| Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
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| 12.03.01 |
Drugs for oral ulceration and inflammation |
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Anaesthetic throat lozenges (Chloralieve®)
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Formulary
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Contains lidocaine.
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Antacid with Oxetacaine
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Formulary
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Mouthwash (unlicensed) - Named patient use only
Usual dose is 5-10ml slowly sipped and swallowed four times a day.
Not routinely stocked at SFH- usually takes 3 days for delivery.
SFH guide to all mouthcare products
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Benzydamine
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Formulary
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Oral rinse, Spray
- May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
- SFH guide to all mouthcare products
 Patients should be advised to purchase over the counter
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Betamethasone
(mouth ulcers)
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Formulary
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Soluble tablets
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Carmellose Sodium (Orabase®)
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Formulary
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Protective paste
SFH guide to all mouthcare products
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Choline Salicylate (Bonjela® Adult)
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Formulary
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Oral gel
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Patients should be advised to purchase over the counter
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May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
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NB: Bonjela Adult is suitable from 16 years only
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Doxycycline
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Formulary
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Dispersible tablet (unlicensed indication)
Disperse in water and use as a mouthwash
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Hydrocortisone (Corlan®)
(mouth ulcers)
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Formulary
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Pellets 2.5mg
SFH guide to all mouthcare products
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 MHRA (Dec18): Hydrocortisone muco-adhesive buccal tablets: should not be used off-label for adrenal insufficiency in children due to serious risks
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Lidocaine 10% mouth spray
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Formulary
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unlicensed indication
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Lidocaine 5% ointment
(mouth)
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Formulary
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15g tube (£5)
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Lidocaine and Chlorhexidine (Instillagel®)
(mouth)
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Formulary
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Contains Lidocaine 2%, Chlorhexidine 0.25%
- May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
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 MHRA alert: Anaphylaxis risk with chlorhexidine
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Lidocaine mouth gel (Teething Gel)
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Formulary
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- Lidocaine 1%, Chlorocresol 0.1% and Cetylpyridinium Chloride 0.02% (Anbesol teething gel)
- Lidocaine 0.33% and Cetylpyridinium Chloride 0.1% (Dentinox teething gel)
- Patients should be advised to purchase over the counter
- May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased
- SFH guide to all mouthcare products
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Caphosol®
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 Restricted
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Oral rinse, dispersible tablets
At SFH supplied from pharmacy.
Treatment of oral mucositis.
ONLY for oncology patients.
Relatively expensive - £35 per box of 30 (£1.14 per dose).
SFH guide to all mouthcare products
Patient information leaflet for caphosol tablets
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Gelclair®
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Restricted
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Oral gel - sachets (at SFH usually obtained through supplies rather than pharmacy, but Pharmacy may have stock)
Treatment of oral mucositis.
ONLY for oncology patients.
Relatively expensive - £40 per box of 21 (£2 per dose).
Classified as a medical device
SFH guide to all mouthcare products
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Glycerol dioleate (Episil®)
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Restricted
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Oral Spray
Treatment of oral mucositis.
ONLY for oncology patients.
£49.21 per 10mL (£0.75 per dose)
Classified as a medical device
Click here for independent reviews
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Lidocaine and Phenylephrine
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Restricted
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Spray- specialist use only
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| Non Formulary Items |
Benzocaine
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Non Formulary
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Cetylpyridinium, Chlrocresol, Lidocaine (Anbesol®)
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Non Formulary
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Liquid |
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Doxycycline (Periostat®)
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Non Formulary
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Flurbiprofen lozenge
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Non Formulary
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For relief of sore throat |
Link to reviews
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Salicylates - Salicylic acid (Pyralvex®)
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Non Formulary
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Triamcinolone Acetonide 0.1% in Adhesive Basis (Adcortyl in Orabase®)
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Non Formulary
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Oral paste
Discontinued December 2009) |
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
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Description |
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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.
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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.
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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.
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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
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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.
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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. |
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