| Formulary Chapter 3: Respiratory system - Full Chapter
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| Chapter Links... |
 Asthma guidance (BTS / Sign 2014) |
 Asthma guideline (Adults): Nottinghamshire |
| Asthma Guidelines (NICE NG80) |
| Asthma inhaler devices (children under 5): NICE TA10 |
| Asthma inhaler devices (older children): NICE TA38: |
| Asthma self management plan (Notts APC) |
| COPD emergency supply medicines - prescribing information |
| COPD guideline: NICE CG101 |
| COPD guideline: Nottinghamshire |
| COPD self management plan |
| Cost comparison chart: Inhaler devices |
| COVID19: COPD / asthma rescue packs (Notts CCG) |
| COVID19: Management of severe asthma (Notts CCG) |
| COVID19: NICE (NG166) - severe asthma |
| COVID19: Should I avoid prescribing steroids for asthma / COPD? (Notts CCG) |
| COVID19: Should oxygen be used in COVID related end of life? (Notts CCG) |
| Equipotency of inhaled corticosteroids |
| Inhalers - table of drugs (courtesy of Leicestershire) |
| Inhalers in pictures (courtesy of Leicestershire) |
| Inhalers Venn diagram |
| Nebuliser compatibilities (UKMI Q&A) |
| NUH: Medicines Matters Bulletin – Inhaler Costs |
| Details... |
| 03.04.01 |
Antihistamines |
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Non-sedating antihistamines |
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Sedating antihistamines |
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Chlorphenamine
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Formulary
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Tablet, Liquid, Injection
 Patients should be advised to purchase a suitable product over the counter first line for hayfever.- May be prescribed if appropriate to in-patients; patients should be advised on discharge that further supply should be purchased.
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SFH: Anaphylaxis full policy
SFH: Anaphylaxis quick guide
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Hydroxyzine
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Formulary
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Tablet (syrup discontinued)
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MHRA: QT prolongation with hydroxyzine
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Promethazine hydrochloride (Phenergan®)
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Formulary
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Tablet, Liquid, Injection.
- Patients should be advised to purchase a suitable product over the counter first line.
- when used as an antihistamine.
 for sedation in children (APC Jan 15).- See section 4.6 for use as antiemetic.
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Link to reviews
NICE Evidence summary: Promethazine for rapid tranquillisation in mental health settings
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Alimemazine
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Formulary
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Tablet, Liquid.
- Second line to promethazine in both paediatric and dermatology patients
Cost increase (October 2017):
- 28 x 10mg tablets cost: £112.85
- 30mg/5ml solution x 100ml = £243.51
7.5mg/5ml solution x 100ml = £179.55
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See unexpectedly expensive medicines list
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| Non Formulary Items |
Clemastine (Tevegil®)
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Non Formulary
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Clemastine liquid no longer available. |
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Cyproheptadine (Periactin®)
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Non Formulary
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For use for the treatment of serotonin syndrome see chapter 18 |
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Diphenhydramine (Nytol®)
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Non Formulary
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No formal submission |
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Ketotifen (Zaditen®)
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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
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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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