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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.01.03  Expand sub section  Theophylline
 note  CAUTION -
  • Theophylline has a narrow therapeutic index and troublesome interactions (especially with macrolides & nicotine).
    N.B.
    PRESCRIBE BY BRAND - Be aware that oral modified release brands of theophylline and aminophylline are NOT interchangeable. All patients need to be maintained on the same brand as initally prescribed for them.

    N.B. BTS guidelines state liquid preparations are not recommended for the prophylaxis of wheeze
  • Theophylline (Uniphyllin Continus)
    View adult BNF View SPC online View childrens BNF
    First Choice
    Green

    Tablet MR (200mg, 300mg, 400mg)

    • PRESCRIBE BY BRAND
    • First choice for adults and children over six
    • Green - adults only, children= Amber 2
     
    Theophylline (Nuelin SA)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Green

    Tablet MR (175mg, 250mg)

    • Brand discontinued July 2019
    • Restricted for existing patients only
    • Green - adults only, children unclassified
     
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
       
    Aminophylline (Phyllocontin Continus)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Green
  • Tablet MR - Restricted for existing patients only, new patients to start on theophylline.
  • Tablets cannot be crushed. Switch to theophylline(100mg aminophylline = 80mg theophylline)
  • Care with dose frequency when switching from modified release preparations to normal release preparations: same total daily dose needs to be given, but split into 3-4 doses
  • Green - adults only, use in children not classified 
  •    
    Aminophylline IV
    (Injection)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
  • Secondary care only
     
  • Link  NUH:Therapeutic Drug Monitoring in Adults at NUH
    Link  SFH Drug levels information - compilation table
    Link  SFH: Aminophylline infusion guidelines
    Link  UKMI Q&A: Conversion of IV aminophylline dose to oral aminophylline or theophylline
       
     ....
     Non Formulary Items
    Theophylline  (Slo-Phyllin)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Amber 2
    • Brand now discontinued: See details
    • Preferred preparation in children up to 6 years of age
    • PRESCRIBE BY BRAND
    • Capsule MR - Restricted for existing adult patients or those unable to swallow MR tablets.
    • Administration: Contents of the capsule (enteric-coated granules) may be sprinkled on to a spoonful of soft food (e.g. yoghurt) and swallowed without chewing (BNFC)
    • Traffic light classification relates to children. Green if being used in adults
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
     
      
    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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