Formulary Chapter 20: Unlicensed Medicines / Significant off-label use - Full Chapter
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Chapter Links... |
UKMI Q&A: Where can I find free online information about pharmaceutical products licensed in other countries |
Details... |
20 |
Unlicensed Medicines |
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5-Aminolevulinic acid hydrochloride (Gliolan®)
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Formulary
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Powder for oral solution NUH only Fluorescence guided neurosurgery for high grade malignant brain tumours Authorised prescribers only Licensed product
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Acapella (Device)
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Formulary
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- For use by respiratory physiotherapists
- Oscillating positive expiratory pressure device for mucous clearance
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Link to reviews
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Acarizax
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Restricted
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Sublingual tablets - unlicensed medicine - named patient use only
Available at NUH only
- For treatment of house dust mite allergic rhinitis in patients aged 6 years and over.
- For use by Allergy Specialists only
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Acetarsol Suppositories
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Restricted
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Unlicensed medicine - named patient use only
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UKMI Q and A: Can acetarsol be used to treat proctitis
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Acetic acid 5% solution
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Formulary
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SFH: Available in: - 200ml non-sterile bottles (~£8) - 20ml sterile bottles (~£6)
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Acetic Acid Solution 3% (Endoscopy)
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Restricted
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NUH only: Unlicensed medicine - named patient use only. Restricted for use by endoscopy
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ACETYLCYSTEINE (Renal protection)
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Formulary
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Effervescent Tablets-600mg
- Little evidence of benefit for preventing contrast media induced nephropathy
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Link to reviews
SFH: Renal protection from contrast media information
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ACID CITRATE DEXTROSE (ACD)
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Restricted
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SFH only 500ml bags for cell salvage
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ADRENALINE 1:200,000 inj
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Restricted
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Unlicensed medicine - named patient use only NUH only
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ADRENALINE TOPICAL SOLUTION (1 in 1000)
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Restricted
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30ml bottle. Unlicensed medicine - named patient use only.
Unlicensed but listed in the Palliative Care Formulary for use on palliative care advice
SFH information only:
- For use as a haemostatic.
- Do not apply for long periods. See the Palliative Care Formulary (password needed) or discuss with Medicines information 3163.
- In an emergency 1 in 1000 (1mg/ml) ampoules can be used.
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Ajmaline
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Formulary
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Injection SFH only for the diagnosis of Brugada Syndrome
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SFH: Guide to ajmaline administration
Link to reviews
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ALTRETAMINE (HEXAMETHYLMELAMINE) Capsules 50 mg
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Restricted
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Unlicensed medicine - named patient use only NUH only Used for ovarian cancer
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ALUM Bladder Irrigation
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Restricted
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Unlicensed medicine - named patient use only NUH only For treatment of bladder haemorrhage Potash Alum Bladder Irrigation 10% is a concentrated solution and must be diluted to 1% before use
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NUH: Potash Alum Bladder Irrigation 10% 100ml information sheet
SFH: Potash Alum Bladder Irrigation 10% 100ml information sheet
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Aluminium Hydroxide
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Restricted
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Tablets (600mg) - NUH Only - Unlicensed medicine - named patient use only
- Prescribe and monitor as per phosphate binder guidance.
- Generally reserved for short term use in patients with severe and difficult to control hyperphosphataemia.
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AMANTADINE Injection 200 mg in 500mL
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Restricted
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Unlicensed medicine - named patient use only NUH only- restricted for chronic pain
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Amidotrizoates (Gastrografin®)
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Formulary
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- Contrast medium for gastrointestinal radiography
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Amoxicillin (Nebulised)
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Formulary
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SFH: All patients on nebulised antibiotics must be referred to a respiratory specialist nurse.
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SFH: Nebulised antibiotics guideline
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Amphotericin 500mg in 5ml oral soln
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Restricted
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Unlicensed medicine - named patient use only NUH only
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Anastrozole (Gynaecomastia)
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Formulary
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Link to reviews
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Aprotinin
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Restricted
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Unlicensed medicine - named patient use only 500,000 units/50ml Infusion Restricted to patients at high risk of major bleed during cardiac surgery NUH only
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Artesunate
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Restricted
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Injection
- Unlicensed medicine - named patient use only
- Treatment of severe and/or complicated malaria. See NUH guideline for the management of malaria.
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ASCORBIC ACID Injection 500 mg in 1mL
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Restricted
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Unlicensed medicine - named patient use only Manufacturer unable to supply JUNE 2011 NUH only
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ASPARAGINASE (MEDAC) Injection 10000 units
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Aspirin IV (ASPEGIC®) (Lysine Acetylsalicylate)
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Restricted
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Injection Unlicensed medicine (imported)- named patient use onlyRestricted to use in cardiac catheter lab for use during coronary interventionsRestricted to use by consultant neuroradiologists to prevent or treat device-related thrombus formation during procedures in interventional neuroradiology (for use in patients without prior antiplatelet medication, mainly patients with ruptured brain aneurysms)NUH only
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Benzbromarone
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Restricted
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Tablets 100mg. Unlicensed medicine - named patient use only At SFH:
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Benzoin Tincture, Compound, BP (Friars balsam)
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Formulary
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Tincture (unlicensed indication) Also known as Tinct. Benz. (Tincture of Benzoin) SFH: Used in max fax surgery to aid dressing adhesion.
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Betamethasone (injection - intraocular use)
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Formulary
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Unlicensed use
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BEVACIZUMAB 2.5mg/0.1ml syringe
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Restricted
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Unlicensed medicine - named patient use only NUH only for AMD
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BRILLIANT GREEN 1:500 soln
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Brincidofovir
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Restricted
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Tablets, Oral Suspension. Unlicensed medicine - named patient use only
Available at NUH only:
- Approved for adults in accordance with compassionate use scheme for adenovirus infection. Only on consultant decision with microbiology / virology input.
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Bupivacaine 0.1% ,fentanyl 2mcg/ml 50ml
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Caffeine Citrate
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Formulary
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Injection 5mg/ml BASE (10mg/ml caffeine citrate) Oral Solution 5mg/ml BASE (10mg/ml caffeine citrate) Prescribe as "caffeine citrate" (see MHRA warning below). Unlicensed medicine - named patient use only Licensed product of higher strength Peyona = non-formulary
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NUH Neonatal monograph
NUH: Use of caffeine in apnoea of prematurity guideline
Link to reviews
MHRA Drug Safety Update (Aug 13): Caffeine for apnoea of prematurity: all products to be named and prescribed as caffeine citrate
MHRA: safe use of caffeine citrate
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Calcium carbonate (Phosphate binder)
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Formulary
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250mg dispersible tablets, unlicensed special 10% suspension, unlicensed special, manufactured at NUH 500mg chewable tablets (Tums®) For use in hyperphosphataemia of chronic kidney disease in paediatric patients Phosphate binder, started by paediatric nephrology
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CALCIUM CHLORIDE 14.7% 50ml,100ml
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Formulary
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Unlicensed medicine - named patient use only NUH only
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CALCIUM GLUCONATE 10% 50ml,100ml
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Calcium sulfate (Stimulan® Rapid Cure)
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Restricted
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- Medical Device
- Calcium matrix powder and mixing solution - when mixed the resultant paste is used to make biodegradable, radiopaque beads.
- NUH only - microbiology input required regarding the choice of antibiotic required to be mixed with the paste. Restricted to use by the foot and ankle service for diabetic ulcers with underlying osteomyelitis.
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Carbex granules
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Restricted
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SFH only Used by x-ray
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CARNOY'S soln 100ml
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Restricted
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Unlicensed medicine - named patient use only NUH only Used post enucleation of keratocystic odontogenic tumours and certain types of unicystic ameloblastoma
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Cidofovir ointment
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Restricted
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Ointment 1%
- Available at NUH only
Restricted for severe viral warts or molluscum contagiosum secondary to immunosuppression, unresponsive to standard therapy.
- Manufactured by Pharmacy Non Sterile Production Unit (Unlicensed Product)
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CoaguChek XS PT Test strips (for INR testing)
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Restricted
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Amber 2 - specialist recommendation - restricted to patients who have been assessed as suitable for near patient testing by an anticoagulation clinic. Each box contains 24 strips. This is expected to last a patient in excess of 1 year based on average testing frequency. Patients should be advised not to invest in a meter before they have spoken to the anticoagulation clinic CoaguChek meters will not be provided on the NHS - not funded
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COAL TAR BP 20% in YSP
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Constrictor rings for erectile dysfunction
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Formulary
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Amber 2 - for the patients that meet SLS criteria Grey, non-formulary - if patient does not meet the SLS criteria (see drug tariff for details)
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Drug Tariff (see Part IXa - Appliances, Vacuum pumps)
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Crystal Violet
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Formulary
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Unlicensed medicine - named patient use only NUH only Staining Agent used during endoscopy and colonoscopy.
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CYCLOPHOSPHAMIDE (Respiratory)
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Restricted
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Unlicensed medicine - named patient use only SFH only
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Cyclophosphamide - Regional guideline for the use of IV Cyclophosphamide in auto-immune disorders (East Mids Rheumatology Autoimmune Network - Dec 2017)
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DAUNORUBICIN saline pre-filled syringe
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Formulary
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NUH only Unlicensed medicine - named patient use only For use only after IFR approval 10mg/10ml, 20mg/20ml, 30mg/30ml
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DEPIGMENTING CREAM (Pigmanorm®)
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Restricted
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Unlicensed medicine - named patient use only Contains Hydroquinone, Tretinoin, Hydrocortisone NUH and Treatment Centre use only For dermatologist and burns specialist use only Non formulary at SFH
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Dexamethasone eye injection
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Restricted
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Unlicensed indication SFH only Intravitreal dose is 0.4mg in 0.1ml - i.e. use the injection neat. (Moorfields handbook) Subconjunctival dose is 2mg in 0.5ml - i.e. use the injection neat. (Moorfields handbook) Use the DBL brand (Hospira, Faulding or Mayne are the same) of dexamethasone as it has no preservatives.
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Dexmedetomidine - Paediatric Use (Intranasal)
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Restricted
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Injection to be used intranasally using nasal atomiser (unlicensed use - named patient only)
Available at NUH only:
- Approved intranasally to provide sedation for children receiving intrathecal administration of nusinersen for Spinal Muscular Atrophy (SMA) – see guideline
For intravenous use in adult Critical Care patients, see formulary entry for dexmedetomidine (section 15.01.04.04)
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Link to reviews
NUH Guideline - Use of Intranasal Dexmedetomidine to Sedate Children Receiving Nusinersen by Intrathecal Injection
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Dialyvit®
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Restricted
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Tablet (Unlicensed medicine - named patient use only) NUH only Restricted for paediatric renal use - paediatric formulation of Dialyvit® has been discontinued (2015)
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Dibotermin Alfa, rhBMP-2 (Inductos®)
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Formulary
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Kit for implant 12mg NUH only Currently suspended in the EU. Further information here Use for spinal surgery is commissioned as per NHS England commissioning policy 16063/P Use for any other indication is not routinely commissioned and requires funding approval from the responsible commissioner
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NHS England Commissioning Policy 16063/P
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DIDANOSINE Liquid 10mg in 1ml (after double dilution)
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Formulary
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Unlicensed medicine - named patient use only NUH only
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DIHYDROERGOTAMINE Injection 1 mg in 1mL
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Formulary
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Unlicensed medicine - named patient use only NUH only
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DILUENT A (XANTHAN GUM 1%) Suspension 1%
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Formulary
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Unlicensed medicine - named patient use only NUH only
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DILUENT C susp CAROB BEAN GUM 1% 500ml
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Formulary
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Unlicensed medicine - named patient use only NUH only
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DIMETHYL SULFOXIDE (Extravasation)
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Restricted
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Unlicensed medicine - named patient use only SFH only
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DITHRANOL 0.1% /0.25%,0.5%,1%,2%,4%in lassars paste
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Domperidone (Lactation stimulation)
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Formulary
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Tablet Off label indication. May be considered if benefits outweigh risks when other breastfeeding management techniques (regular feeding/ expressing, attachment optimisation) have failed. Standard letter (print on headed paper) to accompany requests to prescribe.
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Link to reviews
MHRA: Domperidone no longer available without prescription (Sept 14)
The Breastfeeding Network domperidone information
UKMI Q&A: Domperidone / metoclopramide for lactation stimulation
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DOXYCYCLINE Injection 100 mg in 5mL
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Restricted
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Unlicensed medicine - named patient use only
Available at NUH only:
- Restricted antibiotic for pelvic inflammatory disease: see local guidelines [NUH guideline]
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ETHIONAMIDE Tablets 250 mg
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Formulary
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Unlicensed medicine - named patient use only NUH only
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EVEROLIMUS Tablets 250 micrograms,750 micrograms
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Formulary
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Unlicensed medicine - named patient use only NUH only
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FERRIC SUBSULPHATE (monsel's soln)
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Formulary
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Unlicensed special, 50ml bottle £22. Used intravaginally as a haemostatic. Does not need to be sterile so product can be decanted and the bottle reused until its expiry date.
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Fibrin Sealant (Evicel®)
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Restricted
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Evicel Kit NUH only
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Haemostatic Agents at NUH
MHRA Feb 2013: updated guidance on minimising risk of life-threatening and fatal air embolism
Urgent Product Information - Risk of life-threatening air or gas embolism (Dec12 letter)
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Fibrin Sealant (Tisseel®)
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Restricted
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Ready to use syringe NUH only
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MHRA: Risk of air embolism with fibrin sealants (Feb 2013)
Haemostatic Agents at NUH
Tisseel product information
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FLUNARIZINE 5mg capsules
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Link to reviews
NICE Unlicensed Evidence summary: Flunarizine for migraine prophylaxis
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Flutter (Device)
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Formulary
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For use by respiratory physiotherapists Oscillating positive expiratory pressure device for mucous clearance
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Link to reviews
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GABAPENTIN 6% topical
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Restricted
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Unlicensed medicine - named patient use only NUH only Topical preparation for treatment of vulvodynia. Restricted to pain team and gynaecology specialists.
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Gas Gangrene Antitoxin
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Formulary
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Injection 2500 units in 1 mL Unlicensed medicine - named patient use only NUH only Not for administration to humans. Used for calibrating assays. Only available via NIBSC website.
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NUH Pharmacy: Rare antitoxins and immunoglobulins
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Giving sets (IV)
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Formulary
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At SFH and NUH, IV giving sets do not come from pharmacy
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Giving sets (NG)
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Formulary
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At SFH, only the following giving sets come from Pharmacy: Flocare infinity pack set – currently keep stock in pharmacy & on wards Flocare universal (with med port) set Flocare NG feeding tube – currently keep stock in pharmacy & on wards
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GLIADEL wafer Carmustine 7.6mg
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Formulary
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Unlicensed medicine - named patient use only NUH only
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NICE TA121: Glioma - carmustine implants and temozolomide
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GLYCEROL STERILE 30ml
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Formulary
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NUH only: Unlicensed medicine - named patient use only
- No longer stocked at SFH - podiatry to purchase own non-sterile version from NHS Supplies.
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Glycopyrrolate 0.5% topical solution
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Formulary
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- SFH information only: Unlicensed Special. Obtain supplies from SFH Pharmacy rather than FP10HP.
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Glycopyrronium 1% in Unguentum Merck
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Formulary
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SFH info: Dermatology use only
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Haemostatic Agent (Quikclot®)
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Restricted
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Gauze ENT nasal gauze is non formulary
- Consultant use only- Restricted for use in life threatening haemorrhage
- At SFH, discuss with Dr Tim Moorby, Consultant Haematologist.
- Click here for the website
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Haemostatic Agent (Floseal®)
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Restricted
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Haemostatic Matrix NUH only Also approved for NUH ENT specialist use only for the treatment of epistaxis in accordance with local guideline.
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Haemostatic Agents at NUH
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Haemostatic Agent (PuraStat®)
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Restricted
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Gel (1ml and 3ml syringes) NUH only: Approved for the management of bleeding during endoscopic procedures following either sphincterotomy in ERCP, EMR, ESD and when treated for Upper GI bleed. Non pharmacy item, supplied through NHS supplies
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Haemostatic Agent (Surgiflo® with thrombin)
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Formulary
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Haemostatic Matrix
Available at NUH only for surgical procedures. (Surgery division approved specialties only, excluding ophthalmology.)
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Haemostatic Agent (Tachosil®)
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Restricted
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Medicated sponge - used in liver surgery NUH only
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Haemostatic Agents at NUH
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Haemostatic Agent (Willospon®)
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Formulary
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Gelatine sponge - Anal Tampon NUH only For local haemostasis in surgical procedures
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HYDROCHLOROTHIAZIDE
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Formulary
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NUH only Tablet 25mg used for neonatal suspension. Unlicensed.
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MHRA: risk of non-melanoma skin cancer with hydrochlorothiazide
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Hydroquinidine
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Restricted
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MR Capsule Unlicensed medicine - named patient use only
- Available at NUH only for cardiac rhythm disorders on the recommendation of a specialist consultant cardiac physiologist.
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HYDROXYPROGESTERONE 260mg/ml inj
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Icodextrin solution (Adept®)
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Formulary
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- At SFH approved only for patients undergoing laparoscopic gynaecological surgery with a previous history of adhesion formation or those at high risk of adhesions.
- Click here for independent reviews
- Manufacturers information sheet
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Link to reviews
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i-FACTORTM
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Restricted
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Peptide Enhanced Bone Graft NUH only Approved for use in spinal fusion Supplied by Theatre Stores
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Indigo carmine
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Formulary
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SFH: -0.8% sterile solution for use in endoscopy during EMR procedures. Supplied by Pharmacy. -Non-sterile solution used as a mucosal dye spray in endoscopic procedures. Obtained through supplies rather than pharmacy. NUH: 0.8% sterile injection for use in endoscopy. Supplied by Pharmacy.
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Iohexol (Omnipaque®)
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Formulary
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SFH: '140' is used in Endoscopy for ERCP '300' no longer used orally as a bowel contrast in CT colonography as didn't perform as expected
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Link to manufacturer SPC (datasheet)
Link to review
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Iopamidol (Niopam®)
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Formulary
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Injection
- Radiographic contrast medium
- licensed medicinal product
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Joulies Oral Solution (phosphate supplementation)
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Restricted
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Oral Solution Unlicensed medicine - named patient use only
NUH only: For oral phosphate supplementation in paediatric nephrology where potassium phosphate is contraindicated
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Lactose powder
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Formulary
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For hydrogen breath tests in endoscopy.
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LAT gel
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Formulary
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Gel (unlicensed) SFH only. For use when cleaning/ suturing wounds in children in ED Contains lidocaine 4%, adrenaline 0.1% and tetracaine 0.5%
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LEVAMISOLE Tablets 50 mg
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Formulary
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Unlicensed medicine - named patient use only
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Medicines for children leaflet: Levamisole for nephrotic syndrome
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Levosimendan (Simdax®)
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Restricted
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Unlicensed medicine - named patient use only Injection - 12.5mg/5mL
SFH: Not approved for use NUH only: Post cardiac surgery as per guideline.
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NUH: Guidelines for the use of levosimendan following cardiac surgery
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Lipiodol
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Formulary
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Historically used during endoscopy in conjunction with cyanoacryalate glue.
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LIQUID PARAFFIN sterile light (20mL or 25ml)
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Formulary
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Unlicensed medicine - named patient use only
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LITHIUM CHLORIDE (For LIDCO calibration)
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Restricted
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SFH information only:
- For calibration of the ICCU LiDCO machine which is used to monitor cardiac output
- Usual prescription is "Lithium chloride injection (0.15mmol/ml): 2ml (0.3mmol) IV PRN"
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LITMUS PAPER
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Restricted
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SFH information only:
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Lubricating gel
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Formulary
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Available in 5g sachets and 42g tubes
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MAGNESIUM GLYCEROPHOSPHATE powder 350g
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Link to reviews
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MAGNESIUM SULPHATE 10% INFUSION
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Formulary
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Unlicensed medicine - named patient use only NUH only See Chapter 9 for other parenteral magnesium preparations
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Mannitol (Osmohale®)
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Formulary
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Inhalation powder (supplied in hard capsules)
For use in respiratory clinic for diagnosis.
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Link to reviews
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Methacholine solutions various strengths (Methylcholine, Acetyl-β-methylcholine)
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Formulary
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Unlicensed medicine - named patient use only NUH only Inhalation of nebulised solutions of methacholine chloride are used to provoke bronchoconstriction in the diagnosis of bronchial airway hypersensitivity
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METHOCEL 2% eye drops
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Formulary
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Unlicensed medicine - named patient use only NUH only
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METHOTREXATE (Ectopic pregnancy)
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Restricted
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Unlicensed medicine - named patient use only
- Dose is 50mg per square metre given intramuscularly (SFH: See dose calculator)
- At NUH: Pre-filled syringes stocked in pharmacy - contact pharmacy to arrange a supply. Pharmacy procedure available. Prescribe using dedicated drug chart.
- At SFH: Supplied from the Aseptic Dispensing Unit (ADU) - contact your ward pharmacist or send the prescription to Pharmacy (between 9-4pm). Full guideline here.
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NUH: Ectopic pregnancy guideline
SFH: Ectopic pregnancy guideline
SFH: Methotrexate dose calculator
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Methylthioninium chloride (Aguettant®) (visualisation / staining)
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Restricted
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SFH: 1ml 1% for enteral use (not for IV)(unlicensed) (See here for the intravenous product.)
- Also known as 'methylene blue'.
- Aguettant® available for visualisation (staining)(approx £20 each). Click here for SPC or basic guide.
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Memo: Change in Diluent
MHRA safety update April 2009
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Miltefosine
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Restricted
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Unlicensed medicine - named patient use only Capsule NUH only Restricted for treatment of various forms of leishmaniasis
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MORPHINE 40mg/ml inj pfs
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Formulary
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Unlicensed medicine - named patient use only NUH only
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MORPHINE 50mg/50ml syringe
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Formulary
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Unlicensed medicine - named patient use only NUH only
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Morphine epidural 2mg in 10ml
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Formulary
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Mydricaine
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Formulary
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Unlicensed supply available. - Number 1 (for children)(not routinely stocked at SFH) - Number 2 (for adults) Contents and more info.
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Nifedipine (tocolytic)
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Formulary
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Available as: Capsules (normal release) and MR tablets (slow release)
- Normal release capsules now available again (Oct 2019)
- APOSTLE III trial used 20 mg nifedipine (two 10 mg capsules) orally in the first hour, followed by 20 mg slow-release nifedipine per 6 h for the next 47hr.
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APOSTEL III Trial (2016): Nifedipine vs atosiban for threatened preterm birth
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Nifedipine (Immediate release capsules) (for Raynaud's)
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Formulary
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Capsules 5mg & 10mg
- Available again Oct 2019.
- Immediate release capsules for Raynaud's if MR tablets do not work well enough.
- Much more expensive than MR tablets (~£80 vs ~£5pm).
- Capsules have more side effects than MR tablets. See prescribing advice on CKS.
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Nitazoxanide
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Restricted
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Available as tablets or suspension.
- Unlicensed medicine - named patient use only.
- Available at NUH only for treating various intestinal parasites including cryptosporidiosis on recommendation of microbiology or infectious diseases. In tariff. Prolonged or repeat courses should seek one-off request approval.
HCD Excluded from tariff for the treatment of Hepatitis C, but Individual Funding Request must be completed prior to prescribing.
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Octenisan® (Wash, Nasal Gel, Mitts, Shower Caps)
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Formulary
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- At SFH nasal gel and wash to be used in line with MRSA policy for prophylaxis in high risk group patients. Patient information leaflets and stickers available from Infection Control.
- At NUH wash to be used in line with Infection Control recommendations. First line for MRSA decolonisation. Chlorhexidine second line in those unable to use Octenisan.
- Nasal gel available 3rd line (after Bactroban and Naseptin) for patients requiring decolonization. Nasal gel approved for use in critical care during Bactroban supply problem.
- Wash Mitts and Shower Caps may be used in community patients unable to use the standard wash on the advice of infection control (APC Sept 14).
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Link to reviews
NUH Octenisan wash poster
SFH: Prevention against MRSA skin carriage for high risk patients
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ORA-PLUS ORAL SUSPENDING VEHICLE
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Formulary
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Unlicensed medicine - named patient use only NUH only
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OXANDROLONE
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Restricted
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Unlicensed medicine - named patient use only Tablets 2.5mg NUH only for the management of patients with severe burns in adult critical care and the adult burns unit.
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Link to reviews
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Oxitriptan (5-hydroxytryptophan)
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Restricted
|
Unlicensed medicine - named patient use only Capsules 10mg or 20mg
- Used for Phenylketonuria caused by a deficiency of tetrahydrobiopterin. Treatment involves oral supplementation of tetrahydrobiopterin; in some severe cases, the addition of the neurotransmitter precursors, levodopa and 5-hydroxytryptophan, are also necessary
For adults under the care of a tertiary metabolic centre.
For paediatric patients, service delivered through NUH.
|
|
PAPAVERINE HYDROCHLORIDE (2ML AMPOULE) Inj 40 mg in 1mL
|
Formulary
|
Unlicensed medicine - named patient use only At SFH Rarely used in theatres for extravasation and blood vessel spasms and rarely used in cardiac catheter suite as an alternative to adenosine.
|
|
PAROMOMYCIN Tablets 250 mg
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
PATENT BLUE Injection 2.5%
|
Formulary
|
Unlicensed medicine - named patient use. Translation of French SPC MHRA warning of allergies - Feb 2012
|
|
PENICILLIN SKIN TEST KIT
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
pH indicator paper
|
Restricted
|
- SFH information only: Test strips [see photo] with range 2-9 are used for testing NG tube placement. pH 5.5 or below indicates gastric contents. See nursing procedure.
|
|
PHENOL (AQUEOUS) 5ML Injection 6%
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
Phenol 5% in glycerin injection
|
Restricted
|
SFH: Specialist use only for nerve ablation.
|
|
Pollinex Quattro®
|
Restricted
|
NUH only Injection - for moderate/severe rhinoconjunctivitis caused by tree and or grass pollens. Restricted to use by Allergy Department
|
Link to reviews
|
Polydimethylsiloxane (Bioplastique)
|
Restricted
|
SFH information only:
- Can be ordered once divisional manager has approved
- Bioplastique procedure kit (Vox®) for injecting into vocal cords
|
|
POTASSIUM ACETATE inj
|
Formulary
|
Unlicensed medicine - named patient use only
|
|
POTASSIUM CANRENOATE Injection 200 mg in 10mL
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
Potassium Chloride, Magnesium Sulfate, Calcium Chloride, Sodium Chloride and Glucose Intravenous Infusion
|
Restricted
|
Unlicensed medicine - named patient use only Note KCl 0.15% = 20mmol/Litre, 0.3% = 40mmol/Litre NUH only: Approved for paediatric oncology patients KCl 20mmol in 1000mL (20mmol/litre) with Magnesium sulfate 10mmol, Calcium chloride 0.6mmol, Dex 2.5% & NaCl 0.45%.
|
|
Pregnancy tests
|
Restricted
|
SFH information only: Wards/Clinics order direct from NHS supplies.
|
|
Prism0cal® B22
|
Restricted
|
5 litre bags
Available at NUH only:
- Approved for use on PICU for Continuous Renal Replacement Therapy (CRRT)
|
|
Prismocitrate® 18/0
|
Restricted
|
5 litre bags
Available at NUH only:
- Approved for use on PICU for Continuous Renal Replacement Therapy (CRRT)
|
|
Probiotic (Actimel®)
|
Restricted
|
Drink NUH only Restricted to prevent antibiotic associated diarrhoea and C.difficile infection in patients admitted to the elderly wards at QMC campus. Not supplied by pharmacy.
|
|
PROCAINAMIDE Capsules 250 mg
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
Propranolol (Haemangioma)
|
Formulary
|
Liquid Nb the 3.75mg/ml strength of the oral solution (Hemangiol) is non formulary (no formal assessment) (APC, Sept14).
|
SFH: Propranolol for Complicated Infantile Haemangioma guideline
|
PYRIDOXAL 5 PHOSPHATE
|
Formulary
|
Capsules 50mg
Unlicensed medicine - named patient use only NUH only
|
|
Quinidine
|
Formulary
|
- Unlicensed medicine.
- For use at SFH by cardiology consultant only.
|
|
Quizartinib
|
Restricted
|
Tablet
Available at NUH only:
- Available in accordance with compassionate use scheme for relapsed/refractory FLT3-ITD positive AML.
|
|
Regadenoson
|
Restricted
|
|
Link to reviews
|
Resuscitation trollies
|
Restricted
|
SFH information only: Available from MEMD -Contains:
- Adrenaline 1:10,000 x 4
- Amiodarone 300mg x 1
- Calcium Chloride 10% /10ml x 1
- Normal Saline flush (10ml) x 6
- Adrenaline 1:1000 1mL amps x 10
For further information of emergency boxes at SFH click here
|
|
RIBOFLAVIN Tablets
|
Formulary
|
Tablets
Unlicensed medicine - named patient use only NUH only
|
|
RIFAMPICIN 300mg inj
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
ROBINUL-NEOSTIGMINE inj (1ml)
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
SCHILLERS IODINE SOLN 200ml
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
SODIUM ACETATE 30% INJ 50ml
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
SODIUM ACETATE 40mmol/10ml inj
|
Formulary
|
Unlicensed medicine - named patient use only
|
|
SODIUM CHLORIDE 600mg caps
|
Formulary
|
Unlicensed medicine - named patient use only NUH only See also entry for 600mg MR tablets
|
|
SODIUM GLYCEROPHOSPHATE (10ML) Injection 21.6%
|
Formulary
|
Unlicensed medicine - named patient use only
|
|
Sodium Hyaluronate (Hyacyst®)
|
Restricted
|
Bladder instillation NUH only
|
|
Sodium Hyaluronate 800mg/50mL (1.6%), Sodium Chondroitin Sulfate 1g/50mL (2%) (iAluRil®)
|
Restricted
|
Bladder instillation NUH only - used by urology: first line agent for recurrent UTIs, where the patient is not suitable for treatment using antimicrobial therapies, and as a 2nd line bladder instillation for painful bladders.
|
|
SODIUM PROPYL HYDROXYBENZOATE
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
SODIUM THIOSULFATE Injection
|
Formulary
|
Injection 25% used in patients with renal failure calciphylaxis (NB: concentration change). See poisoning section 18 for info on use as an antidote
|
NUH: Renal Metabolic Bone Guidelines
|
SPECTINOMYCIN Injection 2 g
|
Formulary
|
Unlicensed medicine - named patient use only
- At SFH: One vial kept in GU med, one vial kept in pharmacy. Administration guidelines.
- Available at NUH: On GU recommendation only - see restricted antimicrobials list
|
|
St Mark's solution
|
Formulary
|
- Not for prescribing in Primary Care.
- Also known as rehydration salts or electrolyte mix.
- Patients are advised to purchase the powders from community pharmacies and supermarkets, as it will often work out cheaper than paying for a prescription.
- At SFH: For inpatients, the solution should be prepared by the nurses on the ward as per the UKMi document. Glucose powder and sodium bicarbonate powder available from pharmacy, salt from kitchens.
|
UKMI Q&A: What is St Mark’s Electrolyte Mix (solution)?
|
SUCRALFATE 2g/50ml enema
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
Sucrose 24% (Sweat-Ease®)
|
Restricted
|
Unlicensed medicine - named patient use only Restricted for neonatal use only
|
Link to reviews
SFH guideline for use in neonates
|
Sultiame 50mg tabs
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
Tacrolimus suppositories
|
Restricted
|
Suppositories - Unlicensed medicine - named patient use only
Available at NUH only:
- Approved in accordance with the Trust’s unlicensed medicines policy for consultant use only for refractory proctitis in adult patients with either ulcerative colitis or Crohn’s disease.
|
|
TALC BP purified sterile (Steritalc®)
|
Formulary
|
Unlicensed medicine. For pleurodesis.
- 4g vial (for slurry instillation)
- 3g poudrage kit with atomiser (for insufflation) (not routinely stocked at SFH but can be ordered)
|
SFH: Talc for pleurodesis on respiratory wards- Dose and Preparation procedure
BTS Pleural Disease Guidelines
UKMI Q&A: Admin of talc for pleurodesis
|
Tamoxifen (Gynaecomastia)
|
Formulary
|
|
Link to reviews
|
Taurolodine and Citrate 4% (TauroLock®)
|
Restricted
|
Line Lock NUH only Restricted for prophylaxis of infection in chronic haemodialysis catheters in paediatrics and prophylaxis against catheter related bloodstream infections in parenteral nutrition patients.
|
Link to reviews
|
TETRAHYDROBIOPTERIN Tablets 10 mg
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
THALIDOMIDE Tablets 50 mg
|
Formulary
|
Unlicensed medicine - named patient use only NUH only See Chapter 8 for capsules
|
|
THEOPHYLLINE liq 50mg/5ml
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
|
THIAMINE Injection 100 mg in 1mL
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
TICLOPIDINE 250mg tabs
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
Timolol topical (haemangioma)
|
Formulary
|
0.5% ophthalmic gel (Timoptol LA®) Specialist use only for the treatment of infantile haemangioma. Usual dose is BD application to the whole of the haemangioma without occlusion. Usually used for approx 4 months but depends on response.
|
Link to reviews
|
TISOPURINE Tablets 100 mg
|
Formulary
|
Unlicensed medicine - named patient use only At SFH, available under special circumstances via IDIS drug importers. Usual dose is 100mg od-qds. Further information available from Medicines Information
|
|
Tranexamic acid 8% in glycerin 20% nasal spray
|
Formulary
|
SFH: Only available on special order. Costs around £50 per 20ml bottle.
|
|
TRANEXAMIC ACID Oral Solution 500 mg in 5mL
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
TRIAMCINOLONE ACETONIDE 0.1% in a protective emollient vehicle (Oracort® )
|
Restricted
|
Dental Paste NUH only Restricted for use by the maxillo facial team
|
|
Trisodium Citrate 46.7%
|
Restricted
|
Line Lock Restricted to renal use in patients with tunnelled venous catheters for venous catheters Citra-Lock-S® brand used at NUH and SFH (once Duralock-C stock is exhausted)
|
|
TROMETAMOL (THAM) 125ML Injection 3.6% (0.3M)
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
TROMETAMOL 0.3Molar (10.5ml) inj
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
Trypan blue (Oftalblu)
|
Restricted
|
Injection SFH only Previously used Vision blue
|
|
UBIQUENONE 50mg VIT E 15iu/5ml Liq 10
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
Ultravist
|
Formulary
|
Injection SFH only
|
|
Vacuum Pumps for Erectile Dysfunction
|
Formulary
|
- for patients with established erectile dysfunction who qualify for treatment under the SLS criteria
, non-formulary - for patients who don’t qualify for treatment under the SLS criteria
|
Drug Tariff (see Part IXa - Appliances, Vacuum pumps)
Link to reviews
|
VertebroplasticTM Cement
|
Formulary
|
NUH only For vertebroplasty, kyphoplasty and vertebral screw augmentation
|
|
VITAMIN A (RETINYL PALMITATE) Injection 100,000 units in 2 mL (VITAMINE A NEPALM)
|
Formulary
|
Unlicensed medicine - named patient use only Injection NUH only
|
|
Water for humidification
|
Restricted
|
SFH only ITU only
|
|
Whiteheads varnish (Iodoform compound paint)
|
Restricted
|
Unlicensed product NUH Only: Restricted for Max Fax use.
|
|
YOHIMBINE Tablets 5.4 mg
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
ZINC COMPUND PASTE 500g
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
ZINC SULPHATE 1mmol in 10ml inj
|
Formulary
|
Unlicensed medicine - named patient use only NUH only
|
|
|
.... |
Non Formulary Items |
Acetylcarnitine

|
Non Formulary
|
Unlicensed in the UK |
UKMI Q&A: Oral treatments for treating Peyronie’s disease
|
ACETYLCYSTEINE (Pulmonary fibrosis)
|
Non Formulary
|
Classified as GREY at APC May 2017 due to a lack of evidence of benefit. The Panther-IPF study found no significant improvements over placebo, but an increased rate of cardiac disorders with acetylcysteine. Patients currently prescribed acetylcysteine for pulmonary fibrosis should be actively reviewed by secondary care. |
Link to reviews
|
ACETYLCYSTEINE (Cystic fibrosis)
|
Non Formulary
|
Previously used in the treatment of DIOS in CF (off-label usage). No new patients to be started. Existing patients will be reviewed by secondary care. |
Link to reviews
|
Actipatch

|
Non Formulary
|
|
|
Adcon gel

|
Non Formulary
|
|
|
ADEK vitamins

|
Non Formulary
|
Discontinued 2007 |
|
Adrenaline (epinephrine) inhaler (Primatene Mist®)

|
Non Formulary
|
|
|
Afamelanotide (Scenesse®)

|
Non Formulary
|
An a-melanocyte-stimulating hormone analogue. Also known as melanotan I. Widely abused to obtain a cosmetic tan. No formal assessment for other indications. |
|
ALUMINIUM ACETATE 8% or 13% ear drops

|
Non Formulary
|
July 2015: Only Tayside pharmaceuticals in Dundee make as a special, but £52 for 8%, and £47 for 13%. |
|
Aminolevulinic acid (PDT)

|
Non Formulary
|
Unlicensed in the UK Metvix now used for PDT at SFH |
|
ANTI-HUMAN THYMOCYTE GLOBULIN (HORSE) Inj 100 mg in 5mL

|
Non Formulary
|
No longer used for aplastic anaemia and GVHD post BMT as unavailable. Using rabbit ATG now see Thymoglobuline Unlicensed medicine - named patient use only |
|
Antox tablets

|
Non Formulary
|
Previously called Bio-antox |
|
Arthroplex®

|
Non Formulary
|
|
|
Atopiclair

|
Non Formulary
|
Classed as a Medical Device, not a drug. Click here for independent reviews |
|
Autologous cartilage cells (ChrondoCelect®)

|
Non Formulary
|
No formal submission |
|
AZATHIOPRINE Capsules 10 mg

|
Non Formulary
|
Use licensed tablets or 50mg in 5ml suspension |
|
BENZOCAINE 150mg/5ml susp

|
Non Formulary
|
Use Antacid and Oxetacaine mixture instead |
|
Bicaflac®

|
Non Formulary
|
|
|
Biclinocillin

|
Non Formulary
|
|
|
Biloptin

|
Non Formulary
|
Discontinued April 2004 by Schering Healthcare |
|
BISOCODYL 0.274% rectal soln

|
Non Formulary
|
|
|
Blephaclean®

|
Non Formulary
|
|
|
Blephagel®

|
Non Formulary
|
|
|
Blephasol®

|
Non Formulary
|
|
|
Boric acid ear solution

|
Non Formulary
|
- Unlicensed special Boric acid 2% in IMS 70% was previously made by non sterile manufacturing unit at SFH on a named patient basis. Now only an aqueous version is available manufactured by QMC specials.
|
|
CAFFEINE BASE 10mg/ml

|
Non Formulary
|
Unlicensed medicine - named patient use only 10mg/ml strength no longer used at NUH- see above |
|
CAFFEINE CITRATE 20mg/ml INJ

|
Non Formulary
|
Unlicensed medicine - named patient use only Licensed product of this strength now available (Peyona), but non-formulary. See above for alternative |
MHRA letter to healthcare professionals regarding caffeine citrate products
|
Camphor/menthol/cajuput oil/clove oil (Tiger Balm)

|
Non Formulary
|
No formal assessment |
|
Cannabis products for medicinal use

|
Non Formulary
|
- Cannabis products affected by the November 18 re-scheduling may only be prescribed legally by a clinician on the Specialist Register of the General Medical Council, prescribing within their own area of practice and training. More info.
- Epidiolex® (unlicensed) is the product recommended by the British Paediatric Neurology Association. Awaiting assesment pending discussion at Trust DTCs
|
NHS England info on cannabis for medicinal use
RCGP: GP guidance on cannabis-based products (Dec 2018)
UKMI Q & A- interactions with cannabis based medicinal products
UKMI Q & A-adverse effects & interactions with cannabidiol oil
|
CAPTOPRIL Tablets 2 mg

|
Non Formulary
|
Was historically used in children prior to the availability of a suspension. Now use licensed suspension. |
|
CELESTINS ENDO-OESOPHAGEAL TUBE powder

|
Non Formulary
|
|
|
CHLOROTHIAZIDE Tablets 500 mg

|
Non Formulary
|
|
|
Chondroitin

|
Non Formulary
|
|
UKMI Q&A: Chondroitin - drug interactions?
UKMI Q&A: Chondroitin - what are the adverse effects?
|
Cisapride

|
Non Formulary
|
Discontinued by company |
|
Clevidipine

|
Non Formulary
|
|
Link to reviews
|
CODEINE PHOSPHATE Suppositories 15 mg,2mg,3mg,6mg

|
Non Formulary
|
|
|
Copper Histidine

|
Non Formulary
|
Injection Unlicensed medicine |
|
DEFIBROTIDE Capsules 400 mg

|
Non Formulary
|
IFR approval required before initiation |
Link to reviews
|
DHEA (Dehydroepiandrosterone)

|
Non Formulary
|
- Also known as prasterone.
|
|
DIAZEPAM Suspension 2.5 mg in 5mL

|
Non Formulary
|
Use alternative strength. See other diazepam entries
|
|
Diphenylcyclopropenone in acetone

|
Non Formulary
|
Unlicensed special Also known as diphencyprone Solution previously could be made by non sterile manufacturing unit at SFH, may be available on special order |
Link to reviews
|
Echinacea

|
Non Formulary
|
Of no proven value.
- Sarcastic, amusing and educational review in podcast form. See episodes 2 and 18
|
|
Elastolabo®

|
Non Formulary
|
No formal submission APC May 2015 |
|
Eprodisate disodium

|
Non Formulary
|
|
|
Eptotermin Alfa (Osigraft®)

|
Non Formulary
|
Discontinued July 2014 |
Link to reviews
|
Factor Eight Inhibitor Bypassing Activity (FEIBA)

|
Non Formulary
|
Not stocked at SFH. Contact Haematology for advice |
|
Fentanyl (Ionsys®)

|
Non Formulary
|
|
Link to reviews
|
Fentanyl and Suxamethonium pre drawn up kits

|
Non Formulary
|
|
Link to reviews
|
Formaldehyde rectal solution (Rectal solution)

|
Non Formulary
|
SFH: For gastroenterologist use only for radiation proctitis. |
|
Gamolenic Acid and Evening Primrose Oil

|
Non Formulary
|
- Unlicenced Evening Primrose oil which contains Gamolenic Acid is available to buy in pharmacies, health food shops and supermarkets for those wanting to take gamolenic acid as a dietary supplement
|
|
Glycerin (Lubricant)

|
Non Formulary
|
Used to be used as a lubricant (£4 per bottle). Now use Aquagel (7p per sachet OR 60p per tube) |
|
Glycerin and Ichthammol paste

|
Non Formulary
|
|
|
GLYCERYL TRINITRATE Ointment 0.05%

|
Non Formulary
|
Use licensed 0.4% product
|
|
GLYCERYL TRINITRATE Ointment 0.2%

|
Non Formulary
|
Use licensed 0.4% product
|
Link to reviews
NICE Evidence summary: 0.2% glyceryl trinitrate ointment for chronic anal fissures
|
Glycopyrronium tablets (Hyperhidrosis)

|
Non Formulary
|
No formal submission |
Link to reviews
NICE Evidence Summary: glycopyrronium for hyperhidrosis
|
Haemostatic Patch (VerisetTM)

|
Non Formulary
|
Patch |
|
Hydroxyamphetamine 1% eye drops

|
Non Formulary
|
|
|
Hylo-Care eye drops

|
Non Formulary
|
No formal submission |
|
Ibritumomab tiuxetan

|
Non Formulary
|
|
|
Injex needle free administration device

|
Non Formulary
|
GREY non formulary |
Link to reviews
|
Insujet needle free administration device

|
Non Formulary
|
No formal submission |
Link to reviews
|
Insulin devices - Needle free

|
Non Formulary
|
|
Link to reviews
|
Iopamidol (Gastromiro®)

|
Non Formulary
|
|
|
IOPANOIC ACID Tablets 500 mg

|
Non Formulary
|
Unlicensed medicine - named patient use only Discontinued 2012 - NUH and SFHT unable to source an alternative |
|
Ixabepilone

|
Non Formulary
|
|
Link to reviews
|
KETANSERIN Injection 10 mg in 2mL
|
Non Formulary
|
Unlicensed medicine - named patient use only |
|
Lidocaine/adrenaline/tetracaine (LATGEL®)

|
Non Formulary
|
|
Link to reviews
|
Lorcaserin

|
Non Formulary
|
|
Link to reviews
|
Melagatran

|
Non Formulary
|
|
|
Mibefradil

|
Non Formulary
|
|
|
Miglustat

|
Non Formulary
|
|
|
MONOCHLOROACETIC ACID SATURATED soln (5ml)

|
Non Formulary
|
|
|
Mucaine

|
Non Formulary
|
Discontinued- use antacid and oxetacaine |
|
Naltrexone (MS)

|
Non Formulary
|
Unlicensed dosage and indication not achievable without prescribing expensive "specials" No phase III clinical trials to establish efficacy or safety |
UKMI Q&A: Low dose naltrexone for MS
|
NeilMed Sinus Rinse

|
Non Formulary
|
Appliance, not listed in drug tariff NUH ENT use this product and advises patients to buy as OTC. GPs are not recommended to prescribe. |
|
Optison

|
Non Formulary
|
Withdrawn 2005 |
|
Orascreen

|
Non Formulary
|
|
|
Otovent® (Autoinflation device)

|
Non Formulary
|
No formal assessement |
UKMI review: Otovent for otitis media with effusion
|
Oxepa

|
Non Formulary
|
|
|
Pegloticase (Krystexxa)

|
Non Formulary
|
Grey Chronic gout, IV every 2 weeks |
Link to reviews
NICE: TA291 - Pegloticase not recommended for severe chronic gout
|
Phenol liquified BP 80%

|
Non Formulary
|
April 2014 - Supply problem ongoing.
- NUH and SFH theatres/clinics now use EZ swabs available from NHS Supplies.
- NUH: liquified phenol (80% phenol) injection will no longer be stocked in the Trust (2009). Prescribers who used liquified phenol (80% phenol) for toenail ablation should prescribe:
- Phenol EZ Swabs® - (Individually wrapped ampoules, containing 0.175-0.2ml Liquified Phenol USP 89%). The following areas will hold Phenol EZ Swabs® as stock:
Theatre 3 QMC campus Theatre 8 & Day Surgery NCH campus Dermatology Treatment Centre
|
|
PICIBANIL 100mcg inj
|
Non Formulary
|
Unlicensed medicine - named patient use only Previously NUH only |
|
Piperaquine with artenimol (Eurartesim®)

|
Non Formulary
|
Piperaquine with artenimol is not recommended for the first-line treatment of acute uncomplicated falciparum malaria because there is limited experience of its use in travellers who usually reside in areas where malaria is not endemic. Piperaquine has a long half-life. Tablets to be taken at least 3 hours before and at least 3 hours after food. Tablets may be dispersed in water immediately before administration if needed. See here for general advice on dispersing tablets. |
Link to reviews
|
PIRENZEPINE 50mg tabs

|
Non Formulary
|
|
|
Potassium hydroxide

|
Non Formulary
|
Unlicensed special - previously made in non sterile manufacturing unit at SFH |
|
POTASSIUM IODIDE eye drops 5%

|
Non Formulary
|
|
|
Potassium Iodide solution

|
Non Formulary
|
|
|
Povidone-iodine 10 `/. in Boric acid insufflation

|
Non Formulary
|
|
|
Powerbreathe

|
Non Formulary
|
Medical device for inspiratory muscle training. Patients should be encouraged to attend pulmonary rehabilitation No formal submission |
Link to reviews
|
PreOp ®

|
Non Formulary
|
|
Link to reviews
|
PRILOCAINE (50ML) Injection 0.5%

|
Non Formulary
|
|
|
Prismocitrate

|
Non Formulary
|
|
Link to reviews
|
PROCHLORPERAZINE PR 25mg,5mg

|
Non Formulary
|
No longer available in the UK |
|
Prontoderm Nasal gel

|
Non Formulary
|
See local MRSA policies for treatment options for MRSA decolonisation/ eradication |
Link to reviews
|
Pyridoxine (PMS)

|
Non Formulary
|
Awaiting submission for PMS |
|
R
|
Non Formulary
|
|
|
RC cornet ®

|
Non Formulary
|
Airway Clearance Device not in drug tariff non-formulary APC May 2014 |
|
RESPeRATE®

|
Non Formulary
|
Medical device marketed for hypertension Insufficient evidence base and not recommended by the British Hypertension Society |
British Hypertension Society statement on RESPeRATE
Link to reviews
UKMi Update on New Devices - RESPeRATE May 2013
|
Retapamulin ointment

|
Non Formulary
|
|
Link to reviews
|
SACCHAROMYCES BOULARDII 250mg caps

|
Non Formulary
|
Unlicensed medicine - named patient use only |
|
Shaker (Device)

|
Non Formulary
|
Airway Clearance Device not in drug tariffnon-formulary APC May 2014
|
|
Sinurinse®

|
Non Formulary
|
|
|
Sipuleucel- T

|
Non Formulary
|
No formal submission |
NICE TA322: Sipuleucel-T for prostate cancer
|
Sodium hyaluronate (Cystistat®) (bladder instillation)

|
Non Formulary
|
Rejected by the APC September 2013 due to lack of evidence for efficacy. |
Link to reviews
|
Sodium Hyaluronate (SigmaviscTM ) (Endoscopy)

|
Non Formulary
|
Injection
Previously available at NUH for Endoscopy use only: Non Pharmacy Item - order through NHS Supply Chain.
Discontinued Product |
|
Sodium hyaluronate injection (SportVis®)

|
Non Formulary
|
|
|
St Johns Wort

|
Non Formulary
|
|
|
STANOZOLOL 2mg tabs
|
Non Formulary
|
Unlicensed medicine - named patient use only Discontinued 2015 |
|
Sterimar nasal douche

|
Non Formulary
|
Patients should buy OTC if needed. |
|
Sulfapyridine

|
Non Formulary
|
Discontinued. Alternative is sulfamethoxypyridazine |
|
SULPHAMETHOXYPYRIDAZINE tabs 500mg

|
Non Formulary
|
Discontinued, and imported supplies do not appear to be available. |
|
Tacrolimus (Topical for crohns)

|
Non Formulary
|
0.05% in Ung Merck (over £100 a tube). |
|
Taribavirin

|
Non Formulary
|
|
|
TAUROLIDINE Solution 2 % (nebulised)

|
Non Formulary
|
Unlicensed medicine - named patient use only Used as nebulised therapy in transplant patients with B.cepacia (unlicensed indication for unlicensed product) Typical dose 2ml twice daily via nebuliser. See Leeds guideline for possible use in CF. |
|
TheraBite® (Jaw Rehabilitation Device)
|
Non Formulary
|
No formal assesment
- Listed in drug tariff - Part IXA-Appliances
|
|
Tissue adhesive for epidural catheters

|
Non Formulary
|
|
Link to reviews
|
Tolevamer

|
Non Formulary
|
|
|
Treprostinil

|
Non Formulary
|
|
Link to reviews
|
Triamcinolone mouthwash

|
Non Formulary
|
Unlicensed special - previously could be made up in the non sterile manufaturing unit at SFH |
|
UroLift system

|
Non Formulary
|
No formal assessment |
NICE MTG26: UroLift for treating symptoms of BPH
|
Vernakalant

|
Non Formulary
|
|
Link to reviews
|
Vibro-Pulse®
|
Non Formulary
|
DeviceNon-formulary Grey as per APC May 2014. See Midlands Medicines Review
Device is not prescribable on FP10, but disposable covers which require changing for each new treatment are prescribable on FP10Utilises cycloidal vibration (CV) therapy |
Link to reviews
Trent MI: Vibro-Pulse® for cellulitis and venous leg ulcers
|
VITAMIN A Drops 150000 international units in 1mL
|
Non Formulary
|
Unlicensed medicine - named patient use only. Vitamin A is also known as retinol Discontinued in country of origin 2016 |
|
Vitrimix®

|
Non Formulary
|
At SFH, all cases should be referred to a dietition/pharmacist for a TPN assessment |
|
Ximelagatran

|
Non Formulary
|
Withdrawn from market Feb 2006 |
|
XLS-medical fat binder (Litramine)

|
Non Formulary
|
Medical device marketed as a fat binder. Contains Litramine and vitamins A, D and E. Not prescribable (not listed in drug tariff) |
|
|
Key |
|
|
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. |

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