.06.01 Isosorbide Mononitrate Modified Release Tablets/Capsules 
02.06.01 Isosorbide Mononitrate Tablets 
13.06.02 Isotretinoin  Consultant dermatologist only

Pregnancy prevention
In women of child-bearing potential, exclude pregnancy up to 3 days before treatment (start treatment on day 2 or 3 of menstrual cycle), every month during treatment (unless there are compelling reasons to indicate that there is no risk of pregnancy), and 5 weeks after stopping treatment—perform pregnancy test in the first 3 days of the menstrual cycle. Women must practise effective contraception for at least 1 month before starting treatment, during treatment, and for at least 1 month after stopping treatment. Women should be advised to use at least 1 method of contraception, but ideally they should use 2 methods of contraception. Oral progestogen-only contraceptives are not considered effective. Barrier methods should not be used alone, but can be used in conjunction with other contraceptive methods. Each prescription for isotretinoin should be limited to a supply of up to 30 days' treatment and dispensed within 7 days of the date stated on the prescription; repeat prescriptions or faxed prescriptions are not acceptable. Women should be advised to discontinue treatment and to seek prompt medical attention if they become pregnant during treatment or within 1 month of stopping treatment.

Counselling
Warn patient to avoid wax epilation (risk of epidermal stripping), dermabrasion, and laser skin treatments (risk of scarring) during treatment and for at least 6 months after stopping; patient should avoid exposure to UV light (including sunlight) and use sunscreen and emollient (including lip balm) preparations from the start of treatment. (BNF)

01.06.01 Ispaghula Husk 
05.02.01 Itraconazole 

Consultant microbiologist recommendation only.

 

Following reports of heart failure, caution is advised when prescribing itraconazole to patients at high risk of heart failure. Those at risk include:

-patients receiving high doses and longer treatment courses;

-older patients and those with cardiac disease;

- patients with chronic lung disease (including COPD) associated with pulmonary hypertension;

-patients receiving treatment with negative inotropic drugs, e.g. calcium channel blockers.

Itraconazole should be avoided in patients with ventricular dysfunction or a history of heart failure unless the infection is serious.
(BNF)

02.06.03 Ivabradine Procoralan® Specialist initiation only

Ivabradine is recommended as an option for treating chronic heart failure for people:

With NYHA class 2-4 stable chronic heart failure with systolic dysfunction AND

Who are in sinus rhythm with a heart rate of 75 beats per minute or more AND

With a left ventricular ejection fraction of 35% or less AND

Who are given ivabradine in combination with a standard therapy including beta-blocker therapy, ACE inhibitor and aldosterone antagonists, or when beta-blocker therapy is contraindicated or not tolerated.
13.05.03 Ixekizumab solution for injection Taltz

Consultant Dermatologist and Rheumatologist Initiation Only

For use in accordance with NICE guidelines only

15.01.01 Ketamine Ketalar®
04.07.03 Ketamine oral solution  Approved for use in palliative care only

Amber Drug For use in palliative care under direction and advice of palliative care team. Please note: unlicensed indication


Red Drug for Chronic Pain management
13.10.02 Ketoconazole 2% Cream Nizoral®
13.09 Ketoconazole 2% Shampoo 
06.01.06 Ketone Test strips Ketostix®
15.01.04.02 Ketorolac Trometamol Toradol®
11.08.02 Ketorolac Trometamol 0.5% eye drops Acular® Opthalmic consultant initiation only
01.06.05 Klean-Prep® Oral Powder 
02.04 Labetalol Hydrochloride  Tablets / Injection

For use in Pregnancy
04.08.01 Lacosamide Vimpat ® Green following specialist initiation.

For use in conjunction with GMMMG guidelines.
01.06.04 Lactulose  Lactulose takes up to 48 hours to work but is often inappropriately used “when required”. It is unpleasant to take and compliance may be a problem. Its main clinical benefit is in the management of hepatic encephalopathy.
05.03.01 Lamivudine 

For use in Maternity in line with TGH HIV in Pregnancy and Neonatal HIV protocol.

04.08.01 Lamotrigine 
01.03.05 Lansoprazole 
01.03.05 Lansoprazole Orodispersible Tablets Zoton FasTab ® First Choice for patients with dysphagia or feeding tubes only.



09.05.02.02 Lanthanum 500mg, 750mg, 1 gram tablets Fosrenol ®
15.02 LAT gel  Lidocaine, Adrenaline, and Tetracaine (LAT) topical anaesthetic gel
Resticted to use in the Paediatric Emergency Department as per protocol.
11.06 Latanoprost 0.005% with Timolol 0.5% eye drops Xalacom® First choice where combination product required

Combination products licensed for once daily use where prostaglandin analogue alone is not adequate. Only use where patient has difficulty with compliance / administration. (GMMMG)
11.06 Latanoprost 50microgram/ml eye drops 
10.01.03 Leflunomide Arava® Specialist initiation only
08.02.04 Lenalidomide Revlimid®
09.01.06 Lenograstim prefilled syringe Granocyte®
02.06.02 Lercanidipine Hydrochloride  Alternative DIHYDROPYRIDINE
08.03.04.01 Letrozole 
06.07.02 Leuprorelin Acetate Prostap® Red Drug in precocious puberty and for testosterone castration in sex offenders (unlicensed)

Available as:
- 3.75mg (monthly) pre-filled dual chamber syringe (DCS) Prostap® SR DCS
- 11.25mg (3 monthly) DCS Prostap® 3 DCS
08.03.04.02 Leuprorelin Acetate Prostap® SR
08.03.04.02 Leuprorelin Acetate Prostap® 3 Where a luteinising hormone-releasing hormone agonist (LHRHa)is indicated , Leuprorelin 3 monthly injections are cheaper than Goserelin 3 monthly
04.08.01 Levetiracetam Keppra®
11.06 Levobunolol Hydrochloride 0.5% eye drops 
11.06 Levobunolol Hydrochloride 0.5% SDU Betagan® Contains levobunolol hydrochloride 0.5% & polyvinyl alcohol (Liquifilm®) 1.4%

Preservative free
15.02 Levobupivacaine 25mg/10ml Injection Chirocaine®
15.02 Levobupivacaine 50mg/10ml Injection Chirocaine®
11.03.01 Levofloxacin 0.5% eye drops Oftaquix® Opthalmic Consultant use only

Quinolones must not be used for more than 10 days as resistance rapidly develops.(GMMMG)
13.03 Levomenthol 1% Cream BP Menthol 1% in Aqueous Cream
04.02.01 Levomepromazine Nozinan® Green for palliative care use only.

Specialist initiation only.
04.06 Levomepromazine Nozinan® available as:
- tablets
- injection
07.03.05 Levonogrestrel Levonelle® 1500
06.02.01 Levothyroxine Sodium Levothyroxine
15.02 Lidocaine 0.5% Injection 
15.02 Lidocaine 0.5% with Epinephrine (Adrenaline) 1 in 200,000 Injection 
15.02 Lidocaine 1% Epidural Injection 
15.02 Lidocaine 1% Injection 
15.02 Lidocaine 1% with Epinephrine (Adrenaline) 1 in 200,000 Injection 
12.03.01 Lidocaine 10% Spray Xylocaine® Unlicensed indication
15.02 Lidocaine 10% Spray Xylocaine®
15.02 Lidocaine 2% Injection 
15.02 Lidocaine 2% Minijet 
15.02 Lidocaine 2% with Epinephrine (Adrenaline) 1 in 200,000 Injection 
15.02 Lidocaine 2% with Epinephrine (Adrenaline) 1 in 80,000 Cartridges 
15.02 Lidocaine 2.5% with Prilocaine 2.5% Cream EMLA® Can be administered under Patient Group Direction
15.02 Lidocaine 4% Spray 
15.02 Lidocaine 4% Topical Solution Laryngojet®
15.02 Lidocaine 4% with Adrenaline 0.1% and Tetracaine 0.5% Gel LAT Gel For use in paediatric wound closure in A&E only
15.02 Lidocaine 5% Ointment 
12.02 Lidocaine 5% with Phenylephrine 0.5% Nasal Spray  Used widely in ENT
15.02 Lidocaine 5% with Phenylephrine 0.5% Nasal Spray  Used widely in ENT
02.03.02 Lidocaine Hydrochloride  Available as:

- 1mg/ml and 2mg/ml infusion in Glucose 5%
02.03.02 Lidocaine Hydrochloride 1% Minijet® Lignocaine
15.02 Lidocaine Hydrochloride 2% with Chlorhexidine gluconate 0.25% Instillagel® 6ml and 11ml pack sizes available
11.07 Lidocaine Hydrochloride 4% with Fluorescein 0.25% SDU Minims® preservative free
01.06 Linaclotide Constella® Consultant initiation only

Consider linaclotide for people with IBS only if:

•optimal or maximum tolerated doses of previous laxatives from different classes have not helped and

•they have had constipation for at least 12 months.

Follow up people taking linaclotide after 3 months.
(NICE CG61 2008)
06.01.02.03 Linagliptin 

Linagliptin is an alternative for use in patients with moderate or severe renal impairment (CrCl <50ml/min, eGFR <59ml/min)

06.01.02.03 Linagliptin with Metformin Jentadueto® Only to be prescribed if genuine issue
with adherence to therapy
05.01.07 Linezolid 
17 Lipiodol Ultra-Fluid Injection 
13.02.01 Liquid and White Soft Paraffin Ointment (50:50) 
13.07 Liquid Nitrogen 
11.08.01 Liquid Paraffin eye ointment Lacri-Lube® Unpreserved alternative

Contains white soft paraffin 57.3%, liquid paraffin 42.5% & wool alcohols 0.2%.

These preparations are preservative free with expiry dates of 28 days once opened.(GMMMG)
All preparations for inpatient use expire after a maximum of 14 days once opened.
06.01.02.03 Liraglutide Victoza® Insulin and GLP-1 Agonist combination is classified as Green following specialist initiation or advice. This combination should not be initiated in primary care.

Recommended: 0.6mg s/c injection once daily for 1 week. 1.2mg thereafter if untroubled
by side effects. NICE does not support doses of >1.2mg daily, although patients have the option to continue if already prescribed this, treatment should be reviewed regularly (as per NICE).

• Due to the increased risk of hypoglycaemia when liraglutide is used in combination with sulphonylureas, drivers who are taking this combination are required to notify the DVLA
• If patients are prescribed sulphonylureas in combination with liraglutide, the dose should be reduced initially due to the risk of hypoglycaemia
• Liraglutide should be avoided if eGFR < 60ml/min except under Specialist advice

(GMMMG)
02.05.05.01 Lisinopril 
04.02.03 Lithium Carbonate m/r Priadel® First choice antimanic drug
04.02.03 Lithium Citrate 509 mg/5 mL Liquid Li-Liquid® First choice antimanic drug
04.02.03 Lithium Citrate 520 mg/5 mL Liquid Priadel® First choice antimanic drug
06.01.02.03 Lixisenatide Lyxumia® Recommended for use as an option, as per the NICE clinical guideline on type 2 diabetes i.e. third-line therapy (in addition to Metformin and Sulphonylurea) when the control of glucose remains inadequate and/or a high BMI. (D&T Committee)

Insulin and GLP-1 Agonist combination is classified as Green following specialist initiation or advice. This combination should not be initiated in primary care.

01.04.02 Loperamide Hydrochloride 
05.03.01 Lopinavir and Ritonavir Kaletra®

Pancreatitis
Signs and symptoms suggestive of pancreatitis (including raised serum lipase) should be evaluated—discontinue if pancreatitis diagnosed. (BNF)

03.04.01 Loratadine Tablets 10mg, Oral solution 5mg / 5mL  Tablets 10mg
Oral Solution 5mg/5ml

Preferred choice during pregnancy and lactation
04.01.02 Lorazepam 
15.01.04.01 Lorazepam  Available as:
- Tablets
- Injection
18 Lorazepam 
04.08.02 Lorazepam Injection 
02.05.05.02 Losartan Potasium 
01.06 Lubiprostone  Amitiza®
06.01.04 Lucozade  Contains 17g glucose per 100ml and 65g per bottle
01.06.04 Macrogols Movicol® Paediatric Plain Paediatric Use only
09.05.01.03 Magnesium aspartate dihydrate  Magnaspartate®

6.5g sachets (equivalent to 243mg (10mmol) of magnesium)
09.05.01.03 Magnesium Glycerophosphate tablets  4mmol tablets
Restricted for use in diabetic patients where the sucrose content of magnesium aspartate sachets is too high.
09.05.01.03 Magnesium Sulphate injection 50% (2mmol/ml)  Available as:
- 2ml ampoules
- 10ml vials (pharmacy aseptic use only)
13.10.05 Magnesium Sulphate Paste BP 
17 Magnevist 2mmol Syringe 
13.10.04 Malathion 0.5% Derbac-M®
03.07 Mannitol 

Available as inhalation powder (40mg hard capsules)

02.02.05 Mannitol IV Infusion  Consultant recommendation only
14.04 Measles, Mumps and Rubella Vaccine, Live (MMR) 
05.05.01 Mebendazole 
05.05.04 Mebendazole 
01.02 Mebeverine Hydrochloride 
16.01 Medicinal Leeches  Restricted to consultant prescribing only
06.04.01.02 Medroxyprogesterone Acetate Provera®
07.03.02.02 Medroxyprogesterone Acetate Depo-Provera®
08.03.02 Medroxyprogesterone Acetate Provera®
10.01.01 Mefenamic Acid  For gynaecology use only
08.03.02 Megestrol Acetate Megace®
04.01.01 Melatonin Circadin® Red Drug for all Paedatric patients for e.g. sleep disorders, ADHD. The licensed product should be used 1st line in these patients.

Green Drug for all Adult patients over 55. See IPNTS Recommendation.
10.01.01 Meloxicam 
08.01.01 Melphalan Tablets Alkeran®
04.11 Memantine Hydrochloride Ebixa®
09.06.06 Menadiol Phosphate 10mg tablets 
14.04 Meningococcal group C conjugate vaccine Menjugate Kit®
15.02 Mepivacaine 3% Dental Cartridges Scandonest® 3% Plain
01.05.03 Mercaptopurine  GI Specialist only
Unlicensed Indication
01.05.01 Mesalazine Pentasa GI Specialist Initiation only

Available as Granules and suppositories

Granules for patients unable to take tablets

01.05.01 Mesalazine Salofalk® GI Specialist Initiation only

Available as salofalk granules

For patients unable to take tablets
01.05.01 Mesalazine Asacol® GI Specialist Initiation only

Available as foam enema
01.05.01 Mesalazine MR once daily tablets Mezavant® XL GI Specialist Initiation only

Available as 1.2g tablets

For use when concordance is an issue
01.05.01 Mesalazine MR Tablets Octasa® MR

GI Specialist Initiation only

Available as 400mg and 800mg tablets
01.05.01 Mesalazine MR Tablets Pentasa MR GI Specialist initiation only

Available as 500mg and 1g tablets
08.01 Mesna Uromitxan® Available as:
- Tablets
- Injection
13.02.02 Metanium® Ointment 
02.07.02 Metaraminol  Unlicensed
06.01.02.02 Metformin Hydrochloride 


 

06.01.02.02 Metformin Hydrochloride Glucophage® SR

Metformin modified release should only be used where the standard metformin tablets have been tried and are not tolerated due to GI problems. Any new prescription of the SR preparation should be reviewed soon after initiation (recommend checking HbA1c after 3 months and assess patient for compliance/adverse effects), discontinue if not tolerated or ineffective.
(GMMMG)

06.01.02.02 Metformin Oral Powder Glucophage® First Choice for swallowing difficulties or enteral feeding tube use

Titrate dose as per regular metformin
04.10.03 Methadone Hydrochloride 
18 Methionine 500mg Tablets 
10.02.02 Methocarbamol Robaxin® NOT RECOMMENDED by Greater Manchester Medicines Management Group for prescribing in Primary Care
10.01.03 Methotrexate  Specialist initiation only

Methotrexate dose is weekly. To avoid errors it is recommended that:
• The patient is carefully advised of the dose and frequency and the reason for taking methotrexate and any other prescribed medicine (e.g. folic acid)
• The prescription and the dispensing label clearly show the dose and frequency of administration
• The patient is warned to report immediately the onset of any feature of blood disorders (eg. sore throat, bruising and mouth ulcers), liver toxicity (e.g. nausea, vomiting, abdominal discomfort and dark urine), and respiratory effects (e.g. shortness of breath)
• NPSA patient safety alert 13 advises that only 2.5mg tablets should be prescribed to reduce risk of overdosage with 10mg tablets
01.05.03 Methotrexate Injection Metoject® GI specialist only
Unlicensed Indication
Methotrexate dose is weekly. To avoid errors it is recommended that:
• The patient is carefully advised of the dose and frequency and the reason for taking methotrexate and any other prescribed medicine (e.g. folic acid)
• The prescription and the dispensing label clearly show the dose and frequency of administration
• The patient is warned to report immediately the onset of any feature of blood disorders (eg. sore throat, bruising and mouth ulcers), liver toxicity (e.g. nausea, vomiting, abdominal discomfort and dark urine), and respiratory effects (e.g. shortness of breath)(BNF)
10.01.03 Methotrexate Injection Metoject® Specialist use only

Methotrexate dose is weekly. To avoid errors it is recommended that:
• The patient is carefully advised of the dose and frequency and the reason for taking methotrexate and any other prescribed medicine (e.g. folic acid)
• The prescription and the dispensing label clearly show the dose and frequency of administration
• The patient is warned to report immediately the onset of any feature of blood disorders (eg. sore throat, bruising and mouth ulcers), liver toxicity (e.g. nausea, vomiting, abdominal discomfort and dark urine), and respiratory effects (e.g. shortness of breath)
07.01 Methotrexate Intramuscular Injection  For Ectopic pregnancy only

Unlicensed Indication
Although this use is common in UK clinical practice, at the time of publication of NICE Guidance(December 2012), methotrexate did not have UK marketing authorisation for this indication. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. (NICE)


• The patient is warned to report immediately the onset of any feature of blood disorders (eg. sore throat, bruising and mouth ulcers), liver toxicity (e.g. nausea, vomiting, abdominal discomfort and dark urine), and respiratory effects (e.g. shortness of breath)
01.05.03 Methotrexate Tablets  GI specialist only
Unlicensed Indication
Methotrexate dose is weekly. To avoid errors it is recommended that:
• The patient is carefully advised of the dose and frequency and the reason for taking methotrexate and any other prescribed medicine (e.g. folic acid)
• The prescription and the dispensing label clearly show the dose and frequency of administration
• The patient is warned to report immediately the onset of any feature of blood disorders (eg. sore throat, bruising and mouth ulcers), liver toxicity (e.g. nausea, vomiting, abdominal discomfort and dark urine), and respiratory effects (e.g. shortness of breath)
(BNF)
• NPSA patient safety alert 13 advises that only 2.5mg tablets should be prescribed to reduce risk of overdosage with 10mg tablets
13.05.03 Methotrexate Tablets  Consultant Dermatologist initiation only


Methotrexate dose is weekly. To avoid errors it is recommended that:
• The patient is carefully advised of the dose and frequency and the reason for taking methotrexate and any other prescribed medicine (e.g. folic acid)
• The prescription and the dispensing label clearly show the dose and frequency of administration
• The patient is warned to report immediately the onset of any feature of blood disorders (eg. sore throat, bruising and mouth ulcers), liver toxicity (e.g. nausea, vomiting, abdominal discomfort and dark urine), and respiratory effects (e.g. shortness of breath)
(BNF)
• NPSA patient safety alert 13 advises that only 2.5mg tablets should be prescribed to reduce risk of overdosage with 10mg tablets
02.05.02 Methyldopa  For use in pregnancy
01.06.06 Methylnaltrexone Relistor® Methylnaltrexone is a peripherally acting opioid-receptor antagonist that is licensed for the treatment of opioid-induced constipation in patients receiving palliative care, when response to other laxatives is inadequate; it should be used as an adjunct to existing laxative therapy.
04.04 Methylphenidate Hydrochloride Equasym® XL Amber Drug for adults and children once patient stabilised (> 3 months)
04.04 Methylphenidate Hydrochloride  Amber Drug for adults and children once patient stabilised (> 3 months)
04.04 Methylphenidate Hydrochloride Concerta® XL Amber Drug for adults and children once patient stabilised (> 3 months)
06.03.02 Methylprednisolone Solu-Medrone®
06.03.02 Methylprednisolone Depo-Medrone®
10.01.02.02 Methylprednisolone Acetate Depo-Medrone®
10.01.02.02 Methylprednisolone Acetate Depo-Medrone® with Lidocaine
10.01.02.01 Methylprednisolone IV 
18 Methylthioninum Chloride 5mg/ml Injection Proveblue® Note that alternative Blue Marker Aguettant® 1% Methylthioninum Chloride solution is not licensed for this indication and is used within the Trust as a marker dye
01.02 Metoclopramide  except for the following patient groups:
•Age <20
•Elderly
•Weight <60KG
•Parkinson's Disease
(GMMMG)
04.06 Metoclopramide Hydrochloride  except for the following patient groups:
•Age <20
•Elderly
•Weight <60KG
•Parkinson's Disease
(GMMMG)
02.02.01 Metolazone  Specialist initiation/recommendation only

Unlicensed
05.04.02 Metronidazole 
05.04.03 Metronidazole 
05.04.04 Metronidazole 
13.06 Metronidazole 0.75% Rozex® Available as:
- Gel
- Cream

For rosacea only
13.10.01.02 Metronidazole 0.75% Anabact® Malodorous fungating tumours and malodorous gravitational and decubitus ulcers

13.10.01.02 Metronidazole 0.75% Gel Metrogel® Malodorous fungating tumours and malodorous gravitational and decubitus ulcers
07.02.02 Metronidazole 0.75% Vaginal Gel Zidoval®
06.07.03 Metyrapone Metopirone Metyrapone is used for Cushing’s syndrome, often in a lower dose combination with aminoglutethamide to reduce side effects. (GMMMG)
05.02.04 Micafungin 
13.10.02 Miconazole Nitrate 2% Cream 
12.03.02 Miconazole oral gel 24mg/ml Daktarin®
15.01.04.01 Midazolam  Available as:
- Injection
- Oral Solution (RESTRICTED for Paediatric Use Only)
04.08.02 Midazolam Oromucosal Solution Buccolam® Paediatric use only

Buccolam is preferred to other formulations e.g epistatus , which are unlicensed and may have different doses
02.07.02 Midodrine  Consultant Initiation Only
07.01.02 Mifepristone Mifegyne® Mifepristone, an antiprogestogenic steroid, sensitises the myometrium to prostaglandin-induced contractions and ripens the cervix. For termination of pregnancy, a single dose of mifepristone is followed by administration of a prostaglandin (gemeprost or misoprostol [unlicensed]). Guidelines of the Royal College of Obstetricians and Gynaecologists (November 2011) include the following [unlicensed] regimens for inducing medical abortion:

- For gestation up to 49 days, mifepristone 200 mg by mouth followed 24–48 hours later by misoprostol 400 micrograms by mouth

- For gestation at 50–63 days, mifepristone 200 mg by mouth followed 24–48 hours later by misoprostol 800 micrograms vaginally, buccally, or sublingually; if abortion has not occurred 4 hours after misoprostol dose, a further dose of misoprostol 400 micrograms may be given vaginally or by mouth

- For gestation between 9 and 13 weeks, mifepristone 200 mg by mouth followed 36–48 hours later by misoprostol 800 micrograms vaginally, followed if necessary by a maximum of 4 further doses at 3-hourly intervals of misoprostol 400 micrograms vaginally or by mouth

- For gestation between 13 and 24 weeks, mifepristone 200 mg by mouth followed 36–48 hours later by misoprostol 800 micrograms vaginally, followed if necessary by a maximum of 4 further doses at 3-hourly intervals of misoprostol 400 micrograms vaginally or by mouth; if abortion has not occurred 3 hours after the last dose of misoprostol, a further dose of mifepristone may be given, and misoprostol may be recommenced 12 hours later
(BNF)
07.04.02 Mirabegron m/r Tablets Betmiga® Mirabegron is approved as an option only for people in whom antimuscarinic drugs are contra indicated or clinically ineffective or have unacceptable side effects. (D&T Committee)
04.03.04 Mirtazapine 
07.01.01 Misoprostol Cytotec® Unlicensed Indication
08.01.02 Mitomycin Mitomycin C Kyowa® Available as bladder instillation
15.01.05 Mivacurium Chloride Mivacron®
04.04 Modafinil Provigil® Amber Drug for Sleepiness associated with narcolepsy

Red Drug for Postural Hypotension, excessive sleepiness associated with sleep apnoea or shift work disorder (unlicensed) and Idiopathic hypersomnia

Red Drug in paediatric patients

EMEA Guidance August 2010 advised restricting the use of modafinil to the above indication and that all others listed (Postural Hypotension, Excessive sleepiness associated with sleep apnoea or Shift work Disorder and Idiopathic Hypersomnia) should be removed from the product literature.

13.04 Mometasone Furoate 0.1% Cream Elocon®
13.04 Mometasone Furoate 0.1% Ointment Elocon®
12.02.01 Mometasone Furoate nasal spray   Alternative in adults > 16 years old
12.02.01 Mometasone Furoate nasal spray  First choice in children < 16 years old
03.03.02 Montelukast 10mg tablets Singulair® Consider for asthmatic patients with concomitant allergic rhinitis
03.03.02 Montelukast 4mg Granules Singulair® First Choice for Paediatric patients aged 6months-6 years

The Scottish Medicines Consortium has advised (June 2007) that Singulair® chewable tablets and granules are restricted for use as an alternative to low-dose inhaled corticosteroids for children 2–14 years with mild persistent asthma who have not recently had serious asthma attacks that required oral corticosteroid use and who are not capable of using inhaled corticosteroids; Singulair® chewable tablets and granules should be initiated by a specialist in paediatric asthma. (BNF)

Granules may be swallowed or mixed with cold food (but not fluid) and taken immediately (BNF)
03.03.02 Montelukast 5mg ChewableTablets Singulair® First Choice for Paediatric patients aged 6-15 years

The Scottish Medicines Consortium has advised (June 2007) that Singulair® chewable tablets and granules are restricted for use as an alternative to low-dose inhaled corticosteroids for children 2–14 years with mild persistent asthma who have not recently had serious asthma attacks that required oral corticosteroid use and who are not capable of using inhaled corticosteroids; Singulair® chewable tablets and granules should be initiated by a specialist in paediatric asthma. (BNF)

04.07.02 Morphine Salts Oramorph® Oral solution 1st choice short acting strong opiate

Available as:
- 10mg/5ml oral solution
- 20mg/ml concentrated oral solution
04.07.02 Morphine Salts Sevredol® Tablets Immediate Release tablets
04.07.02 Morphine Salts MXL® m/r capsules 24 hourly preparation
04.07.02 Morphine Salts Zomorph® m/r capsules 1st choice long acting strong opiate

12 hourly preparation
04.07.02 Morphine Salts MST Continus® m/r tablets 12 hourly preparation
04.07.02 Morphine Sulphate 100mg/50ml Pre-filled Syringe 
04.07.02 Morphine Sulphate Injection 
12.03.04 Mouthwash Solution-tablets  Mouthwash solution tablets may contain ingredients such as thymol
(BNF)
02.05.02 Moxonidine  Specialist Initiation Only
09.06.07 Multivitamin preparations Dalivit® drops
13.10.01.01 Mupirocin 2% Bactroban® Available as:
- Cream
- Ointment

Mupirocin - limit to use for MRSA to avoid resistance
12.02.03 Mupirocin 2% in White Soft Paraffin ointment Bactroban Nasal® reserve for MRSA only to avoid resistance developing
08.02.01 Mycophenolate Mofetil CellCept® Bioavailability
Different formulations of the same immunosuppressant may vary in bioavailability and to avoid reduced effect or excessive side-effects, it is important not to change formulation except on the advice of a transplant specialist.
13.05.03 Mycophenolate Mofetil CellCept® Unlicensed indication

Specialist initiation only for Severe refractory eczema (GMMMG)

Bioavailability
Different formulations of the same immunosuppressant may vary in bioavailability and to avoid reduced effect or excessive side-effects, it is important not to change formulation except on the advice of a transplant specialist.
(BNF)
02.06.04 Naftidrofuryl Oxalate 
01.06.06 Naloxegol Moventig Available as tablets
For treating opioid induced constipation in adults whose constipation has not adequately responded to laxatives per NICE TA345
15.01.07 Naloxone Hydrochloride Naloxone®
18 Naloxone Injection 
04.10.03 Naltrexone 50mg Tablets 
04.10.01 Naltrexone Hydrochloride  Specialist Use by alcohol dependency services only

Use for alcohol disorders is unlicensed. Recommended in NICE guidance for max 6 months duration. To remain under specialist community alcohol teams. For this indication Naltrexone is classified as a Red Drug.
04.10.03 Naltrexone Suspension  Approved for intractable pruritis in liver disease for exceptional use only, as recommended by supra-regional liver unit only.
Only approved for prescribing by Dr A Massarano.
10.01.01 Naproxen  First Choice for musculoskeletal pain in A&E
06.01.02.03 Nateglinide Starlix® First Choice insulin secretagogue

Recommended: 60mg three times a day within 30 minutes of food. Can be adjusted up to 180mg three times a day.

Nateglinide is only licensed for use in combination with metformin. Cautioned in moderate hepatic impairment
(GMMMG)
02.04 Nebivolol Nebilet® Consultant Cardiologist Use only
12.02 NeilMed Isotonic Sinus Rinse  
10.02.01 Neostigmine 
15.01.06 Neostigmine Metilsulfate with Glycopyrronium 
05.03.01 Nevirapine Viramune® Potentially life-threatening hepatotoxicity including fatal fulminant hepatitis reported usually in first 6 weeks; discontinue permanently if abnormalities in LFTs accompanied by hypersensitivity reaction.
Suspend if severe abnormalities in liver function tests but no hypersensitivity reaction—discontinue permanently if significant liver function abnormalities recur; monitor patient closely if mild to moderate abnormalities in liver function tests with no hypersensitivity reaction

Rash, usually in first 6 weeks, is most common side-effect; incidence reduced if introduced at low dose and dose increased after 14 days; monitor closely for skin reactions during first 18 weeks. Discontinue permanently if severe rash or if rash accompanied by blistering, oral lesions, conjunctivitis, facial oedema, general malaise or hypersensitivity reactions; if rash mild or moderate may continue without interruption but dose should not be increased until rash resolves.

Counselling
Patients should be told how to recognise hypersensitivity reactions and advised to discontinue treatment and seek immediate medical attention if severe skin reaction, hypersensitivity reactions, or symptoms of hepatitis develop. (BNF)

02.06.03 Nicorandil 
04.10.02 Nicotine Gum Nicorette® Available as:
- 2mg
- 4mg
04.10.02 Nicotine Inhalator 15 mg/cartridge Nicorette®
04.10.02 Nicotine Nasal spray Nicorette®
04.10.02 Nicotine Oral spray Nicorette Quickmist® mouthspray
04.10.02 Nicotine Patches Nicorette® Invisi patches 16 hour patch
04.10.02 Nicotine Patches Nicotinell® 24 hour patch
04.10.02 Nicotine Patches NiQuitin® CQ 24 hour patch
04.10.02 Nicotine Tablets Nicorette Microtab®
02.06.02 Nifedipine Capsules 
02.06.02 Nifedipine modified release tablets/capsules 
08.01.05 Nilotinib Tasigna®
02.07.02 Noradrenaline Acid Tartrate / Norepinephrine Bitartrate Noradrenaline/Norepinephrine
06.04.01.02 Norethisterone  Unlicensed for use as HRT
14.05.01 Normal immunoglobulin  Privigen® 10% First Choice for new initiation
14.05.01 Normal immunoglobulin Flebogamma® DIF
14.05.01 Normal immunoglobulin Octagam® 10%
14.05.01 Normal immunoglobulin Vigam®
06.01.05 Nortriptyline Allegron® Unlcensed Indication

Useful if the patient gains benefit with amitriptyline but experiences side/adverse effects
(GMMMG)
09.03 NuTRIflex Lipid Peri®  Available for emergency use out of hours.

If used in this situation, Pabrinex IV (1 pair of injections) daily in 100mL of sodium chloride 0.9% or 5% glucose over 30 minutes should also be given (Unlicensed indication). Facilities for treating anaphylaxis should be available. Give the Pabrinex before or during the Parenteral Nutrition infusion.
09.03 NuTRIflex Lipid Plus® (electrolyte free)  For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
12.03.02 Nystatin oral suspension 100,000 units per ml. Nystan® Normal dose: 1ml four times a day
01.09 Obeticholic acid tablets Ocaliva

GI specialist Initiation Only

Recommended as an option for treating primary biliary cholangitis in combination with ursodeoxycholic acid for people whose disease has responded inadequately to ursodeoxycholic acid.

Recommended only if the company provided the discount agreed in the patient access scheme.

17 Octenisan® 
13.10.01.01 Octenisan® Wash  For MRSA eradication
08.03.04.03 Octreotide  Amber Drug for all licensed indications

Red Drug for all unlicensed indications

Octreotide injection is licensed for acromegaly and symptoms associated with carcinoid syndrome and neuroendocrine tumours. It is also used in hospital to manage high output stomas after surgery and in the palliative care setting as a subcutaneous infusion to reduce intestinal secretions and to reduce vomiting due to bowel obstruction (unlicensed use). (GMMMG)
06.04.01.01 Oesrogens for HRT Premique® Low Dose Continuous combined therapy – for women with a uterus

Conjugated oestrogen 300micrograms + medroxyprogesterone acetate 1.5mg

1 prescription charge
06.04.01.01 Oesrogens for HRT Premique® Continuous combined therapy – for women with a uterus

Conjugated oestrogen 625micrograms + medroxyprogesterone acetate 5mg

1 prescription charge
06.04.01.01 Oesrogens for HRT Prempak-C® Sequential combined therapy – for women with a uterus

Available as:
- Conjugated oestrogens 625micrograms + norgestrel 150micrograms
- Conjugated oestrogens 1.25mg + norgestrel 150micrograms

2 prescription charges
06.04.01.01 Oesrogens for HRT Elleste-Solo® MX Patches Unopposed oestrogen – for women without a uterus

Available as:
- Estradiol 40micrograms
- Estradiol 80micrograms

1 prescription charge
06.04.01.01 Oesrogens for HRT Femoston® Sequential combined therapy – for women with a uterus

Available as:
- Estradiol 1mg + dydrogesterone 10mg
- Estradiol 2mg + dydrogesterone 10mg

2 prescription charges
06.04.01.01 Oesrogens for HRT Kliofem® Continuous combined therapy – for women with a uterus

Estradiol 2mg + norethisterone acetate 1mg

1 prescription charge
06.04.01.01 Oesrogens for HRT Premarin® Unopposed oestrogen – for women without a uterus

Available as:
- Conjugated oestrogen 300micrograms
- Conjugated oestrogen 625micrograms
- Conjugated oestrogen 1.25mg

1 prescription charge
06.04.01.01 Oestrogens for HRT Elleste-Solo® Unopposed oestrogen – for women without a uterus

Available as:
- estradiol 1 mg
- estradiol 2 mg

1mg licensed for menopausal symptoms only, 2mg licensed for menopausal symptoms and osteoporosis prophylaxis

1 prescription charge
06.04.01.01 Oestrogens for HRT Kliovance® Continuous combined therapy – for women with a uterus

Estradiol 1mg + norethisterone acetate 500micrograms

1 prescription charge
06.04.01.01 Oestrogens for HRT Evorel® Sequi Patch Sequential combined therapy – for women with a uterus

Estradiol 50micrograms + norethisterone acetate 170micrograms

2 prescription charges
06.04.01.01 Oestrogens for HRT Elleste-Duet® Sequential combined therapy – for women with a uterus

Available as:
- Estradiol 1mg + norethisterone 1mg
- Estradiol 2mg + norethisterone 1mg

2 prescription charges
06.04.01.01 Oestrogens for HRT Evorel Conti®Patches Continuous combined therapy – for women with a uterus

Estradiol 50micrograms/24 hours + norethisterone acetate 170micrograms/24hours

1 prescription charge
06.04.01.01 Oestrogens for HRT  Evorel® Patches Unopposed oestrogen – for women without a uterus

Available as:
- Estradiol 25micrograms
- Estradiol 50micrograms
- Estradiol 75micrograms
- Estradiol 100micrograms

1 prescription charge
06.04.01.01 Oestrogens for HRT  Femoston Conti® Continuous combined therapy – for women with a uterus

Estradiol 1mg + dydrogesterone 5mg

1 prescription charge
11.03.01 Ofloxacin 0.3% eye drops Exocin® Opthalmic Consultant use only for initial treatment of microbial keratitis

Quinolones must not be used for more than 10 days as resistance rapidly develops. (GMMMG)
13.02.01 Oilatum® Cream 
13.02.01.01 Oilatum® Plus Bath Additive 
01.07.03 Oily phenol injection BP 
04.02.01 Olanzapine Zyprexa® Available as:
- Tablets
- Orodispersible Tablets

AMBER status for all licensed indications and also unlicensed when recommeneded by NICE

RED status in dementia (for new patients only).
12.01.03 Olive Oil ear drops 
03.04.02 Omalizumab Xolair® Respiratory consultants only
02.12 Omega-3-Acid Ethyl Esters Omacor® Following specialist initiation only.

Should only be prescribed for the treatment on hypertriglyceridaemia under the care of a lipid management specialist.

On GMMMG Grey lisy
01.03.05 Omeprazole  Not for use in conjunction with Clopidogrel.
01.03.05 Omeprazole Dispersible Tablets Losec MUPS ® Second choice for patients with dysphagia or feeding tubes only.

Not for use in conjunction with Clopidogrel.

01.03.05 Omeprazole IV  For use in Paediatrics Only
17 Omnipaque 140 
17 Omnipaque 240 
17 Omnipaque 300  Available as:
- 100ml
- 50ml
17 Omnipaque 300 (Intravascular) 
17 Omnipaque 350 
04.06 Ondansetron  Red Drug Post op and following chemotherapy

Green Drug For exceptional use in non oncology patients with chronic emesis following consultant recommendation and where all other options have failed.
04.06 Ondansetron Oral lyophilisates Zofran® Melt Red Drug Post op and following chemotherapy

Green Drug For exceptional use in non oncology patients with chronic emesis following consultant recommendation and where all other options have failed.

Tablets should be placed on the tongue, allowed to disperse and swallowed


17 Optiray 300 Pre-filled Syringe 
12.03.01 Oral Gel Gelclair® Used for treatment of post chemotherapy mucositis
07.03.02.01 Oral Progestogen-Only Contraceptives Cerazette® Cerazette® should be restricted to use in
patients who cannot tolerate oestrogen
containing contraceptives or in whom these
preparations are contra-indicated. (GMMMG)
07.03.02.01 Oral Progestogen-Only Contraceptives Micronor®
07.03.02.01 Oral Progestogen-Only Contraceptives Noriday®
09.02.01.02 Oral Rehydration Salts Dioralyte® May be substituted with Electrolade® if Dioralyte® unavailable
09.02.01.02 Oral Rehydration Salts Electrolade® May be substituted with Dioralyte® if Electrolade® unavailable
04.05.01 Orlistat Xenical®
04.09.02 Orphenadrine Hydrochloride 
05.03.04 Oseltamivir Tamiflu®

Available as

- Capsules

- Suspension (if child under one year of age)

 

12.01.01 Otocomb Otic® Ointment   Replaces discontinued product TriAdcortyl Otic

5g tube contains:
Triamcinolone Acetonide 1mg/g
Gramicidin 0.25mg/g
Neomycin Base (as sulphate) 2.5mg/g
Nystatin in Plastibase 100,000units/g
04.08.01 Oxcarbazepine Trileptal®
11.07 Oxybuprocaine 0.4% Hydrochloride SDU Minims® preservative free

Useful for application of diagnostic lenses or suture removal.(GMMMG)
07.04.02 Oxybutynin 3.9mg/24 hours patches Kentera Can be used as an alternative in women unable to tolerate oral medication
07.04.02 Oxybutynin Hydrochloride  Should not be used in the frail elderly
07.04.02 Oxybutynin Hydrochloride m/r Lyrinel® XL
04.07.02 Oxycodone Hydrochloride OxyNorm® Available as:
- tablets
- injection
- 5mg/5ml oral solution (1st choice short acting strong opiate post hip and knee replacement (short term use only))
- 10mg/ml concentrated oral solution
04.07.02 Oxycodone Hydrochloride m/r OxyContin® 1st choice long acting strong opiate post hip and knee replacement (short term use only)
07.01.01 Oxytocin Syntocinon®
05.03.05 Palivizumab Synagis® Injection
Restricted for respiratory syncytial virus (RSV) in paediatrics and in accordance with the Joint Committee on Vaccination and Immunisation.
From the winter season 2015/2016, all use requires prior approval registration via Blueteq.
Screening pharmacist to confirm authorisation is in place before treatment is given.
Contact the pharmacy for setting up access to Blueteq.
01.09.04 Pancreatin Creon® 10000
01.09.04 Pancreatin Creon® 25000
01.09.04 Pancreatin Creon® 40000
01.09.04 Pancreatin Creon® Micro
08.01.05 Panobinostat Capsules Farydak Available as capsules
01.03.05 Pantoprazole IV Protium®
04.07.01 Paracetamol  Available as:
- tablets
- effervescent tablets (500mg)
- sugar free suspension (120mg/5ml and 250mg/5ml)
- intravenous infusion (1g/100ml ang 500mg/50ml)
- suppositories (60mg, 120mg, 240mg, 500mg and 1g)

Note:
Some patients may be at increased risk of experiencing toxicity at therapeutic doses, particularly those with a body-weight under 50kg and those with risk factors for hepatotoxicity.
Clinical judgement should be used to adjust the dose of oral and intravenousparacetamol in these patients.
Co-administration of enzyme-inducing antiepileptic medications may increase toxicity; doses should be reduced.
(BNF)
04.07.01 Paracetamol 500mg/5ml suspension  Unlicensed
For use in palliative care only
04.07.01 Paracetamol and codeine Co-codamol 8/500 Available as:
- tablets
- effervescent tablets
04.07.01 Paracetamol and codeine Co-codamol 30/500 Available as:
- tablets
- effervescent tablets
04.07.01 Paracetamol and dihydrocodeine tablets Co-dydramol 10/500 More than one strength available, therefore must be prescribed by strength. (MHRA Jan 2018)
04.08.02 Paraldehyde in Olive Oil 50% v/v Enema  Paediatric Use only
15.01.04.02 Parecoxib Dynastat®
04.03.03 Paroxetine  Available as:
- Tablets
- Sugar free suspension
17 Patent Blue Injection 2.5% 
03.01.05 Peak Flow Meter Vitalograph® Standard
09.01.06 Pegfilgrastim Neulasta® May be initiated by haematology specialists where a single-dose GCSF is considered appropriate
09.08.01 Penicillamine 125mg tablets  aids elimination of copper ions
10.01.03 Penicillamine Tablets  Specialist Initiation Only
07.04.03 Pentosan polysulfate  Unlicensed

Consultant urologist only
20 Pentosan polysulfate  Consultant urologist only

Unlicensed
08.01.05 Pentostatin Nipent® Consultant Haematologist prescribing only
01.02 Peppermint Oil 0.2ml e/c Capsules Mintec®
01.02 Peppermint Water BP 
01.01.02 Peptac 
04.09.01 Pergolide Tablets  Green Drug (following specialist initiation)
02.05.05.01 Perindopril Erbumine  Note: Perindopril Arginine is not dose equivalent and is not included in the formulary
13.10.04 Permethrin 5% Lyclear® Dermal Cream For Scabies
04.07.02 Pethidine Hydrochloride Injection  1st choice in maternity and for use with PEG tube insertion
02.08.02 Phenindione Tablets  For patients intolerant to Warfarin and Acenocoumarol only.
04.08.01 Phenobarbital  for paediatric use

Available as:
- Tablets
- 15mg/5ml Elixir (Contanis Alcohol 38%)
- 50mg/5ml Elixir (Alcohol Free)
- 15mg/ml, 60mg/ml and 200mg/ml Injection
02.05.04 Phenoxybenzamine Hydrochloride Dibenyline® Consultant only
02.05.04 Phentolamine Messilate Rogitine® Consultant only
02.07.02 Phenylephrine Hydrochloride 10mg/ml Injection  Hypertensive response: Phenylephrine has a longer duration of action than noradrenaline, and an excessive vasopressor response may cause a prolonged rise in blood pressure.
11.05 Phenylephrine Hydrochloride SDU Minims® Phenylephrine Hydrochloride Available as:
- 2.5%
- 10%

A drop of topical anaesthetic may be applied to the eye a few minutes before using phenylephrine to prevent stinging. (BNF)

04.08.01 Phenytoin Chewable Tablets 
04.08.01 Phenytoin Sodium Flynn Hard Capsules 
04.08.02 Phenytoin Sodium Injection  Flush intravenous line with Sodium chloride 0.9% before and after infusion.

Dilute in sodium chloride 0.9% to a maximum concentration of 10 mg per ml. (i.e. dilute 1g in a minimum of 100mls; doses over 1g can be diluted in 250ml).

Start the infusion immediately after dilution (note: stability of the solution is limited and precipitates may form).

Administer into a large vein through an in-line filter (0.22–0.50 micron) at a rate not exceeding 1mg/kg/min (maximum 50 mg/minute). Complete administration within 1 hour of preparation

Monitor the injection site closely using a recognised infusion phlebitis scoring tool.

(Injectable medicines guide)
04.08.01 Phenytoin Suspension  Contains phenytoin base therefore care is needed when changing to capsules or tablets containing phenytoin sodium (BNF)

Available as:
- 30mg/5ml (Epanutin®)
- 90mg/5ml (Unlicensed preparation)
09.05.02.01 Phosphate supplements Phosphate-Sandoz® effervescent tabs (16mmol/tablet)
01.06.04 Phosphates (Rectal) Fletchers' Phosphate Enema, Fleet Ready to use Enema
09.05.02.01 Phosphates Intravenous infusion 100mmol/L (500ml Polyfusor)  Contains PO43- 100 mmol, K+ 19 mmol, and Na+ 162 mmol/litre
09.06.06 Phytomenadione 1mg Capsules NeoKay® The contents of one capsule should be administered by cutting the narrow tubular tip off and squeezing the liquid contents into the mouth; if the baby spits out the dose or is sick within three hours of administration a replacement dose should be given
(BNF)
09.06.06 Phytomenadione Injection 10mg/ml Konakion® MM only licensed for IV use. However, it has been orally used during shortages of menadiol (off licence).
09.06.06 Phytomenadione Paediatric injection 2mg/0.2ml Konakion® MM Paediatric may be administered orally, by intramuscular or by intravenous injection
01.06.05 Picolax® Oral Powder 
11.06 Pilocarpine 2% SDU Minims® Pilocarpine Nitrate Preservative free
11.06 Pilocarpine Eye Drops  Available as:
- 1%
- 2%
- 4%

06.01.02.03 Pioglitazone 


 

03.11 Pirfenidone Esbriet 267mg capsules
14.04 Pneumococcal polysaccharide conjugate vaccine (13-valent adsorbed) Prevenar 13® The 13-valent conjugate vaccine (Prevenar 13®) is used in the childhood immunisation schedule. The recommended schedule consists of 3 doses, the first at 2 months of age, the second at 4 months, and the third at 12–13 months (BNF)
14.04 Pneumococcal polysaccharide vaccine Pneumovax® II 23 valent preparation
13.07 Podophyllotoxin Warticon® Available as:
- 0.15% Cream
- 0.5% solution
13.10.01.01 Polymyxin B Sulphate 10,000 units with Bacitracin Zinc 500 units /g Polyfax® Ointment
09.02.01.01 Polystyrene Sulfonate Resins powder Calcium Resonium®
13.09 Polytar Plus® Liquid 
13.09 Polytar® Liquid 
11.08.01 Polyvinyl Alchohol 1.4% eye drops SnoTears®
11.08.01 Polyvinyl Alcohol 1.4% SDU Liquifilm Tears®
08.02.04 Pomalidomide Imnovid Available as Capsules
08.01.05 Ponatinib tablets 
03.05.02 Poractant Alfa Suspension Curosurf® Neonatal use only

Available as:
- 120mg/1.5ml vial
- 240mg/3ml vial
05.02.01 Posaconazole 

Consultant Microbiologist recommendation only

09.02.01.01 Potasium Chloride 600mg m/r Tablets (8mmol K+/tablet) Slow-K® Only for those unable to tolerate Sando-K® or Kay-Cee-L® Liquid.
09.02.01.01 Potasium Chloride effervescent tablets (12mmol K+/tablet) Sando-K®
09.02.01.01 Potasium Chloride syrup (1mmol K+/ml) Kay-Cee-L® Where oral solution preferred
09.02.02.01 Potassium Chloride 15% Concentrate (Sterile)  Ready prepared potassium solutions should be used routinely. Concentrated Potassium 15% ampoules are available only to specific areas.
09.02.02.01 Potassium Chloride 50mmol/50ml Syringe  Critical Care Only
09.02.02.01 Potassium Chloride and Glucose Intravenous Infusion 
09.02.02.01 Potassium Chloride and Sodium Chloride Intravenous Infusion 
09.02.02.01 Potassium Chloride, Sodium Chloride and Glucose Intravenous Infusion 
13.11.06 Potassium Permanganate 400mg solution tablets Permitabs® 1 tablet dissolved in 4 litres of water provides a 0.01% (1 in 10 000) solution (BNF)
13.11.04 Povidone-Iodine 2.5% Dry Powder Spray Betadine®
04.09.01 Pramipexole m/r Tablets Mirapexin® Prolonged Release Green Drug (following specialist initiation)

Important: Doses and strengths are stated in terms of pramipexole (base); equivalent strengths in terms of pramipexole dihydrochloride monohydrate (salt) are as follows:
260 micrograms base ≡ 375 micrograms salt;
520 micrograms base ≡ 750 micrograms salt;
1.05 mg base ≡ 1.5 mg salt;
1.57 mg base ≡ 2.25 mg salt;
2.1 mg base ≡ 3 mg salt;
2.62 mg base ≡ 3.75 mg salt;
3.15 mg base ≡ 4.5 mg salt
(BNF)
04.09.01 Pramipexole Tablets  Green Drug (following specialist initiation)

Important: Doses and strengths are stated in terms of pramipexole (base); equivalent strengths in terms of pramipexole dihydrochloride monohydrate (salt) are as follows:
88 micrograms base ≡ 125 micrograms salt;
180 micrograms base ≡ 250 micrograms salt;
350 micrograms base ≡ 500 micrograms salt;
700 micrograms base ≡ 1 mg salt
(BNF)

02.09 Prasugrel Efient® Specialist Initiation Only

Tablets 5mg, 10mg
02.12 Pravastatin Sodium  This is a lower intensity statin. This should be reserved for those patients unable to tolerate atorvastatin or simvastatin (NICE CG181)
11.04.01 Prednisolone 0.5% Ear/Eye Drops Predsol®
11.04.01 Prednisolone 0.5% Single Use Eye Drops Minims® Prednisolone Sodium Phosphate preservative free
11.04.01 Prednisolone 1% Eye Drops Pred Forte®
01.05.02 Prednisolone Foam Enema 
01.05.02 Prednisolone Retention Enema 
01.05.02 Prednisolone Soluble tablets 

To be prescribed for use as a mouthwash in oral surgery only (unlicensed indication)

01.05.02 Prednisolone Suppositories 
01.05.02 Prednisolone Tablets 


 Note enteric coated tablets are NON FORMULARY

06.03.02 Prednisolone Tablets 


 Note enteric coated tablets are NON FORMULARY

10.01.02.01 Prednisolone Tablets 


 Note enteric coated tablets are NON FORMULARY

10.02.01 Prednisolone Tablets  Note enteric coated tablets are NON FORMULARY
04.07.03 Pregabalin Lyrica® Pregabalin should only be prescribed if first choice options and subsequent gabapentin are contra-indicated, intolerant or ineffective. Regular review should assess ongoing effectiveness, stop if ineffective.

Pregabalin capsules cost the same amount per capsule regardless of which strength capsule is used. Reducing the frequency of administration of the required daily dose from three times a day to twice a day improves the cost effectiveness of treatment.
(GMMMG)
04.08.01 Pregabalin Lyrica® Pregabalin capsules cost the same amount per capsule regardless of which strength capsule is used. (GMMMG)
06.01.05 Pregabalin Lyrica® Pregabalin should only be prescribed if first choice options and subsequent gabapentin are contra-indicated, intolerant or ineffective. Regular review should assess ongoing effectiveness, stop if ineffective.

Pregabalin capsules cost the same amount per capsule regardless of which strength capsule is used. Reducing the frequency of administration of the required daily dose from three times a day to twice a day improves the cost effectiveness of treatment.
(GMMMG)
15.02 Prilocaine Hydrochloride 1% Injection Citanest®
15.02 Prilocaine Hydrochloride 3% with Felypressin Citanest 3% with Octapressin®
05.04.01 Primaquine 
05.04.08 Primaquine 
04.08.01 Primidone Mysoline®
17 Primovist Injection 
17 Probiotic Actimel® Obtain from kitchens
04.02.01 Prochlorperazine 
04.06 Prochlorperazine 
04.06 Prochlorperazine Buccastem® (Bucal preparation)
01.07.02 Proctosedyl® 
04.09.02 Procyclidine Hydrochloride 
18 Procyclidine Hydrochloride 
13.10.05 Proflavine Hemisulphate 0.1%, Yellow Beeswax 2.5%, Chlorocresol 0.1%, Liquid Paraffin 67.3%, Water 25%, Wool Fat 5% Proflavine Cream, BPC
06.04.01.02 Progesterone Cyclogest®
04.02.01 Promazine Hydrochloride Promazine®
04.06 Promethazine Hydrochloride 
02.03.02 Propafenone Hydrochloride Arthmol®
15.01.01 Propofol 
02.04 Propranolol Hydrochloride  For use in non-cardiovascular indications

Available as both immediate release and modified release preparations
04.07.04.02 Propranolol Hydrochloride  Available as both immediate and modified release products
06.02.02 Propylthiouracil  Green Drug following specialist initiation for Hyperthyroidism. See FDA warning re extra monitoring required. Prescribing to remain within specialist care until patient stable
02.08.03 Protamine Sulphate 
17 Prothrombin Complex Concentrate Octaplex® Blood Product. Obtain from laboratory.
06.05.01 Protirelin 
01.06.07 Prucalopride Resolor® GI Consultant Use only
NICE TA211: Prucalopride for constipation in women (December 2010)
Prucalopride is recommended for the treatment of chronic constipation in women for whom treatment with at least 2 laxatives from different classes, at the highest tolerated recommended doses for at least 6 months, has failed and invasive treatment is being considered.

Prucalopride should be prescribed only by clinicians experienced in the treatment of chronic constipation. Treatment should be reviewed if prucalopride is not effective after 4 weeks
10.02.01 Pyridostigmine Bromide Mestinon®
09.06.02 Pyridoxine Hydrochloride (vitamin B6)  Pyridoxine Available as:
- 10mg tablets
- 50mg tablets
04.02.01 Quetiapine Seroquel® AMBER status for all licensed indications and also unlicensed when recommeneded by NICE

RED status in dementia (for new patients only).
04.02.01 Quetiapine m/r Seroquel® XL MR formulation is restricted for use as adjunct in depression only.

AMBER status for all licensed indications and also unlicensed when recommeneded by NICE

RED status in dementia (for new patients only).

06.07.01 Quinagolide Norprolac® Specialist initiation only
05.04.01 Quinine Dihydrochloride 

10.02.02 Quinine sulphate 
13.02.01 QV® Cream 
06.04.01.01 Raloxifene Hydrochloride Evisa®
05.03.01 Raltegravir Isentress ® Rash
Rash occurs commonly. Discontinue if severe rash or rash accompanied by fever, malaise, arthralgia, myalgia, blistering, mouth ulceration, conjunctivitis, angioedema, hepatitis, or eosinophilia. (BNF)

02.05.05.01 Ramipril capsules 
01.03.01 Ranitidine Liquid  For Paediatric use only

For adults please refer to Lansoprazole Orodispersible Tablets
01.03.01 Ranitidine Tablets 
02.06.03 Ranolazine Ranexa® Cardiologist Initiation only
04.09.01 Rasagiline Azilect® Specialist initiation only
15.01.04.03 Remifentanil Injection Ultiva®
06.01.02.03 Repaglinide Prandin® Second Choice insulin secretagogue

Recommended: initially 500 microgram dose, within 30 minutes of meal (1mg dose if transferring from another oral hypoglycaemic agent). Adjust dose at 1-2 week intervals depending on response, up to maximum of 4mg as a single dose. Maximum licensed total daily dose is 16mg daily.

Repaglinide can be given as monotherapy or in combination with metformin. It should be avoided in patients >75 years old and in patients with severe liver disease.(GMMMG)
05.01.07 RIfaximin 550mg tablets  Reduction in occurrence of Hepatic Encephalopathy
For use following specialist initiation only
04.09.03 Riluzole Rilutek® For use in line with NICE guidance
11.04.01 Rimexolone 1% Eye Drops Vexol®
06.06.02 Risedronate 
04.02.01 Risperidone  Available as:
- Tablets
- Orodispersible Tablets
- Liquid

Note 4mg and 6mg tablets more expensive than using combination of lower strength tablets (GMMMG)


AMBER status for all licensed indications and also unlicensed when recommeneded by NICE

RED status in dementia (for new patients only).

Risperidone is the only licensed antipsychotic, with moderate evidence base for aggression and should therefore be the first line choice. It should only be used in people with dementia who have pre-existing psychotic disorders or severe aggression. The lowest dose for the shortest time period should be used; it is licensed for 6 weeks use and should be prescribed for no more than 12 weeks.

(GMMMG November 2015)
04.02.02 Risperidone Risperdal Consta®
05.03.01 Ritonavir Norvir® Pancreatitis
Signs and symptoms suggestive of pancreatitis (including raised serum lipase) should be evaluated—discontinue if pancreatitis diagnosed. (BNF)

08.02.03 Rituximab MabThera® Specialist use only
Causes lysis of B lymphocytes
10.01.03 Rituximab MabThera® Specialist use only
02.08.02 Rivaroxaban Tablets Xarelto®
04.11 Rivastigmine Exelon®
15.01.05 Rocuronium Bromide 
03.03.03 Roflumilast Daxas®
09.01.04 Romiplostim Nplate® Consultant haematologist use only
04.09.01 Ropinirole m/r tablets  Green Drug for both Parkinson's Disease (following specialist initiation) and restless legs.
04.09.01 Ropinirole Tablets  Green Drug for both Parkinson's Disease (following specialist initiation) and restless legs.
02.12 Rosuvastatin 

Available as an option for prescribing, as generic alternatives now available. Must be prescribed as generic option.

04.09.01 Rotigotine Patches Neupro® Green Drug (following specialist initiation)
08.01.05 Ruxolitinib Jakavi Consultant Recommendation Only.
Recommended as an option for treating disease-related splenomegaly or symptoms in adults with primary myelofibrosis (also known as chronic idiopathic myelofibrosis), post polycythaemia vera myelofibrosis or post essential thrombocythaemia myelofibrosis, only:
•in people with intermediate‑2 or high-risk disease, and
•if the company provides ruxolitinib with the discount agreed in the patient access scheme.
(NICE TA386, March 2016)
02.05.05 Sacubitril Valsartan Entresto® For initiation by a heart failure specialist only.

Available as:
24mg/26mg film coated tablets
49mg/51mg film coated tablets
97mg/103mg film coated tablets
Sacubitril valsartan is recommended as an option for treating symptomatic chronic heart failure with reduced ejection fraction, only in people:
•with New York Heart Association (NYHA) class II to IV symptoms and
•with a left ventricular ejection fraction of 35% or less and
•who are already taking a stable dose of angiotensin‑converting enzyme (ACE) inhibitors or angiotensin II receptor‑blockers (ARBs).

Treatment with sacubitril valsartan should be started by a heart failure specialist with access to a multidisciplinary heart failure team. Dose titration and monitoring should be performed by the most appropriate team member as defined in NICE’s guideline on chronic heart failure in adults: management.
This guidance is not intended to affect the position of patients whose treatment with sacubitril valsartan was started within the NHS before this guidance was published. Treatment of those patients may continue without change to whatever funding arrangements were in place for them before this guidance was published until they and their NHS clinician consider it appropriate to stop.
(NICE April 2016)
03.01.01.01 Salbutamol 100 micrograms/dose breath-actuated inhaler 

Airomir Autohaler

Salamol Easi-Breathe

03.01.01.01 Salbutamol 100 micrograms/dose CFC free inhaler 
03.01.01.01 Salbutamol 100microgram/dose dry powder inhaler 

Easyhaler

03.01.01.01 Salbutamol 200 micrograms/dose Accuhaler  Dry Powder for inhalation
03.01.01.01 Salbutamol IV Ventolin®

500 micrograms/1ml injection

07.01.03 Salbutamol IV Ventolin®
03.01.01.01 Salbutamol Nebuliser Solution  Where a nebulised product is required

Available as 2.5mg and 5mg
13.05.02 Salicylic Acid in White Soft Paraffin  Available in strengths of 10-20%
12.03.05 Salivix® 
03.01.01.01 Salmeterol 25 micrograms/dose MDI  Serevent®
03.01.01.01 Salmeterol 50 micrograms/dose Accuhaler 
09.05.01.01 Sandocal®  Contains calcium lactate gluconate 2.263g, calcium carbonate 1.75g, providing 1g calcium
10.01.03 Sarilumab solution for injection 

Specialist use only

06.01.02.03 Saxagliptin 


 

06.01.02.03 Saxagliptin with Metformin Komboglyze® Only to be prescribed if genuine issue
with adherence to therapy
13.09 SCC Sal Cap 
01.07.02 Scheriproct® 
14.04 Seasonal Influenza vaccine  Available for staff and antenatal use only
13.05.02 Sebco® Scalp ointment  May be used as a generic substitute for Cocois® Scalp ointment
13.09 Sebco® Scalp ointment  May be used as a generic substitute for Cocois® Scalp ointment
13.05.03 Secukinumab  Cosentyx® For consultant dermatologist and consultant rheumatologist use only


150mg solution for injection in a pre-filled syringe
150mg solution for injection in a pre-filled pen
04.09.01 Selegiline Hydrochloride 
01.06.02 Senna  Available as:
- Tablets
- Liquid
04.03.03 Sertraline Tablets 
09.05.02.02 Sevelamer 800mg tablets Renagel® For use by the Renal Unit Only
15.01.02 Sevoflurane  For use as per anaesthetist guidelines
13.09 Shampoos Selsun®
02.05.01 Sildenafil Revatio® Consultant Only - Pulmonary Hypertension
13.07 Silver Nitrate 75% applicators 
13.07 Silver Nitrate 95% applicators 
13.10.01.01 Silver Sulfadiazine Flamazine® for infected burns

7 day expiry once opened
03.09.02 Simple Linctus, BP 
02.12 Simvastatin 
06.01.02.03 Sitagliptin 


 

06.01.02.03 Sitagliptin with Metformin Janumet® Only to be prescribed if genuine issue
with adherence to therapy
09.03 SmofKabiven 12® (electrolyte free)  For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.03 SmofKabiven 16® (electrolyte free)  For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.03 SmofKabiven® 8 (electrolyte free)  For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
20 Sodium Acetate 40mmol/10ml inj  For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.08.01 Sodium Benzoate 200mg/ml Injection  Paediatric Specialist only
09.08.01 Sodium Benzoate Powder  Paediatric Specialist only
12.01.03 Sodium Bicarbonate 5% ear drops 
09.02.01.03 Sodium Bicarbonate 500mg Capsules 
09.02.02.01 Sodium Bicarbonate 500ml Polyfusor  Available as:
- 1.26%
- 1.4%
- 4.2%
09.02.01.03 Sodium Bicarbonate 600mg Tablets 
09.02.02.01 Sodium Bicarbonate 8.4% 200ml Polyfusor 
09.02.02.01 Sodium Bicarbonate 8.4% Injection  Available as:
- 10ml
- 50ml
09.02.02.01 Sodium Bicarbonate Injection Min-I-Jet® Sodium Bicarbonate Available as:
- 4.2% 10ml pre-filled syringe
- 8.4% 50ml pre-filled syringe
09.02.02.01 Sodium Chloride 0.18% with Glucose 10% Intravenous Infusion 500ml 
09.02.02.01 Sodium Chloride 0.18% with Glucose 4% Intravenous Infusion  Available as:
- 500ml bag
- 1L bag
09.02.02.01 Sodium Chloride 0.45% with Glucose 5% Intravenous Infusion 500ml 
09.02.02.01 Sodium Chloride 0.45% Intravenous Infusion 500ml 
09.02.02.01 Sodium Chloride 0.9% with Glucose 5% Intravenous Infusion 500ml 
09.02.02.01 Sodium Chloride 0.9% Epidural Injection 10ml 
09.02.02.01 Sodium Chloride 0.9% Injection  Available as:
- 5ml
- 10ml
- 20ml
09.02.02.01 Sodium Chloride 0.9% Intravenous Infusion  Available as:
- 1L bag
- 500ml bag
- 250ml bag
- 100ml bag
- 100ml Ecoflac Mix
- 50ml bag
- 50ml Ecoflac Mix
11.08.01 Sodium Chloride 0.9% SDU Minims® Saline
13.11.01 Sodium Chloride 0.9% Solution 
07.04.04 Sodium Chloride 0.9% Solution for Intravesical Use 
09.02.02.01 Sodium Chloride 30% Injection  Available as:
- 10ml
- 50ml
11.08.01 Sodium Chloride 5% Eye Drops  • Unlicensed preparation listed in the Drug Tariff section Part VIIIB.
• Prescribe as sodium chloride 5% preservative free eye drops 10ml.
• Used to reduce corneal oedema. Use may be short term following cataract surgery or long term in recurrent corneal erosions. (GMMMG)
09.02.01.02 Sodium Chloride MR tablets (10mmol Na+/tablet) Slow Sodium®
12.02.02 Sodium Chloride Nasal Drops 0.9%  Second Choice Nasal Decongestant
03.01.05 Sodium Chloride Nebuliser solution 0.9% 2.5ml 
09.02.01.02 Sodium Chloride Oral Solution  For Paediatric use only

Available as:
- 5mmol/ml
- 1mmol/ml
09.02.02.01 Sodium Chloride Polyfusor 500ml  Available as:
- 0.18%
- 1.8%
- 2.7%
- 5%
01.06.04 Sodium Citrate (Rectal) Relaxit® Micro-enema
11.04.02 Sodium Cromoglicate 2% eye drops  For allergic conjunctivitis
09.01.01.01 Sodium Feredetate liquid 190mg/5ml Sytron® First line for paediatric use only
07.04.04 Sodium Hyaluronate Hyacyst® For the treatment of interstitial cystitis. This is classed as a medical device.

This product should be used for all patients being newly initiated on a Sodium Hyaluronate bladder instillation.
07.04.04 Sodium Hyaluronate Bladder instillation Cystistat® A bladder instillation of Sodium hyaluronate (Cystistat®) is used for the treatment of interstitial cystitis. This is classed as a medical device. (GMMMG)

This product should only be used for continuation of treatment in patients already established on Cystistat®.
20 Sodium Hyaluronate Bladder instillation Cystistat® A bladder instillation of Sodium hyaluronate (Cystistat®) is used for the treatment of interstitial cystitis. This is classed as a medical device. (GMMMG)
18 Sodium nitrite Injection 3 % 
04.01.01 Sodium Oxybate Xyrem® Consultant recommendation only
02.13 Sodium Tetradecyl Sulphate Fibro-Vein®
18 Sodium Thiosulphate Injection 50% 
04.02.03 Sodium Valproate  Third choice antimanic drug

Available as:
- e/c tablets
- crushable tablets
- oral solution
- injection
- m/r tablets (Epilim Chrono®)
04.08.01 Sodium Valproate 

Valproate medicines MUST NOT be used in women of childbearing potential unless the Pregnancy Prevention Programme in in place.

 

Available as:
- e/c tablets
- crushable tablets
- oral solution
- injection

04.08.01 Sodium Valproate m/r Epilim® Chrono

Valproate medicines MUST NOT be used in women of childbearing potential unless the Pregnancy Prevention Programme in in place.

10.01.03 Soldium Aurothomalate Myocrisin® Specialist Initiation Only
07.04.02 Solifenacin Succinate Vesicare®
02.04 Sotalol Hydrochloride  Consultant use only
02.02.03 Spironolactone 
13.02.02 Sprilon® Spray application 
13.11.07 Sterile Larvae (Maggots) LarvE® Not supplied by Tameside Hospital Pharmacy Department
02.10.02 Streptokinase 
06.06.02 Strontium Ranelate Protelos® Specialist initiation only
01.03.03 Sucralfate Antepsin®
13.02.02 Sudocrem® Cream 
15.01.06 Sugammadex Bridion® 500mg/5ml solution for injection vials

Anesthetist use only
10.01.03 Sulfasalazine 
10.01.04 Sulfinpyrazone  Available as tablets
04.02.01 Sulpiride 
04.07.04.01 Sumatriptan Injection Imigran®
04.07.04.01 Sumatriptan Tablets  Oral route is first line
09.03 Supplementary Preparations Addiphos® Potassium and Phosphate solution for Critical care and for use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.03 Supplementary Preparations Additrace® For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.03 Supplementary Preparations Dipeptiven® For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only

Available as:
- 100ml
- 50ml
09.03 Supplementary Preparations Glycophos® Sterile Concentrate For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.03 Supplementary Preparations Peditrace® For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.03 Supplementary Preparations Solivito N® For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.03 Supplementary Preparations Vitlipid N® For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only

Available as Adult and Infant prearations
15.01.05 Suxamethonium Chloride 
13.05.03 Tacrolimus 0.03% Ointment Protopic® Specialist initiation only

NOT for first line use unless there is a specific reason to avoid or reduce the use of topical corticosteroids. (GMMMG)
13.05.03 Tacrolimus 0.1% Ointment Protopic® Specialist initiation only

NOT for first line use unless there is a specific reason to avoid or reduce the use of topical corticosteroids. (GMMMG)
08.02.02 Tacrolimus Capsules Prograf® MHRA/CHM advice: Oral tacrolimus products: prescribe and dispense by brand name only, to minimise the risk of inadvertent switching between products, which has been associated with reports of toxicity and graft rejection (June 2012)
Inadvertent switching between oral tacrolimus products has been associated with reports of toxicity and graft rejection. To ensure maintenance of therapeutic response when a patient is stabilised on a particular brand, oral tacrolimus products should be prescribed and dispensed by brand name only.

•Adoport®, Prograf®, Capexion®, Tacni®, and Vivadex® are immediate-release capsules that are taken twice daily, once in the morning and once in the evening.

•Modigraf® granules are used to prepare an immediate-release oral suspension which is taken twice daily, once in the morning and once in the evening.

•Advagraf® is a prolonged-release capsule that is taken once daily in the morning.


Switching between tacrolimus brands requires careful supervision and therapeutic monitoring by an appropriate specialist.(BNF)
11.06 Tafluprost (Preservative Free) 15micrograms/ml SDU Saflutan® For use only where sensitivity to preservative limits other treatment options.(GMMMG)


Preservative Free


08.03.04.01 Tamoxifen  Green Drug following specialist initiation

The cytochrome P450 enzyme, CYP2D6 is the rate-limiting step in the conversion of tamoxifen to its most active metabolite, endoxifen. Some retrospective studies have shown that drugs which inhibit the enzyme activity of CYP2D6 have been shown to increase the relapse rate in patients on adjuvant tamoxifen. Such drugs include two commonly used antidepressants fluoxetine and paroxetine. Where possible, the prescription of moderate / potent CYP2D6 inhibitors with tamoxifen should be avoided. The final decision will be a clinical judgement of risk and benefit.
07.04.01 Tamsulosin Hydrochloride m/r 
04.07.02 Tapentadol Palexia SR Listed on GMMMG Grey List; not a cost effective use of NHS resources.

For use by Chronic Pain Team only

Tapentadol should only be prescribed or initiated under the advice of a specialist in pain management.

Use of tapentadol is restricted to those patients requiring treatment of severe chronic pain which CANNOT be managed with more established opioid therapies.

NTS does not recommend the use of tapentadol over more established therapies.

(GMMMG November 2015)

04.01.01 Temazepam  Second Choice for Night Sedation

Available as:
- tablets
- 10mg/5ml oral solution

Not for initiation unless reviewed at discharge. Temazepam should not routinely be continued on discharge from hospital.
02.10.02 Tenecteplase Metalyse®
05.03.01 Tenofovir Disproxil Viread®
05.02.05 Terbinafine 
13.10.02 Terbinafine 1% cream 
03.01 Terbutaline 2.5mg Respules Bricanyl®
03.01.01.01 Terbutaline 5mg/2ml Nebuliser Solution Bricanyl® Where a nebulised product is required
03.01.01.01 Terbutaline IV 500 micrograms/mL Bricanyl®
07.01.03 Terbutaline Sulfate Injection Bricanyl®
03.01.01.01 Terbutaline Sulphate 500 micrograms/dose Turbohaler  Prescribe if patient used to using a Turbohaler
06.06.01 Teriparatide Forsteo® Specialist initiation only
06.05.02 Terlipressin Glypressin®
06.01.06 Test Strips Freestyle Optium H® For Hospital Use only
06.01.06 Test Strips Multistix SG® for routine urinalysis
06.01.06 Test strips FreeStyle Lite®
06.01.06 Test strips Freestyle® Optium For outpatient use
06.04.02 Testosterone 2% Gel Tostran®
06.04.02 Testosterone 50 mg/5 g sachet Testogel®
06.04.02 Testosterone Implant 100mg 
06.04.02 Testosterone undecanoate 250 mg/mL oily Injection Nebido®
06.04.02 Testosterone undecanoate 40 mg Capsules Restandol® Testocaps
14.05.02 Tetanus immunoglobulin 
04.09.03 Tetrabenazine 
15.02 Tetracaine (Amethocaine) Ametop® Can be administered under Patient Group Direction
11.07 Tetracaine Hydrochloride SDU Minims® Tetracaine Hydrochloride Available as:
- 0.5%
- 1%

All preservative free

Used for most tonometry in both adults and children. (GMMMG)
06.05.01 Tetracosactide Synacthen® • Risk of anaphylaxis with these products – consult individual summary of product characteristics for full information (GMMMG)
08.02.04 Thalidomide Pharmion® In patients older than 75 years, a 100mg/day starting dose is recommended to minimise the risk of adverse drug reactions (MHRA Dec 2015)
03.01.03 Theophylline Uniphyllin® Continus Modified release tablets 200mg, 300mg, 400mg
09.06.02 Thiamine (vit B1) 50mg, 100mg tablets 
15.01.01 Thiopental  Unlicensed
04.08.01 Tiagabine Gabitril®
06.04.01.01 Tibolone Livial® Tibolone should be prescribed in post-menopausal women with predominantly androgenic symptoms e.g. decreased libido, vaginal atrophy, pre-existing low mood. See SPC for additional prescribing notes of tibolone. (GMMMG)
02.09 Ticagrelor Brilique® Specialist Initiation Only

Tablets 90mg

Ticagrelor is not recommended for the long term prevention of atherothrombotic events in adults with a history of MI (GMMMG)

11.06 Timolol Maleate eye drops  Available as:
- 0.25%
- 0.5%
11.06 Timolol Maleate Ophthalmic gel-forming solution Timoptol®-LA Available as:
- 0.25%
- 0.5%

Note this is a ONCE daily preparation for patients with compliance/administration problems only. (GMMMG)
11.06 Timolol Maleate SDU Timoptol® Available as:
- 0.25%
- 0.5%
03.01.04 Tiotropium 2.5micrograms and Olodaterol 2.5 micrograms per dose solution for inhalation Spiolto Respimat 2.5 micrograms per dose

Prescribe as a step up from Tiotropium inhaler

03.01.02 Tiotropium Inhalation powder capsules 

The Braltus 10 microgram dry powder capsule inhaler should be prescribed in preference to the Tiotropium 18 microgram Handihaler.

03.01.02 Tiotropium Solution for inhalation Respimat® 2.5 micrograms / metered inhalation Spiriva
02.09 Tirofiban Aggrastat®
10.02.02 Tizanidine  Amber Drug for treatment of spasticity
05.01.04 Tobramycin dry powder inhalation capsules 28mg Tobi Podhaler

RED for cystic fibrosis patients

Tobramycin dry powder ininhalation (DPI) is an option for treating chronic pulmonary infection caused by Pseudomonas aeruginosa in people with cystic fibrosis, only if colistimethate sodium is contraindicated, is not tolerated, or has not produced an adequate clinical response, and the manufacturer provides tobramycin DPI with the discount agreed as part of the patient access scheme to primary, secondary, and tertiary care in the NHS.

05.01.04 Tobramycin nebuliser solution Tobi nebuliser solution 300mg/5ml ampoules

RED for new patient presenting to the service only

AMBER for existing patients awaiting repatriation

05.01.04 Tobramycin nebuliser solution Bramitob nebuliser solution 300mg/4ml ampoules

RED for new patient presenting to the service only

AMBER for existing patients awaiting repatriation

10.01.03 Tocilizumab RoActemra® Specialist use only
10.01.03 Tofacitinib Tablets  For use strictly in accordance with NICE guidance only
13.05.03 Tofacitinib tablets Xeljanz

Consultant Rheumatologist initiation only

For use in accordance with NICE guidelines only

04.09.01 Tolcapone Tasmar®
07.04.02 Tolterodine 
07.04.02 Tolterodine m/r 
06.05.02 Tolvaptan  SIADH for use in conjunction with GMMMG guidelines.

• Tolvaptan should only be initiated by Specialists in this area of medicine
• Tolvaptan is an oral selective vasopressin V2 receptor antagonist increasing free water excretion.
• Prescribing and initial monitoring should not be transferred out to primary care
• Consult SPC for dosing, monitoring, cautions and contra-indications
04.07.04.02 Topiramate  Available as:
- Tablets
- Capsules
04.08.01 Topiramate Capsules Topamax Sprinkle® Capsules (Sprinkle®):Swallow whole or sprinkle contents of capsule on soft food and swallow immediately without chewing
04.08.01 Topiramate Tablets 
04.07.02 Tramadol Hydrochloride 
02.11 Tranexamic Acid  Injection can be used orally. Keep opened injection no longer than 24 hours in the fridge. (NEWT Guidelines)
11.06 Travoprost 40 micrograms/mL eye drops Travatan®
11.06 Travoprost 40 micrograms/ml with Timolol 5mg/ml eye drops DuoTrav®
04.03.01 Trazodone Hydrochloride 
13.08.02 Tretinoin Bleaching Cream 
06.03.02 Triamcinolone Kenalog®
10.01.02.02 Triamcinolone Acetonide Kenalog®
04.02.01 Trifluoperazine 
04.09.02 Trihexyphenidyl Hydrochloride  For specialist initiation or on recommendation from a specialist on parkinsons disease. (GMMMG)
11.05 Tropicamide SDU Minims® Tropicamide Available as:
- 1%
- 0.5%
07.04.02 Trospium Chloride 
07.04.02 Trospium Chloride m/r Regurin® XL
06.04.01.02 Ulipristal Esmya®

Restricted indication and new contraindication

  • Esmya is now indicated for:
    • the intermittent treatment of moderate to severe symptoms of uterine fibroids in women of reproductive age who are not eligible for surgery

    • one treatment course of pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age

  • Esmya treatment is to be initiated and supervised by physicians experienced in the diagnosis and treatment of uterine fibroids

  • Esmya is contraindicated in women with underlying liver disorders

Liver function monitoring

  • before initiation of each treatment course: perform liver function tests; do not initiate Esmya in women with baseline alanine transaminase (ALT) or aspartate aminotransferase (AST) more than 2-times the upper limit of normal [ULN]

  • during the first 2 treatment courses: perform liver function tests every month

  • for further treatment courses: perform liver function tests once before each new course and when clinically indicated

  • at the end of each treatment course: perform liver function tests after 2–4 weeks

  • Stop Esmya treatment and closely monitor women with ALT or AST more than 3-times ULN; consider the need for specialist hepatology referral

Discuss the risk of liver damage with Esmya with women and report any suspected adverse drug reactions

  • before initiation of Esmya, discuss with women the rare risk of liver damage and need for liver function testing before, during, and after each treatment course

  • advise women to seek urgent medical attention if they develop any symptoms or signs of liver injury (such as tiredness, yellowing of the skin, darkening of the urine, nausea and vomiting)

  • pharmacists should provide the new patient card to women when dispensing Esmya; copies of this card are included in the letter sent to healthcare professionals and are available online

  • report any suspected adverse drug reactions to Esmya on a Yellow Card without delay

 

(MHRA August 2018)

07.03.05 Ulipristal Acetate EllaOne® Recommended where unprotected intercourse has taken place between 72 and 120 hours ago.
13.02.01 Ultrabase® Cream 
03.01.02 Umeclidinium 55 microgram/dose dry powder inhaler  Incruse Ellipta
13.02.01 Unguentum M® Cream 
02.10.02 Urokinase  For use to unblock Occluded central venous catheters
01.09.01 Ursodeoxycholic acid 
13.05.03 Ustekinumab Stelara
05.03.02.02 Valganciclovir 

Hospital use only

04.02.03 Valproic Acid Depakote®

Third choice antimanic drug

Valproate medicines MUST NOT be used in women of childbearing potential unless the Pregnancy Prevention Programme is in place.

 

02.05.05.02 Valsartan 
09.03 Vamin 18® (Electrolyte Free) 500ml  For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
09.03 Vaminolact® 100ml  For use in Pharmacy Aseptic Services for compounding of parenteral nutrition only
05.01.07 Vancomycin  

GREEN for treatment of severe of recurrent Clostridium difficile ONLY

04.10.02 Varenicline Champix® Patients should be advised to discontinue treatment and seek prompt medical advice if they develop agitation, depressed mood or suicidal thoughts. Patients with a history of psychiatric illness should be monitored closely while taking varenicline.

NICE TA123: TA123 Smoking cessation - varenicline states that varenicline is recommended as an option for smokers who have expressed a desire to quit smoking. Varenicline should normally be prescribed only as part of a programme of behavioural support.
(GMMMG)
14.05.02 Varicella-Zoster immunoglobulin  Green Drug provided patient fulfils Department of Health criteria

Available from public health virology laboratory. Prescriber needs to contact department in person to obtain.
14.04 Varicella-zoster vaccine Varivax®
15.01.05 Vecuronium Bromide Norcuron®
01.05.03 Vedolizumab Entyvio® For Consultant Gastroenterologist use only in accordance with NICE guidelines
04.03.04 Venlafaxine  First Choice for doses at and above 300mg

Green Drug following specialist initiation

Venlafaxine is licensed in treatment and prevention of relapse/recurrence of depression, and in XL form for treatment of GAD and social anxiety disorder. Discontinuation syndrome is common and BP is increased at higher doses. It should be avoided in patients with a high risk of cardiac arrhythmia. Use cheapest form may be branded generic. (GMMMG)
04.03.04 Venlafaxine m/r  Green Drug following specialist initiation

Venlafaxine is licensed in treatment and prevention of relapse/recurrence of depression, and in XL form for treatment of GAD and social anxiety disorder. Discontinuation syndrome is common and BP is increased at higher doses. It should be avoided in patients with a high risk of cardiac arrhythmia. Use cheapest form may be branded generic. (GMMMG)
02.06.02 Verapamil Hydrochloride Tablets 
02.06.02 Verapamil Modified Release tablets/capsules 
04.08.01 Vigabatrin Sabril®
17 Visipaque 270 
17 Visipaque 320 
09.06.02 Vitamin B complex preparations Vigranon B® syrup Note that this preparation is NOT prescribable by GPs

Can be prescribed for NG refeeding, as vitamin B compound tablets do not fully dissolve when crushed, and at risk of blocking NG tubes
09.06.02 Vitamin B Tablets (Compound Strong)  Listed on GMMMG Grey list

No longer recommended for the prophylaxis of Wernicke's Encephalopathy or alcohol related peripheral neuropathies.

Can only be prescribed in patients suffering from refeeding syndrome, and only for a 10 day course, which will be supplied from the hospital.
05.02.01 Voriconazole  Consultant Microbiologist recommendation only
02.08.02 Warfarin Sodium Tablets 
09.02 Water for Humidification 
09.02.02.01 Water for Injection  Available as:
- 2ml
- 5ml
- 10ml
- 20ml
- 100ml
- 1L
09.02 Water for Irrigation 
13.02.01 White Soft Paraffin BP 
12.03.05 Xerotin® Oral Spray  Suitable for intensive users

14 day in use life
12.02.02 Xylometazoline Hydrochloride Adult Nasal Drops 0.1% Otrivine® First Choice Nasal Decongestant
01.07.02 Xyloproct® Ointment 
13.02.01 Yellow Soft Paraffin BP 
05.03.04 Zanamivir Relenza®
13.02.01 Zerobase® Cream 
05.03.01 Zidovudine Retrovir®
05.03.01 Zidovudine with Lamivudine Combivir
13.02.02 Zinc and Castor Oil Ointment BP 
09.05.04 Zinc Sulphate Solvazinc® effervescent tabs (45mg Zn)
06.06.02 Zoledronic Acid 4mg Zometa® For acute treatment of hypercalcaemia

Malignancies of the bone (Specialist initiation only)(GMMMG)

06.06.02 Zoledronic Acid 5mg Aclasta® Specialist initiation only for Paget’s disease/osteoporosis (GMMMG)
04.01.01 Zolpidem Tartrate  Third Choice for Night Sedation

Not for initiation unless reviewed at discharge. Zopidem should not routinely be continued on discharge from hospital.

Suitable for use in patients with enteral feeding tubes
04.01.01 Zopiclone  First Choice for Night Sedation


Not for initiation unless reviewed at discharge. Zopiclone should not routinely be continued on discharge from hospital.

For short term use, licensed for max of 28 days. (GMMMG)
04.02.02 Zuclopenthixol Decanoate Clopixol®
04.02.02 Zuclopenthixol Decanoate Clopixol® Conc.
04.02.01 Zuclopenthixol Dihydrochloride Clopixol®
Tameside and Glossop Integrated Care