Formulary Chapter 25: A2 - Borderline substances - Full Chapter
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Notes: |
For specific CCG pathways for Cows Milk allergy and supplentary criteria, please refer to the APC website |
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Chapter Links... |
COVID19: Should I prescribe Baby Milk during COVID19? |
Cows milk allergy Overarching Guideline |
Drug interactions with enteral feeds |
Enteral tube feeding guideline - see page 10 for unblocking tubes (SFH) |
Injections given enterally: UKMI Q & A |
Lactose intolerance in children- patient info (Notts APC) |
Lactose Intolerance in Infants guideline (NottsAPC) |
Nottinghamshire Oral Nutritional Supplement (sip feeds) Guidelines |
Nottinghamshire Sip Feed Guidelines (Quick Reference) |
Nutrition Support in Adults (including refeeding syndrome guidance) NICE guidance |
Premature infant feeding guidelines (Notts APC) |
Refeeding Syndrome: SFH notes |
CCG quick reference guide: Cow’s milk allergy & lactose intolerance - Infant feeds |
Details... |
A2.02.02.03 |
Compact sip feeds |
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Powdered supplements should be used first line for patients within Primary care. If patients require small volumes considering prescribing Aymes Shake Compact made with 100mls of whole milk unless contraindicated. |
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Ensure® Compact (Low volume milkshake style)
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Second Choice
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125ml ready to drink - available flavours are banana, cafe latte, strawberry and vanilla.
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Fortisip® Compact (Low volume milkshake style)
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Second Choice
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125ml ready to drink - available flavours are apricot, banana, chocolate, forest fruit, mocha, neutral, strawberry and vanilla (Starter pack available containing six assorted flavours)
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SFH: TTO supply information
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Altraplen Compact ®
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Formulary
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- Available in vanilla, banana, and strawberry flavours in 125ml bottles.
- Starter pack available containing 4 flavours. NOT FOR REPEAT PRESCRIPTION.
- Clinically lactose free
- On dietician advice only in secondary care. Not stocked at SFH.
- Name changed from Nutriplen
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Fortisip® Compact Fibre
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Formulary
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- Available in mocha, strawberry and vanilla
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SFH: TTO supply information
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Renilon® 7.5
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Restricted
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On dietician recommendation only Available in apricot, and caramel flavours in 125ml bottles.
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Fortisip Compact Protein
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Formulary
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125ml bottles
- Available in vanilla, mocha, banana, strawberry flavours . (Neutral and Hot Tropical Ginger available but not stocked at SFH)
- On dietician recommendation only
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SFH: TTO supply information
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Non Formulary Items |
Fortisip® Extra

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Non Formulary
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SFH: TTO supply information
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Fresubin® 2 kcal Drink

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Non Formulary
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Fresubin® 2 kcal Fibre Drink

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Non Formulary
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Fresubin® Creme

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Non Formulary
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Resource® 2.0

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Non Formulary
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Resource® Dessert Fruit

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Non Formulary
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Vegenat® -med Balanced Protein

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Non Formulary
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Vegenat® -med High Protein

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Non Formulary
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
Status |
Description |

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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. |

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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. |

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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. |

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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 |

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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. |

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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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