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 Formulary Chapter 16: Miscellaneous - Full Chapter
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16.01  Expand sub section  Other items
Autodrop® eye drop device
Formulary
Red

Available from SFH Pharmacy

  • For helping to line up the eye drop bottle with the eye. Does not help with bottle squeezing.
  • £4.40 each
  • See also Opticare below.
  • Patients to purchase own in community
 
Link  Autodrop patient leaflet
   
Opticare® eye drop delivery device
Formulary
Green
  • Available at SFH, and prescribable on FP10.
  • For helping to squeeze the bottle AND align with the eye.
  • Costs £5.50 each.
  • Patients to purchase own in community
 
Link  Opticare website
   
Phoxilium
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

5 litre bags

Available at NUH only:

  • Approved for use on PICU for use as a post-filter replacement fluid for children receiving Continuous Renal Replacement Therapy (CRRT)
 
Link  Link to reviews
   
Pressure offloading boot device (Kerraped®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Only to be prescribed if there is no alternative (such as a slipper or larger shoe) or if wounds are very heavily leaking and would ruin the patients footwear.

Ideally only to be prescribed following advice from Tissue Viability Nurse.

 
   
Urea Breath Test Kits
Formulary
Green
  • For testing H.Pylori status
  • CLOtest® no longer available.
  • Currently available tests: Infai® 75mg oral powder=£21.70 per test; Pylobactell® 100mg soluble tablet=£20.75 per test; Diabact® 50mg tabs=£21.25 per test.
 
   
 ....
 Non Formulary Items
Acupuncture

View adult BNF View SPC online View childrens BNF
Non Formulary
Grey
  • Wise words on acupuncture. (It's just a placebo - but 'a placebo' is different to 'nothing')
  • Is acupuncture just a theatrical placebo?
  •  
    Alternative medicines

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    There is no such thing as 'Alternative medicine'. Something either works or it doesn't. If any 'alternative medicine' is shown to work they become 'medicines'.
     
    Cranberry juice

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
  • 2016 trial: "For every woman who drank cranberry juice for 3.2 years, just one UTI would be prevented. That's a lot of cranberry juice."
  • 2005 review: In women at high risk for a UTI, over six months to a year of cranberry juice use:
    - 7 out of 10 women wouldn't have a urinary tract infection anyway
    - 2 out of 10 women will have a urinary tract infection anyway
    - 1 out of 10 women will not have a urinary tract infection because they used cranberry juice
  •  
    Grapefruit Juice

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Not a drug, but can raise levels of other drugs. Click here for a list.
     
    Herbal medicines

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    • Herbal treatments are on the Nottinghamshire list of Medicines & Appliances of Limited Clinical Value that should never be prescribed.
    • As a general rule, herbal products are poorly standardised, will have no evidence of efficacy (but will have a placebo effect), have unknown side effects and interactions, give false hope and cost money.
    Link  Banned and restricted herbal ingredients
    Link  Cancer chemotherapy patients and Herbal medicines review (UKMi Q&A)
    Link  General review of herbal products by Dr Ben Goldacre
    Link  Handling questions about herbal medicines (or dietary supplements) and conventional medicines
    Link  Herbal medicines in breastfeeding mothers- UKMI Q & A
    Link  Herbal medicines in patients undergoing surgery- UKMI Q&A
    Link  Is it safe to take herbal medicines during pregnancy?
    Link  Menopause: DTB review of herbal items
    Link  MHRA warnings on safety
    Link  Osteoarthritis: DTB review of herbal items
     
    Homeopathy

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    • On the Nottinghamshire list of Medicines & Appliances of Limited Clinical Value that should never be prescribed.
    • Not supported for any indication due to lack of evidence of efficacy.
    • Homeopathic 'medicines' are purely placebos.
    • Do not mix up with herbal products which are a completely different thing.
    Link  Adverse effects and drug interactions with homeopathic remedies
    Link  Audio summary of homeopathy (skeptoid.com)
    Link  Basic information on homeopathic medicines
    Link  Drug interactions with homeopathic remedies: UKMI Q&A
    Link  Nottinghamshire Position Statement on Prescribing of Homeopathic Medicines
     
    Peristeen transanal irrigation system

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

    No formal assessment

    Link  NICE Peristeen transanal irrigation system
     
    Volanesorsen Sodium  (Waylivra®)
    (injection)

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

    Solution for injection

    NUH are not a commissioned specialist centre for treatment. Patients will be referred to an appropriate specialist centre for treatment if required.

    • Approved in accordance with HST13 for treating familial chylomicronaemia syndrome at a commissioned specialist centre.
    Link  HST13: Volanesorsen for treating familial chylomicronaemia syndrome
     
      
    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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