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... |
A2.04.01.02 |
High-energy supplements: fat |
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These products are not nutritionally complete and should not be used as sole source of nutrition. Recommended maximum dosage: 40mls QDS unless otherwise specified by a Dietitian.
Should be used in combination with other nutritional supplements and not alone. |
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Altrashot®
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Restricted
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- On dietician recommendation only
- Available in vanilla and strawberry flavours in 120ml bottles
- Once opened Altrashot should be refrigerated and used within 24 hours.
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Calogen Extra
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Restricted
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Calogen®
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Restricted
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- On dietician recommendation only
- Available in neutral and strawberry flavour in 200ml bottles
- Available in neutral, strawberry and banana flavour in 500ml bottles
- Once opened refrigerate and discard after 14 days Calogen "SPC"
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Duocal® (Liquid)
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Restricted
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- On dietician recommendation only
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Duocal® Super Soluble
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Restricted
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- On dietician recommendation only
- Paediatric use
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Liquigen®
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Restricted
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- Paediatric use
- On dietician recommendation only
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Pro-Cal®
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Restricted
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Scandishake® Mix
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Restricted
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- On dietician recommendation only- not nutritionally complete
- Available in chocolate, banana, strawberry, unflavoured and vanilla flavour in sachets
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Non Formulary Items |
Calisan® 90

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Non Formulary
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Duobar®

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Non Formulary
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Energivit®

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Non Formulary
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Fresubin® 5 kcal Shot

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Non Formulary
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MCT Duocal®

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Non Formulary
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Medium-chain Triglyceride (MCT) Oil

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Non Formulary
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Pro-Cal® Shot

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Non Formulary
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Protifar®

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Non Formulary
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QuickCal®

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Non Formulary
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Discontinued Sept 2013 |
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Vitapro®

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Non Formulary
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Vitasavoury®

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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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