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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 13: Skin - Full Chapter
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13.08.01  Expand sub section  Sunscreen preparations
 note 

  • Sunscreen preparations are regarded as drugs when prescribed for skin protection against ultraviolet radiation in abnormal cutaneous photosensitivity resulting from genetic disorders or photodermatoses, including vitiligo, those resulting from radiotherapy and chronic or recurrent herpes simplex labialis
  • Prescriptions used in this way should be marked "ACBS" (Advisory Committee on Borderline Substances)
  • 13.08.01  Expand sub section  Photodamage
    Cytotoxic Drug Actikerall®
    (Fluorouracil/ salicylic acid)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 3
    Cutaneous solution
  • For the treatment of actinic keratosis when prescribed in line with the Notts APC Solar Keratosis pathway  
  • Link  Actikerall patient Information Leaflet
    Link  Link to reviews
    Link  Solar Keratosis treatment guidance
       
    Cytotoxic Drug Fluorouracil (Efudix®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 3
    Cream 5%
  • For the treatment of actinic keratosis when prescribed in line with the Notts APC Solar Keratosis pathway  
  • Link  Solar Keratosis Efudix® Patient Information leaflet
    Link  Solar Keratosis treatment guidance
       
    Imiquimod  (Zyclara®)
    (Actinic Keratosis)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 3
    Cream 3.75%
  • For the treatment of actinic keratosis when prescribed in line with the Notts APC Solar Keratosis pathway  
  • Link  Link to reviews
       
    Methyl-5-Aminolevulinate (Metvix®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Cream
  • Red: Use in combination with photodynamic therapy in specialist centres 
  • Link  Link to reviews
       
     ....
     Non Formulary Items
    Betacarotene

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    • Not in adult BNF but is in Childrens BNF
    • Grey / Non-Formulary (no formal assessment)
     
    Diclofenac  (Solaraze®, Solacutan®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Ingenol mebutate  (Picato®)

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

    License suspended Feb 2020. MHRA information here

    Link  Ingenol patient information leaflet
    Link  Link to reviews
    Link  MHRA: Increased incidence of skin tumours seen in some clinical studies
     
      
    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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