Nottinghamshire Area Prescribing Committee
Joint Formulary
 
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20 Unlicensed Medicines / Significant off-label use
20 Unlicensed Medicines

5-Aminolevulinic acid hydrochloride Gliolan®
Formulary
Powder for oral solution
NUH only
  • Fluorescence guided neurosurgery for high grade malignant brain tumours
  • Authorised prescribers only
  • Licensed product

  • Red View adult BNF  View SPC online  View childrens BNF
    Acapella®
    Formulary
  • For use by respiratory physiotherapists
  • Oscillating positive expiratory pressure device for mucous clearance
  • Listed in drug tariff - Part IXA-Appliances

  • Red View adult BNF  View SPC online  View childrens BNF
    Acetarsol Suppositories
    Restricted
    Unlicensed medicine - named patient use only
    Link  UKMI Q and A: Can acetarsol be used to treat proctitis
     

    Restricted Drug Red
    Acetic acid 5% solution
    Formulary

    SFH: Available in:
    - 200ml non-sterile bottles (~£8)
    - 20ml sterile bottles (~£6)


    Red View adult BNF  View SPC online  View childrens BNF
    Acetic Acid Solution 3%
    Restricted

    NUH only: Unlicensed medicine - named patient use only. Restricted for use by endoscopy


    Restricted Drug Red
    ACETYLCYSTEINE
    Formulary

    Effervescent Tablets-600mg

    • Little evidence of benefit for preventing contrast media induced nephropathy
    Link  Link to reviews
    Link  SFH: Renal protection from contrast media information
     

    Red
    ACID CITRATE DEXTROSE
    Restricted
    SFH only
  • 500ml bags for cell salvage

  • Restricted Drug Red
    ADRENALINE 1:200,000 inj
    Restricted
    Unlicensed medicine - named patient use only
    NUH only

    Restricted Drug Red
    ADRENALINE TOPICAL SOLUTION
    Restricted

    30ml bottle. Unlicensed medicine - named patient use only.

    SFH information only:

    • For use as a haemostatic.
    • Do not apply for long periods. See the Palliative Care Formulary (password needed) or discuss with Medicines information 3163)
    • In an emergency 1 in 1000 (1mg/ml) ampoules can be used.

    Restricted Drug Red
    Ajmaline
    Formulary
    Injection
  • SFH only for the diagnosis of Brugada Syndrome
  • Link  SFH: Guide to ajmaline administration
    Link  Link to reviews
     

    Red
    ALTRETAMINE (HEXAMETHYLMELAMINE) Capsules 50 mg
    Restricted
    Unlicensed medicine - named patient use only
    NUH only
  • Used for ovarian cancer

  • Restricted Drug Cytotoxic Drug  Red
    ALUM Bladder Irrigation
    Restricted
    Unlicensed medicine - named patient use only
    NUH only
  • For treatment of bladder haemorrhage
  • Potash Alum Bladder Irrigation 10% is a concentrated solution and must be diluted to 1% before use
  • Link  NUH: Potash Alum Bladder Irrigation 10% 100ml information sheet
    Link  SFH: Potash Alum Bladder Irrigation 10% 100ml information sheet
     

    Restricted Drug Red
    Aluminium Hydroxide
    Restricted

    Tablets (600mg) - NUH Only - Unlicensed medicine - named patient use only

    • Prescribe and monitor as per phosphate binder guidance.
    • Generally reserved for short term use in patients with severe and difficult to control hyperphosphataemia.

    Restricted Drug Red
    AMANTADINE Injection 200 mg in 500mL
    Restricted
    Unlicensed medicine - named patient use only
  • NUH only- restricted for chronic pain

  • Restricted Drug Red
    Amidotrizoates Gastrografin®
    Formulary
    • Contrast medium for gastrointestinal radiography

    Red View adult BNF  View SPC online  View childrens BNF
    Amoxicillin
    Formulary
  • SFH: All patients on nebulised antibiotics must be referred to a respiratory specialist nurse.
  • Link  SFH: Nebulised antibiotics guideline
     

    Red
    Amphotericin 500mg in 5ml oral soln
    Restricted
    Unlicensed medicine - named patient use only
    NUH only

    Restricted Drug Red
    Anastrozole
    Formulary
    Link  Link to reviews
     

    Amber 3 View adult BNF  View SPC online  View childrens BNF
    Aprotinin
    Restricted
    Unlicensed medicine - named patient use only
    500,000 units/50ml Infusion
  • Restricted to patients at high risk of major bleed
    during cardiac surgery

  • NUH only

    Restricted Drug Red View adult BNF  View SPC online  View childrens BNF
    Artesunate
    Restricted

    Injection

    • Unlicensed medicine - named patient use only
    • Treatment of severe and/or complicated malaria.  See NUH guideline for the management of malaria.

    Restricted Drug Red
    ASCORBIC ACID Injection 500 mg in 1mL
    Restricted
    Unlicensed medicine - named patient use only
    Manufacturer unable to supply JUNE 2011
    NUH only

    Restricted Drug Red
    ASPARAGINASE (MEDAC) Injection 10000 units
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Aspirin IV ASPEGIC®
    Restricted
    Injection
  • Unlicensed medicine (imported)- named patient use only
  • Restricted to use in cardiac catheter lab for use during coronary interventions
  • Restricted to use by consultant neuroradiologists to prevent or treat device-related thrombus formation during procedures in interventional neuroradiology (for use in patients without prior antiplatelet medication, mainly patients with ruptured brain aneurysms)
  • NUH only

  • Restricted Drug Red
    Benzbromarone
    Restricted

    Tablets 100mg. Unlicensed medicine - named patient use only
    At SFH:

    • Available by import only for consultant rheumatologist prescribing.
    • Requires order form from prescriber for every supply (See instructions)
    • Summary of benzbromarone (from Drugdex)

    Restricted Drug Red
    Benzoin Tincture, Compound, BP
    Formulary
    Tincture (unlicensed indication)
    Also known as Tinct. Benz. (Tincture of Benzoin)
    SFH: Used in max fax surgery to aid dressing adhesion.

    Red
    Betamethasone
    Formulary
    Unlicensed use

    Red
    BEVACIZUMAB 2.5mg/0.1ml syringe
    Restricted
    Unlicensed medicine - named patient use only
    NUH only for AMD

    Restricted Drug Red
    BRILLIANT GREEN 1:500 soln
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Brincidofovir
    Restricted

    Tablets, Oral Suspension.
    Unlicensed medicine - named patient use only

    Available at NUH only:

    • Approved for adults in accordance with compassionate use scheme for adenovirus infection. Only on consultant decision with microbiology / virology input.

    Restricted Drug Red
    Bupivacaine 0.1% ,fentanyl 2mcg/ml 50ml
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Controlled Drug  Red
    Caffeine Citrate
    Formulary
    Injection 5mg/ml BASE (10mg/ml caffeine citrate)
    Oral Solution 5mg/ml BASE (10mg/ml caffeine citrate)
  • Prescribe as "caffeine citrate" (see MHRA warning below).
  • Unlicensed medicine - named patient use only
  • Licensed product of higher strength Peyona = non-formulary
  • Link  NUH Neonatal monograph
    Link  NUH: Use of caffeine in apnoea of prematurity guideline
    Link  Link to reviews
    Link  MHRA Drug Safety Update (Aug 13): Caffeine for apnoea of prematurity: all products to be named and prescribed as caffeine citrate
    Link  MHRA: safe use of caffeine citrate
     

    Red
    Calcium carbonate Phosphate binder
    Formulary
    250mg dispersible tablets, unlicensed special
    10% suspension, unlicensed special, manufactured at NUH
    500mg chewable tablets (Tums®)
  • For use in hyperphosphataemia of chronic kidney disease in paediatric patients
  • Phosphate binder, started by paediatric nephrology

  • Red View adult BNF  View SPC online  View childrens BNF
    CALCIUM CHLORIDE 14.7% 50ml,100ml
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    CALCIUM GLUCONATE 10% 50ml,100ml
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Calcium sulfate Stimulan® Rapid Cure
    Restricted
    • Medical Device
    • Calcium matrix powder and mixing solution - when mixed the resultant paste is used to make biodegradable, radiopaque beads.
    • NUH only - microbiology input required regarding the choice of antibiotic required to be mixed with the paste. Restricted to use by the foot and ankle service for diabetic ulcers with underlying osteomyelitis.

    Restricted Drug Red
    Carbex granules
    Restricted
    SFH only
  • Used by x-ray

  • Restricted Drug Red
    CARNOY'S soln 100ml
    Restricted
    Unlicensed medicine - named patient use only
    NUH only
  • Used post enucleation of keratocystic odontogenic tumours and certain types of unicystic ameloblastoma

  • Restricted Drug Red
    Cidofovir ointment
    Restricted

    Ointment 1%

    • Available at NUH only
      Restricted for severe viral warts or molluscum contagiosum secondary to immunosuppression, unresponsive to standard therapy.
    • Manufactured by Pharmacy Non Sterile Production Unit (Unlicensed Product)

    Restricted Drug Red
    CoaguChek XS PT Test strips
    Restricted
  • Amber 2 - specialist recommendation - restricted to patients who have been assessed as suitable for near patient testing by an anticoagulation clinic.
  • Each box contains 24 strips. This is expected to last a patient in excess of 1 year based on average testing frequency.
  • Patients should be advised not to invest in a meter before they have spoken to the anticoagulation clinic
  • CoaguChek meters will not be provided on the NHS - not funded

  • Restricted Drug Amber 2
    COAL TAR BP 20% in YSP
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Constrictor rings for erectile dysfunction
    Formulary
  • Amber 2 - for the patients that meet SLS criteria
  • Grey, non-formulary - if patient does not meet the SLS criteria (see drug tariff for details)
  • Link  Drug Tariff (see Part IXa - Appliances, Vacuum pumps)
     

    Amber 2
    Crystal Violet
    Formulary
    Unlicensed medicine - named patient use only
    NUH only
    Staining Agent used during endoscopy and colonoscopy.

    Red
    CYCLOPHOSPHAMIDE
    Restricted

    Unlicensed medicine - named patient use only
    SFH only

    Link  Cyclophosphamide - Regional guideline for the use of IV Cyclophosphamide in auto-immune disorders (East Mids Rheumatology Autoimmune Network - Dec 2017)
     

    Restricted Drug Cytotoxic Drug  Red
    DAUNORUBICIN saline pre-filled syringe
    Formulary
    NUH only
  • Unlicensed medicine - named patient use only
  • For use only after IFR approval
    10mg/10ml, 20mg/20ml, 30mg/30ml

  • Cytotoxic Drug  Red  HCD
    DEPIGMENTING CREAM Pigmanorm®
    Restricted
    Unlicensed medicine - named patient use only
  • Contains Hydroquinone, Tretinoin, Hydrocortisone
    NUH and Treatment Centre use only
  • For dermatologist and burns specialist use only
  • Non formulary at SFH

  • Restricted Drug Red
    Dexamethasone eye injection
    Restricted
    Unlicensed indication
    SFH only
  • Intravitreal dose is 0.4mg in 0.1ml - i.e. use the injection neat. (Moorfields handbook)
  • Subconjunctival dose is 2mg in 0.5ml - i.e. use the injection neat. (Moorfields handbook)
  • Use the DBL brand (Hospira, Faulding or Mayne are the same) of dexamethasone as it has no preservatives.

  • Restricted Drug Red
    Dialyvit®
    Restricted
    Tablet (Unlicensed medicine - named patient use only)
    NUH only
  • Restricted for paediatric renal use - paediatric formulation of Dialyvit® has been discontinued (2015)

  • Restricted Drug Red
    Dibotermin Alfa, rhBMP-2 Inductos®
    Formulary
    Kit for implant 12mg
    NUH only
  • Currently suspended in the EU. Further information here
  • Use for spinal surgery is commissioned as per NHS England commissioning policy 16063/P
  • Use for any other indication is not routinely commissioned and requires funding approval from the responsible commissioner
  • Link  NHS England Commissioning Policy 16063/P
     

    Red
    DIDANOSINE Liquid 10mg in 1ml (after double dilution)
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    DIHYDROERGOTAMINE Injection 1 mg in 1mL
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    DILUENT A (XANTHAN GUM 1%) Suspension 1%
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    DILUENT C susp CAROB BEAN GUM 1% 500ml
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    DIMETHYL SULFOXIDE
    Restricted

    Unlicensed medicine - named patient use only
    SFH only


    Restricted Drug Red
    DITHRANOL 0.1% /0.25%,0.5%,1%,2%,4%in lassars paste
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Domperidone
    Formulary
    Tablet
  • Off label indication. May be considered if benefits outweigh risks when other breastfeeding management techniques (regular feeding/ expressing, attachment optimisation) have failed.
  • Standard letter (print on headed paper) to accompany requests to prescribe.
  • Link  Link to reviews
    Link  MHRA: Domperidone no longer available without prescription (Sept 14)
    Link  The Breastfeeding Network domperidone information
    Link  UKMI Q&A: Domperidone / metoclopramide for lactation stimulation
     

    Green
    DOXYCYCLINE Injection 100 mg in 5mL
    Restricted

    Unlicensed medicine - named patient use only

    Available at NUH only:

    • Restricted antibiotic for pelvic inflammatory disease: see local guidelines [NUH guideline]

    Restricted Drug Red
    ETHIONAMIDE Tablets 250 mg
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    EVEROLIMUS Tablets 250 micrograms,750 micrograms
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    FERRIC SUBSULPHATE (monsel's soln)
    Formulary
    Unlicensed special, 50ml bottle £22.
  • Used intravaginally as a haemostatic.
  • Does not need to be sterile so product can be decanted and the bottle reused until its expiry date.

  • Red
    Fibrin Sealant Evicel®
    Restricted
    Evicel Kit
    NUH only
    Link  Haemostatic Agents at NUH
    Link  MHRA Feb 2013: updated guidance on minimising risk of life-threatening and fatal air embolism
    Link  Urgent Product Information - Risk of life-threatening air or gas embolism (Dec12 letter)
     

    Restricted Drug Red
    Fibrin Sealant Tisseel®
    Restricted
    Ready to use syringe
    NUH only
    Link  MHRA: Risk of air embolism with fibrin sealants (Feb 2013)
    Link  Haemostatic Agents at NUH
    Link  Tisseel product information
     

    Restricted Drug Red
    FLUNARIZINE 5mg capsules
    Formulary
    Unlicensed medicine - named patient use only
    NUH only
    Link  Link to reviews
    Link  NICE Unlicensed Evidence summary: Flunarizine for migraine prophylaxis
     

    Red
    Flutter Device
    Formulary
  • For use by respiratory physiotherapists
  • Oscillating positive expiratory pressure device for mucous clearance
  • Link  Link to reviews
     

    Red
    GABAPENTIN 6% topical
    Restricted
    Unlicensed medicine - named patient use only
    NUH only
    Topical preparation for treatment of vulvodynia. Restricted to pain team and gynaecology specialists.

    Restricted Drug Red
    Gas Gangrene Antitoxin
    Formulary
    Injection 2500 units in 1 mL
    Unlicensed medicine - named patient use only
    NUH only
  • Not for administration to humans. Used for calibrating assays.
  • Only available via NIBSC website.
  • Link  NUH Pharmacy: Rare antitoxins and immunoglobulins
     

    Red
    Giving sets (IV)
    Formulary
    At SFH and NUH, IV giving sets do not come from pharmacy


    Giving sets (NG)
    Formulary
    At SFH, only the following giving sets come from Pharmacy:
  • Flocare infinity pack set – currently keep stock in pharmacy & on wards
  • Flocare universal (with med port) set
  • Flocare NG feeding tube – currently keep stock in pharmacy & on wards


  • GLIADEL wafer Carmustine 7.6mg
    Formulary
    Unlicensed medicine - named patient use only
    NUH only
    Link  NICE TA121: Glioma - carmustine implants and temozolomide
     

    Red
    GLYCEROL STERILE 30ml
    Formulary

    NUH only: Unlicensed medicine - named patient use only

    • No longer stocked at SFH - podiatry to purchase own non-sterile version from NHS Supplies.

    Red
    Glycopyrrolate 0.5% topical solution
    Formulary
    • SFH information only: Unlicensed Special. Obtain supplies from SFH Pharmacy rather than FP10HP.

    Red
    Glycopyrronium 1% in Unguentum Merck
    Formulary

    SFH info: Dermatology use only


    Red View adult BNF  View SPC online  View childrens BNF
    Haemostatic Agent
    Restricted

    Gauze
    ENT nasal gauze is non formulary

    • Consultant use only- Restricted for use in life threatening haemorrhage
    • At SFH, discuss with Dr Tim Moorby, Consultant Haematologist.
    • Click here for the website

    Restricted Drug Red
    Haemostatic Agent Floseal®
    Restricted
    Haemostatic Matrix
    NUH only
    Also approved for NUH ENT specialist use only for the treatment of epistaxis in accordance with local guideline.
    Link  Haemostatic Agents at NUH
     

    Restricted Drug Red
    Haemostatic Agent PuraStat®
    Restricted

    Gel (1ml and 3ml syringes)
    NUH only: Approved for the management of bleeding during endoscopic procedures following either sphincterotomy in ERCP, EMR, ESD and when treated for Upper GI bleed.
    Non pharmacy item, supplied through NHS supplies


    Restricted Drug Red
    Haemostatic Agent Surgiflo® with thrombin
    Formulary

    Haemostatic Matrix

    Available at NUH only for surgical procedures. (Surgery division approved specialties only, excluding ophthalmology.)


    Red View adult BNF  View SPC online  View childrens BNF
    Haemostatic Agent Tachosil®
    Restricted
    Medicated sponge - used in liver surgery
    NUH only
    Link  Haemostatic Agents at NUH
     

    Restricted Drug Red
    Haemostatic Agent Willospon®
    Formulary
    Gelatine sponge - Anal Tampon
    NUH only
  • For local haemostasis in surgical procedures

  • Red
    HYDROCHLOROTHIAZIDE
    Formulary
    NUH only
  • Tablet 25mg used for neonatal suspension. Unlicensed.
  • Link  MHRA: risk of non-melanoma skin cancer with hydrochlorothiazide
     

    Red
    Hydroquinidine
    Restricted

    MR Capsule
    Unlicensed medicine - named patient use only

    • Available at NUH only for cardiac rhythm disorders on the recommendation of a specialist consultant cardiac physiologist.

    Restricted Drug Red
    HYDROXYPROGESTERONE 260mg/ml inj
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Icodextrin solution
    Formulary
    • At SFH approved only for patients undergoing laparoscopic gynaecological surgery with a previous history of adhesion formation or those at high risk of adhesions.
    • Click here for independent reviews
    • Manufacturers information sheet
    Link  Link to reviews
     

    Red
    i-FACTORTM
    Restricted
    Peptide Enhanced Bone Graft
    NUH only
    Approved for use in spinal fusion
    Supplied by Theatre Stores

    Restricted Drug Red
    Indigo carmine
    Formulary

    SFH:
    -0.8% sterile solution for use in endoscopy during EMR procedures. Supplied by Pharmacy.
    -Non-sterile solution used as a mucosal dye spray in endoscopic procedures. Obtained through supplies rather than pharmacy.
    NUH: 0.8% sterile injection for use in endoscopy. Supplied by Pharmacy.


    Red
    Iohexol Omnipaque®
    Formulary
    SFH:
  • '140' is used in Endoscopy for ERCP
  • '300' no longer used orally as a bowel contrast in CT colonography as didn't perform as expected
  • Link  Link to manufacturer SPC (datasheet)
    Link  Link to review
     

    Red
    Iopamidol Niopam®
    Formulary

    Injection

    • Radiographic contrast medium
    • licensed medicinal product

    Red
    Isatuximab
    Restricted

    Infusion - NUH Only

    Approved in accordance with Early Access to Medicines Scheme (04425/0002) in combination with pomalidomide and dexamethasone for the treatment of adult patients with relapsed and refractory multiple myeloma. Closed to new patients June 2020


    Restricted Drug Red
    Joulies Oral Solution
    Restricted

    Oral Solution
    Unlicensed medicine - named patient use only

    NUH only: For oral phosphate supplementation in paediatric nephrology where potassium phosphate is contraindicated


    Restricted Drug Red
    Lactose powder
    Formulary
    For hydrogen breath tests in endoscopy.

    Red
    LAT gel
    Formulary
    Gel (unlicensed)
  • SFH only. For use when cleaning/ suturing wounds in children in ED
  • Contains lidocaine 4%, adrenaline 0.1% and tetracaine 0.5%

  • Red
    LEVAMISOLE Tablets 50 mg
    Formulary
    Unlicensed medicine - named patient use only
    Link  Medicines for children leaflet: Levamisole for nephrotic syndrome
     

    Red
    Levosimendan Simdax®
    Restricted

    Unlicensed medicine - named patient use only
    Injection - 12.5mg/5mL

    SFH: Not approved for use
    NUH only: Post cardiac surgery as per guideline.

    Link  NUH: Guidelines for the use of levosimendan following cardiac surgery
     

    Restricted Drug Red
    Lipiodol
    Formulary

    Historically used during endoscopy in conjunction with cyanoacryalate glue.


    Red
    LIQUID PARAFFIN sterile light (20mL or 25ml)
    Formulary
    Unlicensed medicine - named patient use only

    Red
    LITHIUM CHLORIDE
    Restricted

    SFH information only: 

    • For calibration of the ICCU LiDCO machine which is used to monitor cardiac output
    • Usual prescription is "Lithium chloride injection (0.15mmol/ml): 2ml (0.3mmol) IV PRN"

    Restricted Drug Red
    LITMUS PAPER
    Restricted

    SFH information only:


    Restricted Drug Red
    Lubricating gel
    Formulary
  • Available in 5g sachets and 42g tubes

  • Green
    MAGNESIUM GLYCEROPHOSPHATE powder 350g
    Formulary
    Unlicensed medicine - named patient use only
    NUH only
    Link  Link to reviews
     

    Red
    MAGNESIUM SULPHATE 10% INFUSION
    Formulary
    Unlicensed medicine - named patient use only
    NUH only
    See Chapter 9 for other parenteral magnesium preparations

    Red
    Mannitol Osmohale®
    Formulary

    Inhalation powder (supplied in hard capsules)

     For use in respiratory clinic for diagnosis.

    Link  Link to reviews
     

    Red View adult BNF  View SPC online  View childrens BNF
    Methacholine solutions various strengths Methylcholine, Acetyl-β-methylcholine
    Formulary
    Unlicensed medicine - named patient use only
    NUH only
  • Inhalation of nebulised solutions of methacholine chloride are used to provoke bronchoconstriction in the diagnosis of bronchial airway hypersensitivity

  • Red
    METHOCEL 2% eye drops
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    METHOTREXATE
    Restricted

    Unlicensed medicine - named patient use only

    • Dose is 50mg per square metre given intramuscularly (SFH: See dose calculator)
    • At NUH: Pre-filled syringes stocked in pharmacy - contact pharmacy to arrange a supply. Pharmacy procedure available. Prescribe using dedicated drug chart.
    • At SFH: Supplied from the Aseptic Dispensing Unit (ADU) - contact your ward pharmacist or send the prescription to Pharmacy (between 9-4pm). Full guideline here.
    Link  NUH: Ectopic pregnancy guideline
    Link  SFH: Ectopic pregnancy guideline
    Link  SFH: Methotrexate dose calculator
     

    Restricted Drug Cytotoxic Drug  Red
    Methylthioninium chloride Aguettant®
    Restricted

    SFH: 1ml 1% for enteral use (not for IV)(unlicensed)
    (See here for the intravenous product.)

    • Also known as 'methylene blue'.
    • Aguettant® available for visualisation (staining)(approx £20 each). Click here for SPC or basic guide.
    Link  Memo: Change in Diluent
    Link  MHRA safety update April 2009
     

    Restricted Drug Red
    Miltefosine
    Restricted
    Unlicensed medicine - named patient use only
    Capsule
    NUH only
  • Restricted for treatment of various forms of leishmaniasis


  • Restricted Drug Red
    MORPHINE 40mg/ml inj pfs
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Controlled Drug  Red
    MORPHINE 50mg/50ml syringe
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Controlled Drug  Red
    Morphine epidural 2mg in 10ml
    Formulary

    Controlled Drug  Red
    Mydricaine
    Formulary
    Unlicensed supply available.
    - Number 1 (for children)(not routinely stocked at SFH)
    - Number 2 (for adults)
  • Contents and more info.


  • Nifedipine
    Formulary

    Available as: Capsules (normal release) and MR tablets (slow release)

    • Normal release capsules now available again (Oct 2019)
    • APOSTLE III trial used 20 mg nifedipine (two 10 mg capsules) orally in the first hour, followed by 20 mg slow-release nifedipine per 6 h for the next 47hr. 
    Link  APOSTEL III Trial (2016): Nifedipine vs atosiban for threatened preterm birth
     

    Red View adult BNF  View SPC online  View childrens BNF
    Nifedipine Immediate release capsules
    Formulary

    Capsules 5mg & 10mg

    • Available again Oct 2019.
    • Immediate release capsules for Raynaud's if MR tablets do not work well enough.
    • Much more expensive than MR tablets (~£80 vs ~£5pm).
    • Capsules have more side effects than MR tablets. See prescribing advice on CKS.

    Green View adult BNF  View SPC online  View childrens BNF
    Nitazoxanide
    Restricted

    Available as tablets or suspension.

    • Unlicensed medicine - named patient use only.
    • Available at NUH only for treating various intestinal parasites including cryptosporidiosis on recommendation of microbiology or infectious diseases. In tariff. Prolonged or repeat courses should seek one-off request approval. 
    • HCD HCD Excluded from tariff for the treatment of Hepatitis C, but Individual Funding Request must be completed prior to prescribing. 

    Restricted Drug Red  HCD
    Octenisan®
    Formulary
    • At SFH nasal gel and wash to be used in line with MRSA policy for prophylaxis in high risk group patients. Patient information leaflets and stickers available from Infection Control.
    • At NUH wash to be used in line with Infection Control recommendations. First line for MRSA decolonisation. Chlorhexidine second line in those unable to use Octenisan.
    • Nasal gel available 3rd line (after Bactroban and Naseptin) for patients requiring decolonization.  Nasal gel approved for use in critical care during Bactroban supply problem.
    • Wash Mitts and Shower Caps may be used in community patients unable to use the standard wash on the advice of infection control (APC Sept 14).
    Link  Link to reviews
    Link  NUH Octenisan wash poster
    Link  SFH: Prevention against MRSA skin carriage for high risk patients
     

    Green
    ORA-PLUS ORAL SUSPENDING VEHICLE
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    OXANDROLONE
    Restricted

    Unlicensed medicine - named patient use only
    Tablets 2.5mg
    NUH only for the management of patients with severe burns in adult critical care and the adult burns unit.

    Link  Link to reviews
     

    Restricted Drug Red View adult BNF  View SPC online  View childrens BNF
    Oxitriptan
    Restricted

    Unlicensed medicine - named patient use only
    Capsules 10mg or 20mg

    • Used for Phenylketonuria caused by a deficiency of tetrahydrobiopterin. Treatment involves oral supplementation of tetrahydrobiopterin; in some severe cases, the addition of the neurotransmitter precursors, levodopa and 5-hydroxytryptophan, are also necessary

     For adults under the care of a tertiary metabolic centre.

     For paediatric patients, service delivered through NUH.


    Restricted Drug
    PAPAVERINE HYDROCHLORIDE (2ML AMPOULE) Inj 40 mg in 1mL
    Formulary
    Unlicensed medicine - named patient use only
  • At SFH Rarely used in theatres for extravasation and blood vessel spasms and rarely used in cardiac catheter suite as an alternative to adenosine.

  • Red
    PAROMOMYCIN Tablets 250 mg
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    PATENT BLUE Injection 2.5%
    Formulary
    Unlicensed medicine - named patient use.
  • Translation of French SPC
  • MHRA warning of allergies - Feb 2012

  • Red
    PENICILLIN SKIN TEST KIT
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    pH indicator paper
    Restricted
    • SFH information only: Test strips [see photo] with range 2-9 are used for testing NG tube placement. pH 5.5 or below indicates gastric contents. See nursing procedure.

    Restricted Drug Green
    PHENOL (AQUEOUS) 5ML Injection 6%
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    Phenol 5% in glycerin injection
    Restricted
    SFH: Specialist use only for nerve ablation.

    Restricted Drug Red View adult BNF  View SPC online  View childrens BNF
    Polatuzumab Vedotin
    Formulary

    Infusion - Unlicensed medicine: named patient use only

    Available at NUH only:

    • Approved in accordance with Early Access to Medicines Scheme (00031/0010) in combination with bendamustine and rituximab for the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) in adult patients who are not eligible for hematopoietic stem cell transplant.

    Red
    Pollinex Quattro®
    Restricted
    NUH only
    Injection - for moderate/severe rhinoconjunctivitis caused by tree and or grass pollens.
    Restricted to use by Allergy Department
    Link  Link to reviews
     

    Restricted Drug Red
    Polydimethylsiloxane
    Restricted

    SFH information only:

    • Can be ordered once divisional manager has approved
    • Bioplastique procedure kit (Vox®) for injecting into vocal cords

    Restricted Drug Red
    POTASSIUM ACETATE inj
    Formulary

    Unlicensed medicine - named patient use only


    Red
    POTASSIUM CANRENOATE Injection 200 mg in 10mL
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Potassium Chloride, Magnesium Sulfate, Calcium Chloride, Sodium Chloride and Glucose Intravenous Infusion
    Restricted
    Unlicensed medicine - named patient use only
    Note KCl 0.15% = 20mmol/Litre, 0.3% = 40mmol/Litre
    NUH only: Approved for paediatric oncology patients
    KCl 20mmol in 1000mL (20mmol/litre) with Magnesium sulfate 10mmol, Calcium chloride 0.6mmol, Dex 2.5% & NaCl 0.45%.

    Restricted Drug Red
    Pregnancy tests
    Restricted

    SFH information only: Wards/Clinics order direct from NHS supplies.


    Restricted Drug
    Prism0cal® B22
    Restricted

    5 litre bags

    Available at NUH only:

    • Approved for use on PICU for Continuous Renal Replacement Therapy (CRRT)

    Restricted Drug Red
    Prismocitrate® 18/0
    Restricted

    5 litre bags

    Available at NUH only:

    • Approved for use on PICU for Continuous Renal Replacement Therapy (CRRT)

    Restricted Drug Red
    Probiotic Actimel®
    Restricted

    Drink
    NUH only
    Restricted to prevent antibiotic associated diarrhoea and C.difficile infection in
    patients admitted to the elderly wards at QMC campus. 
    Not supplied by pharmacy.


    Restricted Drug Red
    PROCAINAMIDE Capsules 250 mg
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Propranolol
    Formulary
    Liquid
  • Nb the 3.75mg/ml strength of the oral solution (Hemangiol) is non formulary (no formal assessment) (APC, Sept14).
  • Link  SFH: Propranolol for Complicated Infantile Haemangioma guideline
     

    Amber 2
    PYRIDOXAL 5 PHOSPHATE
    Formulary

    Capsules 50mg

    Unlicensed medicine - named patient use only
    NUH only



    Quizartinib
    Restricted

    Tablet

    Available at NUH only:

    • Available in accordance with compassionate use scheme for relapsed/refractory FLT3-ITD positive AML.

    Restricted Drug Red
    Regadenoson
    Restricted
    Link  Link to reviews
     

    Restricted Drug Red
    Resuscitation trollies
    Restricted

    SFH information only:
    Available from MEMD
    -Contains:

    • Adrenaline 1:10,000 x 4
    • Amiodarone 300mg x 1
    • Calcium Chloride 10% /10ml x 1
    • Normal Saline flush (10ml) x 6
    • Adrenaline 1:1000 1mL amps x 10
      For further information of emergency boxes at SFH click here

    Restricted Drug
    RIBOFLAVIN Tablets
    Formulary

    Tablets

    Unlicensed medicine - named patient use only
    NUH only



    RIFAMPICIN 300mg inj
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    ROBINUL-NEOSTIGMINE inj (1ml)
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    SCHILLERS IODINE SOLN 200ml
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    SODIUM ACETATE 30% INJ 50ml
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    SODIUM ACETATE 40mmol/10ml inj
    Formulary
    Unlicensed medicine - named patient use only

    Red
    SODIUM CHLORIDE 600mg caps
    Formulary
    Unlicensed medicine - named patient use only
    NUH only
    See also entry for 600mg MR tablets



    SODIUM GLYCEROPHOSPHATE (10ML) Injection 21.6%
    Formulary
    Unlicensed medicine - named patient use only

    Red
    Sodium Hyaluronate Hyacyst®
    Restricted

    Bladder instillation
    NUH only


    Restricted Drug Red
    Sodium Hyaluronate 800mg/50mL (1.6%), Sodium Chondroitin Sulfate 1g/50mL (2%) iAluRil®
    Restricted
    Bladder instillation
    NUH only
    - used by urology: first line agent for recurrent UTIs, where the patient is not suitable for treatment using antimicrobial therapies, and as a 2nd line bladder instillation for painful bladders.

    Restricted Drug Red
    SODIUM PROPYL HYDROXYBENZOATE
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    SODIUM THIOSULFATE Injection
    Formulary
    Injection
  • 25% used in patients with renal failure calciphylaxis (NB: concentration change).
  • See poisoning section 18 for info on use as an antidote
  • Link  NUH: Renal Metabolic Bone Guidelines
     

    Red
    SPECTINOMYCIN Injection 2 g
    Formulary

    Unlicensed medicine - named patient use only

    • At SFH: One vial kept in GU med, one vial kept in pharmacy. Administration guidelines.
    • Available at NUH: On GU recommendation only - see restricted antimicrobials list   


    St Mark's solution
    Formulary
    • Not for prescribing in Primary Care.
    • Also known as rehydration salts or electrolyte mix.
    • Patients are advised to purchase the powders from community pharmacies and supermarkets, as it will often work out cheaper than paying for a prescription.
    • At SFH for inpatients, the solution should be prepared by the nurses on the ward per the ingredients and quantities listed on the UKMi document attached. (No St Mark on JAC)
    Link  UKMI Q&A: What is St Mark’s Electrolyte Mix (solution)?
     

    View adult BNF  View SPC online  View childrens BNF
    St Mark's solution
    Formulary
    • Not for prescribing in Primary Care.
    • Also known as rehydration salts or electrolyte mix.
    • Patients are advised to purchase the powders from community pharmacies and supermarkets, as it will often work out cheaper than paying for a prescription.
    • At SFH for inpatients, the solution should be prepared by the nurses on the ward per the ingredients and quantities listed on the UKMi document attached. (No St Mark on JAC)
    Link  UKMI Q&A: What is St Mark’s Electrolyte Mix (solution)?
     

    View adult BNF  View SPC online  View childrens BNF
    SUCRALFATE 2g/50ml enema
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    Sucrose 24% Sweat-Ease®
    Restricted
    Unlicensed medicine - named patient use only
    Restricted for neonatal use only
    Link  Link to reviews
    Link  SFH guideline for use in neonates
     

    Restricted Drug
    Sultiame 50mg tabs
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    TALC BP purified sterile  Steritalc®
    Formulary

    Unlicensed medicine. For pleurodesis.

    • 4g vial (for slurry instillation)
    • 3g poudrage kit with atomiser (for insufflation) (not routinely stocked at SFH but can be ordered)
    Link  SFH: Talc for pleurodesis on respiratory wards- Dose and Preparation procedure
    Link  BTS Pleural Disease Guidelines
    Link  UKMI Q&A: Admin of talc for pleurodesis
     

    Red
    Tamoxifen
    Formulary
    Link  Link to reviews
     

    Amber 3 View adult BNF  View SPC online  View childrens BNF
    Taurolodine and Citrate 4% TauroLock®
    Restricted
    Line Lock
    NUH only
    Restricted for prophylaxis of infection in chronic haemodialysis catheters in paediatrics and prophylaxis against catheter related bloodstream infections in parenteral nutrition patients.
    Link  Link to reviews
     

    Restricted Drug
    TETRAHYDROBIOPTERIN Tablets 10 mg
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

     HCD
    THALIDOMIDE Tablets 50 mg
    Formulary

    Unlicensed medicine - named patient use only
    NUH only
    See Chapter 8 for capsules


    Red
    THEOPHYLLINE liq 50mg/5ml
    Formulary
    Unlicensed medicine - named patient use only
    NUH only
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
     


    THIAMINE Injection 100 mg in 1mL
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    TICLOPIDINE 250mg tabs
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    Timolol topical
    Formulary
    0.5% ophthalmic gel (Timoptol LA®)
  • Specialist use only for the treatment of infantile haemangioma.
  • Usual dose is BD application to the whole of the haemangioma without occlusion. Usually used for approx 4 months but depends on response.
  • Link  Link to reviews
     

    Red
    TISOPURINE Tablets 100 mg
    Formulary
    Unlicensed medicine - named patient use only
  • At SFH, available under special circumstances via IDIS drug importers. Usual dose is 100mg od-qds. Further information available from Medicines Information


  • Tranexamic acid 8% in glycerin 20% nasal spray
    Formulary
    SFH: Only available on special order. Costs around £50 per 20ml bottle.

    Red View adult BNF
    TRANEXAMIC ACID Oral Solution 500 mg in 5mL
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    TRIAMCINOLONE ACETONIDE 0.1% in a protective emollient vehicle  Oracort®
    Restricted
    Dental Paste
    NUH only
    Restricted for use by the maxillo facial team

    Restricted Drug
    Trisodium Citrate 46.7%
    Restricted
    Line Lock
  • Restricted to renal use in patients with tunnelled venous catheters for venous catheters
  • Citra-Lock-S® brand used at NUH and SFH (once Duralock-C stock is exhausted)

  • Restricted Drug
    TROMETAMOL (THAM) 125ML Injection 3.6% (0.3M)
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    TROMETAMOL 0.3Molar (10.5ml) inj
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Trypan blue
    Restricted
    Injection
    SFH only
  • Previously used Vision blue

  • Restricted Drug Red
    UBIQUENONE 50mg VIT E 15iu/5ml Liq 10
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    Ultravist
    Formulary
    Injection
    SFH only

    Red
    Vacuum Pumps for Erectile Dysfunction
    Formulary
    - for patients with established erectile dysfunction who qualify for treatment under the SLS criteria
    , non-formulary - for patients who don’t qualify for treatment under the SLS criteria
    Link  Drug Tariff (see Part IXa - Appliances, Vacuum pumps)
    Link  Link to reviews
     


    VertebroplasticTM Cement
    Formulary
    NUH only
    For vertebroplasty, kyphoplasty and vertebral screw augmentation

    Red
    VITAMIN A (RETINYL PALMITATE) Injection 100,000 units in 2 mL VITAMINE A NEPALM
    Formulary
    Unlicensed medicine - named patient use only
    Injection
    NUH only

    Red
    Water for humidification
    Restricted
    SFH only
  • ITU only

  • Restricted Drug
    Whiteheads varnish
    Restricted
    Unlicensed product
    NUH Only: Restricted for Max Fax use.

    Restricted Drug Red
    YOHIMBINE Tablets 5.4 mg
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    ZINC COMPUND PASTE 500g
    Formulary
    Unlicensed medicine - named patient use only
    NUH only


    ZINC SULPHATE 1mmol in 10ml inj
    Formulary
    Unlicensed medicine - named patient use only
    NUH only

    Red
    Piperaquine with artenimol Eurartesim®
    Non Formulary
    Piperaquine with artenimol is not recommended for the first-line treatment of acute uncomplicated falciparum malaria because there is limited experience of its use in travellers who usually reside in areas where malaria is not endemic. Piperaquine has a long half-life.
    Tablets to be taken at least 3 hours before and at least 3 hours after food.
  • Tablets may be dispersed in water immediately before administration if needed. See here for general advice on dispersing tablets.
  • Link  Link to reviews
     

    View adult BNF  View SPC online  View childrens BNF
    Acetylcarnitine
    Non Formulary
    Unlicensed in the UK
    Link  UKMI Q&A: Oral treatments for treating Peyronie’s disease
     

    Grey View adult BNF  View SPC online  View childrens BNF
    ACETYLCYSTEINE
    Non Formulary
  • Previously used in the treatment of DIOS in CF (off-label usage). No new patients to be started. Existing patients will be reviewed by secondary care.
  • Link  Link to reviews
     

    Grey
    ACETYLCYSTEINE
    Non Formulary
  • Classified as GREY at APC May 2017 due to a lack of evidence of benefit. The Panther-IPF study found no significant improvements over placebo, but an increased rate of cardiac disorders with acetylcysteine.
  • Patients currently prescribed acetylcysteine for pulmonary fibrosis should be actively reviewed by secondary care.
  • Link  Link to reviews
     

    Grey
    Actipatch
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Adcon gel
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    ADEK vitamins
    Non Formulary
    Discontinued 2007

    Grey View adult BNF  View SPC online  View childrens BNF
    Adrenaline (epinephrine) inhaler  Primatene Mist®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Afamelanotide Scenesse®
    Non Formulary
  • An a-melanocyte-stimulating hormone analogue. Also known as melanotan I. Widely abused to obtain a cosmetic tan.
  • No formal assessment for other indications.

  • Grey View adult BNF  View SPC online  View childrens BNF
    ALUMINIUM ACETATE 8% or 13% ear drops
    Non Formulary
    July 2015: Only Tayside pharmaceuticals in Dundee make as a special, but £52 for 8%, and £47 for 13%.

    View adult BNF  View SPC online  View childrens BNF
    Aminolevulinic acid (PDT)
    Non Formulary
  • Unlicensed in the UK
  • Metvix now used for PDT at SFH

  • Grey View adult BNF  View SPC online  View childrens BNF
    ANTI-HUMAN THYMOCYTE GLOBULIN (HORSE) Inj 100 mg in 5mL
    Non Formulary
    No longer used for aplastic anaemia and GVHD post BMT as unavailable. Using rabbit ATG now see Thymoglobuline Unlicensed medicine - named patient use only

    Grey View adult BNF  View SPC online  View childrens BNF
    Antox tablets
    Non Formulary
    Previously called Bio-antox

    Grey View adult BNF  View SPC online  View childrens BNF
    Arthroplex®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Atopiclair
    Non Formulary
  • Classed as a Medical Device, not a drug.
  • Click here for independent reviews

  • Grey View adult BNF  View SPC online  View childrens BNF
    Autologous cartilage cells ChrondoCelect®
    Non Formulary
    No formal submission

    Grey View adult BNF  View SPC online  View childrens BNF
    AZATHIOPRINE Capsules 10 mg
    Non Formulary
  • Use licensed tablets or 50mg in 5ml suspension

  • Cytotoxic Drug  Grey View adult BNF  View SPC online  View childrens BNF
    BENZOCAINE 150mg/5ml susp
    Non Formulary
  • Use Antacid and Oxetacaine mixture instead

  • Grey View adult BNF  View SPC online  View childrens BNF
    Bicaflac®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Biclinocillin
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Biloptin
    Non Formulary
    Discontinued April 2004 by Schering Healthcare

    Grey View adult BNF  View SPC online  View childrens BNF
    BISOCODYL 0.274% rectal soln
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Blephaclean®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Blephagel®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Blephasol®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Boric acid ear solution
    Non Formulary
    • Unlicensed special Boric acid 2% in IMS 70% was previously made by non sterile manufacturing unit at SFH on a named patient basis. Now only an aqueous version is available manufactured by QMC specials.

    Grey View adult BNF  View SPC online  View childrens BNF
    CAFFEINE BASE 10mg/ml
    Non Formulary
    Unlicensed medicine - named patient use only
  • 10mg/ml strength no longer used at NUH- see above

  • Grey View adult BNF  View SPC online  View childrens BNF
    CAFFEINE CITRATE 20mg/ml INJ
    Non Formulary
    Unlicensed medicine - named patient use only
  • Licensed product of this strength now available (Peyona), but non-formulary. See above for alternative
  • Link  MHRA letter to healthcare professionals regarding caffeine citrate products
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Camphor/menthol/cajuput oil/clove oil Tiger Balm
    Non Formulary
    No formal assessment

    Grey View adult BNF  View SPC online  View childrens BNF
    Cannabis products for medicinal use
    Non Formulary
    • Cannabis products affected by the November 18 re-scheduling may only be prescribed legally by a clinician on the Specialist Register of the General Medical Council, prescribing within their own area of practice and training. More info.
    • Epidiolex® (unlicensed) is the product recommended by the British Paediatric Neurology Association.  Awaiting assesment pending discussion at Trust DTCs
    Link  NHS England info on cannabis for medicinal use
    Link  RCGP: GP guidance on cannabis-based products (Dec 2018)
    Link  UKMI Q & A- interactions with cannabis based medicinal products
    Link  UKMI Q & A-adverse effects & interactions with cannabidiol oil
     

    Grey View adult BNF  View SPC online  View childrens BNF
    CAPTOPRIL Tablets 2 mg
    Non Formulary
  • Was historically used in children prior to the availability of a suspension. Now use licensed suspension.

  • Grey View adult BNF  View SPC online  View childrens BNF
    CELESTINS ENDO-OESOPHAGEAL TUBE powder
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    CHLOROTHIAZIDE Tablets 500 mg
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Chondroitin
    Non Formulary
    Link  UKMI Q&A: Chondroitin - drug interactions?
    Link  UKMI Q&A: Chondroitin - what are the adverse effects?
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Cisapride
    Non Formulary
    Discontinued by company

    Grey View adult BNF  View SPC online  View childrens BNF
    Clevidipine
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    CODEINE PHOSPHATE Suppositories 15 mg,2mg,3mg,6mg
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Copper Histidine
    Non Formulary
    Injection
  • Unlicensed medicine

  • Grey View adult BNF  View SPC online  View childrens BNF
    DEFIBROTIDE Capsules 400 mg
    Non Formulary
  • IFR approval required before initiation
  • Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF  HCD
    Dexmedetomidine Paediatric
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    DHEA
    Non Formulary
    • Also known as prasterone.

    Grey View adult BNF  View SPC online  View childrens BNF
    DIAZEPAM Suspension 2.5 mg in 5mL
    Non Formulary
  • Use alternative strength. See other diazepam entries

  • Grey View adult BNF  View SPC online  View childrens BNF
    Diphenylcyclopropenone in acetone
    Non Formulary
    Unlicensed special
  • Also known as diphencyprone
  • Solution previously could be made by non sterile manufacturing unit at SFH, may be available on special order
  • Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Echinacea
    Non Formulary

    Of no proven value.

    • Sarcastic, amusing and educational review in podcast form. See episodes 2 and 18

     


    Grey View adult BNF  View SPC online  View childrens BNF
    Elastolabo®
    Non Formulary
    No formal submission APC May 2015

    Grey View adult BNF  View SPC online  View childrens BNF
    Eprodisate disodium
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Eptotermin Alfa  Osigraft®
    Non Formulary
    Discontinued July 2014
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF  HCD
    Factor Eight Inhibitor Bypassing Activity FEIBA
    Non Formulary
  • Not stocked at SFH. Contact Haematology for advice

  • Grey View adult BNF  View SPC online  View childrens BNF
    Fentanyl  Ionsys®
    Non Formulary
    Link  Link to reviews
     

    Controlled Drug  Grey View adult BNF  View SPC online  View childrens BNF
    Fentanyl and Suxamethonium pre drawn up kits
    Non Formulary
    Link  Link to reviews
     

    Controlled Drug  Grey View adult BNF  View SPC online  View childrens BNF
    Formaldehyde rectal solution
    Non Formulary
    SFH: For gastroenterologist use only for radiation proctitis.

    Grey View adult BNF  View SPC online  View childrens BNF
    Gamolenic Acid and Evening Primrose Oil
    Non Formulary
    • Unlicenced Evening Primrose oil which contains Gamolenic Acid is available to buy in pharmacies, health food shops and supermarkets for those wanting to take gamolenic acid as a dietary supplement

     

    • OTC Patients should be advised to purchase a suitable product over the counter


    Grey View adult BNF  View SPC online  View childrens BNF
    Glycerin
    Non Formulary
    Used to be used as a lubricant (£4 per bottle). Now use Aquagel (7p per sachet OR 60p per tube)

    Grey View adult BNF  View SPC online  View childrens BNF
    Glycerin and Ichthammol paste
    Non Formulary

     

     


    Grey View adult BNF  View SPC online  View childrens BNF
    GLYCERYL TRINITRATE Ointment 0.05%
    Non Formulary
  • Use licensed 0.4% product


  • Grey View adult BNF  View SPC online  View childrens BNF
    GLYCERYL TRINITRATE Ointment 0.2%
    Non Formulary
  • Use licensed 0.4% product

  • Link  Link to reviews
    Link  NICE Evidence summary: 0.2% glyceryl trinitrate ointment for chronic anal fissures
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Glycopyrronium tablets Hyperhidrosis
    Non Formulary
    No formal submission
    Link  Link to reviews
    Link  NICE Evidence Summary: glycopyrronium for hyperhidrosis
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Haemostatic Patch VerisetTM
    Non Formulary
    Patch

    Grey View adult BNF  View SPC online  View childrens BNF
    Hydroxyamphetamine 1% eye drops
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Hylo-Care eye drops
    Non Formulary
    No formal submission

    Grey View adult BNF  View SPC online  View childrens BNF
    Ibritumomab tiuxetan
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Injex needle free administration device
    Non Formulary
  • GREY non formulary
  • Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Insujet needle free administration device
    Non Formulary
  • No formal submission
  • Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Insulin devices - Needle free
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Iopamidol  Gastromiro®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    IOPANOIC ACID Tablets 500 mg
    Non Formulary
    Unlicensed medicine - named patient use only
  • Discontinued 2012 - NUH and SFHT unable to source an alternative

  • Grey View adult BNF  View SPC online  View childrens BNF
    Ixabepilone
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    KETANSERIN Injection 10 mg in 2mL
    Non Formulary

    Unlicensed medicine - named patient use only


    Grey
    Leicarbon A
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Lidocaine/adrenaline/tetracaine LATGEL®
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Lorcaserin
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Melagatran
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Mibefradil
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Miglustat
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    MONOCHLOROACETIC ACID SATURATED soln (5ml)
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Mucaine
    Non Formulary
    Discontinued- use antacid and oxetacaine

    Grey View adult BNF  View SPC online  View childrens BNF
    Naltrexone
    Non Formulary
    Unlicensed dosage and indication not achievable without prescribing expensive "specials"
  • No phase III clinical trials to establish efficacy or safety
  • Link  UKMI Q&A: Low dose naltrexone for MS
     

    Grey View adult BNF  View SPC online  View childrens BNF
    NeilMed Sinus Rinse
    Non Formulary
  • Appliance, not listed in drug tariff
  • NUH ENT use this product and advises patients to buy as OTC. GPs are not recommended to prescribe.

  • Grey View adult BNF  View SPC online  View childrens BNF
    Optison
    Non Formulary
    Withdrawn 2005

    Grey View adult BNF  View SPC online  View childrens BNF
    Orascreen
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Otovent®
    Non Formulary
    No formal assessement
    Link  UKMI review: Otovent for otitis media with effusion
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Oxepa
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Pegloticase Krystexxa
    Non Formulary
    Grey
  • Chronic gout, IV every 2 weeks
  • Link  Link to reviews
    Link  NICE: TA291 - Pegloticase not recommended for severe chronic gout
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Phenol liquified BP 80%
    Non Formulary

    April 2014 - Supply problem ongoing.

    • NUH and SFH theatres/clinics now use EZ swabs available from NHS Supplies.
    • NUH: liquified phenol (80% phenol) injection will no longer be stocked in the Trust (2009). Prescribers who used liquified phenol (80% phenol) for toenail ablation should prescribe:
    • Phenol EZ Swabs® - (Individually wrapped ampoules, containing 0.175-0.2ml Liquified Phenol USP 89%). The following areas will hold Phenol EZ Swabs® as stock:
      Theatre 3 QMC campus
      Theatre 8 & Day Surgery NCH campus
      Dermatology Treatment Centre

    Grey View adult BNF  View SPC online  View childrens BNF
    PICIBANIL 100mcg inj
    Non Formulary
    Unlicensed medicine - named patient use only
    Previously NUH only

    Grey
    PIRENZEPINE 50mg tabs
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Potassium hydroxide
    Non Formulary
    Unlicensed special - previously made in non sterile manufacturing unit at SFH

    Grey View adult BNF  View SPC online  View childrens BNF
    POTASSIUM IODIDE eye drops 5%
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Potassium Iodide solution
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Povidone-iodine 10 `/. in Boric acid insufflation
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Powerbreathe
    Non Formulary
  • Medical device for inspiratory muscle training. Patients should be encouraged to attend pulmonary rehabilitation
  • No formal submission
  • Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    PreOp®
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    PRILOCAINE (50ML) Injection 0.5%
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Prismocitrate
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    PROCHLORPERAZINE PR 25mg,5mg
    Non Formulary
  • No longer available in the UK

  • Grey View adult BNF  View SPC online  View childrens BNF
    Prontoderm Nasal gel
    Non Formulary
    See local MRSA policies for treatment options for MRSA decolonisation/ eradication
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Pyridoxine
    Non Formulary

    Awaiting submission for PMS


    Grey View adult BNF  View SPC online  View childrens BNF
    Non Formulary

    Grey
    RC cornet®
    Non Formulary
    Airway Clearance Device
  • not in drug tariff
  • non-formulary APC May 2014

  • Grey View adult BNF  View SPC online  View childrens BNF
    RESPeRATE®
    Non Formulary
  • Medical device marketed for hypertension
  • Insufficient evidence base and not recommended by the British Hypertension Society
  • Link  British Hypertension Society statement on RESPeRATE
    Link  Link to reviews
    Link  UKMi Update on New Devices - RESPeRATE May 2013
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Retapamulin ointment
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    SACCHAROMYCES BOULARDII 250mg caps
    Non Formulary
    Unlicensed medicine - named patient use only

    Grey View adult BNF  View SPC online  View childrens BNF
    Shaker
    Non Formulary
    Airway Clearance Device
  • not in drug tariff
  • non-formulary APC May 2014

  • Grey View adult BNF  View SPC online  View childrens BNF
    Sinurinse®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Sipuleucel- T
    Non Formulary
    No formal submission
    Link  NICE TA322: Sipuleucel-T for prostate cancer
     

    Grey View adult BNF  View SPC online  View childrens BNF  HCD
    Sodium hyaluronate Cystistat®
    Non Formulary
  • Rejected by the APC September 2013 due to lack of evidence for efficacy.
  • Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Sodium Hyaluronate SigmaviscTM
    Non Formulary

    Injection

    Previously available at NUH for Endoscopy use only: Non Pharmacy Item - order through NHS Supply Chain.

    Discontinued Product


    Grey View adult BNF  View SPC online  View childrens BNF
    Sodium hyaluronate injection SportVis®
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    St Johns Wort
    Non Formulary

     


    Grey View adult BNF  View SPC online  View childrens BNF
    STANOZOLOL 2mg tabs
    Non Formulary
    Unlicensed medicine - named patient use only
    Discontinued 2015


    Sterimar nasal douche
    Non Formulary
  • Patients should buy OTC if needed.

  • Grey View adult BNF  View SPC online  View childrens BNF
    Sulfapyridine
    Non Formulary
    Discontinued. Alternative is sulfamethoxypyridazine

    Grey View adult BNF  View SPC online  View childrens BNF
    SULPHAMETHOXYPYRIDAZINE tabs 500mg
    Non Formulary
  • Discontinued, and imported supplies do not appear to be available.

  • View adult BNF  View SPC online  View childrens BNF
    Tacrolimus
    Non Formulary
    0.05% in Ung Merck (over £100 a tube).

    Grey View adult BNF  View SPC online  View childrens BNF
    Taribavirin
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF  HCD
    TAUROLIDINE Solution 2 % (nebulised)
    Non Formulary
    Unlicensed medicine - named patient use only
  • Used as nebulised therapy in transplant patients with B.cepacia (unlicensed indication for unlicensed product)
  • Typical dose 2ml twice daily via nebuliser.
  • See Leeds guideline for possible use in CF.

  • Grey View adult BNF  View SPC online  View childrens BNF
    TheraBite®
    Non Formulary

    No formal assesment

    • Listed in drug tariff - Part IXA-Appliances

    Grey
    Tissue adhesive for epidural catheters
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Tolevamer
    Non Formulary

    Grey View adult BNF  View SPC online  View childrens BNF
    Treprostinil
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF  HCD
    Triamcinolone mouthwash
    Non Formulary
    Unlicensed special - previously could be made up in the non sterile manufaturing unit at SFH

    Grey View adult BNF  View SPC online  View childrens BNF
    UroLift system
    Non Formulary
    No formal assessment
    Link  NICE MTG26: UroLift for treating symptoms of BPH
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Vernakalant
    Non Formulary
    Link  Link to reviews
     

    Grey View adult BNF  View SPC online  View childrens BNF
    Vibro-Pulse®
    Non Formulary
    Device
  • Non-formulary Grey as per APC May 2014. See Midlands Medicines Review
  • Not NHS Device is not prescribable on FP10, but disposable covers which require changing for each new treatment are prescribable on FP10
  • Utilises cycloidal vibration (CV) therapy
  • Link  Link to reviews
    Link  Trent MI: Vibro-Pulse® for cellulitis and venous leg ulcers
     

    Grey
    VITAMIN A Drops 150000 international units in 1mL
    Non Formulary
    Unlicensed medicine - named patient use only.
  • Vitamin A is also known as retinol
  • Discontinued in country of origin 2016


  • Vitrimix®
    Non Formulary
    At SFH, all cases should be referred to a dietition/pharmacist for a TPN assessment

    Grey View adult BNF  View SPC online  View childrens BNF
    Warfarin Suspension 5 mg in 5mL
    Non Formulary
    Unlicensed medicine - named patient use only
  • licensed preparation now available

  • Grey View adult BNF  View SPC online  View childrens BNF
    Ximelagatran
    Non Formulary
  • Withdrawn from market Feb 2006

  • Grey View adult BNF  View SPC online  View childrens BNF
    XLS-medical fat binder Litramine
    Non Formulary
  • Medical device marketed as a fat binder. Contains Litramine and vitamins A, D and E.
  • Not prescribable (not listed in drug tariff)

  • Grey View adult BNF  View SPC online  View childrens BNF