Nottinghamshire Area Prescribing Committee Formulary


	Nottinghamshire Area Prescribing Committee Joint Formulary

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Formulary Chapter 13: Skin - Full Chapter

Chapter Links...

APC Psoriasis Guideline (Adults & Children)

Atopic Dermatitis Treatment Algorithm for High Cost Drugs

Psoriasis Treatment Algorithm for High Cost Drugs

Details...

13.10.04

Parasiticidal preparations

Benzyl Benzoate Application BP 25%

Formulary

Application

Less suitable for prescribing (BNF)

Not recommended for treatment of scabies in local guidance

Not recommended for children — dilution to reduce irritant effect also reduces efficacy. Some manufacturers recommend application to the body but to exclude the head and neck. However, application should be extended to the scalp, neck, face, and ears (BNF)

Cyclomethicone 50% / Isopropyl myristate 50% solution (Full Marks solution)

Formulary

Solution

physical insecticide
Not suitable for children younger than 2 years of age or people with skin conditions
Apply to dry hair, leave for 10 minutes. Comb through hair with comb provided to remove the remains of lice and eggs. Retreat 7 days later.
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

Dimeticone (Hedrin^®)

Formulary

Lotion 4%

a physical insecticide
First line for Pediculosis capitis (head lice) in pregnancy (licensed) if wet combing not suitable
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

Ivermectin

Restricted

Tablets 3 mg,6mg

Unlicensed medicine - named patient use only
Dermatology specialist only

Link to reviews

NICE Evidence summary: Ivermectin for difficult-to-treat scabies

Malathion 0.5% (Derbac-M^®)

Formulary

Aqueous solution 150mL

For crab lice, head lice, and scabies
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

Permethrin 5% (Lyclear^® Dermal Cream)

Formulary

Dermal Cream 30g (generic available)

Currently treatment of choice for therapy and prophylaxis of scabies and is safe in pregnancy and breast-feeding (unlicensed use)
see local guidance for information
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

Permethrin 1% (Lyclear^® Creme Rinse)

Restricted

Cream Rinse

Alcoholic solution
Less suitable for prescribing (BNF) - insufficient contact time therefore not recommended for head lice
Available if required for scabies patients requiring hair treatment in addition to rest of body
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

Anti-microbial Guidelines (Nottinghamshire Primary Care)

Head lice treatment in a breastfeeding mother? UKMI Q&A

MHRA: Risk of burns with head lice treatments if exposed to flames

Pubic lice treatment in a breastfeeding mother? UKMI Q&A

UKMI Q&A Hard to treat and crusted scabies treatment.

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Non Formulary Items

Phenothrin

Non Formulary

Discontinued

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG

Traffic Light Status Information

Status	Description
	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.