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Nottinghamshire Area Prescribing Committee
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 Formulary Chapter 13: Skin - Full Chapter
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13.02.01  Expand sub section  Emollients
Epimax
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First Choice
Green

Cream (Easy squeeze 500g), Ointment (500g tub)

  • Epimax® ointment - First line option for severe dry skin as per Notts Emollient Formulary. Comparable to Hydromol®, Zeroderm®, Cetraben®, and Epaderm®.
  • Epimax® original cream - First line option for moderately dry skin as per Notts Emollient Formulary. Comparable to Zerobase®, Cetraben® and Diprobase®.
 
Liquid and White Soft Paraffin Ointment (50:50)
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First Choice
Green

Ointment (500g tub)

 
Emulsifying Ointment BP (Ovelle)
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First Choice
Green

Ointment

  • First line option for severe dry skin as per Notts Emollient Formulary.
  • Only the Ovelle® Emulsifying Ointment (£4.15 for 500g) is listed in the Drug Tariff (last checked Oct19). Prescribe by brand.
 
Epimax excetra cream
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First Choice
Green

Cream (Easy squeeze 500g)

  • First line option for moderately dry skin as per Notts Emollient Formulary.
  • Comparable to Diprobase® and Cetraben® cream. 
  • Recommended for additional use as soap substitute.
  • Previously called Excetra® cream.
 
Epimax isomol gel (Liquid paraffin 15%, isopropyl myristate 15%)
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First Choice
Green

Gel (Easy squeeze 500g)

  • First line option for moderately dry skin as per Notts Emollient Formulary.
  • Comparable to DoubleBase® gel. 
  • Previously called Isomol®.
 
ExoCream
First Choice
Green

Cream (500g pump dispenser)

OTC Patients with mild dry skin, who do not have a diagnosed dermatological condition or risk to skin integrity, should be advised to purchase a suitable product over the counter.

 
Zeroderm
Second Choice
Green

Ointment (500g tub)

  • Second line option for severe dry skin as per Notts Emollient Formulary.
  • First line options are Ovelle® emulsifying ointment, Epimax ointment and Liquid & white soft paraffin ointment (50:50).
  • Recommended for additional use as soap substitute.

 

 
   
Hydromol
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Second Choice
Green

Ointment (500g tub)

  • Second line option for severe dry skin as per Notts Emollient Formulary.
  • First line options are Ovelle® emulsifying ointment, Epimax ointment and Liquid & white soft paraffin ointment (50:50).
  • Recommended for additional use as soap substitute.

 

 
   
Zerobase 11% cream
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Second Choice
Green

Cream (500g pump dispenser)

  • Second line option for moderately dry skin as per Notts Emollient Formulary.
  • First line options are Epimax® and Excetra® creams.
  • Comparable to Diprobase® cream.
  • Recommended for additional use as soap substitute.
 
   
Zeroderm
Second Choice
Green

Ointment (500g tub)

  • Second line option for severe dry skin as per Notts Emollient Formulary.
  • First line options are Ovelle® emulsifying ointment, Epimax ointment and Liquid & white soft paraffin ointment (50:50).
  • Recommended for additional use as soap substitute.

 

 
   
AproDerm (Isopropyl myristate 15%, liquid paraffin 15%)
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Second Choice
Green

Gel

  • Second line option for moderately dry skin as per Notts Emollient Formulary.
  • First line option is Isomol® gel.
  • Comparable to DoubleBase® gel. 
 
   
Zerocream
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Second Choice
Green

Cream (500g pump dispenser)

OTC Patients with mild dry skin, who do not have a diagnosed dermatological condition or risk to skin integrity, should be advised to purchase a suitable product over the counter.

  • Second line option for mild dry skin as per Notts Emollient Formulary.
  • Comparable to Exocream® and E45® cream. 
  • Recommended for additional use as soap substitute.
 
   
AproDerm emollient
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Restricted Drug Restricted
Amber 3

Cream (500g pump dispenser)

  • Low paraffin (<20% paraffin) emollient
  • Paraffin free / low paraffin products should be reserved for patients who are intolerant/unsuitable for paraffin containing products due to increased fire hazard risks despite appropriate counselling. As per Nottinghamshire Emollient Formulary.
 
   
DoubleBase
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Third Choice
Green

Gel

 
   
Paraffin-free Emollient
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Restricted Drug Restricted
Amber 3

Ointment, Cream

  • Paraffin-free emollients should be reserved for patients who are intolerant/unsuitable for paraffin containing emollients due to increased fire hazard risks despite appropriate counselling. As per Nottinghamshire Emollient Formulary.
  • Paraffin free options:
    • Epimax® Paraffin-Free ointment
    • Aproderm® colloidal oat cream
 
   
Emollients containing Urea
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Formulary
Green

Cream

  • Emollients containing urea for severely dry skin as per Notts Emollient Formulary:
    • First line - Balneum® Plus Cream (100g tube) - also contains lauromacrogols. Use only if emollient alone has not helped itching.
  • Emollients containing urea for moderately dry skin as per Notts Emollient Formulary:
    • First line - ImuDERM® emollient. 5% urea (500g pump dispenser, CliniSupplies Ltd)
    • Second line - Hydromol® Intensive 10% urea cream (100g tube)
  • Eucerin® Intensive 10% urea lotion can be used if lotion required.
  • See separate entry for heel balm.
 
   
Dermol
(Emollient preparation with antimicrobials)
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Restricted Drug Restricted
Amber 3

Lotion, Cream (500g pump disenser)

  • Use in confirmed staphylococcal infection e.g. recurrent folliculitis and impetiginised eczema as per Notts Emollient Formulary
    • First choice - Dermol® 500 Lotion (less greasy than Dermol® cream)
    • Second choice - Dermol® Cream
 
   
Emollient Heel Balm
(Urea 25%)
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Restricted Drug Restricted
Amber 3

Balm 

  • For initial treatment of callused, fissured and hard foot skin as per Notts Emollient Formulary.
  • Any other emollient with low percentage urea can be used for maintenance following the treatment phase.
  • First line is Dermatonics ONCE Heel Balm®, 25% urea 
  • Second line is Flexitol 25% Urea Heel Balm®
 
   
Emollin
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Restricted Drug Restricted
Amber 3

Spray (240ml)

  • Only for patients unable to use ointment/creams/lotions, or where application without touching skin is required, as per Notts Emollient Formulary.
  • Highly Flammable
 
   
Oat based Emollient
Formulary
Green

Cream

OTC Patients with mild dry skin, who do not have a diagnosed dermatological condition or risk to skin integrity, should be advised to purchase a suitable product over the counter.

  • For mild dry skin as per Notts Emollient Formulary.
  • First line is Epimax® oatmeal cream (500g easy squeeze).
  • Second line is Zeroveen® cream (500g pump dispenser).
  • Epimax® oatmeal cream and Zeroveen® cream are additionally recommended for use as a soap substitute.
  • Comparable to Aveeno® cream
 
   
QV 5% skin lotion
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Formulary
Green

Lotion (500ml pump dispenser)

OTC Patients with mild dry skin, who do not have a diagnosed dermatological condition or risk to skin integrity, should be advised to purchase a suitable product over the counter.

 
   
Urea 5% Special Preparation
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Restricted Drug Restricted
Red
Cream
  • NUH:Restricted for ichthyosis
  • NUH:Manufactured by Pharmacy Non Sterile Production Unit (Unlicensed Product) 
  •    
    Yellow Soft Paraffin BP
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    Formulary
    Green

    Yellow petroleum jelly

    • Greasy level 4/4 (most greasy)
    • Not in Nottinghamshire emollient formulary. Use alternative if a leave on emollient is required -see formulary for options.
    • At SFH, obtained from NHS Supplies if needed for other uses eg for lips.
     
       
    13.02.01  Expand sub section  Emollients - preparations containing urea
    13.02.01.01  Expand sub section  Emollient bath and shower preparations
    Oilatum Plus
    (MRSA treatment)
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    Restricted Drug Restricted
    Red

    NUH only: In line with NUH MRSA policy, where Octenisan® is not appropriate.

     
       
     ....
     Non Formulary Items
    Aquadrate

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    Non Formulary
    Grey
    Cream
  • 10% urea
  • Removed from emolllient formulary Jan 2013
  •  
    Aquamax

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    Non Formulary
    Grey
    Cream
  • no formal assessment
  •  
    Aqueous Cream BP

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    Non Formulary
    Grey

    Cream

    • Agreed GREY non formulary for NEW PATIENTS (APC Jan 2020). Other creams available as soap substitutes and leave on emollients.
    • Aqueous cream may be associated with skin reactions (stinging, burning, itching and redness) when used as a 'leave-on' emollient, often within 20 minutes of application, and especially in children with atopic eczema. See MHRA Drug Safety update March 2013.
    • Do not use on eczema
    Link  MHRA: Fire Risk - Paraffin-based skin emollients on dressings or clothing
    Link  UKMI Q & A: Why aqueous cream is not recommended as a leave on moisturiser
     
    Aveeno Cream

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    Non Formulary
    Grey

    Cream

    OTC Patients with mild dry skin, who do not have a diagnosed dermatological condition or risk to skin integrity, should be advised to purchase a suitable product over the counter.

    • First line is Epimax® oatmeal cream (500g easy squeeze) as per Notts formulary 2019
    • Second line is Zeroveen® cream (500g pump dispenser)
     
    Cetraben

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    Non Formulary
    Grey

    Ointment, cream, lotion

     
    Diprobase

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    Non Formulary
    Grey
    • Removed from formulary Jan APC 2013  
    • First choice Epimax®, second choice Zerobase®
    • SFH: Can be used for existing patients where switching to Epimax or Zerobase is not acceptable to the patient.
     
    DoubleBase Dayleve

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    Non Formulary
    Grey
    No formal submission
     
    E45

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    Non Formulary
    Grey
    • Replaced with Exocream/Zerocream as per Notts emollient formulary
    • Can be used for existing patients if switching toExocream/Zerocream is not acceptable to the patient.
     
    Emollient Bath/Shower Additive

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    Non Formulary
    Grey
    • ALL bath and shower emollients should never be prescribed and are on the Nottinghamshire list of Medicines & Appliances of Limited Clinical Value.
    • Note that Oilatum® Plus is Red for MRSA treatment at NUH where Octenisan is not appropriate in line with NUH MRSA policy.
     
    Emollient preparation  (Decubal Clinic)

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    Non Formulary
    Grey
     
    Emollient preparation  (Dermamist)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (Drapolene)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (Epaderm)

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

    MHRA: Fire Risk - Paraffin-based skin emollients on dressings or clothing

     
    Emollient preparation  (Hewletts)

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    Non Formulary
    Grey
     
    Emollient preparation  (Kamillosan)

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    Non Formulary
    Grey
     
    Emollient preparation  (Keri)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (Linola Gamma)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (Lipobase)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (Neutogena Dermatological Cream)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (Ultrabase)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (Vaseline Dermacare)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (ZeroAQS)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation  (Zeroguent®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation containing Urea  (Calmurid)

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

    Cream

    Discontinued

     
    Emollient preparation containing Urea  (E45 Itch Relief Cream)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation containing Urea  (Nutraplus®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Emollient preparation with antimicrobials  (Eczmol)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Lanolin emollient spray
    (Evolve plus)

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

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Cream
     
    Proprietary Emollient Preparations  (Doublebase®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Skin Salvation Cream

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    No formal submission
     
    Unguentum M

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    Non Formulary
    Grey
    Cream
  • Greasy level 3/4
  • Removed from emollient formulary Jan 2013
  •  
    White Soft Paraffin BP

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

    White petroleum jelly

    • Greasy level 4/4 (most greasy)
    • Not in Nottinghamshire emollient formulary. Use alternative if a leave on emollient is required -see formulary for options.
    • At SFH if needed for other uses eg for lips, then use yellow soft paraffin, available from NHS supplies.
    Link  MHRA: Fire Risk - Paraffin-based skin emollients on dressings or clothing
     
    Zerodouble Gel

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Grey

    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.
      

    Red

    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.
      

    Amber 1

    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.
      

    Amber 2

    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
      

    Amber 3

    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.
      

    Green

    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.   

    OTC

      

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