netFormulary
 Report : A-Z of formulary items 26/09/2018 08:32:02
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Section Name Details
01.07.02 Cincochaine with prednisolone  Scheriproct®

Ointment, cinchocaine hydrochloride 5mg/g, prednisolone hexanoate 1.9mg/g.

Suppositories, cinchocaine hydrochloride 1 mg, prednisolone hexanoate 1.3 mg.

01.06.04 Sodium Citrate micro-enema  Micolette Micro-enema
Micralax Micro-enema
Relaxit Micro-enema

Amber Recommended  Micolette and Micralax Micro-enema for paediatrics


Green  Relaxit Micro-enema for paediatrics
10.01.03 Abatacept 

IV infusion 250 mg vial (powder for reconstitution), subcutaneous injection 125mg (pre-filled syringe)
NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents

Grey for Psoriatic Arthritis

02.09 Abciximab  2mg/mL, 5mL vial

Paediatrics: no BNFc entry - seek specialist advice
08.03.04.02 Abiraterone acetate 

Tablets 250mg NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

04.10.01 Acamprosate 

Tablets e/c 333mg

For Alcohol Dependence

RED South Sefton CCG, Southport & Formby CCG - Prescribing retained by local commissioned alcohol service.

Amber Initiated Halton CCG, St Helen's CCG, Knowsley CCG, Liverpool CCG

Amber Recommended Warrington CCG

RAG status to be confirmed by individual CCGs

No BNFc entry – seek specialist advice

02.08.02 Acenocoumarol tablets  1mg


Paediatrics: only warfarin is used in paediatrics
04.08.01 Acetazolamide 

250mg tablets, 250mg m/r capsules

Paediatrics only. Children's dose: 8-30mg/kg in daily divided doses and not to exceed 750mg/day.

11.06 Acetazolamide 

250mg tablets, 250mg m/r capsules

Amber Initiated Paediatrics.

11.06 Acetazolamide  500mg injection
12.01.01 Acetic acid 2% spray  Ear Calm®

Acts as an antifungal and antibacterial in the external ear canal and may be useful to treat mild otitis externa
Can be purchased OTC
11.10 Acetylcholine   1% intraocular irrigation (2ml)
Ophthalmologist only.
For miosis during surgery.
03.07 Acetylcysteine   Injection 200mg in 1mL (administered orally)

For management of distal intestinal obstruction syndrome (DIOS)in cystic fibrosis and meconium ileus.
03.07 Acetylcysteine  

Oral preparations; 600mg effervescent tablets, 200mg powder for oral solution

For treatment of mucolytic respiratory disorders, including COPD.

11.08.01 Acetylcysteine 

5% eye drops, 10ml (Ilube)

11.08.01 Acetylcysteine  5% and 10% eye drops
Preservative-free
Ophthalmologist only. pH approx. 8.5
11.03.03 Aciclovir   3% eye ointment

13.10.03 Aciclovir  5% Cream; 2g
13.05.02 Acitretin  Capsules; 10 mg, 25 mg

Pregnancy prevention
In women of child-bearing potential (including those with a history of infertility), exclude pregnancy up to 3 days before treatment, every month during treatment, and every 1–3 months for 3 years after stopping treatment. Treatment should be started on day 2 or 3 of menstrual cycle. Women must practise effective contraception for at least 1 month before starting treatment, during treatment, and for at least 3 years 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 acitretin 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 seek medical attention immediately if they become pregnant during treatment or within 3 years of stopping treatment. They should also be advised to avoid alcohol during treatment and for 2 months after stopping treatment

Oral retinoids for psoriasis
03.01.02 Aclidinium bromide inhalation powder Eklira Genuair®
Eklira Genuair
Dry powder inhaler
400 micrograms/metered inhalation

PREFERRED CHOICE IN COPD

Paediatrics: no BNFc entry - seek specialist advice
03.01.02 Aclidinium with formoterol Duaklir Genuair®
Duaklir Genuair
Dry powder inhaler
Aclidinium 340 micrograms with formoterol 12 micrograms per inhalation

PREFERRED CHOICE IN COPD

Paediatrics: no BNFc entry - seek specialist advice
01.05.03 Adalimumab 

Injection 40-mg prefilled pen or prefilled syringe, 40 mg/0.8-mL vial

Crohn's disease

Ulcerative Colitis

10.01.03 Adalimumab  Subcutaneous injection 40 mg (prefilled pen or prefilled syringe)
NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents
11.10 Adalimumab 

Injection 40 mg prefilled pen or prefilled syringe

NHS NHSE commissioned drug for non-infectious uveitis (in line with NICE TA 460) - see Specialised Commissioning: Key documents

13.05.03 Adalimumab 

Injection 40 mg prefilled pen or prefilled syringe
In line with NICE TA 146 – Adalimumab for the treatment of adults with psoriasis

NHS NHSE commissioned drug for Paediatric indications (in line with NICE TA 455) - see Specialised Commissioning: Key documents

NHS NHSE for treatment of hidradenitis suppurativa

NHSE IFR for treatment of uveitis

Cytokine modulator

13.06.01 Adapalene  0.1% (Differin®) Cream, Gel; 45 g
13.06.01 Adapalene 0.1%, benzoyl peroxide 2.5%  (Epiduo®) Gel; 45 g
02.03.02 Adenosine injection  6mg/2mL
03.04.03 Adrenaline  Intravenous injection, intramuscular injection; 1 in 1000, 1 in 10,000

Green administered in emergency
03.04.03 Adrenaline   Self administration
150 micrograms, 300 micrograms; Epipen®, Jext®, Emerade®
300 micrograms; Epipen®, Jext®, Emerade®
500 micrograms; Emerade®
These auto-injectors are administered by intramuscular injection. Individuals at considerable risk of anaphylaxis must carry adrenaline at all times. Patients need to be prescribed two devices and carry both at all times.
02.07.03 Adrenaline / Epinephrine Intravenous injection  1 in 10,000 (100microgram/mL) injection
11.08.02 Aflibercept 

solution for intravitreal injection
 

04.03.04 Agomelatine 

Tablets 25mg

No BNFc entry – seek specialist advice

11.10 Alcohol   20% eye drops
08.02.04 Aldesleukin  Injection 18-million unit vial
Aldesleukin in metastatic renal carcinoma
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
08.02.03 Alemtuzumab  Intravenous infusion 30mg/mL (unlicensed)
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
10.01.03 Alemtuzumab 

Concentrate for intravenous infusion 10mg/mL 1.2mL vial
NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents

Paediatrics: no BNFc entry - seek specialist advice

06.06.02 Alendronic Acid 

Tablets (as sodium alendronate) 10mg

Effervescent tablets 70mg

Oral solution, sugar-free, alendronic acid (as sodium alendronate) 70mg/100mL (4×100mL)

Amber Recommended  Paediatrics

09.06.04 Alfacalcidol One-Alpha®

Capsules 250 nanograms, 500 nanograms, 1 microgram

Oral drops sugar-free 2 micrograms/ml

Amber Initiated  Paediatrics

04.07.02 Alfentanil  

Injection 500 micrograms/ml, 5 mg/ml
Amber Recommended Only when recommended by the palliative care team
 

Amber Recommended Paediatrics - Only when recommended by the palliative care team

Opioid – parenteral preparation

07.04.01 Alfuzosin 

MR tablets 10 mg Alpha Blocker

Paediatrics: No BNFc entry, seek specialist advice 

01.01.02 Alginic acid Gaviscon Infant®

Oral powder sachets, sugar-free, sodium alginate 225 mg, magnesium alginate 87.5 mg/dose. Contains sodium.

03.04.01 Alimemazine tartrate 

Tablets 10 mg;
Syrup 7.5 mg/5 mL, 30 mg/5 mL

Amber Recommended Paediatrics only. 

Expensive: recommended only where all other sedating antihistamines are unsuitable. N.B. when used for insomnia - short-term use only

02.12 Alirocumab  75mg/mL; 150mg/mL pre-filled syringe (Praluent®)
02.05.05.03 Aliskiren tablets  150mg, 300mg
13.05.01 Alitretinoin 

Capsules 10 mg, 30 mg
In line with NICE TA 177 - Alitretinoin for the treatment of severe chronic hand eczema

No BNFc entry: Paediatrics seek specialist advice 

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

10.01.04 Allopurinol  Tablets 100mg, 300mg

Paediatrics: no BNFc entry - seek specialist advice
06.01.02.03 Alogliptin 

Tablets 6.25mg, 12.5mg, 25mg

Paediatrics: No BNFc entry, seek specialist advice 

06.01.02.03 Alogliptin with metformin tablets  12.5mg/1g

Dipeptidylpeptidase-4 (DPP-4) Inhibitors

09.06.05 Alpha Tocopheryl Acetate  Capsules 75 IU, 200 IU, 400 IU

Vita-E 200 (D-Alpha Tocopherol) Capsules
09.06.05 Alpha Tocopheryl Acetate  Suspension 100mg/ml
07.04.05 Alprostadil 

Intracavernosal Injection 5micrograms, 10micrograms, 20micrograms, 40micrograms;

Dual Chamber 10 micrograms, 20 micrograms

Black in erectile dysfunction in circumstances outside of those listed above.Urethral application (Muse®)

Black in erectile dysfunction in circumstances outside of those listed above. 



Amber Recommended Cream 3 mg/g(Vitaros®)

 Black  in erectile dysfunction in circumstances outside of those listed above.Paediatrics: No BNFc entry, seek specialist advice 

02.10.02 Alteplase  10mg (5.8 million units)/vial
20mg (11.6 million units)/vial
50mg (29 million units)/vial
11.10 Alteplase (rt-PA)   100micrograms in 0.1ml injection

Ophthalmologist only.
11.10 Alteplase (rt-PA)   25 microgram in 0.1ml injection

Ophthalmologist only.
11.10 Alteplase (rt-PA)   50 microgram in 0.1ml injection

Ophthalmologist only.
13.12 Aluminimum Chloride Hexahydrate   20% Solution; 60 mL (with roll-on applicator)
09.05.02.02 Aluminium Hydroxide Alu-Cap® Capsules, 475mg
01.02 Alverine Citrate  Capsules 60 mg, 120 mg
04.09.01 Amantadine  

Capsules 100mg
Syrup 50mg/5mL

Amber Initiated Paediatrics

 

NICE recommends offering amantadine to treat fatigue in people with multiple sclerosis.

02.05.01 Ambrisentan tablets  5mg, 10mg
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Pulmonary Arterial Hypertension
01.06.05 Amidotrizoates Gastrografin® Solution, sodium amidotrizoate 100 mg, meglumine amidotrizoate 660 mg/mL
10.02.01 Amifampridine  Tablets 10mg
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Paediatrics: no BNFc entry - seek specialist advice
02.02.03 Amiloride oral solution sugar free 

5mg/5ml

Amber Initiated paediatrics

02.02.03 Amiloride tablets 

5mg

Amber Initiated paediatrics

03.01.03 Aminophylline injection  Injection 25 mg/mL, 10-mL amp
02.03.02 Amiodarone hydrochloride tablets 

100mg, 200mg

02.03.02 Amiodarone Suspension 

Suspension 10mg/ml unlicensed special

Paediatrics: specialist centre usually tries to get patients onto doses which will allow use of 25mg segments of the 100mg tablets before discharge.

04.02.01 Amisulpride 

Tablets 50 mg, 100 mg, 200 mg, 400 mg
Solution 100 mg/mL

Amber Patient Retained Paediatrics (in children aged 15 years and above)

 

01.02 Amitriptyline 

Tablets 10mg, 25mg, 50mg

Oral solution 2mg/mL, 5mg/mL, 10mg/mL

Hypersalivation (off-label)

No BNFc entry: seek specialist advice

04.03.01 Amitriptyline 

Tablets 10 mg, 25 mg, 50 mg
Oral solution 10mg/5mL, 25 mg/5 mL, 50 mg/5 mL

Amber Initiated  Paediatrics

04.07.03 Amitriptyline 

Tablets, 10 mg, 25 mg, 50 mg
Oral Solution, 25 mg/5ml, 50 mg/5ml

Amber Initiated Paediatrics

04.07.04.02 Amitriptyline 

Tablets 10 mg, 25 mg, 50 mg
Oral solution 10mg/mL, 25 mg/5 mL, 50 mg/5 mL
It is important to use adequate maintenance doses of 50 – 75mg at night, max. 150mg to obtain benefit

No BNFc entry – seek specialist advice

02.06.02 Amlodipine liquid 

1mg/ml and 2mg/ml

Amber Initiated paediatrics

02.06.02 Amlodipine tablets 

5mg, 10mg

Amber Initiated paediatrics

13.10.02 Amorolfine  5% nail lacquer (Loceryl®)
11.03.02 Amphotericin  

0.15% and 0.3% eye drops. 

No BNFc entry - seek specialist advice.

 

09.01.04 Anagrelide Xagrid® Capsules 500 micrograms
10.01.03 Anakinra 

Subcutaneous injection100mg prefilled syringe

for rheumatoid arthritis

NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents
Red  for Adult Onset Still's Disease, as per Pan Mersey protocol - see links below.

08.03.04.01 Anastrozole Arimidex®

Tablets 1mg

See NICE CG164 for recommendation on use in patients at moderate - high risk in familial breast cancer.

01.01.01 Antacid and Oxetacaine  

Oral suspension, oxetacaine 10mg, aluminium hydroxide equivalent to 200mg aluminium oxide + 100mg magnesium hydroxide per 5ml
For radiation-induced oesophagitis
Paediatrics: no BNFc entry - seek specialist advice

11.04.02 Antazoline 0.5% with Xylometazoline 0.05%  eye drops
13.08.01 Anthelios XL® 

Cream SPF 50+ (UVA and UVB protection; UVB-SPF 50+)50ml

Non-formulary if not for ACBS approved indication

08.02.02 Antithymocyte immunoglobulin (rabbit)  

Intravenous infusion 25mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

01.07.01 Anusol ointment 

Zinc oxide, bismuth oxide, bismuth subgallate & Peru balsam

01.07.02 Anusol-HC  

Ointment, benzyl benzoate, bismuth oxide, bismuth subgallate, hydrocortisone acetate 2.5mg/g, Peru balsam, zinc oxide.

Suppositories, benzyl benzoate, bismuth oxide, bismuth subgallate, hydrocortisone acetate 10 mg, Peru balsam, zinc oxide.

02.08.02 Apixaban tablets  2.5mg, 5mg
Prevention of stroke and systemic embolism in atrial fibrillation.

Paediatrics: only warfarin is used in paediatrics
02.08.02 Apixaban tablets 

2.5mg, 5mg
VTE prophylaxis in patients who have undergone elective hip and knee replacement surgery.

Paediatrics: only warfarin is used in paediatrics

02.08.02 Apixaban tablets 

2.5mg, 5mg
Treatment and secondary prevention of DVT/PE

N.B. Green in Wirral for this indication.

Paediatrics: only warfarin is used in paediatrics

04.09.01 Apomorphine 

SC Injection 50mg/5mL
SC Injection (APO-go® Pen)30mg/3mL pen injector
SC Injection (APO-go® PFS) 50mg/10mL pre-filled syringes

Notes
Apomorphine should be initiated in a specialist clinic with at least two days pre-treatment with domperidone for nausea and vomiting. Treatment with apomorphine should remain under specialist supervision.

No BNFc entry – seek specialist advice

11.08.02 Apraclonidine 

0.5% eye drops and 1% single dose eye drops

 

Amber Recommended 

Apraclonidine eye preparations may be recommended by specialists for the management of chronic glaucoma that is unresponsive to therapy in patients who would otherwise require surgery for their disease. Patients must have tried and failed, or had an adverse reaction, on all standard therapies before apraclonidine may be prescribed.

Apraclonidine 0.5% eye drops are licensed for short-term adjunctive therapy of chronic glaucoma in patients on maximally tolerated medical therapy who require additional intraocular pressure (IOP) reduction to delay laser treatment or glaucoma surgery. Use of 1% preservative-free preparation, or 0.5% eye drops other than previously described, is off-label. The ophthalmologist should clearly communicate the rationale for prescribing apraclonidine in the clinic letter to primary care.

Apraclonidine 1% preservative-free preparations must only be prescribed for patients who have a clearly documented allergy to preservatives contained in eye drops.

10.01.03 Apremilast 

Tablets 10mg, 20mg, 30mg (Otezla®)

In line with NICE TA433 - Apremilast for treating active psoriatic arthritis

Paediatrics: no BNFc entry - seek specialist advice

13.05.03 Apremilast 

Tablet 10 mg, 20mg, 30mg (Otezla®)

 

In line with NICE TA419 - Apremilast for treating moderate to severe plaque psoriasis

No BNFc entry; Paediatrics, seek specialist advice 

04.06 Aprepitant 

Capsules 80mg, 125mg

No BNFc entry - seek specialist advice

13.02.01 AproDerm® 

Emollient cream; 45 g tube; 450 g pump pack

Colloidal oat cream; 500mL pump pack

Medium

13.02.01 Aquamax® 

Cream; 100g tube; 500g tub

Medium

13.02.01.01 Aqueous Cream BP  Cream 100g, 500 g (not recommended as an emollient as contains SLS)

Soap substitute only
01.06.03 Arachis Oil  Enema 130-mL
02.05.05.02 ARB + ACEI combination 
02.08.01 Argatroban 

Injection 100mg/mL

04.02.01 Aripiprazole 

Tablets 5 mg, 10 mg, 15 mg, 30 mg
Orodispersible tablets10 mg, 15 mg
Oral solution 1 mg/1 mL (very expensive - use orodispersible tablets where possible)

Amber Patient Retained Paediatrics

04.02.02 Aripiprazole  

Prolonged-release for injection 300mg & 400mg

No BNFc entry – seek specialist advice

09.06.03 Ascorbic acid 

Tablets 50mg 100mg, 200mg, 500mg

Increasing absorption of iron is not a licensed indication for ascorbic acid and is not recommended. To enhance iron absorption, patients should be advised to take iron preparations on an empty stomach. Iron absorption may be increased if a person has a high intake of fish, or red or white meat; decreased if a person has a high intake of phytate (for example from wholegrain cereals), polyphenols (for example from tea and coffee), calcium (for example from dairy products), or if the person is taking medication that raises the gastric pH (for example antacids and proton pump inhibitors).

09.06.03 Ascorbic Acid 

Tablets 50mg 100mg, 200mg, 500mg

Black  Co-administration with oral iron replacement therapy: Increasing absorption of iron is not a licensed indication for ascorbic acid and is not recommended. To enhance iron absorption, patients should be advised to take iron preparations on an empty stomach. Iron absorption may be increased if a person has a high intake of fish, or red or white meat; decreased if a person has a high intake of phytate (for example from wholegrain cereals), polyphenols (for example from tea and coffee), calcium (for example from dairy products), or if the person is taking medication that raises the gastric pH (for example antacids and proton pump inhibitors).

11.10 Ascorbic acid 500mg  10% eye drops
500mg tablets
04.02.03 Asenapine 

Sublingual tablets 5mg, 10mg

No BNFc entry – seek specialist advice

04.07.01 Aspirin 

Tablets and Dispersible Tablets, 300 mg

BLACK paediatrics - do not use in children

04.07.04.01 Aspirin  Tablets, 300 mg
Soluble tablets should be used in preference.
600-900mg at onset of attack of migraine, 600mg for subsequent attacks

BLACK Paediatrics
Do not use in children < 16 years
02.09 Aspirin suppositories 

Unlicensed special 

Amber Initiated paediatrics

02.09 Aspirin tablets (antiplatelet) 

75mg
 
Amber Initiated paediatrics

Unlicensed in children

27.08 Asthma, acute viral exacerbations 
 

Antibiotics not indicated

Symptomatic treatment only

10.02.02 Ataluren 

Granules 125mg, 250mg, 1g

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

 

02.04 Atenolol injection  500micrograms/mL
02.04 Atenolol syrup sugar free 

Tenormin® syrup 25mg/5ml

Amber Initiated paediatrics

02.04 Atenolol tablets 

25mg, 50mg, 100mg 

Amber Initiated paediatrics

04.04 Atomoxetine 

Capsules 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80mg, 100mg
Oral liquid 4mg/mL
 
Purple Liverpool CCG Adults and Children
 
Purple  Halton CCG, South Sefton CCG and Southport & Formby CCG for the treatment of ADHD in Adults only 

02.12 Atorvastatin tablets 

10mg, 20mg, 40mg, 80mg

Amber Initiated paediatrics

Black Atozet® atorvastatin 20mg + ezetimibe 10mg

07.01.03 Atosiban 

Injection 6.75 mg/0.9mL; 7.5 mg/mL concentrate for infusion 5mL amps.

For uncomplicated premature labour

Paediatrics: No BNFc entry, seek specialist advice 

01.02 Atropine 

Eye drops 1% (used sub-lingually)

Hypersalivation (off-label)

No BNFc entry: seek specialist advice

11.05 Atropine  

1% eye drops, 1% minims

10.04 Autologous chondrocyte implantation 

Including autologous chondrocyte implanatation using chondrosphere.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Tertiary centres only

07.04.05 Avanafil 

Tablets 50mg, 100mg, 200mg

Black  in erectile dysfunction in circumstances outside of those listed above.

Paediatrics: No BNFc entry, seek specialist advice 

13.02.01 Aveeno®  Lotion; 500 mL; Cream; 100ml, 300ml pump pack

For ACBS approved indication only: endogenous and exogenous eczema, xeroderma, ichthyosis, and senile pruritus (pruritus of the elderly) associated with dry skin.

Cream = Medium
Lotion = Light
07.04.05 Aviptadil with Phentolamine 

solution for intracavernosal injection 25microgram/2mg (Invicorp®)

01.05.03 Azathioprine 

Tablets 25 mg, 50 mg
10mg/ml suspension (unlicensed Special for paediatrics)

Azathioprine is metabolised to mercaptopurine.

Red   Paediatrics (NHS England commissioned)

08.02.01 Azathioprine 

Tablets 25mg,50mg;

Oral suspension 10mg/mL (Special)

Injection 50mg vial

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents Transplant immunosuppression only

10.01.03 Azathioprine 

Tablets 25 mg, 50 mg

Red Paediatrics

11.10 Azathioprine  25mg and 50mg tablets
Ophthalmologist only.
13.05.03 Azathioprine 

Tablets 25 mg, 50 mg Oral preparation Off label

Red Paediatrics

13.06.01 Azelaic Acid  15% (Finacea®) Gel; 30 g
20% (Skinoren®) Cream; 30 g (acne vulgaris only)

Topical preparation for rosacea
11.04.02 Azelastine  0.05% eye drops
12.02.01 Azelastine Hydrochloride  Nasal spray

Rhinolast®
11.03.01 Azithromycin  1.5% eye drops

05.01.02.03 Aztreonam nebuliser solution  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

For Cystic Fibrosis
09.06.07 B Complex plus C Water soluble vitamins Renavit®

tablets; for vitamin supplementation in renal dialysis patients

Paediatrics: no BNFc entry - seek specialist advice

08.02.04 Bacillus Calmette-Guérin  Bladder instillation 81-mg (ImmuCyst®),
Bladder instillation 12.5mg (OncoTICE®)
04.09.03 Baclofen 

Tablets 10mg
Oral solution 5mg / 5mL

Amber Initiated Paediatrics

 

04.09.03 Baclofen 

Intrathecal injection 500micrograms/ml and 2mg/ml – specialist use only.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

No BNFc entry – seek specialist advice

04.10.01 Baclofen 

Tablets 10mg
Oral solution 5mg / 5ml

Off label indication.

For Alcohol Dependance

RED Liverpool CCG, South Sefton CCG, Southport & Formby CCG - Prescribing retained by local commissioned alcohol service.

Red St Helen's CCG

Amber Initiated Halton CCG, Knowsley CCG

Amber Recommended Warrington CCG

RAG status to be confirmed by individual CCGs

Paediatrics: No BNFc entry – seek specialist advice

10.02.02 Baclofen 

Tablets 10 mg: Liquid SF 5 mg/5mL

Amber Recommended Paediatrics
 
 
RED Intrathecal injection 500micrograms/ml and 2mg/ml – severe chronic spasticity e.g. with spinal cord injury, specialist use only. NB. Commissioned by NHS England

11.10 Balanced salt solution   15ml,250ml and 500ml
Ophthalmologist only.
For irrigation during surgery.
13.02.01 Balneum Plus®  Urea 5%, lauromacrogols 3% Cream; 500 g pump pack

Medium
13.02.01 Balneum®  Urea 5%, ceramide 0.1% Cream; 500 g

Medium
13.02.01.01 Balneum®  Bath oil; 500 mL, 1 litre
01.05.01 Balsalazide  Capsules 750 mg
03.01.01.01 Bambuterol  Tablets 10 mg, 20 mg

Step 4 asthma

Paediatrics: no BNFc entry - seek specialist advice
10.01.03 Baricitinib 

Film-coated tablets 2mg, 4mg (Olumiant ®)

Paediatrics: no BNFc entry - seek specialist advice

08.02.02 Basiliximab 

Injection 10mg, 20mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

01.05.02 Beclometasone dipropionate Clipper®

Gastro-resistant m/r tablets, 5 mg

Licensed for use in ulcerative colitis.

Max. 4 week course. Not recommended for use in children in SPC but recommended in NICE Clinical Guideline. Where treatment course previously recommended for patient by specialist, further course(s) may be initiated in primary care for symptom relapse where recommended as part of treatment plan.

No BNFc entry – seek specialist advice

03.02 Beclometasone dipropionate / Formoterol fumarate dihydrate / Glycopyrronium Trimbow®

 

 

Metered dose inhaler
Beclometasone diproprionate 100 micrograms, formoterol fumarate dihydrate 6 micrograms, glycopyrronium 10 micrograms per inhalation.
Licensed for COPD only.

PREFERRED CHOICE IN COPD

12.02.01 Beclometasone dipropionate aqueous nasal spray 

*Short-term use only (i.e. 4-6 weeks or use of a single bottle only). Where long-term use is required, a steroid with low systemic bioavailability (e.g. fluticasone or mometasone) should be used.
NB – consider corticosteroids prescribed by other routes. If patient on inhaled or oral steroids, consider using inhaled steroid with low systemic bioavailability.

 

Amber Recommended paediatrics < 6 years

Caution: the risk of growth retardation should be considered when prescribing beclomethasone dipropionate for children.

03.02 Beclometasone diproprionate / formoterol  Fostair®
Fostair

Metered dose inhaler
Beclometasone diproprionate 100 micrograms, formoterol fumarate 6 micrograms/metered inhalation (Licensed for asthma in adults and COPD)

Metered dose inhaler
Beclometasone diproprionate 200 micrograms, formoterol fumarate 6 micrograms/metered inhalation (Licensed for asthma in adults only)

PREFERRED CHOICE IN ASTHMA AND COPD

PRESCRIBE BY BRAND NAME

Please note Fostair® has extra-fine particles and is more potent than traditional beclometasone diproprionate CFC-free inhalers.
Fostair® MDI must be stored in the fridge; once dispensed it no longer requires refrigeration but must then be discarded after five months.


Fostiar NEXThaler

Dry powder inhaler (Fostair® NEXThaler 100/6)
Beclometasone dipropionate 100 micrograms and formoterol fumarate 6 micrograms /inhalation (Licensed for asthma in adults and COPD)

Dry powder inhaler (Fostair® NEXThaler 200/6)
Beclometasone dipropionate 200 micrograms and formoterol fumarate 6 micrograms /inhalation (Licensed for asthma in adults only)


PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME

Paediatrics: no BNFc entry - seek specialist advice

03.02 Beclometasone diproprionate aerosol inhalation Qvar Autohaler® Breath actuated inhaler
50 micrograms/metered inhalation
100 micrograms/metered inhalation
PRESCRIBE BY BRAND NAME

Paediatrics: Not recommended as incompatible with spacer device.
03.02 Beclometasone diproprionate aerosol inhalation Clenil Modulite® Metered dose inhaler
50 micrograms/metered inhalation
100 micrograms/metered inhalation
200 micrograms/metered inhalation
250 micrograms/metered inhalation

PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME
03.02 Beclometasone diproprionate aerosol inhalation Qvar® Metered dose inhaler
50 micrograms/metered inhalation
100 micrograms/metered inhalation

PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME

Paediatrics: Not recommended as incompatible with spacer device.
03.02 Beclometasone diproprionate aerosol inhalation Qvar Easi-Breathe® Breath actuated
50 micrograms/metered inhalation
100 micrograms/metered inhalation
PRESCRIBE BY BRAND NAME
03.02 Beclometasone diproprionate dry powder for inhalation Asmabec clickhaler® Dry powder inhaler
50 micrograms/metered inhalation
100 micrograms/metered inhalation
250 micrograms/metered inhalation
PRESCRIBE BY BRAND NAME
03.02 Beclometasone diproprionate dry powder for inhalation Easyhaler® Beclometasone Dry powder inhaler
200 micrograms/metered inhalation
PRESCRIBE BY BRAND NAME

Paediatrics: no BNFc entry - seek specialist advice
03.04.02 Bee and wasp allergen extracts Pharmalgen® Bee venom injections
Wasp venom injections
08.02.02 Belatacept 

Intravenous infusion 250mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

10.01.03 Belimumab 

IV infusion 120mg, 400mg powder for solution

NHS NHSE commissioned for systemic lupus erythematosus

Paediatrics: no BNFc entry - seek specialist advice

02.02.01 Bendroflumethiazide tablets 

2.5mg, 5mg
For oedema

02.02.01 Bendroflumethiazide tablets 

2.5mg, 5mg 
 

Amber Initiated paediatrics

04.02.01 Benperidol 

Tablets 250 micrograms
(only licensed for control of deviant antisocial sexual behaviour)

No BNFc entry – seek specialist advice

13.09 Benzalkonium chloride 0.5% 

Dermax® Shampoo; 250 mL

10.01.04 Benzbromarone  Tablets 50mg, 100mg

Paediatrics: no BNFc entry - seek specialist advice

13.06.01 Benzoyl Peroxide  5% Aqueous gel, cream
10% cream
13.06.01 Benzoyl Peroxide 3% with Clindamycin 1%  Aqueous gel (Duac® Once Daily); 30 g
13.06.01 Benzoyl Peroxide 5% with Clindamycin 1%  Aqueous gel (Duac® Once Daily); 25 g, 50 g
12.03.01 Benzydamine oral rinse/spray  Difflam®
11.03.01 Benzylpenicillin  5,000 units/ml and 20,000 units/ml eye drops

03.05.02 Beractant 

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

04.06 Betahistine Dihydrochloride 

Tablets 8mg, 16mg

No BNFc entry - seek specialist advice

13.04 Betamethasone Dipropionate 

First Choice

0.05% (Diprosone®) Cream; Ointment; 30 g, 100 g

Potent

Amber Recommended Paediatrics

13.04 Betamethasone Valerate 

First Choice

0.025% (Betnovate-RD®) Cream; Ointment; 100 g

Moderately potent

Amber Recommended Paediatrics

13.04 Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 

Diprosalic® Ointment contains salicylic acid 3%; 30 g, 100 g

Diprosalic® Scalp Application contains salicylic acid 2%; 100 mL

Potent with salicylic acid
Amber Recommended Paediatrics


The keratolytic effect of salicylic acid facilitates the absorption of topical corticosteroids; however, excessive and prolonged topical use may result in symptoms of salicylism.
Manufacturer recommends that Diprosalic preparations are prescribed for two weeks, and that treatment is reviewed at that time. The maximum weekly dose should not exceed 60g. Application in children should be limited to 5 days.

13.04 Betamethasone (as dipropionate) 0.064% (≡ betamethasone 0.05%), clotrimazole 1% 

(Lotriderm®) cream; 30 g

Potent with antifungal

Amber Recommended Paediatrics

13.04 Betamethasone (as Valerate) 0.1%, Clioquinol 3% 

(Betnovate-C®) Cream; Ointment; 30 g

Potent with antimicrobials

Amber Recommended Paediatrics

13.04 Betamethasone (as Valerate) 0.1%, Fucidic Acid 2% 

(Fucibet®) Cream; 30 g

Potent with antimicrobials

 

Amber Recommended Paediatrics

12.02.01 Betamethasone 0.1% nose drops 
12.01.01 Betamethasone 0.1% with Neomycin 0.5% ear drops  Betnesol N®
13.05.02 Betamethasone diproprionate 0.05%, calcipotriol 50 micrograms/g 

(Dovobet®) Gel; 60g

(Enstilar®) Cutaneous Foam; 60g
 
For chronic plaque psoriasis
For body and scalp (Dovobet) or body (Enstilar)
Off label use in children 12-18 years (specialist use only)

Amber Recommended Paediatrics

11.04.01 Betamethasone sodium phosphate 

0.1% eye ointment

0.1% eye/ear/nose drops (Paediatrics only)

12.01.01 Betamethasone sodium phosphate 0.1% ear/eye/nose drops 
06.03.02 Betamethasone soluble tablets 

500micrograms (as sodium phosphate)

Amber Initiated Paediatrics

13.04 Betamethasone Valerate 

First Choice

0.1% (Betnovate®) Cream; Ointment; 30 g, 100 g
Scalp application; 100 mL

Potent

Amber Recommended Paediatrics

11.06 Betaxolol  

0.25% eye drops, 0.25% single dose eye drops, 0.5% eye drops.
Cardioselective - theoretically beneficial in patients with respiratory disease.
Single dose eye drops reserved for patients with known preservative allergy.

Amber Initiated Paediatrics.

11.08.02 Bevacizumab  Intravitreal injection

For pre-specified indications or as part of a clinical trial only.
08.03.04.02 Bicalutamide  Tablets 50mg, 150mg
11.06 Bimatoprost 

100 micrograms/ mL (0.01%) and 300 micrograms/ mL (0.03%) eye drops,

300 micrograms/ ml (0.03%) single dose eye drops
Single dose eye drops reserved for patients with known preservative allergy

Amber Initiated Paediatrics.

11.06 Bimatoprost with timolol  

300 micrograms/ml (0.03%) and 5mg/ml (0.5%) eye drops, 300 micrograms/ml (0.03%) and 5mg/ml (0.5%) single dose eye drops
Single dose eye drops reserved for patients with known preservative allergy
1st choice: preservative free combination product

Amber Initiated Paediatrics.

12.03.05 Biotene Oralbalance gel 
06.01.01.02 Biphasic Insulin Aspart  NovoMix 30
06.01.01.02 Biphasic Insulin Lispro  Humalog Mix25
Humalog Mix50
06.01.01.02 Biphasic Isophane Insulin Highly purified animal  Existing patients or strong patient preference only
Hypurin Porcine 30/70 Mix
06.01.01.02 Biphasic Isophane Insulin Human sequence  Humulin M3
Insuman Comb 15
Insuman Comb 25
Insuman Comb 50
01.06.02 Bisacodyl 

Gastro-resistant tablets, 5 mg.
 
Suppositories 10 mg.

Paediatric suppositories 5 mg

01.03.03 Bismuth subsalicylate 

Chewable tablets 262.5mg
Oral suspension 17.5mg/ml

For Helicobacter pylori eradication - off label indication (N.B. tripotassium dicitratobismuthate is discontinued).
Dose = 2 tablets four times a day for 2 weeks, in combination with appropriate antibiotic therapy.

Paediatrics: no BNFc entry - seek specialist advice

02.04 Bisoprolol tablets 

1.25mg, 2.5mg, 3.75mg, 5mg, 7.5mg, 10mg

May be prescribed in paediatrics under specialist advice. Dosage information from specialist centre. 

Amber Initiated paediatrics

02.08.01 Bivalirudin injection  powder for reconstitution 250mg vial

Paediatrics: no BNFc entry - seek specialist advice
27.06 Blepharitis 

First line: self-care

Second line: Chloramphenicol 1% ointment BD 6 week trial

Third line: Oxytetracycline* 500 mg BD for 4 weeks then 250 mg BD for 8 weeks OR
Doxycycline* 100 mg OD for 4 weeks then 50 mg OD for 8 weeks

*Warning Avoid in pregnancy

When no antibiotic given advise self-care: lid hygiene including warm compresses, lid massage and scrubs, gentle washing, and avoiding cosmetics.

Second line: topical antibiotics if hygiene measures are ineffective after 2 weeks.

Signs of Meibomian gland dysfunction, or acne rosacea: consider oral antibiotics.

 

08.02.03 Blinatumomab 

38.5 micrograms powder for concentrate and solution for infusion.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

02.05.01 Bosentan tablets  62.5mg, 125mg
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Pulmonary hypertension, digital ulceration in systemic sclerosis only by NHSE designated specialist centres
01.07.04 Botulinum toxin  Injection, powder for reconstitution 50-unit vial, 100-unit vial, 200-unit vial

Paediatrics: no BNFc entry - seek specialist advice
04.07.04.02 Botulinum toxin type A 

Injection, 200unit vial (Botox®),
No BNFc entry – seek specialist advice

04.09.03 Botulinum Toxin Type A  Injection, powder for reconstitution
Botox® 50-unit vial, 100-unit vial, 200-unit vial
Xeomin® 50-unit vial, 100-unit vial
Dysport® 300-unit vial, 500-unit vial

Note
Botulinum Toxin preparations are NOT interchangeable

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
07.04.02 Botulinum Toxin Type A 

Injection 50 units, 100 units, 200 units

Paediatrics: No BNFc entry, seek specialist advice 

11.10 Botulinum toxin type A  Injection
For blepharospasm, hemifacial spasm, squint and protective ptosis.
Various brands available – contact your hospital's pharmacy department for further advice.
13.12 Botulinum toxin type A  

Botox®
Restricted use - For severe axillary hyperhidrosis only - see Pan Mersey Policy Statement

04.09.03 Botulinum Toxin Type B 

Injection (NeuroBloc®) 5000 units/mL
For use by The Walton Centre only within its licensed indications and only when Botulinum Toxin Type A fails.

Note
Botulinum Toxin preparations are NOT interchangeable

No BNFc entry – seek specialist advice

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

11.06 Brimonidine  

0.2% eye drops

Amber Initiated Paediatrics.

13.06.03 Brimonidine gel 

0.33% gel (Mirvaso®▼)

Topical preparation for erythema of rosacea

No BNFc entry; Paediatrics - seek specialist advice

11.06 Brimonidine with brinzolamide  

2mg/ml (0.2%) and 10mg/ml (1%) eye drops

No BNFc entry - seek specialist advice.

11.06 Brimonidine with timolol 

0.2% and 0.5% eye drops

Amber Initiated Paediatrics.

11.06 Brinzolamide 

10 mg/ mL (1%) eye drops

Amber Initiated Paediatrics.

11.06 Brinzolamide with timolol 

10mg/ml (1%)and 5mg/ml (0.5%) eye drops

Amber Initiated Paediatrics.

04.08.01 Brivaracetam 

Tablets 10mg, 25mg, 50mg, 75mg, 100mg

Oral solution 10mg/ml

Red Solution for injection 10mg/ml 

 

Red in West Lancashire CCG

Grey for use in adolescents and children from 4 years of age to under 16 years of age.

13.05.03 Brodalumab 

210mg solution for injection (pre-filled syringe)

For treatment of plaque psoriasis

11.08.02 Bromfenac  0.09% eye drops

06.07.01 Bromocriptine  

tablets 1mg, 2.5mg capsules 5mg Treatment of hyperprolactinaemia

Paediatrics: No BNFc entry, seek specialist advice 

27.08 Bronchiectasis, infective exacerbation 
Discuss with appropriate specialist
Always send a sputum sample
27.08 Bronchiolitis or croup in children 
 

Antibiotics not indicated

Symptomatic treatment only

03.02 Budesonde / formoterol Fobumix Easyhaler®

Dry powder inhaler
Budesonide 320microgram/ formoterol 9microgram – 60 dose
Budesonide 160microgram/ formoterol 4.5microgram – 60 dose, 120 dose
Budesonide 80microgram/ formoterol 4.5microgram – 120 dose

Licensed for asthma (adults) and COPD

PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME

Paediatrics: no BNFc entry - seek specialist advice

01.05.02 Budesonide Budenofalk®

Rectal foam 2mg per dose

Amber Initiated paediatrics

01.05.02 Budesonide Cortiment®

Prolonged release tablets 9mg

Licensed for ulcerative colitis.

Second line option to hydrocortisone/ prednisolone rectal foams and Clipper®. Where treatment course previously recommended for patient by specialist, further course(s) may be initiated in primary care for symptom relapse where recommended as part of treatment plan.

01.05.02 Budesonide Budenofalk®

Capsules m/r 3 mg

Licensed for Crohn's Disease.Where treatment course previously recommended for patient by specialist, further course(s) may be initiated in primary care for symptom relapse where recommended as part of treatment plan.

Prescribe by brand name.

01.05.02 Budesonide Budenofalk®

Gastro-resistant granules, 9 mg/sachet 

Licensed for Crohn's Disease.

Where treatment course previously recommended for patient by specialist, further course(s) may be initiated in primary care for symptom relapse where recommended as part of treatment plan.

03.02 Budesonide / formoterol  Symbicort 200/6 pressurised inhalation, suspension
Symbicort MDI

 

Metered dose inhaler Budesonide 200 micrograms, formoterol fumarate 6 micrograms /metered inhalation (Licensed for COPD)

PRESCRIBE BY BRAND NAME

Paediatrics: no BNFc entry - seek specialist advice

03.02 Budesonide / formoterol  Symbicort 200/6 Turbohaler®
Symbicort Turbohaler

Breath actuated
Budesonide 200 micrograms, formoterol fumarate 6 micrograms /metered inhalation
(Licensed for asthma and COPD)


PRESCRIBE BY BRAND NAME

Amber Recommended Paediatrics

03.02 Budesonide / formoterol  Symbicort 400/12 Turbohaler®
Symbicort Turbohaler

Dry powder inhaler
Budesonide 400 micrograms, formoterol fumarate 12 micrograms /metered inhalation
(Licensed for asthma and COPD)

PRESCRIBE BY BRAND NAME

Amber Recommended Paediatrics

03.02 Budesonide / formoterol Symbicort 100/6 Turbohaler®
Symbicort Turbohaler

Dry powder inhaler
Budesonide 100 micrograms, formoterol fumarate 6 micrograms /metered inhalation
(Licensed for asthma only)


PRESCRIBE BY BRAND NAME

Amber Recommended Paediatrics

03.02 Budesonide / formoterol  DuoResp Spiromax ®

Dry powder inhaler
Budesonide 160 micrograms / formoterol 4.5 micrograms per inhalation
Budesonide 320 micrograms/ formoterol 9 micrograms per inhalation

Licensed in asthma in adults and COPD

PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME

Paediatrics: no BNFc entry - seek specialist advice

12.02.01 Budesonide 64mcg/metered spray nasal spray 

Rhinacort®

 

Amber Recommended paediatrics < 6 years

03.02 Budesonide dry powder for inhalation Budesonide Turbohaler® Dry powder inhaler
100 micrograms/metered inhalation
200 micrograms/metered inhalation
400 micrograms/metered inhalation
PRESCRIBE BY BRAND NAME

Amber Recommended Paediatrics
03.02 Budesonide dry powder for inhalation Budesonide Easyhaler® Dry powder inhaler
100 micrograms/metered inhalation
200 micrograms/metered inhalation
400 micrograms/metered inhalation

PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME

Amber Recommended Paediatrics
01.05.02 Budesonide Nebuliser Liquid   500 microgram in 2ml, 1mg in 2ml
Used as oral viscous suspension in Splenda for eosinophilic oesophagitis
PAEDIATRICS: no BNFc entry – seek specialist advice
03.02 Budesonide solution for inhalation Budesonide Respules® Single-dose units for nebulisation
500 micrograms/2mL (250 micrograms/mL)
1 mg/2mL (500 micrograms/mL)
NB Not suitable for use in ultrasonic nebulisers
02.02.02 Bumetanide oral liquid 

1mg/5ml
 

Amber Initiated paediatrics

02.02.02 Bumetanide tablets 

1mg, 5mg
 

Amber Initiated paediatrics

04.07.02 Buprenorphine  

Injection, 300 mcg/ml

Opioid – parenteral preparation

Amber InitiatedPaediatrics

04.07.02 Buprenorphine 
Red Triangle Take care when prescribing and dispensing
Buprenorphine transdermal patches tablets are avialable as 72-hourly, 96-hourly and 7-day dosage form. All transdermal patch preparations should be prescribed by brand name to avoid confusion.
CD CQC: Safer use of fentanyl and buprenorphine transdermal patches
Sublingual tablets
CD Schedule 3
200microgram, 400microgram
Amber Initiated Traffic Light Paediatrics. Patient will remain under the care of the paediatric specialist pain team.
Transdermal patch
CD Schedule 3
72-hourly 35microgam/hr, 52.5microgram/hr, 70microgram/hour
96-hourly 35microgam/hr, 52.5microgram/hr, 70microgram/hour
7-day 5microgram/hr, 10microgram/hr, 15microgram/hr, 20microgram/hr
Amber Initiated Traffic Light Paediatrics. Patient will remain under the care of the paediatric specialist pain team.
04.10.03 Buprenorphine 

Tablets s/l 400micrograms, 2mg, 8mg

Oral lyophilisate tablets 2mg, 8mg (Espranor®)

Black St Helens CCG (Espranor®)

Espranor®  has different bioavailability to other buprenorphine products and is not interchangeable - consult product literature.  

Prescribed by the Drug Service

No BNFc entry – seek specialist advice

04.10.03 Buprenorphine and naloxone 

Tablets s/l 2mg/500micrograms, 8mg/2mg

Prescribed by the Drug Service

No BNFc entry – seek specialist advice

04.10.02 Bupropion Hydrochloride 

Tablets m/r 150mg

Notes
• Bupropion has been used as an antidepressant. Its mode of action in smoking cessation is unclear and may involve an effect on noradrenaline and dopamine transmission.
• Bupropion is contraindicated in patients with previous or current seizure disorder.
• Bupropion should not be offered to young people under 18 nor pregnant or breastfeeding women.
• Bupropion may impair performance of skilled tasks (e.g., driving)

No BNFc entry – seek specialist advice

08.03.04.02 Buserelin 

Injection 1mg/mL; nasal spray 100 micrograms

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

04.01.02 Buspirone Hydrochloride 

Tablets 5 mg, 10 mg

Amber Initiated Paediatrics

 

06.07.01 Cabergoline  

tablets 500micrograms Treatment of hyperprolactinaemia

Paediatrics: No BNFc entry, seek specialist advice 

09.05.01.01 Cacit® 

Effervescent tablets calcium carbonate 1.25g (calcium 500mg)

Paediatric advice: To achieve a smaller dose from a proportion of Cacit® - dissolve one Cacit tablet in 24mL water to give 12.5mmol of calcium in 25mL (i.e. 0.5mmol/mL) orange flavoured solution. Draw up the correct volume for the prescribed dose. Discard the remaining solution and use a new tablet for the next dose.   

03.05.01 Caffeine citrate  Oral solution 10mg in 1mL; injection 10mg in 1mL
Caffeine citrate 2mg = caffeine base 1mg (all doses should be prescribed as citrate)
09.05.01.01 Calcichew®  Chewable tablets calcium carbonate 1.25g (calcium 500mg)
13.05.02 Calcipotriol 

50 micrograms/g (Dovonex®) Ointment;
(not for face or flexures) 30 g

For chronic plaque psoriasis in adult and child 6-18 years
For Body

Amber Recommended Paediatrics < 6 years

06.06.01 Calcitonin (salmon) / Salcatonin injection  50units/mL, 1mL amp
100units/mL, 1mL amp
200units/mL, 2mL vial
09.06.04 Calcitriol  Capsules 250 nanograms, 500 nanograms
13.05.02 Calcitriol  

3micrograms/g (Silkis®) Ointment; 100g

For chronic plaque psoriasis in adult and child over 12 years
For Body

 

Amber Recommended Paediatrics < 12 years

09.05.02.02 Calcium Acetate Phosex® Tablets calcium acetate 1g (calcium 250mg)
09.05.02.02 Calcium acetate with magnesium carbonate Osvaren®

Tablets calcium acetate 435mg (calcium 110mg) and magnesium carbonate 235mg (magnesium 60mg)

Paediatrics: no BNFc entry - seek specialist advice

09.05.02.02 Calcium Carbonate 

Chewable tablets calcium carbonate 1.25g (calcium 500mg) (Calcichew®)

Chewable tablets calcium carbonate 1.5g (calcium 600mg) (Adcal®)
 
Oral mixture calcium carbonate 250mg/5ml(unlicensed) - Paediatric use

Calcium carbonate 500mg (Tums®) - Paediatric use


Calcium Carbonate 680mg (equivalent of 272mg Calcium) and Heavy Magnesium Carbonate 80mg (Rennies®) - Paediatric use

Chewable tablets calcium carbonate 800mg (Remegel®) - Paediatric use (Do not confuse with Renagel®)

NB: Cacit® tablets are NOT suitable as when they disperse in water they provide 500mg calcium as calcium citrate, which is a poor phosphate binder.   

09.05.01.01 Calcium Gluconate  Injection calcium gluconate 10% (Ca2+ approx. 225 micromol/ml)
09.05.01.01 Calcium Salts Adcal® Chewable tablets calcium carbonate 1.5g (calcium 600mg)
09.05.01.01 Calcium Syrup  Syrup (Alliance) – Calcium lactate and calcium gluconate (20.4mg of soluble calcium or 0.51mmol of calcium per ml)
13.02.01 Calmurid®  Urea 10%, lactic acid 5% Cream; 100 g, 500 g

Medium
27.09 Campylobacter enteritis 
 

Antibiotic treatment not usually indicated unless the symptoms are systemic and prolonged.

Initiate treatment on the advice of microbiologist if the patient is systemically unwell.

06.01.02.03 Canagliflozin tablets 

100mg, 300mg

Sodium-glucose co-transporter 2 (SGLT2) inhibitor

Third-line option when used as monotherapy

Paediatrics: No BNFc entry, seek specialist advice 

06.01.02.03 Canagliflozin with metformin Vokanamet® 50mg/850mg; 50mg/1g

Sodium-glucose co-transporter 2 (SGLT2)(combination therapy)

08.02.04 Canakinumab 

Injection 150mg

NHSE commissioned drug - see Specialised Commissioning: Key documents

04.07.04.02 Candesartan  

Tablets 2mg, 4mg, 8mg, 16mg

No BNFc entry – seek specialist advice

02.05.05.02 Candesartan tablets 

2mg, 4mg, 8mg, 16mg, 32mg 

Amber Initiated paediatrics

02.09 Cangrelor  50 mg powder for concentrate for solution for injection / infusion
10.02.02 Cannabis extract 
04.07.03 Capsaicin 

Patches, 179 mg (8%)

No BNFc entry - seek specialist advice

04.07.03 Capsaicin 

Cream 0.025%, 0.075%

No BNFc entry - seek specialist advice

10.03.02 Capsaicin cream 0.025%  Within its licensed indication: symptomatic relief of pain associated with osteoarthritis

Paediatrics: no BNFc entry - seek specialist advice
10.03.02 Capsaicin cream 0.075%  Within its licensed indications: symptomatic relief of neuralgia associated with and following Herpes Zoster infections after open skin lesions have healed, or, symptomatic relief of painful diabetic peripheral polyneuropathy

Paediatrics: no BNFc entry - seek specialist advice
10.03.02 Capsicum patches 179mg (8%)  See chapter 4.7.3 Neuropathic pain

Paediatrics: no BNFc entry - seek specialist advice
02.05.05.01 Captopril liquid 

5mg/5ml, 25mg/5ml
First line in children until stabilised.
No longer routinely recommended in new adult patients. Patients currently stable may remain on treatment.

Amber Initiated paediatrics

02.05.05.01 Captopril tablets 

12.5mg, 25mg, 50mg
First line in children until stabilised.
No longer routinely recommended in new adult patients. Patients currently stable may remain on treatment.

Amber Initiated paediatrics

04.02.03 Carbamazepine 

Tablets 100 mg, 200 mg, 400mg
Tablets M/R 200 mg, 400 mg
Liquid 100 mg/5 mL

 

04.07.03 Carbamazepine 

Tablets, 100 mg, 200 mg, 400 mg
Tablets, m/r, 200 mg, 400 mg
Liquid, 100 mg/5ml
Suppositories, 125 mg, 250 mg

Amber Initiated Paediatrics

04.07.04.03 Carbamazepine 

Trigeminal neuralgia and SUNCT (Short lasting unilateral neuralgiform headache with conjunctival injection and tearing)

Tablets 100mg, 200mg, 400mg
Modified release tablets 200mg, 400mg
Oral suspension 100mg/5mL
 
No BNFc entry - seek specialist advice

04.08.01 Carbamazepine 

Offer a modified release product.
Modified release tablets 200mg, 400mg
Standard release tablets 100mg, 200mg, 400mg
Oral suspension 100mg/5mL
Suppositories 125mg, 250mg
 
Amber Initiated Paediatrics

Focal onset epilepsy - 1st line ALTERNATIVE

Generalised epilepsy – may be best avoided; Carbamazepine has been shown to exacerbate some seizure types in generalised epilepsy, in particular absences and myoclonus.
However, if tonic-clonic seizures are resistant to other treatments in generalised epilepsy then occasionally carbamazepine can be used effectively, but the patients should be warned of the possibility of exacerbating the seizure types.

04.10.01 Carbamazepine  

Tablets 100mg, 200mg, 400mg
M/R Tablets 200mg, 400mg

Off-label indication

For Acute Alcohol Withdrawal
 
Prescribed by specialist services

No BNFc entry – seek specialist advice

06.02.02 Carbimazole tablets  5mg, 20mg

Patient - specific advice on dose and monitoring must be provided to the GP by the specialist.
03.07 Carbocisteine  Capsules 375 mg;
Oral liquid 250 mg/5 mL
Sachets 750mg/10ml
11.08.01 Carbomer 980   0.2% eye drops
0.2% eye gel (Artelac Nighttime gel, Clinitas Carbomer gel, Lumecare Long Lasting gel)
0.2% preservative free eye gel (Xailin, Viscotears unit dose)
07.01.01 Carboprost 

Injection 250 micrograms/ mL For prevention and treatment of haemorrhage

Paediatrics: No BNFc entry, seek specialist advice 

11.08.01 Carmellose 

Optive Plus (carmellose sodium 0.5% with glycerol and castor oil, 10ml)

Celluvisc 1% single dose eye drops (30 units)preservative-free

11.08.01 Carmellose  Optive Fusion® (carmellose sodium 0.5% / sodium hyaluronate 0.1%, 10ml)
Celluvisc® 0.5% single dose eye drops (30 units), preservative free
Xailin Fresh® (carmellose sodium 0.5%, 30 units), preservative free
12.03.01 Carmellose oral paste  Orabase®
02.04 Carvedilol tablets 

3.125mg, 6.25mg, 12.5mg, 25mg

Liquid 1mg/ml Extemp. preparation Alder Hey for paediatric use.

Amber Initiated paediatrics

13.02.02 Cavilon 

Cream; 28 g, 92 g;
Pump spray; 28 mL

No BNFc entry; Paediatrics, seek specialist advice 

11.03.01 Ceftazidime  

5% eye drops
 
Ophthalmologist only.

11.03.01 Cefuroxime   5% eye drops

10.01.01 Celecoxib  Capsules 100 mg, 200mg

Paediatrics: no BNFc entry - seek specialist advice
11.10 Cenegermin 

20 micrograms/ml eye drops

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents. As per IFR approval. No BNFc entry – seek specialist advice

10.01.03 Certolizumab pegol  Subcutaneous injection 200 mg (prefilled syringe, prefilled pen)

Paediatrics: no BNFc entry - seek specialist advice
13.05.03 Certolizumab pegol 

Subcutaneous injection 200mg (pre-filled syringe, pre-filled pen)

For treatment of plaque psoriasis

03.04.01 Cetirizine hydrochloride  Tablets 10 mg;
Oral solution 5 mg/5 mL
13.02.01 Cetraben®  Cream; 500 g pump pack

Medium
13.02.01 Cetraben® 

Ointment; 450 g tub

Very Greasy

13.02.01.01 Cetraben® 

Emollient bath additive 500mL

13.09 Cetrimide 10%, Undecanoic acid 1%  (Ceanel Concentrate®) Shampoo; 150 mL, 500 mL
04.01.01 Chloral Hydrate 

Oral solution 143.3mg /5mL

Oral mixture 500mg /5mL (Specials)

11.03.01 Chloramphenicol  0.5% eye drops, 0.5% minims, 1% eye ointment

1st line for superficial eye infections e.g. conjunctivitis.
Ointment can be used once daily at night in combination with eye drops.
Chloramphenicol can be sold to the public for the treatment of acute bacterial conjunctivitis.
Minims (single dose eye drops) reserved for patients with known preservative allergy.
11.03.01 Chloramphenicol  1% eye ointment

Apply either at night (if eye drops used during the day) or 3 - 4 times daily if ointment used alone. Chloramphenicol can be sold to the public for the treatment of acute bacterial conjunctivitis.
12.01.01 Chloramphenicol 5% ear drops  Contains propylene glycol and can cause hypersensitivity reactions in about 10% of patients
04.10.01 Chlordiazepoxide  

Tablets 5mg, 10mg
Capsules 5mg, 10mg

For Acute Alcohol Withdrawal
 
Prescribed by specialist services

Amber Recommended Warrington CCG

No BNFc entry - seek specialist advice

11.03.01 Chlorhexidine  0.02% eye drops

13.11.02 Chlorhexidine 0.015% with Cetrimide 0.15%  (Tisept®) Solution; 25 x 25 mL sachet, 10 x 100 mL sachet

Chlorhexidine salts with cetrimide
12.02.03 Chlorhexidine 0.1% and neomycin 0.5% nasal cream  Naseptin®
12.03.04 Chlorhexidine 1% dental gel 
13.11.02 Chlorhexidine acetate  Dusting powder 1% (CX Antiseptic Dusting Powder®); 15 g
13.11.02 Chlorhexidine gluconate  Cleansing solution 4% (Hibiscrub®); 250 mL, 500 mL, 5 Litre; Skin Wash (≡solution) 1% (Cepton®); 150 mL


Red Traffic Light  Pink solution 0.05% (Unisept®); 2.5% solution (≡ chlorhexidine gluconate 0.5%) Hydrex®
12.03.04 Chlorhexidine gluconate 0.2% mouthwash 
13.11.02 Chlorhexidine gluconate 2% in isopropyl alcohol 70%  ChloraPrep®
06.01.04 Chlorothiazide 

Tablets 250mg (imported), oral suspension 250mg in 5mL (imported)

Paediatrics only

02.02.01 Chlorothiazide suspension 

250mg in 5ml suspension

Unlicensed special Paediatrics only

03.04.01 Chlorphenamine maleate  Tablets 4 mg;
Oral solution 2 mg/5 mL
04.02.01 Chlorpromazine 

Tablets 25 mg, 50 mg, 100 mg
Oral solution 25 mg/5 mL, 100 mg/5 mL

Amber Patient Retained Paediatrics

04.09.03 Chlorpromazine 

Tablets 25mg, 50mg, 100mg 
Oral solution 25mg/5mL

No BNFc entry - seek specialist advice

02.02.01 Chlortalidone tablets 

50mg tablets scored
(12.5–25mg once daily, recommended by NICE)

Amber Initiated paediatrics

 Not used at Alder Hey

11.03.01 Chlortetracycline  1% eye ointment

27.09 Cholecystitis, acute 

Provide symptomatic relief prior to admission.

Urgently admit to hospital anyone with suspected acute cholecystitis.
12.03.01 Choline salicylate oral gel  For patients aged 16 and over only
06.05.01 Chorionic Gonadotrophin injection  Product choice is dependent on organisation
27.08 Chronic obstructive pulmonary disease, acute infective exacerbations 

Amoxicillin 500 mg TDS for 5 days OR
Doxycycline* 200 mg STAT then 100 mg OD for 5 days in total OR
Clarithromycin* 500 mg BD for 5 days

If at risk of resistance: Co-amoxiclav 500/125 mg TDS for 5 days

*Warning Caution in pregnancy

Treat if dyspnoea with changes in sputum i.e. increase and purulence.

Antibiotics are less effective if only one symptom present.

Risk factors for antibiotic resistance: severe COPD (MRC > 3), comorbid disease, frequent exacerbations, antibiotics in last 3 months.

Obtain sputum sample wherever possible (before second-line antibiotic used).

For further information refer to the links in the left column.

Note: Azithromycin* may be recommended by a respiratory specialist for prevention of exacerbation of COPD. This recommended long-term use is for its immunomodulatory and lung remodelling properties and not its anti-infective action.

01.05.03 Ciclosporin 

Capsules 25 mg, 50 mg, 100 mg
Oral solution 100mg/ml (adults and paediatrics)

Prescribe by brand name

For acute and chronic ulcerative colitis and Crohn's disease

01.05.03 Ciclosporin  Concentrate for intravenous infusion (oily) 50 mg/mL

Acute ulcerative colitis
08.02.02 Ciclosporin 

Capsules 25mg, 50mg, 100mg (Capimune®, Capsorin®, Deximune®, Neoral®)
Capsules 10mg (Neoral®)
Oral solution 100mg/mL (Neoral®)
Intravenous infusion 50mg/mL (Sandimmun®)

Prescribe by brand name

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Ciclosporin is RED for transplant rejection

10.01.03 Ciclosporin 

Capsules 10 mg, 25 mg, 50 mg, 100 mg; Oral solution 100 mg/mL Paediatrics: dose available from initiating specialist centre (Prescribing and dispensing should be by brand to avoid inadvertent switching between formulations. Pan Mersey first line recommended brand is Capimune® for dermatological and rheumatological conditions)

Red Paediatrics

11.08.01 Ciclosporin  

0.05% single use eye drops, preservative free 0.06% eye drops, preservative free 0.2% eye ointment, preservative-free 2% eye drops, preservative-free Ophthalmologist only. For severe dry eyes syndrome.  

Amber Initiated Ikervis brand 1mg/mL (0.1%) eye drops - licensed preparation.

11.08.01 Ciclosporin 

 1 mg/mL eye drops (Ikervis brand) - licensed preparation 

11.10 Ciclosporin   25mg, 50mg, and 100mg capsules

Ophthalmologist only.
13.05.03 Ciclosporin 

Capsules 10 mg, 25 mg, 50 mg, 100 mg (Deximune®, Neoral®, Capimune®) Pan Mersey first line recommended brand is Capimune® Oral solution 100 mg/mL (Neoral®); 50mL Oral preparation NB Ciclosporin must be prescribed by brand, please consult policy statement for further information around brand prescribing.

Red Paediatrics

02.06.04 Cilostazol tablets  50mg, 100mg
09.05.01.02 Cinacalcet Mimpara®

Tablets 30mg, 60mg, 90mg

NHS NHSE commissioned drug, hyperparathyroidism in dialysis patients; primary hyperparathyroidism - see Specialised Commissioning: Key documents
Paediatrics: no BNFc entry - seek specialist advice

04.06 Cinnarizine  Tablets 15mg
04.07.04.01 Cinnarizine  Tablets, 15mg
11.03.01 Ciprofloxacin  0.3% ophthalmic solution/ointment

Ophthalmologist initiation only.
11.03.01 Ciprofloxacin  0.3% eye drops, 0.3% eye ointment

12.01.01 Ciprofloxacin 2mg/mL ear drops 

15 dose pack.
3rd line in the management of otitis externa after Ear Calm® and Otomize®.
NB – may be used earlier in the management of otitis externa where swelling is so severe that topical treatment cannot be administered in the form of a spray or there is confirmed or suspected tympanic membrane perforation or patent grommet.

04.03.03 Citalopram 

Tablets 10 mg, 20 mg, 40 mg
Oral drops SF 40 mg/mL

Amber Initiated  Paediatrics

08.01.03 Cladribine Mavenclad®

Tablets 10mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

For Multiple Sclerosis

13.06.02 Clarithromycin  Tablets 250 mg
(after failure of first choice antibiotics)
07.02.02 Clindamycin  Vaginal cream 2%.
13.06.01 Clindamycin   1% (Dalacin T®) Lotion(aqueous base); 30 mL, 60 mL
Topical solution(aqueous alcoholic base); 30 mL, 50 mL
04.08.01 Clobazam 

Tablets 10mg
Oral suspension 5mg/5ml, 10mg/5mL


Amber Initiated Paediatrics
Focal onset epilepsy - add on drug option.

13.04 Clobetasol Propionate  

First choice

0.05% (Dermovate®) Cream; Ointment; 30 g, 100 g
0.05% foam scalp application (Clarelux®); 100 g (for use in adults only)

Very potent

Amber Recommended Paediatrics

13.04 Clobetasol Propionate 0.05%, Neomycin 0.5%, Nystatin 100,000 units/g 

Cream; Ointment; 30g

Very potent with antimicrobials

Amber Recommended Paediatrics

13.04 Clobetasone Butyrate   First Choice

0.05% (Eumovate®) Cream; Ointment; 30 g, 100 g

Moderately potent
13.04 Clobetasone butyrate 0.05%, oxytetracycline 3%, nystatin 100 000 units/g 

(Trimovate®) Cream; 30 g

Moderately potent with antimicrobials

Amber Recommended Paediatrics

04.10.01 Clomethiazole 

Capsules 192mg
Oral solution 31.5mg/ml

For acute alcohol withdrawal

Prescribed by specialist services

06.05.01 Clomifene citrate tablets 

50mg

Paediatrics: no BNFc entry - seek specialist advice.

04.03.01 Clomipramine 

Capsules 10 mg, 25 mg, 50 mg

No BNFc entry – seek specialist advice

04.08.01 Clonazepam 

Tablets 500mcg, 2mg

Oral solution 2mg/5mL (sugar free)

Oral drops 2.5mg.mL (import)

04.09.03 Clonazepam  

Tablets 500micrograms, 2mg

No BNFc entry – seek specialist advice

04.09.03 Clonazepam 

unlicensedunlicensed

Tablets 500 micrograms, 2mg
Oral solution 500 micrograms / 5mL

Amber Initiated Paediatrics

02.05.02 Clonidine tablets 

25micrograms,100micrograms scored

Amber Initiated paediatrics

02.09 Clopidogrel tablets 

75mg
 
 
Amber Initiated paediatrics

Paediatrics: no BNFc entry - seek specialist advice. Dosage information from initiating centre.

27.09 Clostridium difficile 

Stop unnecessary antibiotics, PPIs, and antimotility agents.

Mild and moderate CDI: Metronidazole 400 mg TDS for 10–14 days. Review after four days.

Severe symptoms, or recurrent disease, or both: Oral vancomycin 125 mg QDS for 10–14 days.

Definition of severe: Temperature > 38.5 °C, or WCC > 15, or rising creatinine or signs or symptoms of severe colitis.

Fidaxomicin may be prescribed only if recommended by a microbiologist, see comment opposite.

May occur up to eight weeks after antibiotic treatment

Consider hospital referral if severe symptoms and to rule out toxic colitis.

Refer to the Public Health England guidance on management of C. difficile which defines mild, moderate and severe criteria.

Pan Mersey APC recommends that Fidaxomicin should only be prescribed on the advice of a consultant microbiologist or consultant in infectious diseases.

Testing for clearance of toxin is not required.

Antimotility agents e.g. loperamide should NOT be prescribed.

Metronidazole liquid: contains the prodrug metronidazole benzoate which requires enzyme activation that may be reduced in patients with diarrhoea. For those with swallowing difficulties consider the off-label use of tablets, crushed.

07.02.02 Clotrimazole  Cream 1%, 2%; Pessaries 100 mg, 200 mg, 500 mg; Vaginal cream 10%.
11.03.02 Clotrimazole 

1% single use eye drops.

No BNFc entry - seek specialist advice.

 

13.10.02 Clotrimazole  1% Cream; 20 g, 50 g
1% Solution; 20 mL
Cutaneous candidiasis - apply until 10 days after lesions healed
12.01.01 Clotrimazole 1% solution  Canestan®
Anti-fungal preparation
04.02.01 Clozapine Denzapine® Tablets 25 mg, 100 mg
Suspension 50 mg/mL
13.09 Coal Tar   Alcoholic coal tar extract 5% (Alphosyl 2 in 1®); Shampoo; 125 mL, 250mL
13.09 Coal tar 1%, coconut oil 1%, salicylic acid 0.5%  (Capasal®) Shampoo; 250 mL
13.05.02 Coal tar 5% solution in 0.025% strength betnovate ointment 

Ointment; 100 g Topical steroid For psoriasis, this unlicensed special may be considered

13.05.02 Coal tar 6% with salicylic acid 2% in emulsifying ointment 

Ointment; 100 g Tar For psoriasis, this unlicensed special may be considered

13.05.02 Coal Tar solution 12%, salicylic acid 2%, precipitated sulphur 4%  

in a coconut oil emollient basis (Sebco®); Ointment, 100 g

For scalp

Amber Recommended Paediatrics < 6 years

13.05.02 Coal tar solution 5% in emollient base  (Exorex®) Lotion; 100 mL, 250 mL

For scalp
02.02.04 Co-amilofruse (furosemide and amiloride) 

2.5/20 (amiloride hydrochloride 2.5mg, furosemide 20mg)
5/40 (amiloride hydrochloride 5mg, furosemide 40mg) 

Amber Initiated paediatrics

04.09.03 Co-beneldopa 

unlicensedunlicensed

Capsules 12.5mg/50mg, 25mg/100mg, 50mg/200mg
Dispersible tablets (Madopar®) 12.5mg/50mg, 25mg/100mg
MR capsules (Madopar® CR) 25mg/100mg

No BNFc entry – seek specialist advice

04.09.01 Co-Beneldopa (Benserazide/Levodopa) 

Capsules 12.5mg/50mg, 25mg/100mg, 50mg/200mg
Dispersible tablets (Madopar®) 12.5mg/50mg, 25mg/100mg
MR capsules (Madopar® CR) 25mg/100mg

No BNFc entry – seek specialist advice

11.10 Cocaine   4% and 10% eye drops
04.09.03 Co-careldopa 

unlicensedunlicensed

Tablets 10mg/100mg, 12.5mg/50mg, 25mg/100mg, 25mg/250mg
MR Tablets 25mg/100mg, 50mg/200mg 

Amber Initiated Paediatrics

04.09.01 Co-Careldopa (Carbidopa/Levodopa) 

Intestinal Gel 100ml cassette (Duodopa®)
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

 No BNFc entry - seek specialist advice

04.09.01 Co-Careldopa (Carbidopa/Levodopa) 

Tablets 10mg/100mg, 12.5mg/50mg, 25mg/100mg, 25mg/250mg
MR Tablets 25mg/100mg, 50mg/200mg

Oral suspension 125mg in 10mL (extemporaneous preparation under Specials Scheme)

Amber Initiated Paediatrics

 

04.07.01 Co-codamol 

Second line

Tablets 8 / 500 (codeine phosphate 8 mg, paracetamol 500 mg)
Soluble tablets, 8 / 500 (codeine phosphate 8 mg, paracetamol 500 mg)

Tablets 15 / 500 (codeine phosphate 15mg, paracetamol 500mg)
Soluble tablets 15 / 500 (codeine phosphate 15mg, paracetamol 500mg)

Tablets, 30 / 500 (codeine phosphate 30 mg, paracetamol 500 mg)
Soluble tablets, 30 / 500 (codeine phosphate 30 mg, paracetamol 500 mg)

Black Paediatrics in children less than 12 years

Compound preparations are considered to be less suitable for prescribing than the separate components. Although such preparations may not be considered as drugs of first choice, their use may be justifiable in certain circumstances.

13.06.02 Co-Cyprindiol 

Cyproterone acetate 2 mg, ethinylestradiol 35 micrograms (Dianette®) Tablets; 63 tablets.

Paediatric: only use in post menarche girls

See MHRA Drug Safety Update June 2013
Venous thromboembolism occurs more frequently in women taking co-cyprindiol than in those taking a low-dose combined oral contraceptive. Co-cyprindiol is licensed for use in women with severe acne that has not responded to oral antibacterials and for moderately severe hirsutism; it should not be used solely for contraception. It is contra-indicated in those with a personal or close family history of venous thromboembolism. Women with severe acne or hirsutism may have an inherently increased risk of cardiovascular disease.

13.09 Co-cyprindiol 

Cyproterone acetate 2 mg, ethinylestradiol 35 micrograms (Dianette®) Tablets

See MHRA Drug Safety Update June 2013

No BNFc entry: Paediatrics seek specialist advice 

01.06.02 Co-danthramer 

Suspension 25/200 in 5 mL (dantron 25 mg, poloxamer ‘188’ 200 mg/5 mL)

Strong suspension 75/1000 in 5 mL (dantron 75 mg, poloxamer ‘188’ 1 g/5 mL)

Restricted use - terminally ill only

01.06.02 Co-danthrusate 

Capsules 50/60 (dantron 50 mg, docusate sodium 60 mg)

Suspension 50/60 (dantron 50 mg, docusate sodium 60 mg/5 mL)

Restricted use - terminally ill only

04.07.02 Codeine 

Codeine use in children and adolescents under 18 years of age

MHRA has recommended restricting codeine use in children. It should only be used in children over 12 years old and only if other pain killers such as paracetamol or ibuprofen are not sufficient. Codeine presents well-known safety and efficacy problems related to genetic variability in biotransformation. Codeine is a prodrug that is converted into its active metabolite morphine. The efficacy of a prodrug depends on the amount of active metabolite formed. Variable expressions of the enzymes involved in the biotransformation of prodrugs can lead to substantial inter-individual and inter-ethnic differences in the conversion rate and the plasma concentration of the active metabolite. As a consequence, the analgesic effect is (very) low or absent in neonates and young children. Furthermore, the percentage of poor metabolizers can vary in ethnic groups, resulting in ineffectiveness in large numbers of patients, including children. Conversely, individuals who metabolize codeine quickly and extensively are at risk of severe opioid toxicity, given the high and uncontrolled conversion of codeine into morphine.Black Initiated Traffic Light Children under 12 yearsRed Triangle Pan Mersey APC: CODINE: USE IN CHILDREN, November 2017


Codeine use in Adults

Codeine is a prodrug that is converted into its active metabolite morphine. The efficacy of a prodrug depends on the amount of active metabolite formed. Variable expressions of the enzymes involved in the biotransformation of prodrugs can lead to substantial inter-individual and inter-ethnic differences in the conversion rate and the plasma concentration of the active metabolite. Furthermore, the percentage of poor metabolizers can vary in ethnic groups, resulting in ineffectiveness in large numbers of patients. Conversely, individuals who metabolize codeine quickly and extensively are at risk of severe opioid toxicity, given the high and uncontrolled conversion of codeine into morphine.
Tablets 15mg, 30mg, 60mg
Linctus 15mg/5ml (3 mg per 1 ml)
Linctus, sugar free 15mg/5ml (3 mg per 1 ml)
Oral liquid 25mg/5ml (5 mg per 1 ml)
Injection
CD Schedule 2
60mg/ml
Red Retained Traffic Light Paediatrics

 

01.04.02 Codeine phosphate  Tablets 15 mg, 30 mg, 60 mg
Syrup 25 mg/5 mL

Amber Recommended  PAEDIATRICS – UNDER SPECIALIST ADVICE (only for patients over 12 years old)
04.07.01 Co-dydramol 

Tablets, 10 / 500 (dihydrocodeine 10 mg, paracetamol 500 mg)

Paediatrics: Not recommended in children under 12 years.

Compound preparations are considered to be less suitable for prescribing than the separate components. Although such preparations may not be considered as drugs of first choice, their use may be justifiable in certain circumstances.

10.01.04 Colchicine 

Tablets 500 micrograms

 Amber Initiated  in paediatrics
Paediatrics: used in paediatrics for gout, periodic fever syndromes and Behcet’s syndrome, dose available from initiating specialist centre

09.06.04 Colecalciferol (THORENS) oral drops 10,000units/ml  Oral drops 10,000units/ml
09.06.04 Colecalciferol 2,400 international units oral drops Invita D3 oral drops® Oral drops 2,400 international units in 1ml (400 international units in 6 drops)
09.06.04 Colecalciferol 2,740 international units oral drops Fultium-D3 drops® Oral drops 2,740 international units in 1ml (400 international units in 6 drops)
09.06.04 Colecalciferol 20,000 international units  Capsules 20,000 international units

09.06.04 Colecalciferol 25,000 international units InVita D3® 25,000 international units in 1ml oral solution
09.06.04 Colecalciferol 3,200 international units Fultium-D3® Capsules 3,200 international units
09.06.04 Colecalciferol 800 international units 

Capsules 800 international units (Fultium D3) Tablets 800 international units (Desunin)

09.06.04 Colecalciferol and calcium  

Sachets calcium carbonate 1.25g (calcium 500mg), colecalciferol 11 micrograms (440 international units)

09.06.04 Colecalciferol and Calcium Carbonate 

Chewable tablets, calcium carbonate 2500mg (equivalent to 1000mg calcium) /colecalciferol 1,000unit (equivalent to 25 micrograms)

09.06.04 Colecalciferol and Calcium Carbonate 

Caplets calcium carbonate (calcium 500mg), colecalciferol 10 micrograms (400 international units)

09.06.04 Colecalciferol and Calcium Carbonate 

Chewable tablets or effervescent tablets calcium carbonate 1.5g (calcium 600mg), colecalciferol 10 micrograms (400 international units)

09.06.04 Colecalciferol and Calcium Carbonate 

Chewable tablets calcium carbonate 1.25g (calcium 500mg), colecalciferol 10 micrograms (400 international units)

09.06.04 Colecalciferol and calcium phosphate 

Sachets calcium phosphate 3.1g (calcium 1.2g), colecalciferol 20 micrograms (800 international units)

01.09.02 Colesevelam  Tablets 625 mg


Diarrhoea secondary to bile salt malabsorption - unlicensed use

Paediatrics: no BNFc entry - seek specialist advice
02.12 Colesevelam tablets  625mg

GI indications

Paediatrics: no BNFc entry - seek specialist advice
02.12 Colesevelam tablets 

625mg

Lipid specialist only

Paediatrics: no BNFc entry - seek specialist advice

02.12 Colestipol hydrochloride granule sachets Colestid®

5mg/sachet

01.09.02 Colestyramine  Powder 4 g/sachet
02.12 Colestyramine powder sachets 

4g/sachet

Amber Initiated paediatrics

05.01.07 Colistimethate for nebulisation  Powder for reconstitution, colistimethate sodium, 1 million-unit vial and 2 million-unit vial

For treatment of bronchiectasis.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
For cystic fibrosis
11.08.01 Collagen implants (’Shields’)  For temporary diagnostic occlusion of puncta in dry eye syndrome
10.03.01 Collagenase  Injection, collagenase Clostridium histolyticum,
900 microgram vial

Dupuytren's Contracture


Paediatrics: no BNFc entry - seek specialist advice
10.03.01 Collagenase  Injection, collagenase Clostridium histolyticum,
900 microgram vial

Peyronie's disease
01.01.01 Co-magaldrox
 

Suspension, sugar-free, co-magaldrox 195/220 (magnesium hydroxide 39mg/ml, dried aluminium hydroxide 44mg/mL (low sodium content) 

11.01 ComplEye 
06.04.01.01 Conjugated oestrogens and bazedoxifene acetate 

Duavive® 0.45 mg/20 mg modified-release tablets

27.06 Conjunctivitis 

First line: self-care

Second line for bacterial infection: continue self care. Chloramphenicol 0.5% eye drops 2 hourly for 2 days then reduce frequency OR chloramphenicol 1% ointment QDS (or just at night if used with eye drops during the day)

Third line: Fusidic acid 1% gel BD

Treat for 48 hours after resolution

Treat if severe, as most viral or self-limiting. 65% of cases resolve on placebo by day 5

When no antibiotic given advise self-care: bathe or clean eyelids with cotton wool dipped in sterile saline or boiled (cooled) water, to remove crusting. Explain red flags for urgent review and advise the person to seek further help if symptoms persist beyond 7 days.

For neonatal infections: treatment not indicated; advise cleaning only and take a swab for Chlamydia

13.02.02 Conotrane®  Cream; 100 g, 500 g

07.03.05 Copper IUD 

See section 7.3.4

Green  Paediatrics: if sexually active

09.05.05 Copper oral Biocare® Tablets copper gluconate 8mg
For use in patients post bariatric surgery (Aintree)

Paediatrics: no BNFc entry - seek specialist advice
05.01.08 Co-trimoxazole  Tablets 480mg
Oral suspension 240mg/5ml and 480mg/5ml

Red for Pneumocystis pneumonia and for any long-term use.

Amber Initiated  any other use, short-term use.
27.08 Cough and cold, viral  
 

Antibiotics not indicated

Symptomatic treatment only. Cough may persist for several weeks

27.08 Cough or bronchitis, acute 

Likely to be viral and does not require antibiotics

First line: self-care and safety netting advice

If antibiotics are indicated:

  • Second line: Amoxicillin 500 mg TDS for 5 days
  • Penicillin allergy: Doxycycline* 200 mg STAT then 100 mg daily for 5 days in total

*Warning Caution in pregnancy

Antibiotics have little benefit if no co-morbidity.

Second line: backup antibiotic with 7 day delay, safety net, advice that symptoms can last 3 weeks.

Consider immediate antibiotics if >80 years of age and one of: hospitalisation in past year; taking oral steroids; insulin-dependent diabetic; congestive heart failure; serious neurological disorder/stroke, or >65 years with two of the above.

Consider CRP if an antibiotic is being considered: no antibiotics if CRP<20mg/L and symptoms for >24 hours; backup antibiotics if 20-100mg/L; immediate antibiotics if >100mg/L.

13.08.02 Covermark® 

Classic Foundation (various shades); 15 mL Finishing powder (various shades); 25 g

13.03 Crotamiton  10% Cream (Eurax®); 100g
10% Lotion (Eurax®); 100ml
13.05.02 Crude coal tar 5% with salicylic acid 2% in emulsifying ointment 

Ointment; 100 g Tar For psoriasis, this unlicensed special may be considered

09.01.02 Cyanocobalamin 

Tablets 50 micrograms
Injection 1mg/ml

Red  Tablets for paediatrics (injection Black for paediatrics)
Paediatrics: no BNFc entry - seek specialist advice

Restricted use Black rating applies to treatment use only. Cyanocobalamin may be recommended by a specialist for short-term administration as part of a diagnostic test

04.06 Cyclizine 

Tablets 50mg
Injection 50mg/mL
Suppositories available as ‘special order’

Amber Recommended Paediatrics

04.07.04.01 Cyclizine 

Tablets, 50mg
Injection, 50mg/ml
Solution - unlicensed, 5mg/5ml
Suppositories - unlicensed, 12.5mg

11.05 Cyclopentolate   0.5% eye drops, 0.5% minims, 1% eye drops, 1% minims
10.01.03 Cyclophosphamide 

Tablets 50 mg
Intravenous injection 500 mg, 1g vial

Use in rheumatoid arthritis is unlicensed.

Paediatrics: no BNFc entry - seek specialist advice

03.04.01 Cyproheptadine  Tablets 4mg

Antidote for the management of serotonin syndrome.

Paediatrics: no BNFc entry; seek specialist advice.
08.03.04.02 Cyproterone Acetate  Tablets 50mg, 100mg
06.04.02 Cyproterone Acetate tablets 

50mg Additionally approved by Pan Mersey APC for treatment of androgenic symptoms in polycystic ovary syndrome (off-label indication). Treatment duration 6 - 12 months, concurrent contraception required.

Amber Patient Retained  Paediatrics

27.08 Cystic fibrosis 
 

This service is commissioned by NHS England. Prescribing should not be undertaken in primary care.

02.08.02 Dabigatran capsules  75mg, 110mg, 150mg
Prevention of stroke and systemic embolism in atrial fibrillation.

Paediatrics: only warfarin is used in paediatrics
02.08.02 Dabigatran capsules 

75mg, 110mg, 150mg
Secondary prevention of Deep Vein Thrombosis and/or Pulmonary Embolism

N.B. Green in Wirral for this indication.

Paediatrics: only warfarin is used in paediatrics

02.08.02 Dabigatran capsules  75mg, 110mg, 150mg
VTE prophylaxis in patients who have undergone elective hip and knee replacement surgery

Paediatrics: only warfarin is used in paediatrics
02.08.01 Dalteparin sodium injection 

12 500 units/mL,  2500-unit (0.2-mL) syringe 

25 000 units/mL, 5000-unit (0.2-mL) syringe , 7500-unit (0.3-mL) syringe, 10 000-unit (0.4-mL) syringe, 12 500-unit (0.5-mL) syringe, 15 000-unit (0.6-mL) syringe, 18 000-unit (0.72-mL) syringe2,500 units/mL, 4mL (10,000-unit) amps10,000 units/mL, 1mL (10,000-unit) amps25,000 units/mL, 4-mL (100,000-unit) amps10,000 units/mL, 1-mL (10,000-unit) graduated syringeRED when used as surgical or medical VTE prophylaxis or treatment in hospital, or for prevention of miscarriage in women with history of recurrent miscarriage for the duration of treatment during pregnancy.Red paediatrics

02.08.01 Danaparoid sodium injection  1,250 units/mL, 0.6-mL amp (750 units)
10.02.02 Dantrolene 

Capsules 25 mg, 100 mg

10.02.02 Dantrolene 

Injection - powder for solution 20mg

06.01.02.03 Dapagliflozin tablets  

5mg, 10mg

Sodium-glucose co-transporter 2 (SGLT2) inhibitor

Third-line option when used as monotherapy

Paediatrics: No BNFc entry, seek specialist advice 

06.01.02.03 Dapagliflozin with metformin Xigduo® 5mg/850mg; 5mg/1g

Sodium-glucose co-transporter 2 (SGLT2)(combination therapy)

07.04.06 Dapoxetine 

Tablets 30 mg, 60 mg

Paediatrics: No BNFc entry, seek specialist advice 

13.13 Dapsone 

For Dermatitis Herpetiformis Tablets; 50 mg, 100 mg

 Red for new patients, current patients continue with current practice until shared care framework is adopted. 

09.01.03 Darbepoetin Alfa Aranesp® Injection.
Contact Pharmacy Dept. for product availability

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
07.04.02 Darifenacin 

MR Tablets 7.5mg, 15mg

Paediatrics: No BNFc entry, seek specialist advice 

09.01.03 Deferasirox Exjade®

Tablets 90mg, 180mg, 360mg

The SPC should be consulted before initiating therapy due to the large number of special warnings and precautions in use

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
For iron chelation in thalassaemia and sickle cell disease

09.01.03 Deferiprone Ferriprox® Tablets 500mg, 1g
Oral solution 100mg/ml

The SPC should be consulted before initiating therapy due to the large number of special warnings and precautions in use

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
For iron chelation in thalassaemia and sickle cell disease
06.03.02 Deflazacort  

tablets 6mg

oral drops 22.75mg in 1mL (unlicensed import)

Amber Initiated  Paediatrics

08.03.04.02 Degarelix  Injection 80mg, 120mg




06.05.02 Demeclocycline capsules 

150mg

Paediatrics: No BNFc entry, seek specialist advice 

06.06.02 Denosumab XGEVA®

70mg/mL, 1.7mL (120mg) vial

Paediatrics: No BNFc entry, seek specialist advice 

06.06.02 Denosumab injection Prolia®

60mg/mL, 1mL prefilled syringe

 

11.10 Densiron®  Ophthalmologist only.
Intra-ocular tamponade.
13.08.02 Dermacolor® 

Camouflage crème (various shades); 25 mL Fixing powder (various shades); 60 g

13.02.01 Dermol®  

Cream; 500 g pump pack (used as emollient and soap substitute)

Medium

13.02.01 Dermol® 500 

Lotion; 500 mL pump pack (used as emollient and soap substitute)

Light

13.02.01.01 Dermol® 200 

Shower emollient; 200 mL

13.02.01.01 Dermol® 600 

Bath additive; 600 mL

09.01.03 Desferrioxamine Mesilate  Injection 500mg, 2g vial

The SPC should be consulted before initiating therapy due to the large number of special warnings and precautions in use

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
For iron chelation in thalassaemia and sickle cell disease
07.04.02 Desmopressin 

Tablets 100 micrograms, 200 micrograms; Oral lyophilisates 120 micrograms, 240 micrograms.

Amber Initiated  Paediatrics

DesmoMelt® has been given ORALLY by dissolving the sublingual tablet in water. Occasionally a proportion of a dose is administered using this method. Anecdotally, one 120 microgram tablet can be dissolved in 12mL water to give 10microgram/mL solution. (off-label) Do not change formulation without consulting the specialist.

06.05.02 Desmopressin acetate nasal spray  10micrograms/metered spray, 6mL unit (60 metered sprays)
06.05.02 Desmopressin acetate oral lyophilisates 

Sublingual tablets 60micrograms, 120micrograms, 240micrograms DDAVP® is licensed for diabetes insipidus and DesmoMelt® is licensed for nocturnal enuresis (see Chapter 7).

DesmoMelt® has been given ORALLY by dissolving the sublingual tablet in water. Occasionally a proportion of a dose is administered using this method. Anecdotally, one 120 microgram tablet can be dissolved in 12mL water to give 10microgram/mL solution. (off-label) Do not change formulation without consulting the specialist.

06.05.02 Desmopressin acetate tablets 

100micrograms, 200micrograms

DDAVP® is licensed for diabetes insipidus and DesmoTab® is licensed for nocturnal enuresis (see Chapter 7).

07.03.02.01 Desogestrel  Tablets 75 micrograms
Cerazette®, Cerelle®, Zelleta®
04.06 Dexamethasone  

Tablets 500micrograms, 2mg
Soluble tablets 2mg
Oral solution SF2mg/5mL
Injection 3.8mg/mL (Note has replaced Dexamethasone 4 mg/mL Injection) and 3.3mg/mL

Notes

Dexamethasone has antiemetic effects and is used in vomiting associated with cancer chemotherapy and postoperative nausea and vomiting (unlicenced use). It may be used alone or with metoclopramide, prochlorperazine, or a 5HT3-receptor antagonist.

When prescribing or administering dexamethasone, it must be taken into account that different preparations may contain different salts which are not equivalent to each other. Therefore care is needed to ensure that the patient receives the correct dose.

06.03.02 Dexamethasone 

Tablets: 500micrograms, 2mg Soluble tablets: 2mg

Oral solution, sugar-free: dexamethasone (as sodium phosphate:) 2mg/5mL

Amber Initiated  Paediatrics

11.04.01 Dexamethasone  

intravitreal implant 700 micrograms

Ophthalmologist only.

Only to be used in line with NICE TA criteria for DMO, not approved for use in phakic patients.

11.04.01 Dexamethasone   0.1% eye drops, 0.1% minims

Minims (single dose eye drops) reserved for patients with known preservative allergy

12.01.01 Dexamethasone 0.05%, Framycetin 0.5%, Gramicidin 0.005% ear drops  Sofradex®

Contains anti-bacterial and anti-fungal component.
12.01.01 Dexamethasone 0.1% Neomycin 3250units/mL,  

Dexamethasone 0.1%, neomycin 3250units/mL, glacial acetic acid 2%

Otomize®

Avoid in children < 2 years

 

12.01.01 Dexamethasone 1mg/ml with Ciprofloxacin 3mg/ml 

Cilodex® ear drops

06.03.02 Dexamethasone injection 

Dexamethasone (as sodium phosphate) 3.8mg/mL, 1mL vial

Dexamethasone (as sodium phosphate) 3.3mg/mL, 1mL amp, 2mL vial

N.B. Dexamethasone 4mg/mL injection is no longer available.

Red  Paediatrics

04.04 Dexamfetamine 

Tablets 5 mg, 10mg, 20mg

Oral solution 5mg/5mL
For the treatment of ADHD. In addition, for the treatment of narcolepsy in adults
 
Purple Liverpool CCG Adults and Children
 
Purple  Halton CCG, South Sefton CCG and Southport & Formby CCG For the treatment of ADHD in Adults only 

04.07.02 Diamorphine HCl  

Injection, 5 mg, 10 mg, 30 mg, 100 mg, 500 mg

Amber Patient Retained Paediatrics

Amber Recommended  Paediatrics, palliative care


 Opioid – parenteral preparation

27.09 Diarrhoea and vomiting, acute 

Oral rehydration therapy is the mainstay of treatment. Children aged less than six months may be prescribed rehydration sachets, in older age groups clear fluids are adequate.

Antimotility agents e.g. loperamide should only be prescribed for the short-term management of symptoms (1-2 days) in the absence of fever or bloody diarrhoea and only for adults and children over 12 years.

Review and stop any prokinetic treatment.

Standby treatment for traveller’s diarrhoea must not be prescribed at NHS expense.

Usually viral and self-limiting.

Antibiotics only tend to prolong the carrier state, do not shorten the duration of illness and may be contraindicated. Antibiotics should only be commenced on the advice of microbiologist or Consultant in Health Protection or Infection Prevention and Control.

Check travel, food, hospitalisation and antibiotic history (Clostridium difficile is increasing in incidence).

Suggest stool specimen in:

  • Patients with inflammatory bowel disease.
  • Immunosuppressed patients.
  • Persistent diarrhoea (more than one week) if no obvious cause
  • Bloody diarrhoea. Sample essential. Antibiotics may be contraindicated e.g. E coli 0157
  • Recent foreign travel
  • Suspected food poisoning.
04.01.02 Diazepam 

Tablets 2 mg, 5 mg, 10 mg
Oral solution 2 mg/5 mL

Amber InitiatedPaediatrics

04.08.02 Diazepam 

Rectal tubes (enema):
2mg/mL 1.25mL (2.5mg) tube
2mg/mL 2.5mL (5mg) tube
4mg/mL 2.5mL (10mg) tube
 
Prolonged or repeated seizures and convulsive status epilepticus in the community.

Only prescribe buccal midazolam or rectal diazepam for children, young people and adults who have had a previous episode of prolonged or serial convulsive seizures.

04.08.02 Diazepam 

Parenteral: IV injection (as emulsion)5mg/mL (0.5%)

Prolonged or repeated seizures and convulsive status epilepticus in the community.

Only use IV products if IV access is already established and resuscitation facilities are available.

Red Paediatrics

04.10.01 Diazepam 

Tablets 2mg, 5mg, 10mg

For Acute Alcohol Withdrawal

Prescribed by specialist services

No BNFc entry – seek specialist advice

10.02.02 Diazepam 

Tablets 2 mg, 5 mg, 10 mg
Oral solution 2mg/5ml

Amber Recommended Paediatrics

06.01.04 Diazoxide  

Tablets 50mg, oral suspension 250mg/5ml (imported)

For chronic hypoglycaemia

11.08.02 Diclofenac   0.1% eye drops, 0.1% unit dose eye drops

04.07.04.01 Diclofenac (for use only in acute treatment where oral route not possible) 

Suppositories 12.5mg, 25mg, 50mg, 100mg

Paediatrics: There is a lack of information surrounding the cardiovascular effects of diclofenac in children, and evidence that diclofenac is more effective for the treatment of common paediatric pain conditions than other NSAIDs is limited (see Pan Mersey link).

10.03.02 Diclofenac gel 

12 hour Emulgel 1.16% 100g

12 hour Emulgel 2.32% 30g, 50g, 100g

Paediatrics: no BNFc entry - seek specialist advice

10.01.01 Diclofenac sodium 

Tablets e/c 25 mg, 50mg
Injection 25 mg/mL
(3mL amp)
Dispersible tablets 50mg (available as unlicensed import)

Modified-release capsule 75mg (restricted to children of school age only)
Suppositories 12.5mg, 25mg, 50mg, 100mg

13.08.01 Diclofenac sodium 

3% Gel (Solaraze®); 50 g, 100 g

No BNFc entry; Paediatrics - seek specialist advice

01.02 Dicycloverine  Tablets 10 mg, 20 mg

Syrup 10 mg/5 mL
08.03.01 Diethylstilbestrol  Tablets 1mg, 5mg
13.04 Diflucortolone Valerate 

Second choice

0.3% (Nerisone Forte®) Oily cream; Ointment; 15 g

Very Potent

Amber Recommended Paediatrics

13.04 Diflucortolone Valerate 

First choice

0.1% (Nerisone Forte®) Oily cream; Ointment; 15 g

Potent

Amber Recommended Paediatrics

02.01.01 Digoxin oral solution 

50micrograms/mL

Amber Initiated paediatrics

02.01.01 Digoxin specific antibody fragments 
02.01.01 Digoxin tablets 

62.5micrograms, 125micrograms, 250micrograms

Amber Initiated paediatrics

04.07.02 Dihydrocodeine Tartrate  Tablets, 30 mg
Oral solution, 10 mg/5ml

Weak opioid – oral preparation
04.07.02 Dihydrocodeine Tartrate   Injection 50 mg/ml

Opioid – parenteral preparation
01.07.04 Diltiazem Cream 2%  Unlicensed product

Paediatrics: no BNFc entry - seek specialist advice
02.06.02 Diltiazem modified release 

Different versions of modified release containing more than 60mg may not have the same clinical effect so should be prescribed by brand.
Modified release available as 60mg, 90mg, 120mg, 180mg, 200mg, 240mg, 300mg and 360mg formulations suitable for either once or twice daily administration depending on brand.
 
Amber Initiated paediatrics : only for Raynaud’s syndrome

Paediatrics: no BNFc entry - seek specialist advice

01.07.04 Diltiazem ointment 2%  Unlicensed product

Paediatrics: no BNFc entry - seek specialist advice
02.06.02 Diltiazem tablets 

60mg 
 
Amber Initiated paediatrics only for Raynaud’s syndrome

08.02.04 Dimethyl fumarate  Capsules e/c 120 mg, 240 mg

Dimethyl fumarate for the treatement of Multiple Sclerosis
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
13.05.02 Dimethyl fumarate 

Skilarence®

No BNFc entry; Paediatrics, seek specialist advice 

07.04.04 Dimethyl sulfoxide 

Bladder instillation 50% (unlicensed)

Paediatrics: No BNFc entry, seek specialist advice 

13.10.04 Dimeticone  4% (Hedrin®) Lotion; 50 mL, 120 mL spray pack, 150 mL
07.01.01 Dinoprostone 

Pessaries 10 mg; Vaginal gel 1 mg/2.5mL, 2 mg/2.5mL For induction of labour and augmentation of labour.

Paediatrics: No BNFc entry, seek specialist advice 

08.02.03 Dinutuximab 

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

13.02.01 Diprobase® 

Cream; 500 g pump pack

Medium

Ointment; 500g tub

Greasy

02.09 Dipyridamole MR capsules  200mg

Paediatrics: no BNFc entry - seek specialist advice
02.09 Dipyridamole oral suspension 

50mg/5ml, 200mg/5ml

Amber Initiated paediatrics

02.09 Dipyridamole tablets 

25mg, 100mg

For paediatrics

06.06.02 Disodium Etidronate tablets 

200mg

Paediatrics: no BNFc entry - seek specialist advice

02.03.02 Disopyramide capsules 

100mg

Paediatrics: no BNFc entry - seek specialist advice

04.10.01 Disulfiram 

Tablets scored 200mg

For Alcohol Dependence

RED Liverpool CCG, South Sefton CCG, Southport & Formby CCG - Prescribing retained by local commissioned alcohol service.

Amber Initiated Halton CCG, St Helen's CCG, Knowsley CCG

Amber Recommended Warrington CCG

RAG status to be confirmed by individual CCGs

Paediatrics: No BNFc entry – seek specialist advice

13.05.02 Dithranol  0.1%, 0.25%, 0.5%, 1%, 2% (Dithrocream®) Cream; 50 g

1%, 3% (Micanol®) Cream; 50 g

For chronic plaque psoriasis
For Body and Scalp

Consider short-contact dithranol only in treatment resistant trunk and limb psoriasis with educational support for self-use or ensure treatment is given in a specialist setting:
27.09 Diverticulitis, acute exacerbation 

Co-amoxiclav 500/125 mg TDS for 7 days

In non-severe penicillin allergy: Metronidazole 400 mg TDS AND Cefalexin 500 mg BD OR Ciprofloxacin (in severe penicillin allergy) 500 mg BD for 7 days

Consider admission for severe cases.

Review within 48 hours or sooner if symptoms deteriorate. Arrange admission if symptoms persist or deteriorate.

02.07.01 Dobutamine hydrochloride infusion  12.5mg/mL concentrate for IV infusion 20mL amps
01.06.02 Docusate Sodium  Capsules 100 mg

Adult oral solution sugar-free, 50 mg/5 mL

Paediatric oral solution sugar-free, 12.5 mg/5 mL
04.06 Domperidone  Tablets 10mg
Suspension 5mg/5mL

Notes
Domperidone is associated with a small increased risk of serious cardiac side effects. Its use is now restricted to the relief of symptoms of nausea and vomiting and the dosage and duration of use have been reduced. Domperidone is now contraindicated in those with underlying cardiac conditions and other risk factors (see below).
04.07.04.01 Domperidone 

Tablets, 10mg
Suspension, 5mg/5mL
 Amber Recommended Paediatrics 
 
 
In the May 2014 Drug Safety Update, the MHRA published evidence showing that domperidone carries a small risk of serious ventricular arrhythmia and sudden cardiac death. Domperidone is now contraindicated in those with underlying cardiac conditions and other risk factors. See MHRA Drug Safety Update May 2014.

04.11 Donepezil 

Tablets 5 mg, 10mg
Orodispersible tablets 5 mg, 10 mg
Oral solution 1mg/ml

Historic shared care agreement in place within South Sefton and Southport & Formby CCGs

No BNFc entry – seek specialist advice

02.07.01 Dopamine hydrochloride infusion  40mg/mL concentrate for IV infusion 5mL amps
02.07.01 Dopexamine hydrochloride infusion  10mg/mL concentrate for IV infusion 5mL amps

Paediatrics: no BNFc entry - seek specialist advice
03.07 Dornase alfa  Nebuliser solution 1000 units (1 mg)/mL
(For use undiluted with jet nebulisers only; ultrasonic nebulisers are unsuitable)

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
N.B. Existing prescribing may remain in primary care until any repatriation to hospitals under NHS England commissioned service takes place.
11.06 Dorzolamide 

2% eye drops, 2% single dose eye drops
Single dose eye drops reserved for patients with known preservative allergy

Amber Initiated Paediatrics.

11.06 Dorzolamide with timolol 

2% and 5% eye drops, 2% and 5% single dose eye drops
Single dose eye drops reserved for patients with known preservative allergy

Amber Initiated Paediatrics.

13.02.01 DoubleBase® 

Gel; 500 g

Dayleave Gel; 100g; 500g pump pack

Greasy

03.05.01 Doxapram  Injection 20mg in 1mL

Paediatrics: no BNFc entry - seek specialist advice.
02.05.04 Doxazosin 

1mg, 2mg, 4mg 

Amber Initiated paediatrics

07.04.01 Doxazosin 

Tablets (standard release) 1 mg, 2 mg, 4 mg.

Alpha Blocker

Amber Initiated Paediatrics

BLACK m/r tablets 4mg, 8mg



02.05.04 Doxazosin M/R  4mg, 8mg
12.03.01 Doxyclicine  

Dispersible tablets 100mg

For severe recurrent mouth ulceration, dispersed solution can be used as a gargle as directed in BNF / BNFc

Amber Recommended Paediatrics: (avoid in children < 12 years)

11.10 Doxycycline  40mg modified release capsules, 50mg capsules, 100mg capsules
13.06.02 Doxycycline (Paediatric only) 

Capsules 50mg, 100mg

Dispersible tablets 100mg

Paediatrics: Avoid in children < 12 years

02.03.02 Dronedarone tablets  400mg

Paediatrics: no BNFc entry - seek specialist advice
04.06 Droperidol  Injection 2.5mg/1ml
06.01.02.03 Dulaglutide injection 

Pre-filled pen 0.75mg, 1.5mg Pre-filled syringe 0.75mg, 1.5mg

Amber Patient Retained when used in combination with insulin.

Paediatrics: No BNFc entry, seek specialist advice 

04.03.04 Duloxetine 

Capsules 30 mg, 60 mg

NB - Other strengths available for a different 'non chapter 4' indication - urinary incontinence.

No BNFc entry - seek specialist advice.

04.07.03 Duloxetine 

 Capsules, 30 mg, 60 mg

No BNFc entry - seek specialist advice

07.04.02 Duloxetine 

Capsules 20 mg, 40 mg (Yentreve ®)

Paediatrics: No BNFc entry, seek specialist advice 

13.05.03 Dupilumab 

solution for injection 300mg; pre-filled pen (Dupixent®)

Treatment of atopic dermatitis

07.04.01 Dutasteride  Capsules 500 micrograms

5 Alpha – reductase inhibitor
06.04.02 Dutasteride capsules  500micrograms

13.02.01 E45®  Lotion; 200 mL, 500 mL pump pack

Light
04.10.02 E-Cigarettes  e-Voke®
07.02.02 Econazole  Cream 1%, Pessaries 150 mg x 3, 150mg x 1.
09.01.03 Eculizumab Soliris® Injection 10mg/ml

Paroxysmal nocturnal haemoglobinuria and atypical haemolytic uraemic syndrome.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
02.08.02 Edoxaban tablets 

15mg, 30mg, 60mg
Treatment and prevention of PE and DVT

N.B. Green in Wirral for this indication.

Paediatrics: only warfarin is used in paediatrics

02.08.02 Edoxaban tablets  15mg, 30mg, 60mg
Prevention of stroke and systemic embolism in atrial fibrillation

Paediatrics: only warfarin used in paediatrics
13.09 Eflornithine  Cream; 11.5%

04.07 Electromagnetic Pulse Therapy  Actipatch®

Drug-free medical device

09.01.04 Eltrombopag Revolade®

Tablets 25mg, 50mg

09.01.04 Eltrombopag Revolade® Tablets 25mg, 50mg

Paediatrics: no BNFc entry - seek specialist advice
09.01.04 Eltrombopag Revolade®

Tablets 25mg, 50mg
 

01.04.02 Eluxadoline 

Film-coated tablets 75mg, 100mg (Truberzi®)

06.01.02.03 Empagliflozin tablets 

10mg, 25mg

Sodium-glucose co-transporter 2 (SGLT2) inhibitor

Third-line option when used as monotherapy

Paediatrics: No BNFc entry, seek specialist advice 

 

06.01.02.03 Empagliflozin with metformin tablets Synjardy® 5mg/850mg, 5mg/1000mg, 12.5mg/850mg, 12.5mg/1000mg

Sodium-glucose co-transporter 2 (SGLT2)(combination therapy)
13.02.01.01 Emulsiderm®  Liquid emulsion; 300 mL (with 15ml measure), 1L (with 30ml measure)
To add 7–30 mL/bath or rub into dry skin until absorbed.
13.02.01 Emulsifying Ointment BP  Ointment; 500 g tub

Very Greasy
02.05.05.01 Enalapril liquid 

Unlicensed special various strengths available from special–order manufacturers.
5mg/5ml is standard strength used at Alder Hey.
No longer routinely recommended in new adult patients. Patients currently stable may remain on treatment.

Amber Initiated paediatrics

02.05.05.01 Enalapril tablets 

2.5mg, 5mg, 10mg, 20mg

No longer routinely recommended in new adult patients. Patients currently stable may remain on treatment.

Amber Initiated paediatrics

02.08.01 Enoxaparin sodium injection 

100 mg/mL: 20-mg (0.2-mL, 2,000-units) syringe 40-mg (0.4-mL, 4,000-units) syringe 60-mg (0.6-mL, 6,000-units) syringe 80-mg (0.8-mL, 8,000-units) syringe 100-mg (1-mL, 10,000-units) syringe 300 mg (3-mL, 30,000-units) vial 150 mg/mL: 120-mg (0.8-mL, 12,000-units) syringe 150-mg (1-mL, 15,000-units) syringe

Enoxaparin is now available as the originator brand (Clexane®) and biosimilar brand (Inhixa®). Prescribing should be by brand to ensure that the correct product is selected for prescribing, dispensing and administration due to differences in syringe design.RED when used as surgical or medical VTE prophylaxis or treatment in hospital, or for prevention of miscarriage in women with history of recurrent miscarriage for the duration of treatment during pregnancy.Red paediatrics

02.01.02 Enoximone injection  5mg/mL
04.09.01 Entacapone 

Tablets 200mg

No BNFc entry – seek specialist advice

08.03.04.02 Enzalutamide  Capsules 40mg
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
12.02.02 Ephedrine 0.5%, 1% nasal drops 

Amber Recommended paediatrics < 12 years

 

Red paediatrics - 0.25% (extemporaneously prepared)

02.07.02 Ephedrine hydrochloride injection  30mg/mL injection 1mL amps
3mg/mL injection 10mL amps
13.02.01 Epimax®  Cream 100 g tube, 500 g pump
(same as Aqueous Cream but SLS free. Use as emollient and soap substitute)

Light
02.02.03 Eplerenone tablets 

25mg, 50mg

Paediatrics: no BNFc entry - seek specialist advice

09.01.03 Epoetin alfa Eprex®Binocrit® Injection.
Contact Pharmacy Dept. for product availability

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
09.01.03 Epoetin beta NeoRecormon® Injection.
Contact Pharmacy Dept. for product availability

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
09.01.03 Epoetin zeta Retacrit® Injection.
Contact Pharmacy Dept. for product availability

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
02.08.01 Epoprostenol  500micogram and 1.5mg vials for reconstitution

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
02.05.01 Epoprostenol injection  500microgram vial
02.09 Eptifibatide  2mg/mL 10mL vial
750micrograms/mL 100mL vial

Paediatrics: no BNFc entry - seek specialist advice
07.01.01 Ergometrine  

Injection 500 micrograms/ mL Also Community Midwives For prevention and treatment of haemorrhage

Paediatrics: No BNFc entry, seek specialist advice 

13.06.02 Erythromycin (Paediatric only) 

Tablets / capsules 250mg

Paediatric: alternative to tetracyclines for treating patients < 12 years

13.06.01 Erythromycin 40mg with Zinc Acetate 12mg/mL  Topical solution (Zineryt®) (for pregnant women); 30 mL, 90 mL
04.03.03 Escitalopram 

Tablets 5 mg, 10 mg, 20 mg
Oral drops SF 20 mg/mL

No BNFc entry – seek specialist advice

04.08.01 Eslicarbazepine 

Tablets 800mg

Focal onset epilepsy - add on drug option.

02.04 Esmolol injection  10mg/ml
01.03.05 Esomeprazole 

Gastro-resistant capsules / tablets 20 mg, 40 mg

Granules 10 mg/sachet N.B. Granules are much more expensive.

2nd line in paediatrics

Green  Paediatrics (in children aged 12 years or above)

Amber Recommended Paediatrics (in children aged under 12 years old)

Black Vimovo® naproxen 500mg + esomeprazole 20mg

01.03.05 Esomeprazole IV  Injection, powder for solution for Injection/Infusion 40mg
07.02.01 Estradiol 

Vaginal tablets 10 micrograms

For vaginal atrophy - topical HRT

Paediatrics: No BNFc entry, seek specialist advice 

07.03.01 Estradiol & dienogest  tablets estradiol 1mg, 2 mg,3 mg,4 mg, dienogest 2 mg and 3 mg
Qlaira®
standard strength
GREENFor heavy menstrual bleeding


BLACKFor oral contraception

07.03.01 Estradiol & nomegestrol  Tablets estradiol 1.5mg, nomegestrol acetate 2.5mg.
Zoely®
07.02.01 Estriol 

Vaginal cream 0.01%, 0.1%; Pessaries 500 micrograms.

Vaginal atrophy – topical HRT

Paediatrics: No BNFc entry, seek specialist advice 

10.01.03 Etanercept 

Subcutaneous injection 10mg, 25mg vial (powder for reconstitution) and 25 mg, 50 mg (prefilled syringe) and 50mg (prefilled pen)

Enbrel® - Originator brand

Erelzi®,biosimilar brand 
Benepali® - Biosimilar brand

Prescribe by brand

NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents

13.05.03 Etanercept 

Injection 25 mg, 50 mg
In line with NICE TA 103 – Etanercept for the treatment of adults with psoriasis

Cytokine modulator

Benepali®,biosimilar brand

Erelzi®,biosimilar brand 
Enbrel®, originator brand
Prescribe by brand

NHS NHSE commissioned drug for Paediatric indications (in line with NICE TA 455) - see Specialised Commissioning: Key documents

 

09.05.01.02 Etelcalcetide Parsabiv®

Solution for injection; 2.5mg, 5mg, 10mg

Paediatrics: no BNFc entry - seek specialist advice

NHS NHSE commissioned drug, secondary hyperparathyroidism in dialysis patients - see Specialised Commissioning: Key documents

06.04.01.01 Ethinylestradiol 

Tablets 10 micrograms, 2 micograms (unlicensed import)

Amber Initiated Paediatrics

08.03.01 Ethinylestradiol  Tablets 10 micrograms, 50 micrograms, 1mg
13.09 Ethinylestradiol 30 micrograms, Drospirenone 3 mg 

(Yasmin®) Tablets
Off label

(Lucette®) Tablets are a less expensive brand
Off label

See MHRA Drug Safety Update June 2011

No BNFc entry: Paediatrics seek specialist advice 

04.08.01 Ethosuximide 

Capsules 250mg 
Oral solution 250mg/5mL

Amber Initiated Paediatrics


Absence seizures and occasionally myoclonic absence seizures

07.03.02.02 Etonorgestrel 

Implant containing 68 mg (Nexplanon ® )

Green  Paediatrics: post menarche

10.01.01 Etoricoxib 

Tablets 30mg, 60 mg, 90 mg (Tablets 120 mg: acute gout only for a max. of 8 days 120 mg once daily)

Amber Recommended Paediatrics < 16 years of age

07.03.02.01 Etynodiol diacetate 

Tablets 500 micrograms
Femulen®

Paediatrics: No BNFc entry, seek specialist advice 

02.12 Evolocumab 

140mg solution for injection in pre-filled pen (Repatha®)

NHS NHSE commissioned drug for treatment of homozymgous familial hypercholesterolaemia only. All other licensed indications are CCG commissioned.

GREY for cardiovascular risk reduction in adults with atherosclerotic cardiovascular disease

08.03.04.01 Exemestane  Tablets 25mg
06.01.02.03 Exenatide prolonged release injection 

m/r, powder and solvent, 2 mg pre-filled pen

Use in accordance with recommendations in NICE NG28.

Amber Patient Retained  when used in combination with insulin - off label indication with insulin.

Paediatrics: No BNFc entry, seek specialist advice 

06.01.02.03 Exenatide standard release injection 

250 micrograms/mL, 5 microgram/dose prefilled pen (60 doses), 10 microgram/dose prefilled pen (60 doses)

Amber Patient Retained  when used in combination with insulin.

Paediatrics: No BNFc entry, seek specialist advice 

02.12 Ezetimibe 

10mg 
 
Amber Initiated paediatrics

Black Atozet® atorvastatin 20mg + ezetimibe 10mg

Grey for prevention of cardiovascular events in patients with CHD and history of ACS where patient choleterol levels are within target range

10.02.01 Fampridine  Tablets 10mg
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Paediatrics: no BNFc entry - seek specialist advice
10.01.04 Febuxostat  Tablets 80 mg, 120 mg

Paediatrics: no BNFc entry - seek specialist advice
04.08.01 Felbamate 

Tablets 400mg, 600mg
Oral suspension 600mg/5mL

Focal onset epilepsy – only to be used when all other options have been tried or when prescribed by a specialist in epilepsy.

No BNFc entry – seek specialist advice

02.06.02 Felodipine m/r tablets  2.5mg, 5mg, 10mg



Paediatrics: no BNFc entry - seek specialist advice
02.12 Fenofibrate capsules 

67mg, 200mg, 267mg

Second choice if statin contraindicated or not tolerated.

67mg can be used in renal impairment but check dose.
200mg and 267mg NOT to be used in renal impairment.

Amber Initiated paediatrics

02.12 Fenofibrate tablets 

160mg

Second choice if statin contraindicated or not tolerated.

Amber Initiated paediatrics

Paediatrics: no BNFc entry - seek specialist advice

04.07.02 Fentanyl   Injection, 50 micrograms/ml

Opioid – parenteral preparation
04.07.02 Fentanyl  

Patches, 12 micrograms/hr, 25 micrograms/hr, 37.5 micrograms/hr, 50 micrograms/hr, 75 micrograms/hr, 100 micrograms/hr
Amber Initiated Paediatrics

Patients requiring high doses of fentanyl (>25mcg/hr) should be reviewed and consideration given to referring to a pain specialist for review.

2nd line - Strong opioid – alternative route
 

04.07.02 Fentanyl  

(as citrate) sublingual tablets, 100 micrograms, 133 micrograms, 200 micrograms, 267 micrograms, 300 micrograms, 400 micrograms, 533 micrograms, 600 micrograms, 800 micrograms
(as citrate) buccal tablets, 100 micrograms, 200 micrograms, 400 micrograms, 600 micrograms, 800 micrograms
(as citrate) lozenge with oromucosal appliactor 200 micrograms, 400 micrograms, 600 micrograms, 800 micrograms, 1.2 mg, 1.6 mg
(as citrate) nasal spray, 50 micrograms, 100 micrograms/metered spray, 200 micrograms/metered spray, 400 micrograms/metered spray

2nd line strong opioid – alternative route. For use in palliative care breakthrough pain only.

09.01.01.02 Ferric Carboxymaltose Ferinject® Injection iron 50mg/ml
09.01.01.01 Ferric Maltol Ferracru®

Hard capsules 30mg (30mg iron)

For treatment of iron deficiency anaemia (IDA) in inflammatory bowel disease (IBD).

The first course of ferric maltol must be supplied in full by the specialist.

GREY for treatment of iron deficiency in adults without inflammatory bowel disease.

09.01.01.01 Ferrous Fumarate  Tablets 210mg (68mg iron)
Syrup sugar-free 140mg (45mg iron)/5ml
09.01.01.01 Ferrous Sulphate  Tablets 200mg (65mg iron)
07.04.02 Fesoterodine 

MR Tablets 4 mg, 8 mg.

Paediatrics: No BNFc entry, seek specialist advice 

03.04.01 Fexofenadine hydrochloride  Tablets 30 mg, 120 mg, 180 mg
05.01.07 Fidaxomicin Dificlir® Tablets 200mg

For the treatment of Clostridium difficile Infections in adults following recommendation by a consultant microbiologist or consultant in infectious diseases
09.01.06 Filgrastim Neupogen® Ratiograstim® Zarzio® Contact Pharmacy dept. for product availability

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
07.04.01 Finasteride 

Tablets 5mg

5 Alpha – reductase inhibitor

Paediatrics: No BNFc entry, seek specialist advice 

06.04.02 Finasteride tablets 

5mg

Paediatrics: no BNFc entry - seek specialist advice.

08.02.04 Fingolimod  Capsules 500 micrograms

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
06.01.06 Flash glucose monitor  FreeStyle Libre®

Sensor

Interstitial fluid glucose measurement

02.03.02 Flecainide liquid 

Only available as an unlicensed special

5mg/ml is standard strength used at Alder Hey

02.03.02 Flecainide tablets 

50mg, 100mg

07.02.02 Fluconazole 

Capsules 50mg, 150 mg.

11.03.02 Fluconazole 

0.2% eye drops.

No BNFc entry - seek specialist advice

06.03.01 Fludrocortisone  

tablets 100micrograms

oral suspension 10micrograms in 1mL (Special)

Amber Initiated  Paediatrics

13.04 Fludroxycortide  

Second choice

4micrograms / cm2 (Haelan®) Tape; 7.5 cm x 50 cm, 7.5 cm x 200 cm

Moderately potent

Amber Recommended Paediatrics

12.01.01 Flumetasone 0.02% with Clioquinol 1% 

Ear drops

Avoid in children < 2 years

04.07.04.02 Flunarizine 

Capsules 5mg, 10mg

No BNFc entry – seek specialist advice

11.04.01 Fluocinolone acetonide  

intravitreal implant 190 micrograms

Ophthalmologist only

Only to be used in line with NICE TA criteria for DMO, not approved for use in phakic patients.

13.04 Fluocinolone Acetonide  

Second choice

0.025% (Synalar®) Cream; Ointment; 30g, 100g
Gel; 30 g, 60 g

Potent

Amber Recommended Paediatrics

13.04 Fluocinolone Acetonide  

Second choice

0.00625% (Synalar 1 in 4 dilution®) Cream; Ointment; 50 g

Moderately potent

Amber Recommended Paediatrics

13.04 Fluocinolone Acetonide  

Second choice

0.0025% (Synalar 1 in 10 dilution®) Cream (for those intolerant to hydrocortisone); 50 g

Mild

13.04 Fluocinolone acetonide 0.025%, Clioquinol 3% 

Synalar C Cream; Ointment; 15 g

Potent with antimicrobials

Amber Recommended Paediatrics

09.05.03 Fluorides En-De-Kay® (Tablet)

Tablets sodium fluoride 1.1mg (fluoride 500 micrograms) children 3-6 yrs; sodium fluoride 2.2mg (fluoride 1mg) 6+ yrs

See Pan Mersey APC: Guidance for dental prescribing in primary care, below
 

09.05.03 Fluorides En-De-Kay® (Oral Drops)

Oral drops SF sodium fluoride 550 micrograms (fluoride 250 micrograms/drop [0.15ml)

See Pan Mersey APC: Guidance for dental prescribing in primary care, below
 

09.05.03 Fluorides Duraphat® (Toothpaste)

Toothpaste sodium fluoride 0.619%, 1.1%

On advice from secondary care specialists e.g. following radiotherapy during active management, haematological malignancies or oral dermatological diseases.

See Pan Mersey APC: Guidance for dental prescribing in primary care, below.

 Black DENTAL prescription for conditions managed by dentists; long term treatment should be under patient’s usual dentist, and toothpaste prescribed by the dentist.                          

11.04.01 Fluorometholone  0.1% eye drops

May have less effect on intraocular pressure than prednisolone acetate or dexamethasone, but intraocular penetration is poor.
11.10 Fluorouracil   5mg in 0.2ml injection
Ophthalmologist only.
For trabeculectomy enhancement.
11.10 Fluorouracil  1% eye drops
13.08.01 Fluorouracil 

5% Cream (Efudix®); 40 g

0.5% + salicylic acid 10% solution (Actikerall®); 25ml

No BNFc entry; Paediatrics - seek specialist advice

04.03.03 Fluoxetine 

Capsules 10mg, 20 mg

10mg capsules are significantly more expensive than 20mg capsules or liquid. Use only as an option where difficulty accurately administering the liquid.

Oral solution 20 mg/5 mL

Dispersible SF tablets 20mg

Amber Initiated  Paediatrics

04.02.01 Flupentixol 

Tablets 500micrograms, 1mg, 3mg

No BNFc entry – seek specialist advice

04.03.04 Flupentixol 

Tablets 500 micrograms, 1 mg, 3mg

No BNFc entry – seek specialist advice

04.02.02 Flupentixol Decanoate 

Injection 20 mg/mL, 40 mg/2 mL
Concentrated injection 50 mg/0.5 mL, 100 mg/mL
Low volume injection 200 mg/mL

No BNFc entry – seek specialist advice

04.02.02 Fluphenazine Decanoate 

Injection 12.5 mg/0.5 mL, 25 mg/mL, 50 mg/2 mL
Concentrated injection 50 mg/0.5 mL, 100 mg/mL

No BNFc entry – seek specialist advice

11.08.02 Flurbiprofen 0.03% & polyvinyl alcohol 1.4%  eye drops

08.03.04.02 Flutamide  Tablets 250mg
03.02 Fluticasone furoate / Vilanterol Relvar Ellipta®
Relvar Ellipta

Dry powder inhaler
Fluticasone furoate 92 micrograms / Vilanterol (as trifanatate) 22 micrograms per inhalation
(for the treatment of asthma and COPD)

PREFERRED CHOICE IN COPD

Fluticasone furoate 184 micrograms / Vilanterol (as trifanatate) 22 micrograms per inhalation
(for the treatment of asthma)
PRESCRIBE BY BRAND NAME

Amber Initiated paediatrics (only where preferred choice ICS+LABA inhalers are not suitable because of twice daily dose schedule, and a once daily dose schedule is essential)

12.02.01 Fluticasone furoate nasal spray 

Avamys®

** First choice where long-term use likely (i.e. >4-6 weeks course)**

 

Amber Recommended paediatrics < 6 years

03.02 Fluticasone furoate/ vilanterol/ umeclidinium inhaler  Trelegy®

 

 

Dry powder inhaler
Fluticasone furoate 92 micrograms, umeclidinium 55 micrograms and vilanterol 22 micrograms per inhalation.
Licensed for COPD only.

PREFERRED CHOICE IN COPD

12.02.01 Fluticasone nasal drops 

Flixonase Nasules®
For the treatment of nasal polyps only

Paediatrics: not recommended in children < 16 years

12.02.01 Fluticasone propionate and azelastine Dymista®

Nasal spray, fluticasone propionate 50 micrograms, azelastine hydrochloride 137 micrograms/metered spray

Paediatrics: not recommended in children < 12 years 

Dymista® can be considered as a treatment option for patients in whom symptom control has not been achieved despite an adequate trial of therapy with:
• intranasal azelastine alone, and where the addition of an intranasal corticosteroid is considered appropriate;
• an intranasal corticosteroid alone, and where the addition of an intranasal antihistamine is considered appropriate.
For patients whose symptoms have not improved despite monotherapy with intranasal corticosteroids, consideration should be given to whether an oral or intranasal antihistamine is more appropriate. Intranasal antihistamines do not improve symptoms at other sites e.g. the eye, pharynx, lower airways, skin, whereas oral antihistamines may provide benefit at these sites.

12.02.01 Fluticasone propionate nasal spray 

Flixonase®

** First choice where long-term use likely (i.e. >4-6 weeks course)

 

Amber Recommended paediatrics < 4 years

03.02 Fluticasone proprionate / formoterol  Flutiform® 125/5
Flutiform
Metered dose inhaler
Fluticasone propionate 125 micrograms, formoterol (as fumarate) 5 micrograms/metered inhalation
(Licensed for asthma only)

PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME

Amber Initiated children <5 years old
03.02 Fluticasone proprionate / formoterol  Flutiform® 50/5
Flutiform
Metered dose inhaler
Fluticasone propionate 50 micrograms, formoterol (as fumarate) 5 micrograms/metered inhalation
(Licensed for asthma only)

PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME

Amber Initiated  children <5 years old
03.02 Fluticasone proprionate / salmeterol  Seretide 500 Accuhaler® , Aerivio Spiromax ®

 

Dry powder inhaler Fluticasone propionate 500 micrograms, salmeterol (as xinafoate) 50 micrograms/blister (Seretide Accuhaler licensed for asthma and COPD, Aerivio Spiromax licensed for asthma and COPD) THIRD CHOICE IN COPD PRESCRIBE BY BRAND NAME Amber Initiated  children

03.02 Fluticasone proprionate / salmeterol Seretide 125 Evohaler®, Sirdupla® 125, AirFluSal MDI®, Sereflo®



Metered dose inhaler
Fluticasone propionate 125 micrograms, salmeterol (as xinafoate) 25 micrograms /metered inhalation
(Licensed for asthma only)
PRESCRIBE BY BRAND NAME

Amber Initiated Seretide: children (Sirdupla, AirFluSal MDI, Sereflo:not recommended in children as unlicensed for <18 years of age).

03.02 Fluticasone proprionate / salmeterol  Seretide 50 Evohaler®
Seretide Evohaler
Metered dose inhaler
Fluticasone propionate 50 micrograms, salmeterol (as xinafoate) 25 micrograms /metered inhalation
(Licensed for asthma only)
PRESCRIBE BY BRAND NAME

Amber Initiated  children <5 years old
03.02 Fluticasone proprionate / salmeterol  Seretide 250 Evohaler®, Sirdupla® 250, AirFluSal MDI®, Sereflo®



Metered dose inhaler
Fluticasone propionate 250 micrograms, salmeterol (as xinafoate) 25 micrograms /metered inhalation
(Licensed for asthma only)
PRESCRIBE BY BRAND NAME

BLACK for treatment of COPD in new patients


Amber Initiated Seretide: children (Sirdupla, AirFluSal MDI, Sereflo: not recommended in children as unlicensed for <18 years of age).

03.02 Fluticasone proprionate / salmeterol  Seretide 100 Accuhaler®
Seretide Accuhaler
Dry powder inhaler
Fluticasone propionate 100 micrograms, salmeterol (as xinafoate) 50 micrograms/blister (Licensed for asthma only)
PRESCRIBE BY BRAND NAME

Amber Initiated children < 5 years old
03.02 Fluticasone proprionate / salmeterol  Seretide 250 Accuhaler®
Seretide Accuhaler
Dry powder inhaler
Fluticasone propionate 250 micrograms, salmeterol (as xinafoate) 50 micrograms/blister (Licensed for asthma only)
PRESCRIBE BY BRAND NAME

Amber Initiated children <5 years old
03.02 Fluticasone proprionate /formoterol  Flutiform® 250/10
Flutiform
Metered dose inhaler
Fluticasone propionate 250 micrograms, formoterol (as fumarate) 10 micrograms/metered inhalation
(Licensed for asthma only)

PREFERRED CHOICE IN ASTHMA

PRESCRIBE BY BRAND NAME

Amber Initiated  children <5 years old
03.02 Fluticasone proprionate aerosol inhalation Fluticasone Evohaler® Metered dose inhaler
50 micrograms/metered inhalation
125 micrograms/metered inhalation
250 micrograms/metered inhalation
PRESCRIBE BY BRAND NAME
03.02 Fluticasone proprionate dry powder for inhalation Fluticasone Accuhaler® Dry powder inhaler
50 micrograms/blister
100 micrograms/blister
250 micrograms/blister
500 micrograms/blister
PRESCRIBE BY BRAND NAME
03.02 Fluticasone proprionate solution for inhalation Fluticasone Nebules® Single-dose units for nebulisation
500 micrograms/2 mL (250 micrograms/mL)
2 mg/2 mL (1 mg/mL)
09.01.02 Folic Acid  Tablets 400 micrograms, 5mg
Syrup 2.5mg/5ml

Amber Recommended In paediatrics when used for other medical conditions e.g. sickle cell disease, dialysis.

Prevention of neural tube defects
Women at low risk of neural tube defects are advised to take folic acid 400 micrograms daily before conception and continue until 12 weeks of pregnancy. Women at high risk (including those women with diabetes) should be advised to take folic acid 5mg until week 12 of pregnancy. Women with sickle cell disease should continue taking their normal dose of folic acid 5mg daily (or increase to 5mg daily) and continue this dose throughout pregnancy.
02.08.01 Fondaparinux sodium injection 

2.5mg/0.5mL prefilled syringe


Paediatrics: no BNFc entry - seek specialist advice

13.07 Formaldehyde  0.75% (Veracur®) Gel; 15g
03.01.01.01 Formoterol fumarate dry powder for inhalation Easyhaler ®
Formoterol Easyhaler
Dry powder inhaler
12 micrograms/metered inhalation Easyhaler®
03.01.01.01 Formoterol fumarate dry powder for inhalation Oxis Turbohaler®
Oxis Turbohaler
Dry powder inhaler
6 micrograms/metered inhalation
12 micrograms/metered inhalation
03.01.01.01 Formoterol fumarate metered dose inhaler Atimos Modulite®
Atimos Modulite
Metered dose inhaler
Formoterol fumarate 12 micrograms/metered inhalation
PREFERRED CHOICE IN COPD
04.06 Fosaprepitant 

Injection, powder for reconstitution 150mg

No BNFc entry - seek specialist advice

11.03.03 Foscarnet 

2.4% eye drops

No BNFc entry - seek specialist advice

11.03.01 Framycetin  0.5% eye drops, 0.5% eye ointment
08.03.04.01 Fulvestrant  Injection 250mg
02.02.02 Furosemide injection  10mg/mL

May be used in the community as part of a specific service
02.02.02 Furosemide oral solution sugar free 

20mg/5mL, 40mg/5mL, 50mg/5mL
(50mg/5ml is standard strength used at Alder Hey)

Amber Initiated paediatrics

02.02.02 Furosemide tablets 

500mg

02.02.02 Furosemide tablets 

20mg, 40mg
 

Amber Initiated paediatrics

11.03.01 Fusidic Acid  1% eye drops

11.03.01 Fusidic Acid  1% eye drops

Useful for staphylococcal infections.
13.10.01.02 Fusidic Acid 2%  2% (Fucidin®) Cream; Ointment; 15 g, 30 g
04.07.03 Gabapentin 

Capsules, 100 mg, 300 mg, 400 mg
Tablets 600 mg, 800 mg (please note that tablets are significantly more expensive than capsules)
Oral solution 250mg in 5mL (sugar free)

Amber Initiated Paediatrics

 

04.07.04.02 Gabapentin 

3rd line

Capsules 100mg, 300mg, 400mg
Oral solution 50 mg/mL
It is important to use adequate doses up to 2.4g daily to obtain benefit.

No BNFc entry – seek specialist advice

04.07.04.03 Gabapentin 

Hemicrania Continua
SUNCT (Short lasting unilateral neuralgiform headache with conjunctival injection and tearing)
 
Capsules 100mg, 300mg, 400mg

Oral solution 50mg/5mL
 
No BNFc entry - seek specialist advice

04.08.01 Gabapentin 

Capsules 100mg, 300mg, 400mg
Oral solution 50mg/mL


Amber Initiated Paediatrics
Focal onset epilepsy - add on drug option.

04.09.03 Gabapentin 

Capsules 100mg, 300mg, 400mg
Oral solution 50mg/5mL
Gabapentin is off-label for tremors

No BNFc entry - seek specialist advice

04.11 Galantamine 

Tablets 8 mg, 12 mg
MR Capsules 8 mg, 16 mg, 24 mg
Oral solution 4 mg/mL

Historic shared care agreement in place within South Sefton and Southport & Formby CCGs

No BNFc entry – seek specialist advice

11.03.03 Ganciclovir  

0.15% ophthalmic gel

No BNFc entry - seek specialist advice

Paediatrics: alternative to aciclovir eye ointment in the event of a supply problem; off-label use.

12.03.05 Gelclair®  For oral mucositis particularly in cancer patients
07.01.01 Gemeprost 

Pessaries 1 mg

For induction of abortion

Paediatrics: No BNFc entry, seek specialist advice 

11.03.01 Gentamicin  0.3% eye drops

11.03.01 Gentamicin  0.3% unit dose eye drops unlicensed

Preservative Free

Ophthalmologist only.

11.03.01 Gentamicin 

1.4% eye drops, 1.5% eye drops, 2% eye drops, 0.3% single dose eye drops

11.03.01 Gentamicin  1.5% eye drops

Ophthalmologist only.
12.01.01 Gentamicin 0.3% ear drops 
27.09 Giardia lamblia 

Metronidazole 2 g single dose* daily for 3 days

*Warning Caution in pregnancy

Consider ‘blind’ treatment of family contacts only if they are symptomatic.

12.03.05 Glandosane® spray 
08.02.04 Glatiramer Acetate  Injection 20mg/mL

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
06.01.02.01 Gliclazide tablets 

40mg, 80mg Second choice: M/R 30mg (approximately equivalent in effect to 80mg standard release). M/R 60mg

Amber Initiated  Paediatrics

06.01.02.01 Glimepiride tablets 

1mg, 2mg, 3mg, 4mg

Paediatrics: No BNFc entry, seek specialist advice 

06.01.02.01 Glipizide tablets 

5mg

Paediatrics: No BNFc entry, seek specialist advice 

06.01.04 Glucagon injection  

Injection, powder for reconstitution, glucagon hydrochloride with lactose, 1mg vial with prefilled syringe containing water for injection.

Amber Recommended Paediatrics

10.01.05 Glucosamine  The Pan Mersey APC does not recommend the routine prescribing of glucosamine products with or without chondroitin.

06.01.04 Glucose (oral)  

Initially glucose 10–20g (e.g. Dextro-Energy tablet) is given by mouth either in liquid form or as granulated sugar or sugar lumps (or dextrose sweets or jelly babies). Approximately 10g of glucose is available from non-diet versions of Lucozade® Energy Original 55mL, Coca-Cola® 100mL, Ribena® Blackcurrant 19mL (to be diluted), 2 teaspoons of sugar, and also from 3 sugar lumps. If necessary this may be repeated in 10–15 minutes. After initial treatment, a snack providing sustained availability of carbohydrate (e.g., a sandwich, fruit, milk, or biscuits) or the next meal, if it is due, can prevent blood-glucose concentration from falling again.

06.01.04 Glucose 40% oral gel  3 x 25g tubes (10g glucose)
1 x 80g bottle (32g glucose)
09.02.02.01 Glucose Intravenous  Contact Pharmacy dept. for prescribing advice and product availability
06.01.04 Glucose intravenous infusion 10% and 20%   10% (100mg/mL) and 20% (200mg/mL)
13.07 Glutaraldehyde  10% (Glutarol®) Solution; 10 mL
11.10 Glycerin   Eye drops

01.06.02 Glycerol (Glycerin)  Suppositories 1 g, 2 g, 4g
01.07.04 Glyceryl Trinitrate 0.2% 

Ointment (Special)

Red  Paediatrics

01.07.04 Glyceryl Trinitrate 0.4% 

Rectal ointment

Paediatrics: no BNFc entry - seek specialist advice

02.06.01 Glyceryl Trinitrate patches 

5mg/24 hours, 10mg/24 hours

Amber Initiated paediatrics

Paediatrics: no BNFc entry - seek specialist advice

02.06.01 Glyceryl Trinitrate spray  400micrograms/metered dose


Paediatrics: no BNFc entry - seek specialist advice
02.06.01 Glyceryl Trinitrate sublingual tablets  300micrograms, 500micrograms, 600micrograms


Paediatrics: no BNFc entry - seek specialist advice
07.04.04 Glycine 

Bladder irrigation 1.5% in WFI

Paediatrics: No BNFc entry, seek specialist advice 

13.12 Glycopyrrolate in cetomacrogol cream 

Glycopyrrolate in cetomacrogol cream 0.5%, 1%, 2% Cream; 100 g, 500 g Restricted Item Restricted prescribing - For hyperhidrosis This unlicensed special may be considered in exceptional circumstances.

01.02 Glycopyrronium 

Injection 200 micrograms/mL
Treatment of bowel colic or excessive respiratory secretions in palliative care

Oral liquid 400micrograms/ml glycopyronium bromide (320micrograms/ml glycopyronium). Treatment of hypersalivation (off-label in adults)

Tablets 1mg glycopyrronium bromide. Treatment of hypersalivation (off-label). N.B. Very expensive, not to be used unless oral liquid is unsuitable

Amber Initiated Paediatrics

13.12 Glycopyrronium 

Tablets; 1 mg and 2 mg - off label, oral solution; 1 mg/5 mL - off label. For hyperhidrosis

03.01.02 Glycopyrronium inhalation powder Seebri Beezhaler®
Seebri Breezhaler
Dry powder inhaler
Hard capsule, for use with Seebri Beezhaler® device
50 micrograms per capsule

PREFERRED CHOICE IN COPD

Paediatrics: no BNFc entry - seek specialist advice
03.01.02 Glycopyrronium with indacaterol inhaler Ultibro Breezhaler®
Ultibro Breezhaler
Capsules for inhalation via Breezhaler inhaler device
Indacaterol 85 micrograms with glycopyrronium 43 micrograms per inhalation

PREFERRED CHOICE IN COPD

Paediatrics: no BNFc entry - seek specialist advice

01.05.03 Golimumab  Injection 50-mg prefilled pen or prefilled syringe, 100-mg prefilled pen

Ulcerative colitis moderate - severe

Paediatrics: no BNFc entry - seek specialist advice
10.01.03 Golimumab 

Subcutaneous injection 50 mg prefilled pen or prefilled syringe, 100mg prefilled pen
Paediatrics: no BNFc entry - seek specialist advice

NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents

06.05.01 Gonadorelin injection  Injection, powder for reconstitution, 100microgram vial (with diluent)
06.07.02 Goserelin 

Zoladex®: goserelin (as acetate) 3.6mg in SafeSystem® syringe applicator; Zoladex® LA: goserelin (as acetate) 10.8mg in SafeSystem® syringe applicator Use in accordance with its licensed indications:

 

RED St Helen's CCG endometriosis and reduction of uterine fibroids

 

Red Infertility

 

Amber Patient Retained  Precocious puberty

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

08.03.04.02 Goserelin 

Implant 3.6mg, 10.8mg For prostate cancer and breast cancer indications.

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

RED St Helen's CCG for endometriosis, endometrial thinning and uterine fibroids.

04.06 Granisetron  Tablets 1mg
Injection (as hydrochloride) for dilution before use 1mg/mL, 3mg/3mL
03.04.02 Grass pollen extract Grazax® SPECIALIST SERVICE
Tablets, grass pollen extract 75 000 units
04.04 Guanfacine 

Prolonged-release tablets; 1mg, 2mg, 3mg, 4mg
 
Purple Liverpool CCG Adults and Children
 
Purple  Halton CCG, South Sefton CCG and Southport & Formby CCG for the treatment of ADHD in Adults only 

13.05.03 Guselkumab 

solution for injection 100mg; pre-filled pen (Tremfya®)

For treatment of psoriasis

04.02.01 Haloperidol 

Capsules 500 micrograms
Tablets 500 micrograms, 1.5 mg, 5 mg, 10 mg, 20 mg
Liquid SF 1 mg/mL, 2 mg/mL
Injection 5 mg/mL (in primary care syringe driver)

Amber Patient Retained Paediatrics


 Red Injection 5 mg/mL in combination with i.m. promethazine for rapid tranquilisation

 

04.06 Haloperidol  

Tablets 500micrograms, 1.5mg, 5mg, 10mg
Capsules 500micrograms
Oral liquid SF 1mg/1mL, 2mg/mL
Injection 5mg/mL

 Amber Recommended Paediatrics

In palliative care, haloperidol is used to prevent nausea and vomiting associated with opioid therapy and for most metabolic causes of vomiting.

04.09.03 Haloperidol 

Capsules 500micrograms
Tablets 1.5mg, 5mg, 10mg
Oral liquid, SF 1mg/mL, 2mg/mL

Amber Patient Retained Paediatrics

04.02.02 Haloperidol decanoate 

Injection 50 mg/mL, 100 mg/mL

Red Paediatrics

No BNFc entry – seek specialist advice

27.09 Helicobacter pylori, eradication 

First line

PPI BD AND
Amoxicillin 1 g BD AND
Clarithromycin* 500 mg BD OR Metronidazole 400 mg BD
All for 7 days

In penicillin allergy

First line: PPI BD AND
Clarithromycin* 500 mg BD AND
Metronidazole 400 mg BD

If previous clarithromycin: PPI BD AND
Bismuth subsalicylate 525 mg BD AND
Metronidazole 400 mg BD AND
Tetracyline 500 mg QDS
All for 7 days

For children, refer to a specialist for advice.

*Warning Caution in pregnancy

Choose either Clarithromycin* or Metronidazole depending upon previous exposure to these antimicrobials in the last 12 months.

Second line treatment involves the use of whichever antimicrobial (Clarithromycin* or Metronidazole) was not used first-line.

Diabact UBT test kit available on FP10

Refer to NICE guidance on Dyspepsia or local Dyspepsia pathway for information on testing.

In paediatrics, a test and treat strategy is not recommended, nor is the faecal antigen test recommended for diagnosis.

Bismuth subsalicylate availability is subject to local variation.

02.08.01 Heparin 

Flush 10units/mL, 100units/mL

The use of heparin flushes should be kept to a minimum. For maintaining patency of peripheral venous catheters, sodium chloride injection 0.9% is as effective as heparin flushes. The role of heparin flushes in maintaining patency of arterial and central venous catheters is unclear.

02.08.01 Heparin sodium injection (unfractionated)  1,000 units/mL (1mL, 5mL, 20mL amps)
5,000 units/mL (1mL amp) restricted use
08.02.04 Histamine  Injection 1mg/mL
11.08.01 Hyaluronic acid 0.1%, co-enzyme Q 0.1%, vitamin E TPGS 0.5% 

VisuXL® , 10mL

Severe dry eyes - Sjogren's syndrome, chronic keratitis.

10.01 Hyaluronic acid and derivatives (Hyaluronans) 

Intra-articular injection

Includes combination products such as hyaluronic acid + triamcinolone (Cingal®)

10.03.01 Hyaluronidase 

Hypodermoclysis only Injection 1500-unit amp

Paediatrics: no BNFc entry - seek specialist advice

02.05.01 Hydralazine tablets 

25mg, 50mg

Amber Initiated paediatrics

01.05.02 Hydrocortisone Colifoam® Rectal foam in aerosol pack, hydrocortisone acetate 10%

Amber Initiated  Paediatrics
06.03.01 Hydrocortisone  

standard release tablets 10mg, 20mg

oral Suspension 5mg in 5mL (Special)

Amber Initiated  Paediatrics

06.03.02 Hydrocortisone  

tablets 10mg, 20mg

oral suspension 5mg in 5mL (Special)

Amber Initiated  Paediatrics

13.04 Hydrocortisone  First Choice
0.5%, 1.0% Cream; Ointment; 15 g, 30 g

Mild
13.04 Hydrocortisone 0.5%, Nystatin 100,000 units/g, Benzalkonium chloride solution 0.2%, dimeticone '350' 10%  (Timodine®) Cream; 30 g

Mild with antimicrobials
13.04 Hydrocortisone 1% with oxytetracycline  

Terra-Cortril® ointment 30 g

 

Mild with antimicrobials 

13.04 Hydrocortisone 1%, Clotrimazole 1%  (Canestan HC®) Cream; 30 g

Mild with antifungal
13.04 Hydrocortisone 1%, Miconazole Nitrate 2%  (Daktacort®) Cream; ointment; 30 g

Mild with antifungal
13.04 Hydrocortisone 1%, Nystatin 100,000 units/g, Chlorhexidine Hydrochloride 1%  (Nystaform-HC®) Ointment; 30 g

Mild with antimicrobials
10.01.02.02 Hydrocortisone acetate  injection 25 mg/mL (1-mL)
by intra-articular injection


RED in paediatrics


injection 40 mg/mL (1-mL, 2-mL, 3-mL vials)
by intra-articular injection or intra-lesional injection
12.01.01 Hydrocortisone Acetate 1% with Gentamicin 0.3% 
13.04 Hydrocortisone Acetate 1%, Fusidic Acid 2%  (Fucidin H®) Cream; 30 g, 60 g

Mild with antimicrobials
06.03.02 Hydrocortisone acetate injection  25mg/mL, 1mL amp
13.04 Hydrocortisone Butyrate 

Second choice 0.1% (Locoid®) Cream; Lipocream; Ointment; 30 g, 100 g

Potent

Amber Recommended Paediatrics

06.03.01 Hydrocortisone modified release tablets Plenadren® 5mg, 20mg
06.03.02 Hydrocortisone sodium phosphate 

Injection 100mg/1ml

Amber Recommended  Paediatrics

06.03.02 Hydrocortisone sodium succinate 

Injection 100mg

Red  Paediatrics

12.03.01 Hydrocortisone sodium succinate 2.5mg muco adhesive pellets 
01.07.02 Hydrocortisone with lidocaine 5%/0.275% Xyloproct®

Ointment (water-miscible), aluminium acetate 3.5%, hydrocortisone acetate 0.275%, lidocaine 5%, zinc oxide 18%

01.07.02 Hydrocortisone with pramocaine  Proctofoam HC enema®

Foam in aerosol pack, hydrocortisone acetate 1%, pramocaine hydrochloride 1%.

13.11.06 Hydrogen Peroxide   Solution 3% (10 vols); 200 mL
Solution 6% (20 vols); 200 mL
(Crystacide®) 1% Cream; 25 g, 40 g
12.03.04 Hydrogen peroxide 3% and 6% mouthwash BP 

Paediatrics: dilute 10mL of the 3% hydrogen peroxide solution to100mL of water before use as a mouthwash

13.02.01 Hydromol Intensive® 

Urea 10%; Cream; 30 g; 100 g

Medium

13.02.01 Hydromol®  Ointment only (not cream); 500 g, 1 kg tub

Very Greasy
13.02.01.01 Hydromol®  Bath and shower emollient; 350 mL, 500 mL, 1 litre
04.07.02 Hydromorphone 














note Patients requiring high doses of Hydromorphone(> 8mg BD) should be reviewed and consideration given to referring to a pain specialist for review.
Capsules
CD Schedule 2
1.3mg, 2.6mg
Amber Initiated Traffic Light Paediatrics. Patient will remain under the care of the paediatric specialist pain team.
Modified release capsules
CD Schedule 2
2mg, 4mg, 8mg,16mg, 24mg
Amber Initiated Traffic Light Paediatrics. Patient will remain under the care of the paediatric specialist pain team.
13.13 Hydroquinone, Hydrocortisone, Tretinoin 

(Pigmanorm cream®) For Melasma. Hydroquinone 5% w/w, hydrocortisone 1% w/w and tretinoin 0.1% w/w

09.01.02 Hydroxocobalamin  Injection 1mg/ml

Amber Recommended  For paediatrics

Hydroxocobalamin has replaced cyanocobalamin as the form of vitamin B12 of choice for therapy; it is retained in the body longer than cyanocobalamin and thus for maintenance therapy can be given at intervals of up to 3 months
08.01.05 Hydroxycarbamide 

500mg capsules, 500mg/5ml oral solution (unlicensed).

For myeloproliferative disorders including essential thrombocythaemia and polycythaemia.

Prescribing for new patients should not be passed out to primary care. Existing patients may continue to receive prescriptions until arrangements have been made for the hospital trust to take back prescribing.

09.01.03 Hydroxycarbamide Siklos® Tablets 100mg, 1g

For sickle-cell disease only

10.01.03 Hydroxychloroquine 

Tablets 200mg

Oral suspension 35mg in 5mL (unlicensed special)

11.08.01 Hydroxypropyl Guar  Systane® eye drops (10ml)

Systane® single dose eye drops (28 units), preservative-free
11.08.01 Hydroxypropyl Guar 

Systane Ultra® eye drops 10ml
Single dose eye drops

03.04.01 Hydroxyzine hydrochloride  Tablets 10 mg, 25 mg

MHRA Advice:
The maximum adult daily dose of hydroxyzine is now 100 mg. Do not prescribe hydroxyzine to people with a prolonged QT interval or risk factors for QT interval prolongation
01.02 Hyoscine Butylbromide 

Injection 20 mg/mL 1-mL amp

Amber Recommended  Paediatrics for enteral administration

Red Paediatrics for intravenous administration

Safety advice

Hyoscine butylbromide injection can cause serious adverse effects including tachycardia, hypotension, and anaphylaxis. These adverse effects can result in a fatal outcome in patients with underlying cardiac disease, such as those with heart failure, coronary heart disease, cardiac arrhythmia, or hypertension.

MHRA: Hyoscine butylbromide (Buscopan) injection: risk of serious adverse effects in patients with underlying cardiac disease, Feb-2017

01.02 Hyoscine Butylbromide  Tablets 10 mg
01.02 Hyoscine hydrobromide 

Tablets 300micrograms

Transdermal patch 1.5mg

Oral liquid 100micrograms/mL - paediatrics (Special)

Hypersalivation (off-label)

Amber Initiated Paediatrics

04.06 Hyoscine Hydrobromide Scopolamine Hydrobromide Chewable tablets 150micrograms, 300micrograms
Patches (Scopoderm®) 1mg/72hours
03.07 Hypertonic sodium chloride  

Nebuliser solution 3%, 6%, 7%, ampoules

11.08.01 Hypromellose Isopto Alkaline®

1% eye drops 10ml

11.08.01 Hypromellose Isopto Plain®

0.5% eye drops 10ml

11.08.01 Hypromellose  0.3% eye drops (10ml)

0.3% single use eye drops, preservative free
0.3% eye drops (10ml), preservative free
11.08.01 Hypromellose  2% eye drops
For use with fundus lenses and gonioscopy lenses
06.06.02 Ibandronic acid injection 

1mg/mL, 3mL prefilled syringe Concentrate for intravenous infusion, 1mg/mL, 2mL vial, 6mL vial

Paediatrics: no BNFc entry - seek specialist advice

06.06.02 Ibandronic acid tablets 

50mg, 150mg For post-menopausal osteoporosis

Amber Patient Retained  for other indications

Paediatrics: no BNFc entry - seek specialist advice

04.07.04.01 Ibuprofen 

Tablets 200mg, 400mg, 600mg
Melts 200mg
Orodispersible tablet 200mg
Oral suspension 100mg/5ml

10.01.01 Ibuprofen 

Tablets 200 mg, 400 mg,
Oral suspension SF 100mg/5mL

Orodispersible tablets 200mg (paediatrics)

10.03.02 Ibuprofen gel 

Gel 5% 30 g, 50 g, 100g; Gel 10% 30g, 50g, 100g

Paediatrics: no BNFc entry - seek specialist advice

02.08.02 Idarucizumab  Praxbind® 2.5g/50mL solution for injection/infusion
02.06.04 Iloprost infusion  Concentrate for infusion 100micrograms/ml

Paediatrics: only for Raynaud’s syndrome.
Available from Bayer on a named patient basis.
02.05.01 Iloprost injection   Unlicensed special

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
02.05.01 Iloprost nebules  10mcg/ml 1ml vials.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

04.03.01 Imipramine 

Tablets 10 mg, 25 mg
Oral solution 25 mg/5 mL

Amber Initiated  Paediatrics

04.07.03 Imipramine 

Tablets, 10 mg, 25 mg
Oral solution, 25 mg/5ml

No BNFc entry - seek specialist advice

04.07.04.02 Imipramine 

Tablets 10 mg, 25 mg
Oral solution 25 mg/5 mL

No BNFc entry – seek specialist advice

13.07 Imiquimod 

5% (Aldara®) Cream (12 sachet packs)

Anogenital warts, actinic keratosis.

 

  Amber Patient Retained Superficial basal cell carcinoma. Also lentigo maligna (Off label)

13.02.01 ImuDerm® 

Urea 5%, glycerol 5%, Cream; 500 g pump

Medium

03.01.01.01 Indacaterol inhalation powder Onbrez Breezhaler®
Onbrez Breezhaler
Dry powder inhaler
150 micrograms/capsule
300 micrograms/capsule


Paediatrics: no BNFc entry - seek specialist advice
02.02.01 Indapamide standard release tablets  2.5mg

N.B. the modified release preparation is not recommended

Paediatrics: no BNFc entry - seek specialist advice
04.07.04.03 Indometacin 

Ice-pick headache, Paroxysmal Hemicrania and Hemicrania Continua
 
Capsules 25mg, 50mg
 
No BNFc entry - seek specialist advice

07.01.03 Indometacin  

Capsules 25mg, 50mg. Suppositories 100mg

For uncomplicated premature labour - off label

Paediatrics: No BNFc entry, seek specialist advice 

10.01.01 Indometacin 

Capsules 25mg, 50mg

Oral suspension 25mg in 5mL

For symptoms of acute gout.

01.05.03 Infliximab  Intravenous infusion, powder for reconstitution, 100-mg
Remicade® - Originator Brand
Flixabi ®, Inflectra®, Remisima® - Biosimilar Brands

Prescribe by brand

Crohn's disease
Acute ulcerative colitis
10.01.03 Infliximab  IV infusion 100 mg (powder for reconstitution)
Remicade® - Originator Brand
Flixabi ®, Inflectra®, Remsima® - Biosimilar Brands

Prescribe by brand

NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents

Paediatrics: no BNFc entry - seek specialist advice
13.05.03 Infliximab 

Injection 100 mg
Remicade® - Originator Brand
Flixabi ®, Inflectra®, Remsima® - Biosimilar Brands

Prescribe by brand

In line with NICE TA 134 – Infliximab for the treatment of adults with psoriasis

Cytokine modulator

No BNFc entry; Paediatrics, seek specialist advice 

NHS NHSE commissioned drug for Paediatric indications (where Adult TA available) - see Specialised Commissioning: Key documents

27.08 Influenza 

Treat ‘at risk’ patients when influenza is circulating in the community or in a care home where influenza is likely.

For treatment: Oseltamivir 75 mg BD for 5 days

For prophylaxis: Oseltamivir 75 mg daily for 10 days

Refer to the most recent supporting info from PHE for up to date dosing for children or the BNF for Children.

See PHE advice on the use of antivirals in pregnancy, breastfeeding, hepatic or renal dysfunction and immunosuppression.

Avoid use in otherwise healthy adults.

Treatment must be started within 48 hours of onset of symptoms of ILI.

PHE or DH will advise when influenza is considered to be circulating in the community.

At risk: pregnant (including up to two weeks post-partum); children under six months; adults 65 years or older; chronic respiratory disease (including COPD and asthma); significant cardiovascular disease (not hypertension); severe immunosuppression; diabetes mellitus; chronic neurological, renal or liver disease; morbid obesity (BMI > 40).

To check current situation log onto PHE.

13.08.01 Ingenol mebutate 

150 micrograms/g (Picato®), 3 × 0.47 g single-use tubes;
500 micrograms/g (Picato®), 2 × 0.47 g single-use tubes

No BNFc entry; Paediatrics - seek specialist advice

03.01.05 Inhalation aid Haleraid® Haleraid® -120 For 120 dose inhalers
Haleraid® -200 For 200 dose inhalers
Device to place over pressurised (aerosol) inhalers to aid when strength in hands is impaired (e.g., in arthritis).
(For use with Flixotide®, Seretide®, Serevent® and Ventolin® inhalers).
Please note these devices are not allowable on NHS prescriptions, but can be purchased by patients.
02.06.04 Inositol nicotinate tablets  500mg, 750mg
06.01.01.01 Insulin - Highly purified animal 

note Existing patients or strong patient preference only

Hypurin Bovine Neutral
Hypurin Porcine Neutral

06.01.01.01 Insulin - Human sequence 

note  Existing patients or strong patient preference only

Actrapid
Humulin S
Insuman Rapid

Red Actrapid and Humulin S for hospital in-patient use

06.01.01.01 Insulin Aspart 

100 units/ml

Fiasp®

Novorapid®

Prescribers and patients need to be aware of the faster initial absorption of insulin with Fiasp® resulting in a more rapid onset of action (5 minutes earlier than with Novorapid®) and earlier peak concentration  

06.01.01.02 Insulin Degludec 

100 units/mL; 200 units/mL

Tresiba

06.01.02.03 Insulin degludec and liraglutide Xultophy®

Insulin Degludec 100units/ml + Liraglutide 3.6mg/ml solution for injection

Where the combination of a GLP-1 analogue with insulin is clinically indicated, clinicians should continue to prescribe a separate GLP-1 analogue and insulin in line with current Pan Mersey recommendations.

06.01.01.02 Insulin Detemir  100 units/mL
Levemir
06.01.01.02 Insulin Glargine  100 units/mL
Lantus
Abasaglar (biosimilar)
06.01.01.02 Insulin Glargine 300 units/mL 

300 units/ml Toujeo Not interchangeable with insulin glargine 100 units/mL

06.01.02.03 Insulin glargine and lixisenatide Suliqua®

Insulin Glargine 100 units/ml + Lixisenatide 50 micrograms/ml solution for injection; 3ml pre-filled pen

Insulin Glargine 100 units/ml + Lixisenatide 33 micrograms/ml solution for injection; 3ml pre-filled pen

Where the combination of a GLP-1 analogue with insulin is clinically indicated, clinicians should continue to prescribe a separate GLP-1 analogue and insulin in line with current Pan Mersey recommendations.

06.01.01.01 Insulin Glulisine  100units/ml
Apidra
06.01.01.01 Insulin Lispro 100 units/mL  100 units/ml
Humalog
06.01.01.01 Insulin Lispro 200 units/mL  200 units/ml
Humalog
06.01.01.02 Insulin Zinc Suspension Highly purified animal  Existing patients or strong patient preference only.
Hypurin Bovine Lente
08.02.04 Interferon Alfa  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
11.10 Interferon Alfa-2b   1,000,000 units/ml eye drops
08.02.04 Interferon Beta  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
08.02.04 Interferon gamma-1b 
12.02.02 Ipratropium bromide 0.03% nasal spray 

Rinatec®

 

Amber Recommended Paediatrics < 12 years

03.01.02 Ipratropium bromide aerosol inhalation  Metered dose inhaler
20 micrograms/metered inhalation
Short-acting muscarinic antagonist
03.01.02 Ipratropium bromide nebuliser solution  250 micrograms/mL
500 micrograms/2 mL (250 micrograms/mL)
Short-acting muscarinic antagonist
02.05.05.02 Irbesartan tablets 

75mg, 150mg, 300mg 
 
Amber Initiated paediatrics

Paediatrics: no BNFc entry - seek specialist advice

09.01.01.02 Iron Dextran CosmoFer® Injection iron 50mg/ml
09.01.01.02 Iron Isomaltoside Diafer®, Monofer®

Injection iron 100mg/ml

Paediatrics: no BNFc entry - seek specialist advice

09.01.01.02 Iron Sucrose Venofer® Injection iron 20mg/ml
06.01.01.02 Isophane Insulin Highly purified animal  Existing patients or strong patient preference only.
Hypurin Bovine Isophane
Hypurin Porcine Isophane
06.01.01.02 Isophane Insulin Human sequence  100 units/ml
Insulatard
Humulin I
Insuman Basal
02.06.01 Isosorbide Dinitrate injection  0.1% injection (1mg/mL) 10mL amps

Paediatrics: no BNFc entry - seek specialist advice
02.06.01 Isosorbide Mononitrate tablets  10mg, 20mg, 40mg
M/R 25mg, 40mg, 50mg, 60mg


Paediatrics: no BNFc entry - seek specialist advice
13.06.02 Isotretinoin  Capsules 5mg, 10 mg, 20 mg (Roaccutane®)

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.
13.06.01 Isotretinoin 0.05%, erythromycin 2% 

(Isotrexin®) Gel; 30 g

 

Amber Recommended Paediatrics - for neonatal and infantile acne

01.06.01 Ispaghula Husk  Granules 3.5 g/sachet
07.02.02 Itraconazole 

Capsules 100 mg.

Paediatrics: No BNFc entry, seek specialist advice 

02.06.03 Ivabradine tablets  Heart failure 5mg, 7.5mg

Paediatrics: no BNFc entry - seek specialist advice
02.06.03 Ivabradine tablets  Angina 5mg, 7.5mg


Paediatrics: no BNFc entry - seek specialist advice
03.07 Ivacaftor Kalydeco® Film coated tablets 150mg
Granules sachets 50mg, 75mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
13.10.04 Ivermectin 

10mg/g cream (Soolantra®▼)

Topical preparation for treatment of moderate to severe rosacea (papulopustular).  Use when standard topical treatments (azelaic acid 15% gel and metronidazole 0.75% gel/cream) have failed as an alternative option before oral antibiotics.

10.01.03 Ixekizumab 

80mg solution for injection (Taltz®) prefilled syringe; prefilled pen

Psoriatic Arthritis

No BNFc entry; Paediatrics, seek specialist advice 

13.05.03 Ixekizumab 

80mg solution for injection (Taltz®) prefilled syringe; prefilled pen

No BNFc entry; Paediatrics, seek specialist advice 

13.08.02 Keromask® 

Masking cream (various shades); 15 mL Finishing powder (various shades); 20 g

04.07.01 Ketamine 

Oral Solution 50 mg/5ml (unlicensed)
Injection s/c 10 mg/ml, 50 mg/ml, 100 mg/ml (off label - in palliative care only)

REDi/v 10 mg/ml, 50 mg/ml, 100 mg/ml

Red Opioid cross-tapering and weaning

Amber Recommended In paediatric palliative care

 

13.09 Ketoconazole  2% Shampoo; 120 mL
11.08.02 Ketorolac  0.5% eye drops

06.01.06 Ketostix®  Reagent strips, for detection of ketones in urine
02.04 Labetalol injection  5mg/mL
02.04 Labetalol tablets 

100mg, 200mg 

Amber Initiated paediatrics

27.07 Labyrinthitis 
Antibiotics not indicated  
04.08.01 Lacosamide 

Tablets 50mg, 100mg, 150mg, 200mg
 Oral solution 10mg/mL


Amber Initiated Paediatrics
Focal onset epilepsy - add on drug option.

01.11 Lactase Colief® Oral liquid 50,000 units/g 7ml dropper bottle
01.06.04 Lactulose  Solution 3.1–3.7 g/5 mL
04.02.03 Lamotrigine 

Tablets, 25 mg; 50 mg; 100 mg; 200 mg
Dispersible tablets, 2 mg; 5 mg; 25 mg; 100 mg

No BNFc entry – seek specialist advice

04.07.03 Lamotrigine 

Tablets, 25mg, 50mg, 100mg, 200mg
Dispersible tablets, 2mg, 5mg, 25mg, 100mg
N.B. Unlicensed indication

No BNFc entry - seek specialist advice

04.07.04.03 Lamotrigine 

SUNCT (Short lasting unilateral neuralgiform headache with conjunctival injection and tearing), Trigeminal neuralgia - only if allergic to carbamazepine
 
Tablets 25mg, 50mg, 100mg, 200mg
Dispersible tablets 2mg, 5mg, 25mg, 100mg
 
No BNFc entry - seek specialist advice

04.08.01 Lamotrigine 

Tablets 25mg, 50mg, 100mg, 200mg,
Dispersible tablets 2mg, 5mg, 25mg, 100mg
Amber Initiated Paediatrics
Focal onset epilepsy - 1st line
If a more rapid titration of drug is required then consider an alternative first-line AED such as levetiracetam or carbamazepine.

Generalised epilepsy - 1st line

Lamotrigine is a 1st line option in women of childbearing age, if the main seizure type is tonic clonic seizures and if, after discussion, the young person or woman does not wish to take sodium valproate

08.03.04.03 Lanreotide  Injection 30mg, 60mg, 90mg, 120mg

REDLanreotide is RED for acromegaly and neuroendocrine tumour

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
01.03.05 Lansoprazole 

Gastro-resistant capsules 15 mg, 30 mg

Green  Paediatrics (in children aged 12 years or above)

Amber Recommended Paediatrics (in children aged under 12 years old)

01.03.05 Lansoprazole 

Orodispersible tablet 15 mg, 30 mg

Green  Paediatrics (in children aged 12 years or above)

Amber Recommended Paediatrics (in children aged under 12 years old)
 

09.05.02.02 Lanthanum Fosrenol ®

Chewable tablets 500mg, 750mg, 1000mg
Lanthanum - only for its licensed indication - control of hyerphosphataemia in patients with chronic renal failure on haemodialysis or continuous ambulatory peritoneal dialysis and in patients with chronic kidney disease not on dialysis who have a serum-phosphate concentration of 1.78 mmol/litre or more that cannot be controlled by a low-phosphate diet.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
COMMISSIONED BY NHS ENGLAND FOR PATIENTS RECEIVING RENAL DIALYSIS.
REDfor patients receiving dialysis (newly initiated)

Amber Initiated  for existing patients on dialysis already prescribed in primary care, and in pre-dialysis

Paediatrics: no BNFc entry - seek specialist advice

03.01.05 Large volume device Volumatic®

Spacer inhaler; First choice in paediatrics (with paediatric mask)
(For use with Clenil Modulite®, Flixotide®, Seretide®, Serevent® and Ventolin® metered dose inhalers)

27.07 Laryngitis, acute 
No antibiotic indicated
Issue Patient Information Leaflet (PIL) on viral sore throats.
 
11.06 Latanoprost 

50 micrograms/ mL (0.005%) eye drops, 50 micrograms/ml (0.005%) single dose eye drops
Single dose eye drops reserved for patients with known preservative allergy.

Amber Initiated Paediatrics.

11.06 Latanoprost with timolol 

50 micrograms/ml (0.005%) and 5mg/ml (0.5%) eye drops

Amber Initiated Paediatrics.

10.01.03 Leflunomide 

Tablets 10 mg, 15mg, 20 mg, 100mg (100mg for loading dose only)

Paediatrics: dose available from initiating specialist centre

08.02.04 Lenalidomide 

Capsules 5mg, 10mg, 15mg, 25mg


NHS NHSE drug

09.01.06 Lenograstim Granocyte® Contact Pharmacy dept. for product availability

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
10.01.04 Lesinurad 

Tablets 200mg (Zurampic®)

08.03.04.01 Letrozole  Tablets 2.5mg
06.07.02 Leuprorelin 

Prostap® SR DCS: leuprorelin (as acetate) 3.75mg in pre-filled syringe; Prostap® 3 DCS: leuprorelin (as acetate) 11.25mg in pre-filled syringe. Use in accordance with its licensed indications:

 

Red St Helen's CCG endometiosis and uterine fibroids

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

 

08.03.04.02 Leuprorelin acetate 

Injection 3.75mg, 11.25mg

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

RED St Helen's CCG for endometriosis and uterine fibroids.

04.08.01 Levetiracetam 

Tablets 250mg, 500mg, 750mg, 1g
Oral Solution 100mg/mL

Granules 250mg, 500mg, 1g (expensive - for use in tube-fed patients only)


Amber Initiated Paediatrics
Focal onset epilepsy - 1st line ALTERNATIVE

Generalised epilepsy - 1st line
Levetiracetam is a 1st line option in women of childbearing age, if myoclonus is prominent, for example in juvenile myoclonic epilepsy and if after discussion, the young person / woman does not wish to take valproate.

04.09.03 Levetiracetam 

Tablets 250mg, 500mg, 750mg, 1g
Oral solution 100mg/mL

Granules 250mg, 500mg, 1g (expensive - for use in tube-fed patients only)

No BNFc entry - seek specialist advice

11.06 Levobunolol  

0.5% eye drops, 0.5% single dose eye drops
Single dose eye drops reserved for patients with known preservative allergy

Amber Initiated Paediatrics.

04.09.01 Levodopa/carbidopa/entacapone 

Tablets 50mg/12.5mg/200mg
Tablets 75mg/18.75mg/200mg
Tablets 100mg/25mg/200mg
Tablets 125mg/31.25mg/200mg
Tablets 150mg/37.5mg/200mg
Tablets 175mg/43.75mg/200mg
Tablets 200mg/50mg/200mg

No BNFc entry – seek specialist advice

11.03.01 Levofloxacin  0.5% eye drops

Ophthalmologist initiation only. Use hourly for 48 hours and then review [unlicensedunlicensed dose].
11.03.01 Levofloxacin  0.5% eye drops, 0.5% unit dose eye drops

Single dose eye drops reserved for patients with known preservative allergy.
13.03 Levomenthol Cream, BP (Menthol in aqueous cream) 

Cream (Dermacool®) Strengths; 1%, 100 g, 500 g pump pack & 2%, 500 g pump pack.
Dermacool® is now SLS-Free

04.02.01 Levomepromazine 

Tablets 25 mg
Injection 25 mg/mL (in primary care syringe driver)

Amber Patient Retained Paediatrics

04.06 Levomepromazine 

Tablets 25mg
(a 6.25mg dose of levomepromazine tablet can be achieved by quartering a 25mg tablet- note however that this is unlicensed. Where this is not practical an unlicensed “special” 6mg tablet is available and may be considered)
Injection 25mg/mL

Amber Recommended Paediatrics


 Levomepromazine is also used as an antiemetic in palliative care

07.03.02.01 Levonorgestrel  Tablets 30 micrograms
Norgeston ®
07.03.02.03 Levonorgestrel 

Intra-uterine delivery system Prescribe by brand name as products are not interchangeable

20 micrograms/24 hours (Mirena®)- 5 year duration of action

20 micrograms/24 hours (Levosert®)- 3 year duration of action

6 micrograms/24 hours (Jaydess®) - 3 year duration of action

Grey 9 micrograms/24 hours (Kyleena®) - 5 year duration of action 

Green Paediatrics: if sexually active Red  Paediatrics: if NOT sexually active

07.03.05 Levonorgestrel 

Tablets 1.5 mg Upostelle

Green  Paediatrics: post menarche

06.02.01 Levothyroxine sodium 

Tablets: 12.5micrograms, 25 micrograms, 50 micrograms, 75micrograms, 100 micrograms

N.B. 12.5micrograms strength primarily recommended for small dose increments required in paediatrics; this strength is relatively expensive and should not be routinely used in adults unless small dose increment is essential in an individual patient.

Prescribe/ dispense with care to avoid confusion with 125micrograms dosage

Oral solution: 25 micrograms/5mL, 50 micrograms/5mL, 100 micrograms/5mL sugar-free.

04.07.03 Lidocaine 

Plaster, 5% (700 mg per medicated plaster)*

 Amber Initiated Paediatrics

No BNFc entry - seek specialist advice

Notes
*Consider topical lidocaine plaster for treatment of localised pain only for people who are unable to take oral medication because of medical conditions and/or disability.

11.10 Lidocaine   1% injection

Ophthalmologist only.
12.03.01 Lidocaine 10% mouth spray 

Xylocaine®

Paediatrics: No BNFc entry - seek specialist advice

01.07.01 Lidocaine 5% ointment 
07.04.03 Lidocaine hydrochloride 

Gel lidocaine hydrochloride 2%, chlorhexidine gluconate 0.25% 6ml (female) and 11ml (male) syringes

Topical application in urethral pain

Amber Recommended  Paediatrics

11.07 Lidocaine Hydrochloride 4% with Fluorescein 0.25%  minims

02.03.02 Lidocaine hydrochloride injection 

1% (2mL, 5mL, 10mL, 20mL)

2% (2mL, 5mL, 10mL, 20mL)

01.06.07 Linaclotide  Capsules 290 micrograms

Irritable Bowel Syndrome - constipation

Paediatrics: no BNFc entry - seek specialist advice
06.01.02.03 Linagliptin tablets 

5mg

Dipeptidylpeptidase-4 (DPP-4) Inhibitors

Paediatrics: No BNFc entry, seek specialist advice 

06.01.02.03 Linagliptin with metformin tablets 

2.5mg/850mg, 2.5mg/1g Dipeptidylpeptidase-4 (DPP-4) Inhibitors

05.01.07 Linezolid  Tablets 600mg
Suspension 100mg/5ml

Short-term use (14 days or less) in patients not admitted to hospital.

Red for long-term use (>14days) and where patient has been admitted to hospital.

Microbiologist recommendation only.


06.02.01 Liothyronine sodium tablets 

20 micrograms

5 micrograms (unlicensed)

 

Existing stable patients in primary care may continue to be prescribed liothyronine by the GP where they are satisfied the patient is benefiting specifically from the use of liothyronine.

06.01.02.03 Liraglutide injection Victoza®

6mg/mL, 3mL prefilled pen

 Amber Patient Retained  when used in combination with insulin.

 

GREY when used as monotherapy

 

 Black  Liraglutide with insulin degludec (Xultophy®▼)

 

Paediatrics: No BNFc entry, seek specialist advice 

 

Victoza® is not licensed for obesity/weight management and is not interchangeable with Saxenda® brand, which is licensed for weight management and used at a higher dose. It is recommended liraglutide is prescribed by brand name to avoid confusion.

06.01.02.03 Liraglutide injection Saxenda®

6mg/mL, 3mL prefilled pen

Max dose 3.0mg

Saxenda® is not licensed for the treatment of type 2 diabetes and is not interchangeable with Victoza® brand, which is licensed for type 2 diabetes and used at a lower dose.

04.04 Lisdexamfetamine 

Capsule 20mg, 30 mg, 40mg, 50 mg, 60mg, 70 mg

There can be variation in the licensing of different medicines containing the same drug.
 
Elvanse Adult® to treat ADHD in adults - TEMPORARY RED POSITION WITH THE FOLLOWING EXCEPTIONS

Purple Liverpool CCG (Adults and Children) and Halton CCG (Adults only).

02.05.05.01 Lisinopril liquid 

Unlicensed special various strengths available from special–order manufacturers.
5mg/5ml is standard strength used at Alder Hey.

Amber Initiated paediatrics

02.05.05.01 Lisinopril tablets 

2.5mg, 5mg, 10mg, 20mg 

Amber Initiated paediatrics

04.02.03 Lithium Carbonate Camcolit®

M/R tablets 400 mg
 

Purple Paediatrics (in children above 12 years)

04.02.03 Lithium Carbonate Liskonum®

M/R tablets 450 mg

Purple Paediatrics (in children above 12 years)

04.02.03 Lithium Carbonate Priadel®

MR tablets 200 mg, 400 mg

Purple Paediatrics (in children above 12 years)

04.07.04.03 Lithium carbonate (prescribe by brand) 

Prophylaxis of Cluster Headache- Shared Care

Priadel® MR tablets 200 mg, 400 mg
Lithium Carbonate Essential Pharma® tablets 250 mg (previously known as Camcolit® 250mg)
Camcolit® M/R tablets 400 mg
Liskonum® M/R tablets 450 mg

No BNFc entry - seek specialist advice.

04.02.03 Lithium Citrate Li-Liquid®

liquid 509 mg/5 mL, 1.018 g/5 mL

Purple Paediatrics (in children above 12 years)

04.02.03 Lithium Citrate Priadel®

liquid SF 520 mg/5 mL

Purple Paediatrics (in children above 12 years)

04.07.04.03 Lithium citrate (prescribe by brand) 

Prophylaxis of Cluster Headache -Shared care

Priadel® Liquid SF 520 mg/5 mL
Li-Liquid® 509 mg/5 mL, 1.018 g/5 mL
 
No BNFc entry - seek specialist advice

06.01.02.03 Lixisenatide injection 

50 micrograms/mL, 10 micrograms/dose prefilled pen (14 doses) 100 micrograms/mL, 20 micrograms/dose prefilled pen (14 doses) Treatment initiation pack, 10 micrograms/dose prefilled pen and 20 micrograms/dose prefilled pen Incretin mimetic Second line - use only when both exenatide and liraglutide are unsuitable or not tolerated.

Amber Patient Retained  when used in combination with insulin

Paediatrics: No BNFc entry, seek specialist advice 

11.04.02 Lodoxamide  0.1% eye drops.
Can be sold to the public for the treatment of allergic conjunctivitis in adults and children over 4 years
04.03.01 Lofepramine 

Tablets 70 mg
Oral suspension 70 mg/5 mL

No BNFc entry – seek specialist advice

04.10.03 Lofexidine 

Tablets f/c 200micrograms

Prescribed by the Drug Service

No BNFc entry – seek specialist advice

01.04.02 Loperamide 

Capsules and tablets 2 mg
 Oral solution sugar-free 1 mg/5 mL

04.01.01 Loprazolam 

Tablets 1 mg

No BNFc entry – seek specialist advice

03.04.01 Loratadine  Tablets 10 mg;
Syrup 5 mg/5 Ml
04.01.02 Lorazepam 

Tablets 1 mg, 2.5 mg (can be used sublingually)
Injection 4 mg/1 mL

Red injection for rapid tranquilisation

No BNFc entry – seek specialist advice

04.08.02 Lorazepam 

Parenteral: IV injection 4mg/mL

Prolonged or repeated seizures and convulsive status epilepticus in the community.

Only use IV products if IV access is already established and resuscitation facilities are available.

Red Paediatrics

04.10.01 Lorazepam 

Tablets 1mg, 2.5mg

For Acute Alcohol Withdrawal
 
Prescribed by specialist services

No BNFc entry – seek specialist advice

04.01.01 Lormetazepam 

Tablets 500 microgram, 1 mg

No BNFc entry – seek specialist advice

02.05.05.02 Losartan oral suspension 

12.5mg/5ml when reconstituted 

Amber Initiated paediatrics

02.05.05.02 Losartan tablets 

12.5mg, 25mg, 50mg, 100mg 

Amber Initiated paediatrics

11.04.01 Loteprednol  0.5% eye drops

May have less effect on intraocular pressure than prednisolone acetate or dexamethasone.
04.02.01 Loxapine  

inhalation powder, 9.1mg

01.06.07 Lubiprostone  Capsules 24 micrograms

Chronic Idiopathic Constipation

Paediatrics: no BNFc entry - seek specialist advice
03.07 Lumacaftor and Ivacafotor Orkambi® Film coated tablets 200mg lumacaftor/125mg ivacaftor

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
04.02.01 Lurasidone 

Tablets 18.5mg, 37mg, 74mg

Lurasidone should only be prescribed as an alternative treatment option when existing antipsychotic treatments are unsuitable for adult patients with schizophrenia who have experienced or are at risk of excessive weight gain and metabolic adverse events.

No BNFc entry – seek specialist advice

 

11.10 Lutein, zeaxanthin, omega-3 fatty acids and beta carotene containing products 
13.06.02 Lymecycline 

Capsules 408 mg

Paediatric: Avoid in < 12 years   

02.05.01 Macitentan tablets  10mg
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Pulmonary Hypertension
01.06.05 Macrogol ‘3350’ with anhydrous sodium sulfate, ascorbic acid, potassium chloride, sodium ascorbate & sodium chloride Moviprep®

Oral powder sachets
 
RED in some areas - consult local policy


RED in paediatrics

01.06.05 Macrogol ‘3350’ with anhydrous sodium sulfate, potassium chloride, sodium bicarbonate & sodium chloride Klean-Prep®

Oral powder sachets

RED in some areas - consult local policy

RED in paediatrics

01.06.04 Macrogol 3350 with potassium chloride, sodium bicarbonate & sodium chloride (chronic constipation & faecal impaction)  

Oral powder sachets – several brands available

Bicarbonate 17 mmol per 1 litre

Chloride 53 mmol per 1 litre

Macrogol ‘3350’ 105 gram per 1 litre

Potassium 5.4 mmol per 1 litre

Sodium 65 mmol per 1 litre

 

Oral powder sachets (6.9g/Paediatric/Half-strength) – several brands available

Bicarbonate 17 mmol per 1 litre

Chloride 53 mmol per 1 litre

Macrogol ‘3350’ 52.5 gram per 1 litre

Potassium 5.4 mmol per 1 litre

Sodium 65 mmol per 1 litre

09.05.01.03 Magnesium Aspartate Magnaspartate® Magnesium aspartate dehydrate equivalent to 243 mg (10 mmol) of magnesium per sachet for oral administration.

Where Magnaspartate® is not suitable e.g. diabetic patients (due to sucrose content), paediatric or other patients where administration volume is restricted, then magnesium glycerophosphate oral preparations (unlicensed special) may be prescribed.

Where magnesium is used for nutritional reasons rather than treatment of a medical condition then nutritional supplements are available for purchase by patients.
01.06.05 Magnesium citrate with sodium picosulfate Picolax® or Citra-Fleet®

Oral powder, sugar-free sachets
 
RED in some areas - consult local policy


RED in paediatrics

CitraFleet - Paediatrics: no BNFc entry - seek specialist advice

09.05.01.03 Magnesium Glycerophosphate 

Tablets magnesium 97.2mg (4mmol/tablet)
Solution magnesium 24.25mg/ml (1mmol/ml) (unlicensed)
Suspension, magnesium 24.25mg/ml (1mmol/ml)  (unlicensed)
Capsules magnesium 500mg (2mmol)- for paediatrics  (unlicensed)

Of the formulations currently available, tablets have the lower acquisition cost.

Where oral magnesium is for treatment of a medical condition then magnesium aspartate dihydrate (Magnaspartate®) should be prescribed as first choice. Where magnesium is used for nutritional reasons rather than treatment of a medical condition then nutritional supplements are available for purchase by patients.


Where Magnaspartate® is not suitable e.g. diabetic patients (due to sucrose content), paediatric or other patients where administration volume is restricted, then magnesium glycerophosphate oral preparations may be prescribed.

01.06.04 Magnesium hydroxide  

Mixture 8%

Constipation in palliative care

09.05.01.03 Magnesium oxide  Aintree University Hospital only - for high output stomas and short bowel syndrome.
Capsules 160mg (4mmol Mg2+)

Paediatrics: no BNFc entry - seek specialist advice
09.05.01.03 Magnesium Sulphate  Intravenous injection 20% (magnesium approx. 0.8mmol/ml), 50% (Mg2+ approx. 2mmol/ml)
01.01.01 Magnesium trisilicate with magnesium carbonate & sodium bicarbonate 

Magnesium trisilicate suspension, containing magnesium trisilicate 50mg/ml, light magnesium carbonate 50mg/ml, and sodium bicarbonate 50mg/ml in a suitable vehicle with a peppermint flavour (high sodium content)

01.06.04 Magnesium trisilicate with magnesium carbonate & sodium bicarbonate  

Magnesium trisilicate suspension containing magnesium trisilicate 50mg/ml, light magnesium carbonate 50mg/ml and sodium bicarbonate 50mg/ml. (High sodium content)

13.10.04 Malathion  0.5% (Derbac-M®) Liquid (in aqueous basis); 50 mL, 200 mL
03.07 Mannitol  Mannitol 40 mg inhalation powder, hard capsule

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents


Paediatrics: no BNFc entry - seek specialist advice
02.02.05 Mannitol intavenous infusion  500mL infusion 10%, 20%
01.02 Mebeverine Hydrochloride  Tablets 135 mg

Modified release capsule 200mg

Oral suspension 50 mg/5 mL
06.07.04 Mecasermin 

injection 10mg in 1mL

 NHS NHSE commissioned drug - see Specialised Commissioning: Key documents 


06.01.06 Medi-Test® Glucose   Reagent strips, for detection of glucose in urine.
03.01.05 Medium-volume device Space Chamber Plus ®

Spacer device; 

With or without small, medium or large mask 

(For use with all pressurised (aerosol) inhalers)

07.03.02.02 Medroxyprogesterone Acetate 

Injection 150 mg/1mL for intramuscular injection (Depo-Provera®)

Injection 104 mg/0.65mL for subcutaneous injection (Sayana Press®)

Prescribers must clearly specify the route of administration to avoid confusion.

Amber Initiated  Paediatrics under 16 years of age

08.03.02 Medroxyprogesterone Acetate  Tablets 100mg, 200mg, 400mg, 2.5mg, 5mg, 10mg
06.04.01.02 Medroxyprogesterone Acetate tablets 

2.5mg; 5mg; 10mg

Amber Recommended  Paediatrics

10.01.01 Mefenamic Acid 

Capsules 250 mg
Tablets 500 mg
Suspension 50 mg/5 mL

Dysmenorrhoea and menorrhagia

Amber Recommended Paediatrics < 12 years of age

08.03.02 Megestrol Acetate  Tablets 160mg
04.01.01 Melatonin  Circadin®

Tablets M/R 2 mg; ‘off-label’ use in adults, children and young people

N.B. AMBER RETAINED designation in children and young people is pending Pan Mersey CCGs approval

Amber Initiated Chronic sleep disorders in adults in Halton CCG

BLACK for primary insomnia in adults

04.01.01 Melatonin 

Alder Hey uses 2mg capsules

10.01.01 Meloxicam 

Tablets 7.5 mg, 15 mg

Orodispersible tablets 7.5mg, 15mg

Amber Recommended  Paediatrics < 12 years of age

04.11 Memantine 

Treatment initiation pack
Tablets 10 mg, 20 mg

Orodispersible tablets 10mg, 20mg
Oral solution 10 mg/mL

Historic shared care agreement in place within South Sefton and Southport & Formby CCGs

No BNFc entry – seek specialist advice

09.06.06 Menadiol Sodium Phosphate  Tablets menadiol phosphate 10mg

Not to be confused with Menadione®
Not to be prescribed as Vitamin K
Length of treatment to be clearly stated
10.01.03 Mepacrine Hydrochloride 

Tablets 100mg

For skin manifestations of discoid lupus erythematosus, erythema multiforme, sarcoidosis and dermatomyositis.

Paediatrics: no BNFc entry - seek specialist advice

03.04.02 Mepolizumab 

100mg powder for solution for injection
(As per NICE TA431)

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

01.05.03 Mercaptopurine  Tablets 50 mg,
Tablets 10mg (unlicensed special for paediatrics)
Suspension 100mg/5ml (licensed (Nova) for paediatrics – expensive

Red  Paediatrics (NHS England commissioned)
08.02.01 Mercaptopurine 

Tablets 50mg

Tablets 10mg (unlicensed special for paediatrics)

Oral suspension 100mg/5mL (licensed for paediatrics) - expensive

01.05.01 Mesalazine Salofalk®

Gastro-resistant tablets 250mg
 Prescribe by brand name and maintain on same brand.

Gastro-resistant granules, m/r 500mg/sachet, 1g/ sachet, 1.5g/sachet, 3g/sachet
Foam enema, 1g

Suppositories 500mg & 1g

Retention enema 2g in 59ml

01.05.01 Mesalazine Octasa®

Gastro-resistant m/r tablets 400 mg, 800 mg

Octasa brand is considered to be equivalent to Asacol brand and currently represents a more cost-effective choice.
 
Prescribe by brand name and maintain on same brand.

01.05.01 Mesalazine Pentasa® Tablets, m/r, 500 mg, 1 g
Prescribe by brand name and maintain on same brand.

Granules, m/r, 1 g/sachet, 2 g/sachet, 4 g/sachet

Retention enema 1 g in 100-mL
01.05.01 Mesalazine Asacol®

Gastro-resistant m/r tablets 400mg, 800mg.

Octasa brand is considered to be equivalent to Asacol brand and currently represents a more cost-effective choice.


Prescribe by brand name and maintain on same brand.

Foam enema, 1 g/metered application

Suppositories, 250 mg

01.05.01 Mesalazine  Mezavant® XL

Tablets m/r, 1.2 g,

Prescribe by brand name and maintain on same brand.

13.02.02 Metanium®   Ointment; 30 g
02.07.02 Metaraminol injection  10mg/mL injection
Unlicensed special
13.09 Metformin 

Tablets; 500 mg

Off label

No BNFc entry: Paediatrics seek specialist advice 

06.01.02.02 Metformin m/r tablets 

500mg

2nd line if standard release metformin not tolerated

Amber Initiated  Paediatrics

06.01.02.02 Metformin oral solution 

500mg/5mL sugar-free

2nd line for patients unable to swallow metformin tablets

Amber Initiated  Paediatrics

06.01.02.02 Metformin tablets 

500mg, 850mg

Amber Initiated  Paediatrics

04.07.02 Methadone  

Injection 10 mg/ml

Opioid – parenteral preparation

Amber Initiated  Paediatrics: palliative care

 

04.10.03 Methadone (see notes) 

Oral Concentrate 10mg/ml, 20mg/mL

No BNFc entry – seek specialist advice

04.10.03 Methadone (see notes) 

Oral solution 1mg/mL
Oral solution s/f 1mg/mL
Injection 25mg/mL

Prescribed by the Drug Service

10.02.02 Methocarbamol 

Tablets 750mg

BNF designates as "Less suitable for prescribing"
 

01.05.03 Methotrexate 

Tablets 2.5 mg

Oral solution sugar-free 2mg/ml

Subcutaneous injection 50 mg/mL prefilled pen, 7.5mg, 10mg, 12.5mg, 15mg, 17.5mg, 20mg, 22.5mg, 25mg, 27.5mg, 30mg

Subcutaneous injection 25mg/mL pre-filled syringes, 7.5mg, 12.5mg, 15mg, 17.5mg, 20mg, 22.5mg, 25mg
Red  Paediatrics (NHS England commissioned)

RED Injection intramuscular or intravenous injection 2.5mg/ml, 25mg/ml 100mg/ml


The dose is always a weekly dose.
If oral methotrexate is prescribed only use the 2.5 mg strength. NPSA Patient Safety Alert No.13 June 2006

BLACK 10mg tablets. Do not prescribe – see link below

07.01.03 Methotrexate 

Injection

For ectopic Pregnancy

Paediatrics: No BNFc entry, seek specialist advice 

10.01.03 Methotrexate 

Tablets 2.5 mg Suspension various strengths (available as unlicensed “special order”) Subcutaneous injection 50 mg/mL prefilled pen, 7.5mg, 10mg, 12.5mg, 15mg, 17.5mg, 20mg, 22.5mg, 25mg, 27.5mg, 30mg

Red Paediatrics

RED Injection intramuscular or intravenous injection 2.5mg/ml, 25mg/ml 100mg/ml
Red For patients attending St Helen's and Knowsley Teaching Hospitals NHS Trust as there is not a shared care agreement for subcutaneous methotrexate. The hospital prescribes and admininsters the doses.

Red For subcutaneous methotrexate for St Helen's CCG patients attending any provider trust.

The dose is always a weekly dose. If oral methotrexate is prescribed only use the 2.5 mg strength. NPSA Patient Safety Alert No.13 June 2006

BLACK 10mg tablets. Do not prescribe – see link below

11.10 Methotrexate  2.5mg tablets
Ophthalmologist only.

BLACK 10mg tablets

13.05.03 Methotrexate 

Tablets 2.5 mg Metoject® PEN solution for injection in prefilled pens available in a range of doses for subcutaneous administration. BLACK 10mg tablets
Important Note administered as a weekly dose. To avoid error with low dose methotrexate, 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); • only one strength of methotrexate tablet (2.5 mg) is prescribed and dispensed; • the prescription and the dispensing label clearly show the dose and frequency of methotrexate administration; • the patient is warned to report immediately the onset of any feature of blood disorders (e.g. 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).

Red Paediatrics

02.05.02 Methyldopa tablets 

125mg, 250mg, 500mg

Amber Initiated paediatrics

01.06.06 Methylnaltrexone 

Injection 20 mg/mL, (12mg/0.6-mL vial

Opioid-induced constipation in adult patients with advanced illness (palliative care patients)
Restricted - palliative care recommendation only

Grey 
Opioid-induced constipation in adult patients with chronic pain (except palliative care patients with advanced illness)

Paediatrics: no BNFc entry - seek specialist advice

04.04 Methylphenidate 

Tablets 5 mg, 10 mg, 20 mg
Modified-release tablets 18 mg, 27 mg, 36 mg, 54mg.

Modified-release capsules 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, 60mg.

IMPORTANT: Different modified release preparations have different release profiles and different dosages. Therefore the brand of modified release methylphenidate should be maintained and stated on the prescription.


Purple Liverpool CCG Adults and Children
 
Purple  Halton CCG, South Sefton CCG and Southport & Formby CCG for the treatment of ADHD in Adults only 

11.10 Methylprednisolone   500mg, 1g and 2g injection
Ophthalmologist only.
10.01.02.02 Methylprednisolone acetate 

Injection 40mg/ml (1-ml, 2-ml & 3-ml vials)
by intra-articular injection or intra-lesional injection


RED in paediatrics < 12 years of age
 

Amber Recommended Paediatrics ≥ 12 years of age

06.03.02 Methylprednisolone acetate injection 

40mg/mL; 1mL, 2mL, 3mL vial

Red  Paediatrics

10.01.02.02 Methylprednisolone acetate with lidocaine  injection -methlyprednisolone 40 mg, lidocaine hydrocholoride 10 mg/mL (1-mL & 2-mL vials)
by intra-articular injection

Paediatrics: no BNFc entry - seek specialist advice

06.03.02 Methylprednisolone injection 

Injection, powder for reconstitution, methylprednisolone (as sodium succinate) (all with solvent).
40mg, 125mg, 500mg, 1g vial, 2g vials

Red  Paediatrics

06.03.02 Methylprednisolone tablets 

2mg, 4mg, 16mg, 100mg

Amber Initiated Paediatrics

04.06 Metoclopramide 

Tablets 10mg
Oral solution 5mg/5mL
Injection 5mg/mL
 
Black PaediatricsAmber Recommended Paediatrics Palliative Care

Notes

The European Medicines Agency’s Committee on Medicinal Products for Human Use has reviewed the benefits and risks of the antiemetic metoclopramide in 2013. The review recommended changes that include a restriction to the dose and duration of use to help minimise the risk of potentially serious neurological adverse effects. The risk of acute neurological effects is higher in children than in adults.

04.07.04.01 Metoclopramide 

Tablets, 10mg
Tablets / sachets, 5mg with paracetamol 500mg
Oral solution, 5mg/5mL
Injection, 5mg/ml

BLACK Paediatrics


Metoclopramide can induce acute dystonic reactions and oculogyric crisis. These effects are more common in the young (especially girls and young women) and the very old. Metoclopramide should also be avoided in patients with Parkinson’s disease. It should not be used for migraine in children, and use should be restricted to 5 days or less for all other ages. See MHRA Drug Safety Update August 2013.

02.02.01 Metolazone tablets  2.5mg, 5mg

Unlicensed special
02.04 Metoprolol injection  1mg/mL
02.04 Metoprolol tablets 

50mg, 100mg 

Amber Initiated paediatrics

07.02.02 Metronidazole  Vaginal gel 0.75%.
13.10.01.02 Metronidazole   0.75% (Rozex®) Cream; Gel; 30 g, 40 g (Only licensed for rosacea)
0.75% (Metrogel®) Gel; 40 g (Licensed for rosacea and malodorous fungating tumours)
06.07.03 Metyrapone  capsules 250mg
02.03.02 Mexiletine  Capsules 150mg, 200mg, 250mg

Unlicensed "Special"
07.02.02 Miconazole 

Vaginal cream 2%.

Paediatrics: No BNFc entry, seek specialist advice.

13.10.02 Miconazole 

2% cream; 20 g, 30 g, 45 g

12.03.02 Miconazole oral gel  Daktarin®
04.08.02 Midazolam 

Red Triangle Take care when prescribing and dispensing

Buccal midazolam is available as both a 5mg/ml and 10mg/ml solution. To avoid confusion prescribe midazolam buccal solution using the brand name and state the dose in milligrams (mg) and millilitres (ml)

Buccal solution (Buccolam®) 5mg/mL in prefilled syringe:
0.5mL (2.5mg) prefilled syringe
1mL (5mg) prefilled syringe
1.5mL (7.5mg) prefilled syringe
2mL (10mg) prefilled syringe

Prolonged or repeated seizures and convulsive status epilepticus in the community. Only prescribe buccal midazolam or rectal diazepam for children, young people and adults who have had a previous episode of prolonged or serial convulsive seizures.

02.07.02 Midodrine tablets  2.5mg, 5mg
Oral alpha agonist treatment for severe orthostatic
hypotension due to autonomic dysfunction when corrective factors have been ruled out and other forms of treatment are inadequate.

Paediatrics: no BNFc entry - seek specialist advice
06.01.05 Midodrine tablets 

2.5mg, 5mg

Oral alpha agonist treatment for severe orthostatic hypotension due to autonomic dysfunction when corrective factors have been ruled out and other forms of treatment are inadequate.

Paediatrics: No BNFc entry, seek specialist advice 

11.10 Midricaine no. 2   subconjunctival injection

Ophthalmologist only.
Contains procaine, atropine, boric acid, adrenaline and sodium metabisulphite
08.02.04 Mifamurtide  Intravenous infusion 4mg
07.01.02 Mifepristone 

Tablets 200 mg For termination of pregnancy

Paediatrics: No BNFc entry, seek specialist advice 

02.01.02 Milrinone injection  1 mg/mL, 10-mL amp
02.05.01 Minoxidil tablets 

2.5mg, 5mg, 10mg

For renal use only.

Paediatrics: no BNFc entry - seek specialist advice

07.04.02 Mirabegron 

MR Tablets 25 mg, 50mg

Amber Initiated  Paediatrics

04.03.04 Mirtazapine 

Tablets 15 mg, 30 mg, 45 mg
Orodispersible tablets 15 mg, 30 mg, 45 mg
Oral solution 15 mg/mL

No BNFc entry – seek specialist advice

01.03.04 Misoprostol  Tablets 200 micrograms

Paediatrics: no BNFc entry - seek specialist advice
07.01.01 Misoprostol 

Tablets 200 micrograms For prevention and treatment of haemorrhage - Off label Also Community Midwives

Paediatrics: No BNFc entry, seek specialist advice 

07.01.02 Misoprostol 

Tablets 200 micrograms

For termination of pregnancy - Off label

Paediatrics: No BNFc entry, seek specialist advice 

06.01.06 Mission® Glucose  Reagent strips, for detection of glucose in urine
06.01.06 Mission® Ketone  Reagent strips, for detection of ketones in urine.
11.10 Mitomycin  0.04% eye drops
11.10 Mitomycin-C   200-400 micrograms/ml

Ophthalmologist only.
For trabeculectomy enhancement.
04.03.02 Moclobemide 

Tablets 150 mg, 300 mg

No BNFc entry – seek specialist advice

04.04 Modafinil 

Tablets 100 mg, 200 mg

Modafinil is indicated for excessive sleepiness associated with narcolepsy with or without cataplexy only.

Red Paediatrics

 

13.04 Mometasone Furoate  

Second choice

0.1% (Elocon®) Cream; Ointment; 30 g, 100 g

Potent

Amber Recommended Paediatrics

12.02.01 Mometasone furoate nasal spray 

Nasonex®

** First choice where long-term use likely (i.e. >4-6 weeks course)

Paediatrics: not recommended in children under 3 years

03.03.02 Montelukast 

Tablets 10 mg;
Chewable tablets 4 mg, 5 mg;
Granules 4 mg

04.07.02 Morphine 

Solution for infusion 1mg/ml, 2mg/ml

04.07.02 Morphine 
Red Triangle Take care when prescribing and dispensing
Morphine modified release capsules are avialable as both 12 hourly and 24 hourly dosage forms. All modified release morphine preparations should be prescribed by brand name to avoid confusion.
Patients requiring high doses of morphine(> 60mg BD) should be reviewed and consideration given to referring to a pain specialist for review.
Hyperlink NPSA: High dose morphine and diamorphine injections, 25 May 2006
Oral solution 100micrograms/ml (special order medicine)
10mg/5ml (2 mg per 1 ml)
100mg/5ml (20 mg per 1 ml) CD Schedule 2
Tablets
CD Schedule 2
10mg, 20mg, 50mg
Modified-release tablets
CD Schedule 2
12-hourly 5mg, 10mg, 15mg, 30mg, 60mg, 100mg, 200mg
Modified-release capsules
CD Schedule 2
12-hourly 10mg, 30mg, 60mg, 100mg, 200mg
24-hourly 30 mg, 60 mg, 90 mg, 120 mg, 150 mg, 200 mg
Modified-release granules
CD Schedule 2
12-hourly 20mg, 30mg, 60mg, 100mg, 200mg
Suppositories
CD Schedule 2
10 mg, 15 mg, 30 mg
Solution for injection
CD Schedule 2
1mg/ml, 10mg/ml, 15mg/ml, 20mg/ml, 30mg/ml
Amber Retained Traffic Light Paediatrics
Amber Recommended Traffic Light Paediatric palliative care
12.03.04 Mouthwash solution tablets  Thymol®
02.05.02 Moxonidine tablets 

200micrograms, 300micrograms, 400micrograms

Paediatrics: no BNFc entry - seek specialist advice

06.01.06 Multistix® 

Reagent strips for urine testing for glucose

09.06.07 Multivitamin preparations Abidec® Drops (paediatrics); Abidec® - contains arachis (peanut) oil
09.06.07 Multivitamin preparations Dalivit®

Drops (paediatrics)

13.10.01.01 Mupirocin 

2% (Bactroban®) Cream; Ointment; 15 g

Should only be used to treat methicillin-resistant Staphylococcus aureus

12.02.03 Mupirocin 2% nasal ointment  Bactroban®
Prevention or treatment of MRSA infection
09.06.07 Mutivitamin 

Capsules

08.02.01 Mycophenolate Mofetil  Capsules 250mg; Tablets 500mg; Oral suspension 1g/5mL when reconstituted with water Cellcept®; Injection 500mg vial powder for reconstitution for IV infusion Cellcept®

Expert opinion locally is that mycophenolate does not require brand prescribing – significant cost savings are available with generic prescribing.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
Transplant immunosuppression only
10.01.03 Mycophenolate Mofetil  

Capsules 250 mg Tablets 500mg
Red Paediatrics: used in paediatrics for inflammatory connective tissue disorders e.g. lupus, vasculitis - dose available from initiating specialist centre

Use in rheumatoid arthritis is unlicensed.

Mycophenolate should be prescribed generically

11.10 Mycophenolate mofetil  250mg capsules and 500mg tablets
Ophthalmologist only.
13.05.03 Mycophenolate mofetil 

Capsules 250 mg: Tablets 500 mg
Oral suspension 1 g/5 mL

Expert opinion locally is that mycophenolate does not require brand prescribing – significant cost savings are available with generic prescribing Oral preparation Off label

Red Paediatrics

08.02.01 Mycophenolic acid  Mycophenolic acid (as mycophenolate sodium)
e/c tablets 180mg, 360mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
Transplant immunosuppression only
03.07 N-Acetylcysteine  Tablets / capsules
(unlicensed)
For interstitial pulmonary fibrosis
02.04 Nadolol tablets 

80mg licensed (40mg import- unlicensed in the UK)

Amber Initiated paediatrics

02.06.04 Naftidrofuryl oxalate capsules  100mg

Paediatrics: no BNFc entry - seek specialist advice
04.10.01 Nalmefene 

Tablets f/c 18mg

For Alcohol Dependance

RED Liverpool CCG, South Sefton CCG, Southport & Formby CCG - Prescribing retained by local commissioned alcohol service.

Amber Patient Retained Knowsley CCG

Amber Initiated St Helens CCG

Amber Recommended  Halton CCG, Warrington CCG

RAG status to be confirmed by individual CCGs

No BNFc entry – seek specialist advice

01.06.06 Naloxegol  Tablets 12.5mg, 25mg

Paediatrics: no BNFc entry - seek specialist advice
04.10.03 Naloxone (for opioid overdose) 

Injection 20micrograms/mL, 400micrograms/mL, 1mg/mL

Prescribed by the Drug Service

04.10.01 Naltrexone  

Tablets f/c scored 50mg

For Alcohol Dependence

Off-label indication

RED Liverpool CCG, South Sefton CCG, Southport & Formby CCG - Prescribing retained by local commissioned alcohol service.

Amber Initiated Halton CCG, St Helen's CCG, Knowsley CCG

Amber Recommended Warrington CCG

RAG status to be confirmed by individual CCGs

Paediatrics: No BNFc entry – seek specialist advice

04.10.03 Naltrexone 

Tablets f/c scored 50mg

Prescribed by the Drug Service

No BNFc entry – seek specialist advice

04.05.02 Naltrexone/Bupropion Mysimba®

Prolonged-release tablets; 8mg naltrexone hydrochloride/90mg bupropion hydrochloride

No BNFc entry – seek specialist advice

04.07.04.01 Naproxen 

Tablets 250mg, 500mg 
Effervescent tablets 250mg
 
 
 Amber Recommended Paediatrics 


Do not use in routinely in children - no BNFc entry for migraine

10.01.01 Naproxen 

Tablets 250 mg, 500 mg
Oral suspension 25mg/1mL, 50mg/1mL (expensive)

Black  Vimovo® naproxen 500mg + esomeprazole 20mg

04.07.04.01 Naratriptan 

Tablets 2.5mg
No BNFc entry – seek specialist advice

08.02.04 Natalizumab  Intravenous infusion 20mg/mL

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
02.04 Nebivolol tablets 

2.5mg, 5mg

Paediatrics: no BNFc entry - seek specialist advice

11.04.02 Nedocromil 

2% eye drops

04.07.01 Nefopam 

Tablets, 30 mg

No BNFc entry – seek specialist advice

11.03.01 Neomycin  0.5% eye drops, 0.5% eye ointment

10.02.01 Neostigmine 

Tablets 15 mg

10.02.01 Neostigmine 

I.V. injection 2.5mg/ml

11.08.02 Nepafenac  1mg/ml (0.1%) eye drops
02.06.03 Nicorandil tablets  10mg, 20mg

Paediatrics: no BNFc entry - seek specialist advice

Due to risk of ulcer complications use nicorandil for treatment of stable angina only in patients whose angina is inadequately controlled by other anti-anginal therapies, or who have a contraindication or intolerance to other anti-anginal therapies such as beta-blockers or calcium antagonists.
04.10.02 Nicotine Replacement Therapy  Patches: 16 hour: 10mg, 15mg, 25mg
24 hour: 7mg, 14mg, 21mg

Sublingual tablets: 2mg
Chewing Gum: 2mg, 4mg, 6mg
Lozenges: 1mg, 1.5mg, 2mg, 4mg
Oral Spray: 1mg/metered dose
Nasal Spray: 500micrograms/metered spray
Inhalator: 10mg/cartridge, 15mg/cartridge
Oral film: 2.5mg

Notes
• The use of nicotine replacement products in an individual who is already accustomed to nicotine introduces few new risks and it is widely accepted that there are no circumstances in which it is safer to smoke than to use NRT.
• Some patients benefit from having more than one type of NRT prescribed.
• The combination of NRT with varenicline or bupropion is not recommended.
07.01.03 Nifedipine 

Capsules 10mg For uncomplicated premature labour - off label

Paediatrics: No BNFc entry, seek specialist advice 

02.06.02 Nifedipine m/r tablets and capsules 

All modified release preparations of nifedipine must be prescribed by brand.
Modified release available as 10mg, 20mg, 30mg, 40mg and 60mg formulations suitable for either once or twice daily administration depending on brand.

Amber Initiated paediatrics

02.06.02 Nifedipine capsules 

5mg, 10mg 

Amber Initiated paediatrics

02.06.02 Nifedipine oral liquid 

Unlicensed special oral drops 20mg/ml

Amber Initiated paediatrics

02.06.02 Nimodipine intravenous infusion  200microgram/ml 50ml vial
02.06.02 Nimodipine tablets  30mg
03.11 Nintedanib 

Capsule 100mg, 150mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

04.08.01 Nitrazepam 

Tablets 5mg

Oral suspension 2.5mg/5mL

Amber Patient Retained Paediatrics for epilepsy

No BNFc entry – seek specialist advice

07.03.03 Nonoxinol 9 

Gel 2%.

Green  Paediatrics: if sexually active

02.07.02 Noradrenaline / Norepinephrine injection  Noradrenaline base 1mg/mL 4ml amps
07.03.02.01 Norethisterone  Tablets 350 micrograms
Micronor ®, Noriday ®
08.03.02 Norethisterone  Tablets 5mg
06.04.01.02 Norethisterone tablets 

5mg

Amber Recommended  Paediatrics < 12 years old

04.03.01 Nortriptyline 

Tablets 10 mg, 25 mg

Nortriptyline is significantly more expensive then amitriptyline. Use only as an option where amitriptyline has not been tolerated.

Amber Initiated  Paediatrics

04.07.03 Nortriptyline 

 Tablets, 10 mg, 25 mg

No BNFc entry - seek specialist advice
 
Nortriptyline is significantly more expensive then amitriptyline. Use only as an option where amitriptyline has not been tolerated.

04.07.04.02 Nortriptyline  

Tablets 10 mg, 25 mg
No BNFc entry – seek specialist advice

 Nortriptyline is significantly more expensive then amitriptyline. Use only as an option where amitriptyline has not been tolerated.

10.01.04 NSAIDs  See section 10.1.1
03.01.03 Nuelin SA®  Theophylline tablets m/r 175 mg, 250 mg

Amber Recommended Use in step 4 asthma

Amber Initiated Paediatrics
13.02.01 Nutraplus®  Urea 10%, Cream; 500 g

Medium
12.03.02 Nystatin oral suspension 
01.09.01 Obeticholic acid 

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

08.02.03 Obinutuzumab  Intravenous infusion 25mg/ml
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
08.02.03 Ocrelizumab 

Concentrate for solution for infusion 30mg/mL

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

11.08.02 Ocriplasmin  intravitreal injection
12.02.03 Octenidine Octenisan md®

nasal gel 6mL

Prevention or treatment of MRSA infection 

13.10.01.01 Octenidine Octenisan®

Wash lotion 150mL, 500mL.

Hand, body and hair washing; MRSA suppression therapy (decolonisation)

06.01.04 Octreotide 

Injection 50micrograms/mL ampoules, 500micrograms/mL (1mL vial, !mL prefilled syringe)

 NHS NHSE commissioned drug - see Specialised Commissioning: Key documents for congenital hyperinsulinism


08.03.04.03 Octreotide  Injection 50 micrograms/mL,
100 micrograms/mL, 200 micrograms/mL,
500 micrograms/mL;
Depot preparation 10mg, 20mg, 30mg

REDOctreotide is RED for acromegaly and neuroendocrine tumour.

Amber Initiated  Octreotide is AMBER Initiated in palliative care, although in some circumstances may be initated in primary care

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
08.02.03 Ofatumumab  Intravenous infusion 100mg/5mL
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
11.03.01 Ofloxacin Eye drops 

0.3% eye drops

Consult local hospital for availability

13.02.01.01 Oilatum Plus®  Bath additive; 500 mL
13.02.01 Oilatum®  Cream; 150 g, 500 mL pump pack, 1.05 litre pump pack

Medium
13.02.01.01 Oilatum®  Emollient bath additive; 250 mL, 500 mL

Junior emollient bath additive (fragrance free); 250 mL, 600 mL

01.07.03 Oily phenol injection BP  5% 5-mL amp

Paediatrics: no BNFc entry - seek specialist advice
04.02.01 Olanzapine 

Tablets 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg
Orodispersible tablets 5 mg, 10 mg, 15 mg, 20 mg
NB oral lyophylisate form is not cost effective.

Amber Patient Retained Paediatrics (in children aged 12 years and above)

04.02.02 Olanzapine Embonate 

Injection 210mg, 300mg, 405mg.

Post-injection reactions have been reported leading to signs and symptoms of overdose. After each injection, patients should be observed in a healthcare facility by appropriately qualified personnel for at least 3 hours for signs and symptoms consistent with olanzapine overdose.

No BNFc entry – seek specialist advice

12.01.03 Olive Oil Ear Drops 
03.01.01.01 Olodaterol solution for inhalation 
Striverdi Respimat
2.5 micrograms per dose Olodaterol(Striverdi Respimat®▼)
Not recommended for use at this time
11.04.02 Olopatadine  0.1% eye drops

Has antihistaminic and mast cell stabilising properties.
01.05.01 Olsalazine  Capsules 250 mg, tablets 500 mg
03.04.02 Omalizumab  Pre-filled syringe 75mg in 0.5mL, 150 mg in 1mL
(As per NICE guidance TA278 & TA339)

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
for allergic asthma

CCG Commissioned for chronic urticaria
02.12 Omega-3-Acid Ethyl Esters capsules  Management of patients with primary IgA nephropathy

1g of omega-3-acid ethyl esters 90 containing eicosapentaenoic acid 460mg and docosahexaenoic acid 380mg

02.12 Omega-3-Acid Ethyl Esters capsules 

Hypertriglyceridaemia

1g of omega-3-acid ethyl esters 90 containing eicosapentaenoic acid 460mg and docosahexaenoic acid 380mg
 

02.12 Omega-3-Acid Ethyl Esters capsules  Primary or secondary prevention of CVD

1g of omega-3-acid ethyl esters 90 containing eicosapentaenoic acid 460mg and docosahexaenoic acid 380mg

02.12 Omega-3-Acid Ethyl Esters capsules  Multiple sclerosis

1g of omega-3-acid ethyl esters 90 containing eicosapentaenoic acid 460mg and docosahexaenoic acid 380mg

01.03.05 Omeprazole 

Gastro-resistant capsules 10 mg, 20 mg, 40 mg

Green  Paediatrics (in children aged 12 years or above)

Amber Recommended Paediatrics (in children aged under 12 years old)
 

01.03.05 Omeprazole 

Gastro-resistant dispersible tablets (as omeprazole magnesium) 10 mg, 20 mg, 40 mg
 Oral Liquid 10mg in 5ml (Special) - Restricted option in children
 

Green  Paediatrics (in children aged 12 years or above)

Amber Recommended Paediatrics (in children aged under 12 years old)

01.03.05 Omeprazole IV  Intravenous infusion, powder for reconstitution, 40-mg vial
04.06 Ondansetron 

Tablets, orodispersible film tablets and “Melt” tablets 4mg, 8mg
Oral solution 4mg/5mL
Injection 4mg/2mL, 8mg/4mL

04.09.01 Opicapone 

Capsules (Ongentys(r) ) 50mg

No BNFc entry – seek specialist advice

11.01 Opticare  For 2.5, 5, 10, 15 and 20 mL bottles
11.01 Opticare Arthro 10  For 10, 15 and 20 mL bottles
11.01 Opticare Arthro 5   For 2.5 and 5 mL bottles
01.04 Oral rehydration salts  See section 9.2.1.2
09.02.01.02 Oral Rehydration Salts Dioralyte® Dioralyte Relief® Electrolade®


Amber Initiated  Double strength for use in stoma patients
27.06 Orbital cellulitis 
 
Urgent referral to hospital
04.05.01 Orlistat 

Capsules, 120mg

Amber Initiated Paediatrics

04.09.02 Orphenadrine 

Tablets 50mg - manufacture ceased 30 Nov 2015.

Oral liquid 50mg/5mL
Oral liquid SF 25mg/5mL (unlicensed Special)
 
Advice on alternative treatment from local specialists:
Patients treated with orphenadrine for Parkinsons’ Disease may be changed to procyclidine at a dose of 5mg * for each 50mg of orphenadrine.
Patients treated with orphenadrine for management of extra-pyramidal side effects of antipsychotic drugs may be changed to procyclidine or trihexyphenidyl at a dose equivalence of orphenadrine 50mg = procyclidine 5mg * = trihexyphenidyl 2mg
Some patients may experience anticholinergic side effects (dry mouth, blurred vision, urinary hesitancy, confusion) after any switch and others may find control of tremor / dystopia / extra-pyramidal side effects not as good, and dose may need to be adjusted appropriately.

* Bazire. Psychotropic Drug Directory 2016. Lloyd-Reinhold Communications, 2016, Page 216. 


Amber Initiated Paediatrics

04.09.03 Orphenadrine 

unlicensedunlicensed

Tablets 50mg - manufacture ceased 30 Nov 2015.

Oral liquid 50mg/5mL
Oral liquid SF 25mg/5mL (unlicensed Special)

No BNFc entry – seek specialist advice

Advice on alternative treatment from local specialists:
Patients treated with orphenadrine for Parkinsons’ Disease may be changed to procyclidine at a dose of 5mg * for each 50mg of orphenadrine.
Patients treated with orphenadrine for management of extra-pyramidal side effects of antipsychotic drugs may be changed to procyclidine or trihexyphenidyl at a dose equivalence of orphenadrine 50mg = procyclidine 5mg * = trihexyphenidyl 2mg
Some patients may experience anticholinergic side effects (dry mouth, blurred vision, urinary hesitancy, confusion) after any switch and others may find control of tremor / dystopia / extra-pyramidal side effects not as good, and dose may need to be adjusted appropriately.

* Bazire. Psychotropic Drug Directory 2016. Lloyd-Reinhold Communications, 2016, Page 216. 

07.02.01 Ospemifene 

film-coated tablets, 60mg

27.07 Otitis externa 

First, where available use aural toilet (microsuction) and analgesia.

First line: Acetic acid 2% (EarCalm®) 1 spray TDS for 7 days

Second line: Ciprofloxacin* 2 mg/ml (Cetraxal®) ear drops Apply 0.25 ml twice a day for 7 days

If swelling is so severe that topical treatment cannot be administered in the form of a spray or there is confirmed or suspected tympanic membrane perforation: Ciprofloxacin 2 mg/ml (Cetraxal®) ear drops Apply 0.25 ml twice a day for 7 days (off-label use)

Intermittent or prolonged use (> 7 days) should be avoided in primary care

For cellulitis or extensive infection to outside ear canal: Flucloxacillin 500 mg QDS for 7 days

In penicillin allergy: Clarithromycin* 500 mg BD for 7 days

*Warning Avoid in pregnancy

If cellulitis or disease extending outside ear canal, start oral antibiotics and refer.

In severe infection of the pinna: swab to exclude pseudomonas.

Caution: topical neomycin has been known to cause ototoxicity and must not be used if there is a suspicion of ear drum perforation. See third line recommendation (unlicensed indication)

Self-care: EarCalm® is available to buy from pharmacies.

27.07 Otitis media, acute 

First line: paracetamol or ibuprofen and observe.

If no improvement after 72 hours: Amoxicillin 500 mg TDS for 5 days

In penicillin allergy: Clarithromycin* 500 mg BD for 5 days

*Warning Avoid in pregnancy

AOM resolves in 60% of cases in 24 hours without antibiotics, which only reduce pain at 2 days (NNT 15) and do not prevent deafness. 80% of cases will resolve in 72 hours.

If no vomiting and temp < 38.5 C use paracetamol or ibuprofen.

If in doubt, use of a back-up prescription is an option

Consider immediate antibiotics for pain relief: < 2 years AND bilateral AOM (NNT4) OR bulging membrane OR symptom score >8 for: fever, tugging ears, crying, irratibility, difficulty sleeping, less playful, eating less (0=no symptoms, 1= a little and 2 = a lot)

All ages with otorrhoea: NNT 3

Antibiotics to prevent mastoiditis: NNT > 4000

 

04.10.01 Oxazepam 

Tablets 10mg, 15mg

For Acute Alcohol Withdrawal

Prescribed by specialist services

No BNFc entry – seek specialist advice

04.08.01 Oxcarbazepine 

Tablets 150mg, 300mg, 600mg
Oral suspension 300mg/5mL

Focal onset epilepsy - add on drug option.

Amber Initiated Paediatrics

11.07 Oxybuprocaine   0.4% minims
07.04.02 Oxybutynin 

Tablets 2.5 mg, 3 mg, 5 mg;

MR Tablets 5 mg, 10mg;

Patches 3.9mg per 24 hours.

Oral solution 5mg in 5mL 

Use MR tablets, oral solution and patches only if standard tablets not suitable or not tolerated.
Amber Initiated  Paediatrics

13.12 Oxybutynin  

Immediate release tablets; 2.5 mg, 5 mg;

MR Tablets 5 mg, 10mg

Oral solution 5mg in 5mL

For hyperhidrosis

Use MR tablets, oral solution and patches only if standard tablets not suitable or not tolerated.

Off label

04.07.02 Oxycodone 
Red Triangle Take care when prescribing and dispensing
Oxycodone modified release tablets are available as both 12 hourly and 24 hourly dosage forms. All modified release oxycodone preparations should be prescribed by brand name to avoid confusion.
Patients requiring high doses of oxycodone(> 30mg BD) should be reviewed and consideration given to referring to a pain specialist for review.
CD CQC Safer use of oral oxycodone medicines
Capsule
CD Schedule 2
5mg, 10mg, 20mg
Modified-release tablet
CD Schedule 2
12-hourly 5mg, 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, 80mg, 120mg
Oral solution
CD Schedule 2
5mg/5ml (1 mg per 1 ml)
10mg/ml (10 mg per 1 ml)
Solution for injection
CD Schedule 2
10mg/ml, 50mg/ml
Amber Retained Traffic Light Paediatrics
Amber Recommended Traffic Light Paediatric palliative care
04.07.02 Oxycodone with naloxone  

Tablets M/R 5 mg/2.5 mg, 10 mg/5 mg, 20 mg/10 mg, 40 mg/20 mg

Restricted use: see Pan Mersey statement - link below

GREY for restless legs syndrome

No BNFc entry – seek specialist advice

04.07.04.03 Oxygen 

Acute treatment of Cluster Headache

100%, flow rate at least 12L/minute, non-rebreathing mask and reservoir bag

Maximum 25 minutes treatment at any one time

N.B. Refer to specialist. Prescribing of oxygen requires completion of a Home Oxygen Order Form (HOOF) by specialist.

No BNFc entry - seek specialist advice

13.06.02 Oxytetracycline 

Tablets 250 mg

Paediatric: Avoid in < 12 years   

07.01.01 Oxytocin 

Injection 5 units/mL, 10 units/ mL. For prevention and treatment of haemorrhage, and induction and augmentation of labour. Also Community Midwives

Paediatrics: No BNFc entry, seek specialist advice 

04.02.02 Paliperidone palmitate  

Prolonged-release suspension for injection 50mg, 100mg, 150mg (1 month depot)Prolonged-release suspension for injection 175mg, 263mg, 350mg, 525mg (3 month depot)

No BNFc entry – seek specialist advice

06.06.02 Pamidronate disodium  Concentrate for intravenous infusion:
3mg/mL, 5mL vial, 10mL vial
6mg/mL, 10mL vial
9mg/mL, 10mL vial
15mg/mL, 1mL vial, 2mL vial, 4mL vial, 6mL vial

Intravenous infusion, powder for reconstitution, 15mg vial, 30mg vial, 90mg vial (all with diluent)
01.09.04 Pancreatin  Prescribe by brand name.

Consult BNF for available brands
01.03.05 Pantoprazole IV  Injection, powder for reconstitution, 40-mg

Paediatrics: no BNFc entry - seek specialist advice
04.07.01 Paracetamol 

Tablets, 500 mg
Soluble Tablets, 500 mg, 120 mg

Melts 250mg

Oral Suspension, 120 mg/5ml, 250 mg/5ml

Suppositories, 60 mg, 80mg, 120 mg, 125mg, 240mg, 250 mg, 500 mg, 1 g
RED i/v 10 mg/ml, *switch to oral as soon as possible*

Intravenous paracetamol: risk of accidental overdose especially in infants, neonates and adults with low body weight.

04.07.04.01 Paracetamol 

Tablets, 500 mg

Soluble Tablets, 500 mg, 120 mg

Melts 250mg

Oral Suspension, 120 mg/5ml, 250 mg/5ml

Suppositories, 60mg, 80mg, 120mg, 125mg, 240mg, 250mg, 500mg, 1g

Paracetamol paediatric dosing – see MHRA advice

04.07.01 Paracetamol and Tramadol Tramacet®

Tablets and effervescent tablets

11.08.01 Paraffins  Lacri-Lube® eye ointment, preservative-free
VitA-Pos® eye ointment, preservative-free
Xailin® Night, preservative-free
Simple eye ointment, preservative-free

Reserved for severe disease or for patients who require additional night time dosing in addition to daytime eye drops.
04.08.02 Paraldehyde 

Rectal enema

Prolonged or repeated seizures and convulsive status epilepticus in the community.

No BNFc entry – seek specialist advice

06.06.01 Parathyroid Hormone 

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Paediatrics: No BNFc entry, seek specialist advice 

09.06.04 Paricalcitol Zemplar®

Capsules 1 microgram, 2 micrograms, 4 micrograms

Paediatrics: no BNFc entry - seek specialist advice

27.07 Parotid gland infection, bacterial 

Flucloxacillin 500 mg QDS for 7 days

In penicillin allergy: Clindamycin 450 mg QDS for 7 days

Ensure the patient is hydrated.

04.03.03 Paroxetine 

Tablets 10 mg, 20 mg, 30 mg
Oral suspension SF10 mg/5 mL

No BNFc entry - Not recommended by NICE (CG28) for use in children.

08.03.04.03 Pasireotide  Injection 300 micrograms/mL, 600 micrograms/mL, 900 micrograms/mL

Pasireotide for the treatment of Cushings Disease and acromegaly
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
09.02.01.01 Patiromer Veltassa

Powder for oral suspension; 8.4g, 16.8g, 25.2g sachets

11.08.02 Pegaptanib  solution for intravitreal injection
Not recommended – see NICE TA155
09.01.06 Pegfilgrastim Neulasta®

Contact Pharmacy dept. for product availability

Paediatrics: no BNFc entry - seek specialist advice

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

08.02.04 Peginterferon Alfa  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
08.02.04 Peginterferon Beta  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
for Multiple Sclerosis
10.01.04 Pegloticase 

Intravenous infusion 8mg vial (concentrate)

06.05.01 Pegvisomant 

Injection, powder for reconstitution, pegvisomant, 10mg vial, 15mg vial, 20mg vial NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Paediatrics: no BNFc entry - seek specialist advice.

10.01.03 Penicillamine 

Tablets 125 mg, 250 mg

Paediatrics: no BNFc entry - seek specialist advice

02.06.04 Pentoxifylline tablets  400mg
01.02 Peppermint Oil 

Modified release capsules 200 microlitre (Colpermin) – may contain arachis (peanut) oil.

Gastro-resistant capsules 200 microlitre.

04.08.01 Perampanel 

Tablets 2mg, 4mg, 6mg, 8mg, 10mg, 12mg
Amber Initiated Paediatrics
Focal onset epilepsy - add on drug option.

11.10 Perfluorocarbon injection  Ophthalmologist only.
Retinal detachment surgery not with SPU.
11.10 Perfluorohexiloctane injection  Ophthalmologist only.
Alternative to silicone oil and perfluoctane.
27.07 Perichondritis 

Ciprofloxacin 500 mg BD for 7 days

Rarely, erysipelas can present with swelling of the skin over the pinna, Penicillin V 500mg QDS for 7 days is appropriate for this indication.

Perichondritis confined to the pinna can be managed in primary care, but cellulitis spreading across the face needs referral to the local ENT unit and often results in admission for intravenous antibiotics due to the risk of haematogenous intracranial spread.

04.02.01 Pericyazine 

Tablets 2.5 mg, 10 mg
Syrup 10 mg/5 mL

Amber Patient Retained Paediatrics

02.05.05.01 Perindopril erbumine tablets 

2mg, 4mg, 8mg 
 

Amber Initiated paediatrics

Paediatrics: no BNFc entry - seek specialist advice

13.10.04 Permethrin  5% Cream; 30 g
04.02.01 Perphenazine 

Tablets 2 mg, 4 mg

 

Amber Patient Retained Paediatrics (in children aged 14 years and above)

04.07.02 Pethidine 











Tablets
CD Schedule 2
50mg
Injection
CD Schedule 2
10mg/ml, 50mg/ml
Red Retained Traffic Light Paediatrics
04.03.02 Phenelzine 

Tablets 15 mg

No BNFc entry – seek specialist advice

02.08.02 Phenindione tablets  10mg, 25mg, 50mg

Paediatrics: only warfarin is used in paediatrics
04.08.01 Phenobarbital 

Tablets 15mg, 30mg, 60mg
Elixir 15mg/5mL (licensed) contains 38% alcohol, unsuitable for use in children
Alcohol free oral solution 50mg/5mL (Specials)
CD schedule 3
May be initiated in secondary care by a paediatric neurologist to manage difficult cases of epilepsy.

Amber Initiated Paediatrics

02.05.04 Phenoxybenzamine capsules 

10mg

For phaeochromcytoma only

02.05.04 Phentolamine injection  10mg/mL

For phaeochromcytoma only

Paediatrics: no BNFc entry - seek specialist advice
11.05 Phenylephrine   2.5% and 10% minims
02.07.02 Phenylephrine hydrochloride injection  10mg/mL 1ml amps
04.07.04.03 Phenytoin 

Only for trigeminal neuralgia if allergic to carbamazepine
 
Capsules 25mg, 50mg, 100mg, 300mg
Tablets 100mg
Chewable tablets 50mg
Oral suspension 30mg/5mL

Different formulations of phenytoin have clinically important differences in bioavailability and may require dose adjustment when converting between them

04.08.01 Phenytoin 

Capsules 25mg, 50mg, 100mg, 300mg
Tablets 100mg
Chewable tablets 50mg
Oral suspension 30mg/5mL, 90mg/5mL (Specials)
 
Different formulations of phenytoin have clinically important differences in bioavailability and may require dose adjustment when converting between them.
 
May be initiated in secondary care in an acute situation (e.g., following an IV loading dose for status epilepticus), not necessarily by an epilepsy specialist.

Note caution below:
Phenytoin has been shown to exacerbate some seizure types in generalised epilepsy, in particular absences and myoclonus.
However, if tonic-clonic seizures are resistant to other treatments in generalised epilepsy then occasionally phenytoin can be used effectively, but the patients should be warned of the possibility of exacerbating the seizure types.

04.07.03 Phenytoin sodium 

Tablets, 100mg
Capsules, 25 mg, 50 mg, 100 mg, 300 mg
Chewable tablets (as base), 50 mg
Suspension (as base) 30 mg/5ml

No BNFc entry - seek specialist advice

09.05.02.01 Phosphate Polyfusor®  Intravenous infusion (phosphates 100mmol, K+ 19mmol, Na+ 162mmol/litre)
09.05.02.01 Phosphate supplements Phosphate-Sandoz®

Effervescent tablets phosphorus 500 mg (phosphate 16.1mmol) & sodium 468.8mg (Na+ 20.4mmol), potassium 123mg (K+ 3.1mmol)

Paediatric advice: To make an oral solution containing 1mmol/mL of phosphate, dissolve a 500mg Phosphate Sandoz tablet in water and make the resultant solution up to 16 mL. (also contain 1.28mmol/mL sodium and 0.2mmol/mL potassium)

Potassium acid phosphate 1mmol/ml oral solution - for paediatrics (unlicensed preparation)

Sodium acid phosphate 1mmol/ml oral solution - for paediatrics (unlicensed preparation)

03.01.03 Phyllocontin Continus Forte®  Aminophylline tablets m/r 350 mg
(these are for smokers and other patients with shorter theophylline half life)

Amber Recommended Use in step 4 asthma

Amber Initiated Paediatrics
03.01.03 Phyllocontin Continus®   Aminophylline tablets m/r 225 mg

Amber Recommended Use in step 4 asthma

Amber Initiated Paediatrics

09.06.06 Phytomenadione (vitamin K1) Konakion® MM Paediatric Injection 10mg/ml; may be administered by mouth, IM or IV injection

May be administered by mouth, IM or IV injection

Green  For emergency use in Primary care
09.06.06 Phytomenadione (vitamin K1) Neokay® Capsules 1mg

Length of treatment to be clearly stated
09.06.06 Phytomenadione (vitamin K1) Konakion® MM Injection 10mg/ml

Green  For emergency use in Primary care
Used in primary care anticoagulant services.
09.06.06 Phytomenadione (vitamin K1) Menadione® Tablets 10mg
NB not to be confused with menadiol sodium phosphate

Vitamin K deficiency in cystic fibrosis adults and children;

Length of treatment to be clearly stated


11.06 Pilocarpine 

1% eye drops, 2% eye drops, 4% eye drops, 2% single dose eye drops

Amber Initiated Paediatrics.

11.06 Pilocarpine  All other preparations
12.03.05 Pilocarpine 

Tablets 5mg

For dry mouth caused by irradiation for head and neck cancers and Sjogren’s syndrome

Paediatrics: No BNFc entry - seek specialist advice

13.05.03 Pimecrolimus 

1% (Elidel®) Cream; 30 g, 60 g, 100 g In line with NICE TA 82 - Tacrolimus and pimecrolimus for atopic eczema (see also NICE CG 153 –Psoriasis - off label indication) Topical preparations

04.02.01 Pimozide 

Tablets 4 mg

Amber Patient Retained Paediatrics

06.01.02.03 Pioglitazone tablets 

15mg, 30mg, 45mg

Glitazone Pioglitazone is GREEN. However, please see: - MHRA safety advice Pioglitazone: risk of bladder cancer - MHRA and MHRA/CHM advice: incidence of heart failure increased when pioglitazone is combined with insulin. - MHRA advice: cardiovascular safety and fracture risk

Paediatrics: No BNFc entry, seek specialist advice 

04.09.03 Piracetam 

Tablets (Nootropil®) 800mg, 1.2g
Oral solution (Nootropil®) 333.3mg/mL

Amber Initiated Paediatrics

No BNFc entry - seek specialist advice

03.11 Pirfenidone 

Capsule 267 mg; Film-coated tablet 267mg, 534mg, 801mg
 
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents


Paediatrics: no BNFc entry - seek specialist advice

10.03.02 Piroxicam gel 

Gel 0.5% 60 g, 112 g

Paediatrics: no BNFc entry - seek specialist advice

04.07.04.02 Pizotifen (limited effectiveness and poor tolerability, not encouraged for new patients, but should be continued for those already taking it) 

Tablets 500 micrograms, 1.5 mg

09.01.07 Plerixafor Mozobil® Injection 20mg/ml
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents


Paediatrics: no BNFc entry - seek specialist advice
27.08 Pneumonia, community-acquired in adults 

Low risk CRB-65 = 0
Amoxicillin 500 mg TDS for 5 days

In penicillin allergy: Clarithromycin* 500 mg BD for 5 days OR
Doxycycline* 200 mg STAT then 100 mg OD for 5 days in total

Intermediate risk CRB-65 = 1 and at home
Amoxicillin 500 mg TDS for 7 days AND Clarithromycin* 500 mg BD for 7 days OR
Doxycycline* alone 200 mg STAT then 100 mg OD for 7 days in total

*Warning Caution in pregnancy

For low-risk CAP consider extending antibiotic course for up to 7 – 10 days if no improvement after 3 days.

Explain to patients treated in the community, and when appropriate their families or carers, they should seek further medical advice if symptoms do not begin to improve within 3 days of starting the antibiotic, or earlier if their symptoms are worsening.

Only a small range of pathogens causes CAP, with Streptococcus pneumoniae being the most frequent. The frequency of pathogens can vary in specific patient groups. Mycoplasma infections are less frequent in the elderly.

Administer benzylpenicillin 1.2 g IM/IV or Amoxicillin 1 g orally immediately where the illness is considered to be life-threatening or if there are likely to be a delay (>2 hours) in admission.

27.08 Pneumonia, community-acquired in children 

0-3 months

Seek paediatric specialist advice

 

> 3 months

Consider using traffic light assessment tool in the NICE guideline on Feverish Illness in Children to assess the need for admission to hospital

Amoxicillin TDS 5 days

In penicillin allergy: Clarithromycin BD

 
13.07 Podophyllotoxin 

0.5% (Condyline®) Solution; 3.5 mL 0.15% (Warticon®) Cream; 5 g

 

Amber Recommended Paediatrics < 12 years

11.03.01 Polyhexamethylene biguanide (PHMB) 

0.02% eye drops, 0.06% eye drops

No BNFc entry - seek specialist advice

13.10.01.01 Polymixins 

Polyfax® ointment; 4 g, 20 g

Alternative to Bactoban when there is a supply problem or if patient does not tolerate Bactroban

09.02.01.01 Polystyrene Sulphonate Resins Resonium A® Powder
09.02.01.01 Polystyrene Sulphonate Resins Calcium Resonium® Powder
11.08.01 Polyvinyl alcohol   Eye drops 1.4% (Sno-Tears®)

Ophthalmic solution preservative free 1.4% (Liquifilm Tears®PF)
08.02.04 Pomalidomide  Capsules 1mg, 2mg, 3mg, 4mg

NHS NHSE drug
03.05.02 Poractant Alfa  Suspension 120 mg/1.5 mL, 240 mg/3 mL (80 mg/mL)
NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
05.02.01 Posaconazole  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
For Fungal infection or Chronic Pulmonary Aspergillosis
09.06.02 Potassium aminobenzoate  Capsules 500 mg; Envules ® 3 g

For use in Peyronie's disease - see section 7.4.5

Paediatrics: no BNFc entry - seek specialist advice
09.02.01.01 Potassium Chloride  Tablets M/R 600mg - unlicensed special
09.02.01.01 Potassium Chloride Sando-K® Effervescent tablets, potassium bicarbonate and chloride (12mmol of K+ and 8 mmol Cl-/tablet)

Amber Patient Retained  For paediatrics
09.02.01.01 Potassium Chloride Kay-Cee-L® Syrup sugar free potassium chloride (1mmol/ml of each of K+ and Cl-)
Amber Patient Retained  For paediatrics

Oral solution potassium chloride 2mmol/ml- unlicensed preparation
Amber Patient Retained  For paediatrics
09.02.02.01 Potassium Chloride and Glucose Intravenous Infusion   Contact Pharmacy dept. for prescribing advice and product availability
09.02.02.01 Potassium Chloride and Sodium Chloride Intravenous Infusion  Contact Pharmacy dept. for prescribing advice and product availability
09.02.02.01 Potassium Chloride Concentrate (Sterile) 

Contact Pharmacy dept. for prescribing advice and product availability

Restricted Use

07.04.03 Potassium Citrate  Oral mixture 'BP' 30%
13.14 Potassium hydroxide  5% topical solution
Treatment of Molluscum contagiosum
13.11.06 Potassium Permanganate  Solution tablets 400 mg
NB/ 1 tablet dissolved in 4 litres of water provides a 0.01 % (1 in 10 000) solution
11.03.01 Povidone iodine   5% eye drops, solution minims (Bausch & Lombe)

For surgical prophylaxis
11.08.02 Povidone-iodine  5% single dose eye drops
13.11.04 Povidone-Iodine  (Videne®) 10% alcoholic tincture; 500 mL
(Videne®) 10% antiseptic solution; 500 mL
(Videne®) 7.5% surgical scrub; 500 mL
13.11.04 Povidone-Iodine  (Betadine®) 2.5% Dry powder spray
04.09.01 Pramipexole 

Tablets 88micrograms, 180micrograms, 350micrograms, 700micrograms
MR Tablets 260micrograms, 520micrograms, 1.05mg, 1.57mg, 2.1mg, 2.62mg, 3.15mg

Restless legs syndrome -
Tablets 88micrograms, 180micrograms, 350micrograms

(Strengths above expressed as base; see BNF for salt equivalence; pramipexole doses may be expressed as either.)

No BNFc entry - seek specialist advice

02.09 Prasugrel tablets 

5mg, 10mg

Paediatrics: no BNFc entry - seek specialist advice

02.12 Pravastatin tablets 

10mg, 20mg, 40mg

Amber Initiated paediatrics

02.05.04 Prazosin suspension 

500micrograms/5ml unlicensed special

02.05.04 Prazosin tablets 

1mg, 2mg, 5mg

01.05.02 Prednisolone 

Rectal foam in aerosol pack, prednisolone 20 mg /metered application

N.B. Very expensive

Amber Initiated  Paediatrics

01.05.02 Prednisolone 

Tablets 1mg, 2.5mg, 5mg, 10mg and 25mg
Oral liquid 5mg in 5ml single-dose units (Dompe)
Oral liquid 10mg in 1ml x 30ml
Soluble tablets 5mg (can be more expensive than oral formulations depending on the dose and duration of treatment) 
 
BLACK e/c tablets

Retention enema 20 mg in 100-mL
Suppositories 5 mg
Amber Initiated  Paediatrics

11.04.01 Prednisolone  Various strengths available
11.10 Prednisolone  Tablets 1mg, 2.5mg, 5mg, 10mg and 25mg
Oral liquid 5mg in 5ml single-dose units (Dompe)
Oral liquid 10mg in 1ml x 30ml
Soluble tablets 5mg (more expensive than oral liquid)

Ophthalmologist only.

BLACK enteric coated tablets

11.04.01 Prednisolone acetate   1% eye drops

06.03.02 Prednisolone enteric coated tablets  2.5mg, 5mg
04.07.04.03 Prednisolone Intermittent short courses 

Acute treatment of Cluster Headache.

Tablets 1mg, 2.5mg, 5mg, 10mg and 25mg, 30mg 
Oral solution 5mg in 5ml single-dose units
Oral solution 10mg in 1ml
Soluble tablets 5mg (more expensive than oral liquid) 
 
No BNFc entry - seek specialist advice
 
BLACK e/c tablets

06.03.02 Prednisolone non-enteric coated tablets 

Tablets 1mg, 2.5mg, 5mg, 10mg and 25mg

Oral liquid 5mg in 5ml single-dose units (Dompe) Oral liquid 10mg in 1ml x 30ml

Soluble tablets 5mg (more expensive than oral liquid)

Amber Initiated Paediatrics

11.04.01 Prednisolone sodium phosphate  0.5% eye drops, 0.5% minims

Minims (single dose eye drops) reserved for patients with known preservative allergy
Prednisolone sodium phosphate 0.5% is not half the strength of prednisolone acetate 1%

12.01.01 Prednisolone sodium phosphate 0.5% ear / eye drops 
04.07.03 Pregabalin 

Capsules, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200mg, 225 mg, 300 mg
Oral solution 20mg/ml

Amber Initiated Paediatrics

04.08.01 Pregabalin 

Capsules 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg
Oral solution 20mg/mL
Amber Initiated Paediatrics
Focal onset epilepsy - add on drug option.

04.09.03 Primidone 

Tablets (Mysoline®) 50mg, 250mg

No BNFc entry – seek specialist advice

04.06 Prochlorperazine 

Tablets 5mg
Syrup 5mg/5mL
Intramuscular injection 12.5mg/1mL
Buccal tablets 3mg

Amber Recommended Paediatrics. In children under 12 years.

Notes
Severe dystonic reactions sometimes occur with phenothiazines, especially in children. Prochlorperazine should be avoided in patients with Parkinson’s disease and should be used cautiously in the elderly.

04.07.04.01 Prochlorperazine 

Tablets, 5mg
Syrup, 5mg/5mL
Buccal tablets, 3mg


Amber Recommended Intramuscular injection, 12.5mg/1mL


Amber Recommended Paediatrics < 12 years

Severe dystonic reactions sometimes occur with prochlorperazine, especially in children. It should be avoided in patients with Parkinson’s disease and should be used cautiously in the elderly. Prochlorperazine should not be used frequently and when it is used, this should be in conjunction with a prokinetic antiemetic medication

04.09.02 Procyclidine 

Tablets 5mg
Oral solution 2.5mg/5mL, 5mg/5mL

Amber Initiated Paediatrics

Red Injection 10mg/2mL

06.04.01.02 Progesterone 

Pessaries 200mg

For prevention of miscarriage in women with history of recurrent miscarriage, progesterone pessaries are Red  for the duration of treatment during pregnancy required.

Where low-molecular weight heparin is prescribed in combination with progesterone pessaries, or used alone or with aspirin, for prevention of miscarriage in women with history of recurrent miscarriage it is RED

Paediatrics: no BNFc entry - seek specialist advice

06.04.01.02 Progesterone (micronised) 

Capsules 100mg

04.02.01 Promazine Hydrochloride 

Tablets 25 mg, 50 mg
Oral solution 25 mg/5 mL, 50 mg/5 mL

No BNFc entry – seek specialist advice

04.06 Promethazine Hydrochloride 

Tablets 10mg, 25mg
Elixir 5mg/5mL
Injection 25mg/mL

Red Paediatrics: short term use only

03.04.01 Promethazine hydrochloride  Tablets 10 mg, 25 mg;
Elixir 5 mg/5 mL

Paediatrics: short term use only.
04.01.01 Promethazine Hydrochloride 

Tablets 10 mg, 25 mg
Elixir 5 mg/5 mL
Specific ‘off-label’ use in pregnant women with a severe or chronic sleep problem

Paediatrics: short-term use only

Injection 25 mg/mL
Red in combination with i.m. haloperidol for rapid tranquilisation.

02.03.02 Propafenone hydrochloride tablets 

150mg, 300mg

Paediatrics: no BNFc entry - seek specialist advice

11.03.01 Propamidine isetionate  0.1% eye drops

Non-formulary for licensed indications.
Used off-label in the management of acanthamoeba keratitis.
13.12 Propantheline 

Tablets; 15 mg For gustatory sweating Off label

07.04.02 Propiverine 

Tablets 15mg Capsules m/r 30mg, 45mg

Restricted use For neurogenic detrusor overactivity (detrusor hyperreflexia) from spinal cord injuries only, e.g. transverse region paraplegia Spinal injury specialist recommendation or initiation only.Paediatrics: No BNFc entry, seek specialist advice 

04.07.04.02 Propranolol 

Tablets 10mg, 40mg, 80mg, 160mg
Modified release capsule, 80mg, 160mg
Oral solution 5mg/5ml, 10mg/5ml, 40mg/5ml, 50mg/5ml
It is important to use adequate doses of 80 – 240mg daily in divided doses to obtain benefit.

Amber Recommended Paediatrics under 12 years. Green for older children.

04.09.03 Propranolol 

Tablets 40mg, 80mg
Oral solution 40mg/5mL

Amber Initiated Paediatrics

06.02.02 Propranolol 

Tablets: 10mg, 40mg, 80mg, 160mg M/R capsules: 80mg, 160mg Oral solution: 5mg/5ml, 10mg/5ml, 40mg/5ml, 50mg/5ml (50mg/5ml standard strength used at Alder Hey)

First choice Beta-blocker

Amber Initiated  Paediatrics

02.04 Propranolol m/r capsules 

80mg, 160mg 

Amber Initiated paediatrics

02.04 Propranolol oral solution  

5mg/5ml, 10mg/5ml, 40mg/5ml, 50mg/5ml
(50mg/5ml standard strength used at Alder Hey)

Amber Initiated paediatrics

02.04 Propranolol tablets 

10mg, 40mg, 80mg, 160mg 

Amber Initiated paediatrics

06.02.02 Propylthiouracil tablets  50mg

Patient - specific advice on dose and monitoring must be provided to the GP by the specialist.
13.02.02 Proshield Plus® 

Spray; 115 g

No BNFc entry; Paediatrics, seek specialist advice 

02.08.03 Protamine Sulphate injection  10mg/mL, 5mL amps
06.01.01.02 Protamine Zinc Insulin  Existing patients or strong patient preference only
Hypurin Bovine Protamine Zinc
11.07 Proxymetacaine  0.5% minims

01.06.07 Prucalopride  Tablets 1 mg, 2 mg

Chronic constipation in women as per NICE TA211. Pan Mersey APC recommends use in men under same criteria as recommended for women in NICE TA211.

Paediatrics: no BNFc entry - seek specialist advice
10.02.01 Pyridostigmine Bromide 

Tablets 60 mg

09.06.02 Pyridoxine Hydrochloride (vitamin B6)  Tablets 10mg, 20mg, 50mg
04.02.01 Quetiapine 

Immediate release formulations
Tablets 25 mg, 100 mg, 150 mg, 200 mg, 300 mg

Modified release formulations <!> Expensive
M/R Tablets 50 mg, 150 mg 200 mg, 300 mg, 400 mg
Use of QUETIAPINE M/R tablets should be reserved for individual patients identified as having a defined clinical need for the modified release formulation. Justification of the decision to continue prescribing the QUETIAPINE M/R formulation should be documented in the clinical notes and made clear in any discharge/appointment letters to the GP e.g. compliance, over-sedation or other adverse effect issues

Oral liquid 20mg/mL

 

Amber Patient Retained Paediatrics (in children aged 12 years and above)

 

06.07.01 Quinagolide  

tablets 75microgram; starter pack of 3×25microgram tabs with 3×50microgram tabs Treatment of hyperprolactinaemia

Paediatrics: No BNFc entry, seek specialist advice 

10.02.02 Quinine  Tablets 200 mg, 300 mg

Paediatrics: no BNFc entry - seek specialist advice
01.04.03 Racecadotril  

Granules 10 mg/sachet, 30 mg
/sachet

06.04.01.01 Raloxifene hydrochloride tablets 

60mg

Paediatrics: No BNFc entry - seek specialist advice

02.05.05.01 Ramipril capsules 

1.25mg, 2.5mg, 5mg, 10mg 

Amber Initiated paediatrics

Paediatrics: no BNFc entry - seek specialist advice

11.08.02 Ranibizumab  Solution for intravitreal injection

01.03.01 Ranitidine  Tablets 150 mg, 300 mg
Effervescent tablets 150mg, 300mg
Oral solution 75mg / 5mL (75mg/5ml is a licensed standard strength used in paediatrics (either Zantac® or Rosemont product which contain 8% alcohol))

01.03.01 Ranitidine  Injection 25 mg/mL 2-mL
02.06.03 Ranolazine m/r tablets 

375mg, 500mg, 750mg

As adjunctive therapy in line with licence after calcium channel blockers and beta blockers

Dose titration necessary: The recommended initial dose is 375 mg twice daily. After 2–4 weeks, the dose should be titrated to 500 mg twice daily and, according to the patient's response, further titrated to a recommended maximum dose of 750 mg twice daily. If patient experiences treatment-related adverse events (e.g. dizziness, nausea, or vomiting), down-titration to 500 mg or 375 mg twice daily may be required.



Paediatrics: no BNFc entry - seek specialist advice

04.09.01 Rasagiline 

Tablets 1mg

No BNFc entry – seek specialist advice

10.01.04 Rasburicase 

Intravenous infusion 1.5mg, 7.5mg (powder for reconstitution)

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Black for off-label use to treat severe, refractory tophaceous gout (CCG commissioned for this indication)

 

06.01.02.03 Repaglinide tablets 

500micrograms, 1mg, 2mg

Although rarely used, is a treatment option in the current NICE guidance.

Paediatrics: No BNFc entry, seek specialist advice 

03.04.02 Reslizumab 

10 mg/mL concentrate for solution for infusion

(As per NICE TA479)

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

09.06.02 Riboflavin (Vitamin B2)  Tablets 50mg
For mitochondrial disorders
05.01.07 Rifaximin Targaxan® Tablets 550mg

For treatment of hepatic encephalopathy only. Other strengths & indications are non-formulary.
04.09.03 Riluzole 

Tablets 50mg

Oral solution 5mg in 1mL
Motor Neurone Disease- Riluzole NICE TA20 
 
NICE: Riluzole for motor neurone disease (January 2001)
Riluzole is recommended for treating the amyotrophic lateral sclerosis (ALS) form of motor neurone disease (MND). Treatment should be initiated by a specialist in MND but it can then be supervised under a shared-care arrangement involving the general practitioner.

 

Red  for new patients, current patients continue with current practice until shared care framework is implemented.

No BNFc entry – seek specialist advice

02.05.01 Riociguat tablets  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
06.06.02 Risedronate tablets 

5mg, 30mg, 35mg

Amber Recommended  Paediatrics

04.02.01 Risperidone 

Tablets 500 micrograms, 1 mg, 2 mg, 3 mg, 4 mg, 6 mg
Liquid 1 mg/mL
Orodispersible tablets 500 micrograms, 1 mg, 2 mg, 3 mg, 4mg

 

Amber Patient Retained Paediatrics

04.02.02 Risperidone 

Injection 25 mg (powder), Injection 37.5 mg (powder), Injection 50 mg (powder)

No BNFc entry – seek specialist advice

08.02.03 Rituximab  Intravenous infusion 10mg/mL
10.01.03 Rituximab 

IV infusion 10 mg/mL, 10ml and 50ml vials 

Originator brand: MabThera®

Biosimilar brands: Truxima®, Rixathon®

Prescribe by brand.

Paediatrics: no BNFc entry - seek specialist advice

NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents

02.08.02 Rivaroxaban tablets  10mg, 15mg, 20mg
VTE prophylaxis in patients who are having elective hip and knee replacement surgery

Paediatrics: only warfarin is used in paediatrics
02.08.02 Rivaroxaban tablets 

10mg, 15mg, 20mg
Treatment and prevention of PE and DVT

N.B. Green in Wirral for this indication.

2.5mg tablets - Acute Coronary Syndrome (ACS) only

Paediatrics: only warfarin is used in paediatrics

02.08.02 Rivaroxaban tablets  10mg, 15mg, 20mg
Prevention of stroke and systemic embolism in atrial fibrillation

Paediatrics: only warfarin is used in paediatrics
04.11 Rivastigmine 

Capsules 1.5 mg, 3 mg, 4.5 mg, 6 mg
Oral solution 2 mg/mL
Patch 4.6 mg/24hr, 9.5 mg/24hr, 13.3mg/24hr

Historic shared care agreement in place within South Sefton and Southport & Formby CCGs

No BNFc entry – seek specialist advice

03.03.03 Roflumilast 

Tablets 500 microgram

09.01.04 Romiplostim Nplate® Injection 250 micrograms

Paediatrics: no BNFc entry - seek specialist advice

Grey  for use in patients where splenectomy is not contra-indicated
04.09.01 Ropinirole 

Tablets  (Requip®, Accord brand generic ropinirole) 250micrograms, 500micrograms, 1mg, 2mg, 5mg
MR Tablets 2mg, 3mg, 4mg, 6mg, 8mg
 
Restless legs syndrome
Tablets (Adartrel®, Actavis brand generic ropinirole) 250micrograms, 500micrograms, 1mg, 2mg

No BNFc entry - seek specialist advice

02.12 Rosuvastatin tablets 

5mg, 10mg, 20mg, 40mg

N.B. restricted use ONLY where no other statin is suitable(see link below). 

Amber Initiated paediatrics

04.09.01 Rotigotine 

Patches (Neupro®) 2mg/24 hours, 4mg/24 hours, 6mg/24 hours, 8mg/24 hours
28 day Starter pack (Neupro®) (7x2mg/24hr, 7x4mg/24hr, 7x6mg/24hr, and 7x8mg/24hr patches)

Restless legs syndrome
Patches (Neupro®) 1mg/24 hours, 2mg/24 hours, 3mg/24 hours

No BNFc entry – seek specialist advice

 

04.08.01 Rufinamide 

Tablets 100mg, 200mg, 400mg
Oral suspension 40mg/mL


Amber Initiated Paediatrics
 
For atonic and tonic seizures and atypical absences as part of Lennox-Gastaut syndrome.

08.01.05 Ruxolitinib Jakavi®

NHS NHSE commissioned for all cancer indications, including myelofibrosis.

Restricted use For all non-NHS England commissioned indications, apply via CCG IFR process

02.05.05 Sacubitril/Valsartan tablets Entresto® 24mg/26mg, 49mg/51mg, 97mg/103mg

Prescribing and monitoring of sacubitril/valsartan must be retained by the heart failure team during dose titration and until the patient is stabilised on the maximum tolerated dose, this is expected to be a minimum of 3 months of prescribing by the heart failure team to allow dose titration and review of the patient once they are stable on optimum dose.
04.09.01 Safinamide 

Tablets 50mg, 100mg

No BNFc entry – seek specialist advice

07.01.03 Salbutamol 

Injection 1mg/ml For uncomplicated premature labour

Paediatrics: No BNFc entry, seek specialist advice 

03.01.01.01 Salbutamol aerosol inhalation  Metered dose inhaler
100 micrograms/metered inhalation

PREFERRED CHOICE IN ASTHMA AND COPD
03.01.01.01 Salbutamol aerosol inhalation breath actuated   Breath actuated inhaler
100 micrograms/metered inhalation
03.01.01.01 Salbutamol dry powder for inhalation 

100 micrograms/metered inhalation Easyhaler®
200 micrograms/metered inhalation Easyhaler®

PREFERRED CHOICE IN ASTHMA AND COPD

03.01.01.01 Salbutamol dry powder for inhalation Ventolin Accuhaler®® Dry powder inhaler
200 micrograms/blister
03.01.01.01 Salbutamol injection  Injection 500 micrograms/mL
Solution for intravenous infusion 1 mg/mL
03.01.01.01 Salbutamol nebuliser solution  2.5 mg/2.5 mL (1 mg/mL)
5 mg/2.5 mL (2 mg/mL)

Green Acute administration in primary care
03.01.01.01 Salbutamol oral  Oral syrup 2mg in 5ml (sugar free)

Step 4 asthma

Amber Initiated Paediatrics
13.07 Salicylic acid  Salicylic acid 12%, lactic acid 4% (Salatac®) Gel; 8 g
Salicylic acid 16.7%, lactic acid 16.7% (Salactol®) Paint; 10 mL
13.07 Salicylic acid  Salicylic acid 26% (Occlusal® ) Cutaneous solution; 10 mL
13.05.02 Salicylic acid 10% w/w in emulsifying ointment 

Ointment; 100 g Keratolytic For psoriasis, this unlicensed special may be considered

13.05.02 Salicylic acid 2% w/w in emulsifying ointment 

Ointment; 100 g Keratolytic For psoriasis, this unlicensed special may be considered

13.05.02 Salicylic acid 5% w/w in emulsifying ointment 

Ointment; 100 g Keratolytic For psoriasis, this unlicensed special may be considered

12.03.05 Saliva Orthana® spray 
12.03.05 Salivix® pastilles 
03.01.01.01 Salmeterol aerosol inhalation 
Serevent Evohaler
Metered dose inhaler
25 micrograms/metered inhalation
03.01.01.01 Salmeterol dry powder for inhalation Serevent Accuhaler®
Serevent Accuhaler
Dry powder inhaler
50 micrograms/blister
27.09 Salmonellosis 
 

Antibiotic treatment not usually indicated.

Initiate treatment on the advice of microbiologist if the patient is systemically unwell.

09.05.01.01 Sandocal-1000®  Effervescent tablets 1.75g (calcium 1g)
10.01.03 Sarilumab 

Solution for injection 150mg, 200mg (pre-filled pen; pre-filled syringe)

Rheumatoid arthritis

Paediatrics: no BNFc entry - seek specialist advice

06.01.02.03 Saxagliptin tablets 

2.5mg, 5mg

Dipeptidylpeptidase-4 (DPP-4) Inhibitors

Paediatrics: No BNFc entry, seek specialist advice 

06.01.02.03 Saxagliptin with dapagliflozin Qtern®

5mg/10mg film-coated tablets

27.07 Scarlet fever 

First line (mild): analgesia

Phenoxymethylpenicillin 500 mg QDS for 10 days

Penicillin allergy: Clarithromycin 500 mg BD for 5 days

Prompt treatment with antibiotics significantly reduces complications. Observe immunocompromised individuals (diabetes, women in puerperal period, chickenpox) as at increased risk of developing invasive infection.

10.01.03 Secukinumab 

150mg solution for injection (Cosentyx ®)
prefilled syringe; prefilled pen

For Ankylosing Spondylitis & Psoriatic Arthritis

Paediatrics: no BNFc entry - seek specialist advice
 

13.05.03 Secukinumab  

150mg solution for injection (Cosentyx®) prefilled syringe; prefilled pen.

In line with NICE TA 350: Secukinumab for treating moderate to severe plaque psoriasis

No BNFc entry; Paediatrics, seek specialist advice 

04.09.01 Selegiline  

Tablets 5mg, 10mg
Oral liquid 10mg/5mL
Oral lyophilisates (Zelapar®) 1.25mg

Selegiline tablets 10mg are equivalent to oral lyophilisates (Zelapar®) 1.25mg

No BNFc entry - seek specialist advice

09.05.05 Selenium oral  Oral solution 50 micrograms/ml

Paediatrics: no BNFc entry - seek specialist advice
09.05.05 Selenium parenteral Selenase® Injection 50 micrograms/ml

Use only in patients receiving prolonged parenteral nutrition

Paediatrics: no BNFc entry - seek specialist advice
13.09 Selenium Sulfide  2.5% (Selsun®) Shampoo; 100 mL, 150 mL
01.06.02 Senna  Tablets 7.5 mg
Syrup sugar-free 7.5 mg/5 mL
04.03.03 Sertraline 

Tablets 50 mg, 100 mg

Oral suspension 50mg in 5mL (Special)

Amber Initiated  Paediatrics

09.05.02.02 Sevelamer  

Tablets 800mg
Sevelamer carbonate – licensed for hyperphosphataemia in patients on haemodialysis or continuous ambulatory peritoneal dialysis and in patients with chronic kidney disease not on dialysis who have a serum-phosphate concentration of 1.78 mmol/litre or more that cannot be controlled by a low-phosphate diet.

Sevelamer hydrochloride – licensed for hyperphosphataemia in patients on haemodialysis or continuous ambulatory peritoneal dialysis.

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
COMMISSIONED BY NHS ENGLAND FOR PATIENTS RECEIVING RENAL DIALYSIS.
REDfor patients receiving dialysis (newly initiated), and paediatrics

Amber Initiated  for existing patients on dialysis already prescribed in primary care, and in pre-dialysis 

02.05.01 Sildenafil   tablets 20mg

oral suspension - 10mg/mL

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
07.04.05 Sildenafil 

Tablets 25 mg,50 mg,100 mg

Paediatrics: No BNFc entry, seek specialist advice 

11.10 Silicone oil  1300cST, 5000cST, 5700cST(10ml)
Ophthalmologist only. Intra-ocular tamponade
13.05 Silk garments Dermasilk®, Dreamskin®, Skinnies Silk®

eye masks, socks, gloves, vests, pyjamas, body suits etc.

13.10.01.01 Silver Sulfadiazine  1% (Flamazine®) Cream;
20 g, 50 g, 250 g, 500 g

Large areas: Plasma-sulfadiazine concentrations may approach therapeutic levels with side-effects and interactions as for sulfonamides if large areas of skin are treated. Owing to the association of sulfonamides with severe blood and skin disorders, treatment should be stopped immediately if blood disorders or rashes develop—but leucopenia developing 2–3 days after starting treatment of burns patients is reported usually to be self-limiting and silver sulfadiazine need not usually be discontinued provided blood counts are monitored carefully to ensure return to normality within a few days. Argyria may also occur if large areas of skin are treated (or if application is prolonged).
01.01.01 Simeticone 

Infantile colic.

Liquid, 40 mg/mL

Red for use in endoscopy.

03.09.02 Simple Linctus  SF Adult; Paediatric
02.12 Simvastatin oral suspension 

20mg/5ml, 40mg/5ml

Amber Initiated paediatrics

02.12 Simvastatin tablets 

10mg, 20mg, 40mg

Amber Initiated paediatrics

Black Inegy® ezetimibe/simvastatin 10mg/20mg, 10mg/40mg, 10mg/80mg

27.07 Sinusitis, acute 

Symptoms for 10 days or less: no antibiotic

Symptoms with no improvement for more than 10 days: consider no antibiotic or back-up antibiotic prescription depending on likelihood of bacterial cause; consider prescribing a high-dose nasal corticosteroid for 14 days for adults and children aged 12+ (off-label use), Mometasone 200 micrograms BD 14 days

Systemically unwell, symptoms of more serious illness, high risk of complications: immediate antibiotic

Back-up or immediate antibiotic: Phenoxymethylpenicillin 500 mg QDS for 5 days

Amoxicillin TDS may be preferable in children

Penicillin allergy: Doxycycline* 200 mg STAT then 100 mg OD for 5 days in total (for children under 12 use Clarithromycin*)

Systemically unwell, more serious illness, high risk of complications: Co-amoxiclav 500/125 mg TDS for 5 days

Worsening symptoms after 2 days of first choice antibiotic: Co amoxiclav 500/125 mg TDS for 5 days

Worsening symptoms and penicillin allergy: consult local microbiologist.

*Warning Avoid in pregnancy

Avoid antibiotics as 80% resolve in 14 days without, and they only offer marginal benefit after 7 days.

When no antibiotic given or delay antibiotic prescription given: advise self-care with paracetamol or ibuprofen for pain or fever.

Refer people to hospital if they have symptoms and signs of acute sinusitis associated with any of the following:

  • A severe systemic infection
  • Intraorbital or periorbital complications, including periorbital oedema or cellulitis, a displaced eyeball, double vision, ophthalmoplegia, or newly reduced visual acuity
  • Intracranial complications, including swelling over the frontal bone, symptoms or signs of meningitis, severe frontal headache, or focal neurological signs.

Bacterial cause may be more likely if several of the following are present:

  • Symptoms for more than 10 days
  • Discoloured or purulent nasal discharge
  • Severe localised unilateral pain (particularly pain over teeth and jaw)
  • Fever
  • Marked deterioration after an initial milder phase
27.07 Sinusitis, chronic 
Refer to ENT and treat according to advice  
08.02.02 Sirolimus 

Tablets 500 microgram, 1mg, 2mg (Rapamune®)
Oral solution 1mg/mL (Rapamune®)

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Sirolimus is RED for transplant rejection

06.01.02.03 Sitagliptin tablets 

25mg, 50mg, 100mg

Dipeptidylpeptidase-4 (DPP-4) Inhibitor

Paediatrics: No BNFc entry, seek specialist advice 

03.01.03 Slo-Phyllin®   Theophylline capsules m/r 60 mg, 125 mg, 250 mg

Amber Recommended Use in step 4 asthma

Amber Initiated Paediatrics
03.01.05 Small volume device Space Chamber Plus Compact®

Spacer device; 

With or without small, medium or large mask.


(For use with all pressurised (aerosol) inhalers)

01.06.04 Sodium acid phosphate with sodium phosphate (constipation)  

Phosphates Enema BP Formula B
Fleet® Ready-to-use Enema

Amber Recommended  Paediatrics

01.01.02 Sodium alginate with potassium bicarbonate  Gaviscon Advance®

Suspension, sugar-free, sodium alginate 100mg/ml, potassium bicarbonate 20mg/ml. Contains sodium and potassium. 

Chewable tablets, sugar-free, sodium alginate 500 mg, potassium bicarbonate 100 mg. Contains sodium and potassium.

01.01.02 Sodium alginate, calcium carbonate & sodium bicarbonate  Peptac liquid®

Suspension, sugar-free, sodium bicarbonate 26.7mg/ml, sodium alginate 50mg/ml, calcium carbonate 16mg/ml. Contains some sodium.

10.01.03 Sodium Aurothiomalate 

Injection 20 mg/mL 0.5-mL (10 mg), 100 mg/mL 0.5-mL (50 mg) ampoule

Paediatrics: no BNFc entry - seek specialist advice

07.04.03 Sodium Bicarbonate 

Capsules 500mg

Paediatrics: No BNFc entry, seek specialist advice 

07.04.03 Sodium Bicarbonate 

Infusion

09.02.01.03 Sodium Bicarbonate  Capsules 500mg (6mmol each of Na+ & HCO3-)



Oral solution Sodium Bicarbonate 1mmol/ml (unlicensed preparation)
Amber Recommended for paediatrics
09.02.02.01 Sodium Bicarbonate  Contact Pharmacy dept. for prescribing advice and product availability
12.01.03 Sodium bicarbonate 5% drops 
03.01.05 Sodium Chloride  Nebuliser solution, 0.9%, 2.5 mL

Green For acute administration in primary care
07.04.04 Sodium chloride  

Irrigation 0.9% sachets

Amber Recommended  Paediatrics

09.02.01.02 Sodium Chloride 

Tablets modified-release 600mg (approx. 10mmol each of Na+ & Cl-) Slow Sodium®

 Oral solution (30%) sodium chloride 5mmol/ml (unlicensed preparation)
Amber Patient Retained  For paediatrics
 

11.08.01 Sodium Chloride 

0.9% single use eye drops

Preservative Free

11.10 Sodium Chloride   5% eye drops, 5% eye ointment, 5% preservative-free eye drops
13.11.01 Sodium Chloride   Solution 0.9% (Clinipod® first choice; Irripod® second choice - for irrigation of wounds)
25 x 20 mL
12.02.02 Sodium chloride 0.9% nasal drops  May relieve nasal congestion by helping to liquefy mucous secretions
09.02.02.01 Sodium Chloride and Glucose Intravenous Infusion  Contact Pharmacy dept. for prescribing advice and product availability
09.02.02.01 Sodium Chloride Intravenous  Contact Pharmacy dept. for prescribing advice and product availability
11.10 Sodium chondroitin sulphate 4% and sodium hyaluronate 3%  injection
Ophthalmologist only.
11.10 Sodium citrate  6.5% eye drops
06.06.02 Sodium Clodronate  400mg capsules
520mg tablets
800mg tablets
01.05.04 Sodium cromoglicate  Capsules 100 mg
11.04.02 Sodium Cromoglicate  2% eye drops
Can be sold to the public for the treatment of acute seasonal and perennial allergic conjunctivitis
09.01.01.01 Sodium Feredetate Sytron® Elixir sugar free 190mg (27.5mg iron)/5ml
11.08.01 Sodium hyaluronate  Eye drops

Hylo-Tear® eye drops (sodium hyaluronate 0.1%, 10ml), preservative-free

Artelac Rebalance® eye drops (sodium hyaluronate 0.15%, 10ml)

Lumecare® eye drops (sodium hyaluronate 0.15%, 10ml)

Hyabak® eye drops (sodium hyaluronate 0.15%, 10ml), preservative-free

Vismed® eye drops (sodium hyaluronate 0.18%, 10ml), preservative-free

Hylo-Forte® eye drops (sodium hyaluronate 0.2%, 10ml), preservative-free

Vismed® eye gel (sodium hyaluronate 0.3%, 10ml), preservative-free


Single use eye drops

Vismed® single dose eye drops (sodium hyaluronate 0.18%, 20 units), preservative-free

Vismed® single dose eye gel (sodium hyaluronate 0.3%, 20 units), preservative-free

Clinitas® single dose eye drops (sodium hyaluronate 0.4%, 30 units), preservative-free
11.08.01 Sodium Hyaluronate 

0.1% eye drops, 10ml, preservative free (Hylo-Tear)
0.15% eye drops, 10ml (Artelac Rebalance, Lumecar)
0.15% eye drops, 10ml, preservative free (Hyabak)
0.18% eye drops, 10ml, preservative free (Vismed)
0.18% eye drops, single dose, preservative free (Vismed)
0.2% eye drops, 10ml, preservative free (Hylo-Forte)
0.3% eye gel, 10ml, preservative free (Vismed)
0.3% eye gel, single dose, preservative free (Vismed)
0.4% eye drops, resealable, preservative free (Clinitas)

11.10 Sodium hyaluronate   1.4% Injection
Ophthalmologist only.
11.08.01 Sodium hyaluronate 0.1% with dexpanthenol 2% 

Hylo-Care® eye drops, preservative-free

07.04.04 Sodium hyaluronate and sodium chondroitin  

Bladder instillation: iAluril® (sodium hyaluronate 1.6% and sodium chondroitin 2% solution-50 mL) Cystistat® (sodium hyaluronate solution 40 mg/50 mL) Uracyst® (sodium chondroitin 2% solution-20 mL)

Paediatrics: No BNFc entry, seek specialist advice 

02.05.01 Sodium Nitroprusside 

Injection 10mg/mL

04.01.01 Sodium Oxybate 

Oral Solution 500 mg/mL For narcolepsy with cataplexy only when recommended by a consultant in a specialist commissioned sleep service.

PLEASE NOTE: new patients are by prior approval only for South Sefton, and Southport and Formby CCGs.

Black Traffic Light in West Lancashire CG

NHS Paediatric use: NHSE commissioned drug - see Specialised Commissioning: Key documents. As per IFR approval. No BNFc entry – seek specialist advice

09.08.01 Sodium Phenybutyrate 

Oral granules 483mg/g (Pheburane®)

Oral granules 940mg/g (Ammonaps®)

Tablets 500mg (Ammonaps®)

Oral solution 1250mg / 5mL (Ambutyrate® - unlicensed)


NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

01.06.02 Sodium Picosulfate 

Oral solution 5 mg/5 mL

02.13 Sodium Tetradecyl Sulphate injection Fibrovein® 1% (2mL)
3% (2mL, 5mL)

Paediatrics: no BNFc entry - seek specialist advice
04.07.04.02 Sodium valproate 

Tablets 100mg
Modified-release tablets 200mg, 300mg, 500mg
Modified-release capsules 150mg, 300mg
Gastro-resistant tablets 200mg, 500mg
Modified release granules 50mg, 100mg, 250mg, 500mg, 750mg, 1000mg
Oral solution 200mg/5ml

 Green in males only

Green In headache pathway

Amber Initiated Paediatrics: seek specialist advice

04.07.04.03 Sodium valproate 

Prophylaxis of Cluster Headache
 
Tablets 100mg
Modified-release tablets, 200mg, 300mg, 500mg
Modified-release capsules, 150mg, 300mg
Gastro-resistant tablets, 200mg, 500mg
Modified-release granules, 50mg, 100mg, 250mg, 500mg, 750mg, 1000mg
Oral solution 200mg/5ml



No BNFc entry - seek specialist advice

Amber Initiated For women of childbearing age

04.08.01 Sodium Valproate 

Tablets 100mg
Modified-release tablets 200mg, 300mg, 500mg
Modified-release capsules 150mg, 300mg
Gastro-resistant tablets 200mg, 500mg
Modified-release granules 50mg, 100mg, 250mg, 500mg, 750mg, 1g
Oral solution 200mg/5mL

Amber Initiated For women of childbearing age


Amber Initiated Paediatrics
Focal onset epilepsy - add on drug option

Generalised epilepsy:
MEN - 1st line

WOMEN - Valproate carries more risks in pregnancy than other AEDs, so although it would be 1st line in women from an efficacy point of view, potential teratogenic effects must be considered and fully discussed.

CHILDREN OF BOTH SEXES - 1st line

04.09.03 Sodium valproate 

Tablets 100mg
Modified-release tablets 200mg, 300mg, 500mg
Modified-release capsules 150mg, 300mg
Gastro-resistant tablets 200mg, 500mg
Modified-release granules 50mg, 100mg, 250mg, 500mg, 750mg, 1g
Oral solution 200mg/5mL

May provoke or increase postural tremor, and rarely Parkinsonism.

Amber Initiated  for use in women of child bearing age or girls. Valproate carries more risk in pregnancy than other AEDs, potential teratogenic effects must be considered and fully discussed.

No BNFc entry – seek specialist advice

07.04.02 Solifenacin 

Tablets 5 mg,10 mg

Amber Initiated  Paediatrics

07.04.04 Solution G  

Irrigation citric acid 3.23%, disodium edetate 0.01%, magnesium oxide 0.38%, sodium bicarbonate 0.7% 2x 30ml, 100ml sachets.

Amber Recommended  Paediatrics

07.04.04 Solution R  

Irrigation citric acid 6%, gluconolactone 0.6%, magnesium carbonate 2.8%, disodium edetate 0.01% 50ml and 100ml sachets

Amber Recommended  Paediatrics

06.05.01 Somatropin   Injection
Brands include: Genotropin®, Humatrope®, Omnitrope®, Norditropin SimpleXx®

27.07 Sore throat, acute bacterial 

FeverPAIN 0 or 1 or Centor score 0, 1 or 2: Self-care

FeverPAIN 2 or 3: back-up prescription with 3 day delay

FeverPAIN 4 or 5 or Centor score 3 or 4: if severe, immediate prescription, or back-up prescription with 48 hour delay

Phenoxymethylpenicillin 500 mg QDS for 10 days

Amoxicillin TDS may be preferable in children

In penicillin allergy: Clarithromycin* 500 mg BD for 5 days

Penicillin allergy in pregnancy: Erythromycin 500 mg QDS for 5 days

*Warning Avoid in pregnancy

Take a throat swab in persistent infections lasting 3-4 weeks (CKS).
27.07 Sore throat, acute viral 

No antibiotic indicated

Issue Patient Information Leaflet (PIL) on viral sore throats.

If in doubt, use of back-up prescription is an option.

Use FeverPAIN or Centor to guide diagnosis.

FeverPain 4 or 5 or Centor score 3 or 4: treat as for bacterial sore throat.

Note If symptoms persist refer to ENT.

02.04 Sotalol tablets 

40mg, 80mg, 160mg

04.11 Souvenaid® 

Oral nutritional supplement

13.09 Spironolactone 

Tablets; 20 mg, 50mg & 100mg

Off label

No BNFc entry: Paediatrics seek specialist advice 

02.02.03 Spironolactone oral suspension 

5mg/5ml, 10mg/5ml, 25mg/5ml,50mg/5ml, 100mg/5ml
(50mg/5ml is standard strength used at Alder Hey)

Amber Initiated paediatrics

02.02.03 Spironolactone tablets 

25mg, 50mg, 100mg 

Amber Initiated paediatrics

07.04.04 Sterile Water 

Water for irrigation

Amber Recommended  Paediatrics

04.08.01 Stiripentol 

Capsules 250mg, 500mg
Powder 250mg/sachet, 500mg/sachet

Only for Dravet syndrome.

Focal onset epilepsy – only to be prescribed by a specialist in epilepsy.

02.10.02 Streptokinase  1.5 million unit vial
06.06.02 Strontium ranelate Protelos®

Granules 2g/sachet

PRODUCT DISCONTINUATION AUGUST 2017 - CONSIDER SEEKING SPECIALIST ADVICE ON ALTERNATIVES FOR PATIENTS CURRENTLY PRESCRIBED.

Strontium ranelate should only be used to treat severe osteoporosis in postmenopausal women and men at high risk of fracture, for whom treatment with other medicinal products approved for the treatment of osteoporosis is not possible. It must not be used in patients with established, current or past history of ischaemic heart disease, peripheral arterial disease and/or cerebrovascular disease or those with uncontrolled hypertension.

 

Paediatrics: No BNFc entry, seek specialist advice 

01.03.03 Sucralfate 

Tablets 1 g
Suspension 1 g/5 mL

Unlicensed

Amber Recommended  Paediatrics

09.05.02.02 Sucroferric oxyhydroxide 

Chewable tablets 500mg

Paediatrics: no BNFc entry - seek specialist advice

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

01.05.01 Sulfasalazine 

Tablets 500 mg

Suspension 250 mg/5 mL

Suppositories 500 mg

10.01.03 Sulfasalazine 

Tablets e/c or uncoated 500 mg

Oral suspension 250mg/5ml

Consult any local prescribing arrangements for shared-care prescribing of sulfasalazine.

Red Paediatrics

10.01.04 Sulfinpyrazone  Tablets 100mg, 200mg

Paediatrics: no BNFc entry - seek specialist advice
04.02.01 Sulpiride 

Tablets 200 mg, 400mg
Oral solution SF 200 mg/5 mL

Amber Patient Retained Paediatrics

04.09.03 Sulpiride  

Tablets 200mg
Oral solution 200mg/5mL
Sulpiride is off-label for chorea

Amber Initiated Paediatrics

04.08.01 Sultiame 

Tablets 200mg

Also known as sulthiame.

Focal onset epilepsy – only to be prescribed by a specialist in epilepsy.

No BNFc entry – seek specialist advice

04.07.04.01 Sumatriptan 

Tablets 50mg, 100mg
Injection 6mg/0.5ml
Nasal spray 10mg per actuation, 20mg per actuation

Advise patient to bend forward for one minute after administration of nasal spray to avoid swallowing the dose.
 
 Amber Recommended Paediatrics < 12 years
May be prescribed for ages lower than stated in BNFc under specialist advice.

04.07.04.03 Sumatriptan 

Acute treatment of Cluster Headache
 
Injection 6mg/0.5ml
Nasal spray 10mg per actuation, 20mg per actuation - unlicensed.

Advise patient to bend forward for one minute after administration of nasal spray to avoid swallowing the dose.

Amber Recommended Paediatrics

13.08.01 Sunsense® Ultra  UVB-SPF 50+ Lotion (water resistant); 125 mL, 500 mL

Non-formulary if not for ACBS approved indication
13.11.01 Surgical Spirit  Spirit; 100 mL
07.01.01 Syntometrine® 

Injection (ergometrine 500 micrograms and oxytocin 5 units / mL)

For prevention and treatment of haemorrhage Also Community Midwives

Paediatrics: No BNFc entry, seek specialist advice 

01.05.03 Tacrolimus 

See BNF for individual brands.
Suspension 2.5mg in 5ml (unlicensed special for paediatrics)

For acute and chronic ulcerative colitis and Crohn's disease.

Prescribe by brand name

Tacrolimus is RED for ulcerative colitis and Crohn's disease. Please see other relevant chapters of this formulary for use in other indications.

08.02.02 Tacrolimus 

Capsules 500 micrograms, 1mg, 5mg (Adoport®, Prograf®, Tacni®, Capexion®, Vivadex®)
MR capsules 500 micrograms, 1mg, 3mg, 5mg (Advagraf®)
Granules 200 micrograms, 1mg (Modigraf®)
Oral suspension 2.5mg in 5mL (Special)
Concentrate for intravenous infusion 5mg/mL

Prescribe by brand name

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

Tacrolimus is RED for transplant rejection

11.10 Tacrolimus  500micrograms, 1mg and 5mg capsules

Ophthalmologist only.
13.05.03 Tacrolimus 

0.03%, 0.1% (Protopic®) Ointment; 30g, 60g In line with NICE TA 82 - Tacrolimus and pimecrolimus for atopic eczema (see also NICE CG 153 –Psoriasis - off label indication) Topical preparation

13.13 Tacrolimus 

For Lichen Planus

0.1% in Orabase; Ointment; 50 g
0.3% in Orabase; Ointment; 50 g

No BNFc entry: Paediatrics seek specialist advice 

02.05.01 Tadalafil   tablets 20mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
07.04.05 Tadalafil 

Erectile dysfunction
Tablets 10 mg, 20 mg
Black  in erectile dysfunction in circumstances outside of those listed above.

Black  daily use in erectile dysfunction. 

Black Benign prostatic hyperplasia.

Paediatrics: No BNFc entry, seek specialist advice 

11.06 Tafluprost 

15 micrograms/ml (0.0015%) single dose eye drops

Single dose eye drops reserved for patients with known preservative allergy

Amber Initiated  Paediatrics

11.06 Tafluprost with timolol 

15 micrograms/ml (0.0015%) and 5mg/ml (0.5%) unit dose eye drops
Single dose eye drops reserved for patients with known preservative allergy

Amber Initiated Paediatrics.

08.03.04.01 Tamoxifen 

Tablets 10mg, 20mg, 40mg; oral solution 10mg/5mL

REDTamoxifen is RED for fertility (unlicensed)
See NICE CG164 for recommendation on use in patients at moderate - high risk in familial breast cancer.

 

07.04.01 Tamsulosin 

MR Capsule 400 micrograms.

Alpha Blocker

Amber Initiated  Paediatrics

BLACK Tamsulosin with solifenacin M/R tablets 400 micrograms / 6 mg "Vesomni"
BLACK Tamsulosin with dutasteride M/R tablets 400 micrograms / 500 micrograms "Combodart"

04.07.02 Tapentadol  

Tablets M/R, 50 mg, 100 mg, 150 mg, 200 mg, 250 mg

Strong opioid – oral preparation, modified release

Red Retained Traffic Light  when used in cross titration

BLACKTablets, 50 mg, 75 mg immediate release, Oral solution 20 mg per 1 ml 

 

No BNFc entry – seek specialist advice

11.03.01 Teicoplanin 

1% eye drops

No BNFc entry - seek specialist advice

11.03.01 Teicoplanin  2% eye drops

Ophthalmologist only.For severe corneal ulcers that do not respond to treatment.
01.04.02 Telotristat 

Film-coated tablets, 250mg (Xermelo®)

For treatment of carcinoid syndrome diarrhoea.

04.01.01 Temazepam  Tablets 10 mg, 20 mg
Oral solution 10 mg/5 mL
02.10.02 Tenecteplase  10,000 units (50mg) vial
8,000 units (40mg) vial

Paediatrics: no BNFc entry - seek specialist advice
07.04.01 Terazosin 

Tablets 2 mg, 5 mg, 10mg.

Alpha Blocker

Paediatrics: No BNFc entry, seek specialist advice 

13.10.02 Terbinafine hydrochloride  1% Cream; 30 g
03.01.01.01 Terbutaline  Tablets 5 mg

Step 4 asthma

Amber Initiated Paediatrics
03.01.01.01 Terbutaline injection  Injection 500 micrograms/mL
03.01.01.01 Terbutaline nebuliser solution  5 mg/2 mL (2.5 mg/mL)

Green Acute administration in primary care
07.01.03 Terbutaline sulphate 

Injection 500 micrograms/ml

For uncomplicated premature labour

Paediatrics: No BNFc entry, seek specialist advice 

03.01.01.01 Terbutaline sulphate dry powder for inhalation Bricanyl Turbohaler® ® Dry powder inhaler
500 micrograms/metered inhalation

PREFERRED CHOICE IN ASTHMA AND COPD
08.02.04 Teriflunomide  Tablets 14mg

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

In multiple sclerosis
06.06.01 Teriparatide injection Forsteo®

250micrograms/mL, 2.4mL prefilled pen

 

NHS NHSE commissioned drug in male and juvenile osteoporosis as per IFR approval - see Specialised Commissioning: Key documents

Paediatrics: No BNFc entry, seek specialist advice 

06.05.02 Terlipressin acetate injection  Injection, powder for reconstitution, terlipressin acetate, 1mg vial with 5mL diluent

Injection, solution for injection, terlipressin acetate, 0.12mg/mL, 1mg (8.5mL) amp

For oesophageal varices

06.04.02 Testosterone and Esters injection 

Testosterone undecanoate 250mg/mL: 4mL amp and 4mL vial Intramuscular

Red  Paediatrics

06.04.02 Testosterone enantate injection 

Testosterone enantate 250mg/mL; 1mL amp Intramuscular

Red  Paediatrics

06.04.02 Testosterone gel  

Testosterone 50mg/5g Transdermal


06.04.02 Testosterone injection 

Testosterone propionate 30mg, testosterone phenylpropionate 60mg, testosterone isocaproate 60mg, and testosterone decanoate 100mg/mL; 1mL amp Intramuscular

Red  Paediatrics

06.04.02 Testosterone undecanoate capsules  40mg

Oral

04.09.03 Tetrabenazine 

Tablets 25mg

Tetrabenazine is effective in only a proportion of patients and its use may be limited by the development of depression

No BNFc entry – seek specialist advice

11.07 Tetracaine   0.5% minims and 1% minims

06.05.01 Tetracosactide injection  Tetracosactide 250micrograms (as acetate)/mL, 1mL amp

For testing adrenocortical function
08.02.04 Thalidomide 

Capsules 50mg


NHS NHSE drug

03.01.03 Theophylline  Oral liquid 50mg/5ml (unlicensed Special)

Paediatrics
20 Theophylline   Oral liquid 50mg/5ml (unlicensed Special)

Amber Initiated Paediatrics
09.06.02 Thiamine (vitamin B1)  Tablets 50mg ,100mg
09.06.02 Thiamine (vitamin B1) Pabrinex® Intravenous injection high potency

Paediatrics: no BNFc entry - seek specialist advice
27.09 Threadworms, pinworms 

Mebendazole 100 mg STAT For adults and children > 6 months

A second dose may be given after 2 weeks for adults and children > 6 months as re-infection is very common.

Note this is an unlicensed use for children under 2 years

All members of the family require treatment at the same time.

Hygiene measures are needed to avoid re-infection for two weeks.

Wash sleepwear, linen, dust and vacuum on day one.

Washing hands and scrubbing nails before eating and after visiting the toilet are essential.

A bath in the morning removes ova laid overnight.

For children under 6 months of age, seek paediatric specialist advice.

06.02.01 Thyroid, desiccated (Armour thyroid)  
04.08.01 Tiagabine 

Tablets 5mg, 10mg, 15mg


Amber Initiated Paediatrics
Focal onset epilepsy - add on drug options.

Generalised epilepsy – may be best avoided. Tiagabine and vigabatrin has been shown to exacerbate some seizure types in generalised epilepsy, in particular absences and myoclonus.

02.09 Ticagrelor 

Tablets 90mg, 60mg

Orodispersible tablets 90mg

Maximum treatment duration of 1 year at 90mg bd; extended treatment with 60mg bd up to a maximum of 3 years.     

 

Paediatrics: no BNFc entry - seek specialist advice

11.06 Timolol  

0.25% eye drops, 0.25% single dose eye drops, 0.5% eye drops, 0.5% single dose eye drops.
Single dose eye drops reserved for patients with known preservative allergy.

Amber Initiated Paediatrics.

11.06 Timolol (other preparations) 

0.25% and 0.5% long acting ophthalmic gel forming solution, 0.1% unit dose eye gel.
Unit dose eye gel reserved for patients with known preservative allergy.

Amber Initiated Paediatrics.

02.08.01 Tinzaparin sodium injection 

10,000 units/mL: 2,500-unit (0.25-mL) syringe 3,500-unit (0.35-mL) syringe 4,500-unit (0.45-mL) syringe 20,000-unit (2-mL) vial 20,000 units/mL: 0.5mL (10,000-unit) syringe 0.7-mL (14,000-unit) syringe 0.9-mL (18,000-unit) syringe 2-mL (40,000-unit) vial

 RED when used as surgical or medical VTE prophylaxis or treatment in hospital, or for prevention of miscarriage in women with history of recurrent miscarriage for the duration of treatment during pregnancy.Red paediatrics

03.01.02 Tiotropium inhalation powder  
Braltus Zonda

 

Dry power inhaler (Braltus Zonda®)

 

Hard capsule and Zonda® device
10 micrograms per capsule
PREFERRED CHOICE IN COPD

Prescribe by brand name.

Dry powder inhaler unlicensed in asthma.

Paediatrics: no BNFc entry - seek specialist advice

03.01.02 Tiotropium solution for inhalation  
Spriva Respimat

2.5 micrograms/metered inhalation Respimat®

PREFERRED CHOICE IN COPD

For use in Step 4 Asthma see separate entry below.

Paediatrics: no BNFc entry - seek specialist advice



03.01.02 Tiotropium solution for inhalation  

2.5 micrograms/metered inhalation Respimat®

For use in Step 4 Asthma.

Grey Paediatrics

03.01.02 Tiotropium with Olodaterol  Spiolto Respimat®
Spiolto Respimat
Tiotropium 2.5microgram/ Olodaterol 2.5microgram inhalation solution

PREFERRED CHOICE IN COPD

Paediatrics: no BNFc entry - seek specialist advice

02.09 Tirofiban  Concentrate for intravenous infusion, 250micrograms/mL. For dilution before use, 50mL (12.5mg) vial
Intravenous infusion, 50 micrograms/mL, 250mL bag

Paediatrics: no BNFc entry - seek specialist advice
10.02.02 Tizanidine 

Tablets 2 mg, 4 mg Paediatrics: no BNFc entry - seek specialist advice

Paediatrics: no BNFc entry - seek specialist advice

05.01.04 Tobramycin nebuliser solution  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

For Cystic Fibrosis
10.01.03 Tocilizumab 

IV infusion 20 mg/mL, Subcutaneous injection 162mg prefilled syringe

NHS NHSE commissioned drug for some indications - see Specialised Commissioning: Key documents

01.05.03 Tofacitinib 

Film-coated tablets 5mg

For ulcerative colitis

10.01.03 Tofacitinib 

Film-coated tablets 5mg (Xeljanz®)

For Rheumatoid ArthritisPaediatrics: no BNFc entry - seek specialist advice

Grey for Psoriatic Arthritis

04.09.01 Tolcapone 

Tablets (Tasmar®) 100mg

No BNFc entry – seek specialist advice

07.04.02 Tolterodine Tartrate 

Tablets 1 mg, 2 mg; MR Capsules 4 mg. Use MR tablets only if standard tablets not suitable or not tolerated.

Amber Initiated  Paediatrics

06.05.02 Tolvaptan tablets 

15mg, 30mg

NHS NHSE commissioned drug: hyponatraemia in cancer - see Specialised Commissioning: Key documents. (Samsca® brand)


CCG commissioned for autosomal dominant polycystic kidney disease (Jinarc® brand), in accordance with NICE TA358

 

Paediatrics: No BNFc entry, seek specialist advice 

04.07.04.02 Topiramate 

Tablets 25mg, 50mg, 100mg, 200mg
Sprinkle capsules 15mg, 25mg, 50mg

As cognitive and mood-related side effects are common with topiramate, patients should be specifically warned about these and advised to stop if they occur. More gradual withdrawal is only recommended if there is a history of epilepsy.

Amber Initiated Paediatrics

04.07.04.03 Topiramate 

Prophylaxis of Cluster Headache,  Hemicrania Continua
 
Tablets 25mg, 50mg, 100mg, 200mg

As cognitive and mood-related side effects are common with topiramate, patients should be specifically warned about these and advised to stop if they occur.

 No BNFc entry - seek specialist advice

04.08.01 Topiramate 

Tablets 25mg, 50mg, 100mg, 200mg
Sprinkle capsules 15mg, 25mg, 50mg 


Amber Initiated Paediatrics
Focal onset epilepsy - add on drug option.
 

04.09.03 Topiramate  

Tablets 25mg, 50mg, 100mg, 200mg
Sprinkle capsules 15mg, 25mg, 50mg
Topiramate is off-label for tremors

No BNFc entry - seek specialist advice

08.03.04.01 Toremifene  Tablets 60mg
04.07.02 Tramadol 
Red Triangle Take care when prescribing and dispensing
Tramadol modified release capsules are avialable as both 12 hourly and 24 hourly dosage forms. All modified release tramadol preparations should be prescribed by brand name to avoid confusion.
Capsules
CD Schedule 3
50mg
Amber Initiated Traffic Light Children under 12 years will remain under the care of the paediatric specialist pain team.
Orodispersible tablets
CD Schedule 3
50mg
Amber Initiated Traffic Light Children under 12 years will remain under the care of the paediatric specialist pain team.
Oral drops
CD Schedule 3
100mg/1ml (100 mg per 1 ml)
Amber Initiated Traffic Light Children under 12 years will remain under the care of the paediatric specialist pain team.
Modified-release tablets
CD Schedule 3
12-hourly 50mg, 100mg, 150mg, 200mg
24-hourly 100 mg, 150 mg, 200 mg, 300 mg, 400 mg
Amber Initiated Traffic Light Children under 12 years will remain under the care of the paediatric specialist pain team.
Modified-release capsules
CD Schedule 3
12-hourly 50 mg, 100 mg, 150 mg, 200 mg
Amber Initiated Traffic Light Children under 12 years will remain under the care of the paediatric specialist pain team.
Solution for injection
CD Schedule 3
50mg/ml
Red Recommended Traffic Light Paediatrics
04.07.02 Tramadol + dexketoprofen Skudexa®

Tablets tramadol 75mg + dexketoprofen 25mg

02.05.05.01 Trandolapril capsules 

500micrograms, 1mg, 2mg, 4mg
 
Amber Initiated paediatrics

Paediatrics: no BNFc entry - seek specialist advice

02.11 Tranexamic acid injection  100mg/mL 5mL amp
02.11 Tranexamic acid liquid  500mg/ml unlicensed special


02.11 Tranexamic acid tablets  500mg

11.06 Travoprost 

40 micrograms/ mL (0.004%) eye drops
Travatan brand does not contain benzalkonium chloride as the preservative and therefore may be used in patients where a known allergy to benzalkonium chloride exists. Generic version and Bondulc brand contain benzalkonium chloride.

Amber Initiated Paediatrics.

11.06 Travoprost with timolol  

40 micrograms/ml (0.004%) and 5mg/ml (0.5%) eye drops

Does not contain benzalkonium chloride as the preservative and therefore may be used in patients where a known allergy to benzalkonium chloride exists.

Amber Initiated Paediatrics.

04.03.01 Trazodone 

Capsules 50 mg, 100 mg
Tablets 150 mg
Oral solution SF 50 mg/5 mL

13.06.01 Tretinoin 0.025%, clindamycin1%  

(Treclin®) Gel, 30g

Amber Recommended Paediatrics - for neonatal and infantile acne

10.01.02.02 Triamcinolone Acetonide  injection 10 mg/mL (1-mL & 5-mL vials)
by intra-articular or intradermal injection


RED in paediatrics


injection 40 mg/mL (1-mL vial)
by intra-articular or intramuscular injection
10.01.02.02 Triamcinolone hexacetonide 

injection 20mg/mL

by intra-articular or peri-articular injection 

Red Paediatrics

13.13 Trichloroacetic acid  

For Warts 25% Solution; 10 mL
50% Solution; 10 mL
90% Solution; 50 mL

No BNFc entry: Paediatrics seek specialist advice 

07.04.03 Tricitrate 

Oral mixture (Special)

Paediatrics: No BNFc entry, seek specialist advice

PIL available from Medicines for Children

04.02.01 Trifluoperazine 

Tablets 1 mg, 5 mg
Syrup SF 1 mg/5 mL
Oral solution 5 mg/5 mL

Amber Patient Retained Paediatrics

11.03.03 Trifluorothymidine  

1% eye drops

No BNFc entry - seek specialist advice.

01.02 Trihexyphenidyl 

Tablets 2mg

Oral solution 5mg/5mL

Hypersalivation (off-label)

Amber Initiated  Paediatrics

04.09.02 Trihexyphenidyl 

Tablets 2mg, 5mg
 Oral solution 5mg/5mL

Amber Initiated Paediatrics

04.09.03 Trihexyphenidyl 

unlicensedunlicensed

Tablets 2mg, 5mg
Oral solution 5mg/5ml

Amber Initiated Paediatrics

08.03.04.02 Triptorelin Gonapeptyl

Injection: 3.75mg depot

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

08.03.04.02 Triptorelin 

Decapeptyl® SR Injection, (powder for suspension), m/r, triptorelin (as acetate), 3mg vial (with diluent); Decapeptyl® SR Injection, (powder for suspension), m/r, triptorelin (as acetate/pamoate), 11.25mg vial (with diluent); Decapeptyl® SR Injection, (powder for suspension), m/r, triptorelin (as pamoate), 22.5mg vial (with diluent).

Use in accordance with its licensed indications.

 

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

Amber Patient Retained Decapeptyl® SR 3mg for early breast cancer

 REDSt Helen's CCG for endometriosis and uterine fibroids

06.07.02 Triptorelin injection 

Decapeptyl® SR Injection, (powder for suspension), m/r, triptorelin (as acetate), 3mg vial (with diluent);

 

Decapeptyl® SR Injection, (powder for suspension), m/r, triptorelin (as acetate), 11.25mg vial (with diluent);

 

Gonapeptyl Depot® Injection, (powder for suspension), triptorelin (as acetate), net price 3.75mg prefilled syringe (with prefilled syringe of vehicle);

 

Red Salvacyl® Injection, (powder for suspension), triptorelin (as embonate), 11.25mg vial (with diluent)

 

Use in accordance with its licensed indications:

 

RED St Helen's CCG endometriosis and reduction of uterine fibroids

 

Amber Patient Retained  Precocious puberty

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

11.05 Tropicamide  0.5% eye drops, 0.5% minims, 1% eye drops, 1% minims
07.04.02 Trospium Chloride 

Tablets 20 mg Capsules M/R 60mg

Amber Initiated  Paediatrics

27.08 Tuberculosis 
Discuss with specialist

TB care should be provided directly by an Infectious Diseases or Respiratory Physician with experience in managing the disease. TB medications are dispensed by TB specialist doctors and nurses from community and hospital clinics. TB medications are not routinely prescribed or dispensed by other primary care providers; in the occasional circumstances where this is required, arrangements can be made in partnership with the TB clinical and specialist nursing team.

Important TB drugs have many recognised drug interactions, side effects, and cautions. This is particularly important when the TB drugs are not prescribed or dispensed in primary care, as the drugs may not be recorded in the GP clinical system or pharmacy patient medication records and so alerts may not be issued.

(TB drugs are occasionally used for other non-TB indications)

07.03.05 Ulipristal Acetate 

Tablets 30 mg

Green  Paediatrics: post menarche

06.04.01.02 Ulipristal acetate tablets Esmya®

Red Triangle Monitor liver function in current and recent users; do not initiate treatment in new users or those between treatment courses

Five reports of serious liver injury, including four cases of hepatic failure needing liver transplantation, have been reported worldwide in women using Esmya for uterine fibroids. The following temporary safety measures have been introduced while an EU-wide review of the evidence is ongoing:
      • Do not initiate new treatment courses of Esmya, including in women who have completed one or more treatment courses previously
      • Perform liver function tests at least once a month in all women currently taking Esmya. Stop Esmya treatment in any woman who develops transaminase levels more than 2 times the upper limit of normal, closely monitor and refer for specialist hepatology evaluation as clinically indicated. Liver function tests should be repeated in all women 2 to 4 weeks after stopping treatment.
      • Check transaminase levels immediately in current or recent users of Esmya who present with signs or symptoms suggestive of liver injury (such as nausea, vomiting, malaise, right hypochondrial pain, anorexia, asthenia, jaundice). If transaminase levels are more than 2 times the upper limit of normal, stop treatment, closely monitor and refer for specialist hepatology evaluation as clinically indicated.
      • Advise women using Esmya on the signs and symptoms of liver injury.

MHRA: Esmya (ulipristal acetate) for uterine fibroids, 09 Feb 2018


Paediatrics: no BNFc entry - seek specialist advice.

03.01.02 Umeclidinium bromide inhalation powder Incruse Ellipta®
Incruse Ellipta
Dry powder inhaler
55 micrograms per inhalation

Second line to tiotropium

Paediatrics: no BNFc entry - seek specialist advice

03.01.02 Umeclidinium with vilanterol Anoro Ellipta®
Anoro Ellipta
Dry powder inhaler
Umeclidinium 55 micrograms with vilanterol 22 micrograms per inhalation

Paediatrics: no BNFc entry - seek specialist advice
03.01.03 Uniphyllin Continus®   Theophylline MR; Tablets m/r 200 mg, 300 mg, 400 mg

Amber Recommended Use in step 4 asthma

Amber Initiated Paediatrics
02.10.02 Urokinase  10,000 unit vial
25,000 unit vial

01.09.01 Ursodeoxycholic acid  Tablets 150 mg, 300 mg, 500mg
Capsules 250 mg
Suspension 250mg in 5ml
01.05.03 Ustekinumab 

Injection; Pre-filled syringe 45mg, 90mg

Concentrate for solution for infusion; 130mg

 Crohn's Disease; moderate to severe

10.01.03 Ustekinumab 

Subcutaneous injection 45mg, 90mg prefilled syringes and 45mg/0.5ml vials

 

for psoriatic arthritis

13.05.03 Ustekinumab 

Injection 45 mg
In line with NICE TA 180 - Ustekinumab for the treatment of adults with moderate to severe psoriasis

Cytokine modulator

No BNFc entry; Paediatrics, seek specialist advice 

NHS NHSE commissioned drug for Paediatric indications (in line with NICE TA 455) - see Specialised Commissioning: Key documents

04.02.03 Valproic Acid Semisodium Depakote®

Tablets 250 mg, 500 mg

 

Amber Patient Retained Paediatrics

 

02.05.05.02 Valsartan tablets and capsules 

40mg, 80mg, 160mg, 320mg

Amber Initiated paediatrics

11.03.01 Vancomycin  

5% eye drops

No BNFc entry - seek specialist advice

07.04.05 Vardenafil 

Tablets 5 mg, 10 mg, 20 mg.

Black  in erectile dysfunction in circumstances outside of those listed above.

Paediatrics: No BNFc entry, seek specialist advice 

04.10.02 Varenicline 

Tablets 500micrograms, 1mg

Notes
• 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.
• 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.
• Varenicline should not be offered to young people under 18 nor pregnant or breastfeeding women.

No BNFc entry – seek specialist advice

01.05.03 Vedolizumab  Concentrate for intravenous infusion, powder for reconstitution 300-mg vials

Ulcerative Colitis & Crohn's Disease

Paediatrics: no BNFc entry - seek specialist advice
04.03.04 Venlafaxine 

Tablets 37.5 mg, 75 mg
MR capsules 37.5mg, 75 mg, 150 mg
MR tablets 37.5 mg, 75 mg, 150 mg, 225 mg

No BNFc entry – seek specialist advice

04.07.04.03 Verapamil 

Termination of attack and prophylaxis of Cluster Headache - 1st line
 
Standard-release tablets, 40mg, 80mg, 120mg, 160mg
Modified-release tablets, 120mg, 240mg
Modified-release capsules, 120mg, 180mg, 240mg
Oral solution, 40mg/5ml


Careful ECG monitoring is required and doses up to 960mg per day can be considered. ECG monitoring should continue at stable dose as PR interval may prolong over time. 

No BNFc entry -seek specialist advice

02.06.02 Verapamil modified release 

120mg, 180mg, 240mg

Amber Initiated paediatrics

02.06.02 Verapamil oral solution 

40mg/5ml
Not used at Alder Hey

Amber Initiated paediatrics

02.06.02 Verapamil tablets 

40mg, 80mg 

Amber Initiated paediatrics

11.08.02 Verteporfin  Injection

Intravenous injection. For wet AMD – see NICE TA68.
04.08.01 Vigabatrin 

Tablets 500mg
Oral powder 500mg
 
Testing of visual fields every 6 months is recommended.

Focal onset epilepsy – drugs only to be used when all other options have been tried or when prescribed by a specialist in epilepsy.

Generalised epilepsy – may be best avoided. Vigabatrin has been shown to exacerbate some seizure types in generalised epilepsy, in particular absences and myoclonus.

13.05 Viscose stockinette garments Clinifast®, Comfifast Easywrap®, Skinnies Viscose®, Tubifast 2-way Stretch®

Elasticated viscose stockinette - in a range of garments, e.g. body suits, vests, leggings and gloves, and in a variety of sizes.

09.06.07 Vitamin and mineral supplements Forceval Soluble®

For use in tube fed patients, those with swallowing difficulties and those post bariatric surgery

Paediatrics: no BNFc entry - seek specialist advice

09.06.07 Vitamin and mineral supplements Ketovite® Tablets; Liquid
09.06.07 Vitamin and mineral supplements Forceval® Capsules; Forceval®; Forceval® Junior
09.06.02 Vitamin B Tablets (Compound) 
09.06.02 Vitamin B Tablets, Compound Strong 

Some patients dependent on alcohol may benefit from vitamin B co strong supplementation, for example patients with vitamin/nutritional deficiencies possibly leading to peripheral neuropathies and those at risk of refeeding syndrome. If an individual is no longer considered dependent on alcohol, has a good diet and is not malnourished, then it would be reasonable to review and discontinue treatment with vitamin B compound strong.

09.06.01 Vitamins A and D  Capsules vitamin A 4000 IU (also contains vitamin D); Halibut-liver oil
Capsules BPC 1973, vitamin A 4000 IU, vitamin D 400 IU (10 micrograms).

Prescribe generically
09.06.01 Vitamins A C and D  Oral drops, vitamin A 5000 IU, vitamin D 2000 IU (50 micrograms) ascorbic acid 150mg/ml; Healthy Start Children’s Vitamin Drops

Where available.

09.06.07 Vitamins A,D,E,K 

Paravit CF® Liquid

Paravit CF® Capsules (suitable age 4 and above)

Guideline – Nutritional Management of Cystic Fibrosis. September 2016. 

05.02.01 Voriconazole  NHS NHSE commissioned drug - see Specialised Commissioning: Key documents
For Fungal infection or Chronic Pulmonary Aspergillosis
11.03.02 Voriconazole 

1% eye drops.

No BNFc entry - seek specialist advice.

04.03.04 Vortioxetine 

Tablets 5mg, 10mg, 20mg

No BNFc entry – seek specialist advice

02.08.02 Warfarin oral suspension 

5mg/5ml
 
Amber Initiated paediatrics

Specialist Centre usually tries to get patients onto 1mg tablets before discharge.

02.08.02 Warfarin tablets 

500micrograms, 1mg, 3mg, 5mg

Amber Initiated Treatment and secondary prevention of DVT/PE. Includes initiation by specialist warfarin service.

Amber Initiated paediatrics

09.02.02.01 Water for Injection 
13.02.01 White Soft Paraffin 50% / Liquid Paraffin 50%  Ointment; 500 g tub

Very Greasy
13.02.01 Whitesoft paraffin  Ointment; 500 g tub

Very Greasy
27.08 Whooping cough 

Treatment should be given to:

  • Any person in whom the clinician suspects pertussis infection OR
  • Any person with an acute cough lasting for ≥ 14 days without an apparent cause plus one or more of the following:
    • - paroxysms of coughing,
    • - post-tussive vomiting,
    • - inspiratory whoop.

Clarithromycin* 500 mg BD for 7 days

If allergic to macrolides: Co-trimoxazole 960 mg BD for 7 days (not in pregnancy)

*Warning Caution in pregnancy

Treatment of children does not affect the duration of illness but may control the spread of infection as untreated children shed organism for many weeks. Non-infectious coughing may continue for several weeks.

Note: cases of pertussis should be notified to Public Health England but treatment should be commenced as soon as possible and not withheld until advice is sought.

12.02.02 Xylometazoline 0.05% paediatric nasal drops 

Amber Recommended Paediatrics < 6 years ; avoid in infants under 3 months old

12.02.02 Xylometazoline 0.1% nasal drops/spray 

Amber Recommended paediatrics < 12 years

13.02.01 ZeroAQS®  Cream; 500 g tub

Light
13.02.01 Zerobase®  Cream; 500 g pump pack

Medium
13.02.01 Zerocream®  Cream; 500 g pump pack

Medium
13.02.01 Zeroderm®  Ointment; 500 g tub

Very Greasy
13.02.01 Zerodouble®  Gel; 475g squeeze bottle

Greasy
13.02.01 Zeroguent®  Cream; 500 g tub

Greasy
13.02.01.01 Zerolatum®  Emollient medicinal bath oil; 500 mL
13.02.01.01 Zeroneum®  Bath oil; 500 mL
04.07.01 Ziconotide 

Intrathecal infusion 100micrograms /mL

No BNFc entry - seek specialist advice

NHS NHSE commissioned drug - see Specialised Commissioning: Key documents

13.05.02 Zinc and salicylic acid paste (Lassar’s Paste) half-strength 

Paste; 100 g Keratolytic For psoriasis, this unlicensed special may be considered

13.05.01 Zinc Paste (6%) and Ichthammol (2%) Bandage, BP 1993  Ichthopaste® (6/2%); 6 m x 7.5 cm
13.05.01 Zinc paste bandage  Viscopaste®; 6 m x 7.5 cm
Steripaste®; 6 m x 7.5 cm
09.05.04 Zinc Sulphate Solvazinc®

Effervescent tablets 125mg (45mg zinc)

Amber Initiated Paediatrics: in neonates

06.06.02 Zoledronic Acid Zometa®

Concentrate for intravenous infusion, 800micrograms/mL, 5mL (4mg) vial Solution for intravenous infusion, 40micrograms/mL, 100mL (4mg) bottle Licensed for: Reduction of bone damage in advanced malignancies involving bone; Hypercalcaemia of malignancy

Paediatrics: No BNFc entry, seek specialist advice 

06.06.02 Zoledronic Acid Aclasta®

Intravenous infusion, 50micrograms/mL, 100mL bottle Licensed for: Treatment of Paget's disease of bone; Treatment of postmenopausal osteoporosis and osteoporosis in men (including corticosteroid-induced osteoporosis)

Paediatrics: No BNFc entry, seek specialist advice 

04.07.04.01 Zolmitriptan 

Tablets 2.5mg
Orodispersible tablets 2.5mg
Nasal spray 5mg per actuation

Advise patient to bend forward for one minute after administration of nasal spray to avoid swallowing the dose.
 
 Amber Recommended Paediatrics < 12 years
May be prescribed for ages lower than stated in BNFc under specialist advice.

04.07.04.03 Zolmitriptan 

Acute treatment of Cluster Headache
 
Nasal spray 5mg/0.5mL unit dose

Advise patient to bend forward for one minute after administration of nasal spray to avoid swallowing the dose.

Amber Recommended Paediatrics

04.01.01 Zolpidem 

Tablets 5 mg, 10 mg

No BNFc entry – seek specialist advice

04.08.01 Zonisamide 

Capsules 25mg, 50mg, 100mg


Amber Initiated Paediatrics
Focal onset epilepsy - add on drug option.

04.07.04.02 Zonisamide (on recommendation of consultant neurologist only) 

Capsules 25 mg, 50mg, 100mg
No BNFc entry – seek specialist advice

As cognitive and mood-related side effects are common with zonisamide, patients should be specifically warned about these and advised to stop if they occur. More gradual withdrawal is only recommended if there is a history of epilepsy.

04.01.01 Zopiclone 

Tablets 3.75 mg, 7.5 mg

No BNFc entry – seek specialist advice

04.02.01 Zuclopenthixol 

Tablets 2 mg, 10 mg, 25 mg

No BNFc entry – seek specialist advice

04.02.01 Zuclopenthixol Acetate 

Injection 50mg in 1mL

No BNFc entry – seek specialist advice

04.02.02 Zuclopenthixol Decanoate 

Injection 200 mg/mL
Concentrated injection 500 mg/mL

No BNFc entry – seek specialist advice

Pan Mersey Area Prescribing Committee