Alternative to chloramphenicol for empirical treatment in people who: - Are pregnant. - Have a personal or family history of blood dyscrasias, such as aplastic anaemia. - Are intolerant of chloramphenicol. - Need a twice-a-day treatment for infective conjunctivitis See CKS topic for more information.
Jan 2016: price increased from £2 a tube to £35 a tube!
Red - if used for Acanthamoeba keratitis (specialist only)
Eye drops 5% (preservative free) - Special order, takes a few days to arrive at SFH.
Intravitreal injection: - NUH: 3mg in 0.3ml and 2mg in 0.2mL manufactured by Pharmacy Sterile Production Unit (Unlicensed Products - extra volume counts for dead space in the needle). - SFH: For guidance on Intravitreal preparations at SFHT see link below.
Discontinued in the UK 2004, but may be available as an import.
Azithromycin now available for chlamydia
Gentamicin single use (Minims® Gentamicin Sulphate)
Neomycin Eye drops
Polymyxin B Sulphate eye ointment (Polyfax®)
Discontinued March 2012
Alternative for Acanthamoeba keratitis is dibrompropamidine eye ointment (in conjunction with polihexanide 0.02% eye drops, propamidine isetionate 0.1%(Brolene) eye drops during the day and chlorhexidine 0.02% eye drops if not responding)
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Section Title (sub level)
First Choice item
Non Formulary section
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Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data. Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting. Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
Medicines which should normally be prescribed by specialists only. eg hospital only.
For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
*Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
Primary care/ non specialist may initiate as per APC guideline.
The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
Medicines suitable for routine use within primary care.
Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.