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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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03.04.01  Expand sub section  Antihistamines
03.04.01  Expand sub section  Non-sedating antihistamines
03.04.01  Expand sub section  Sedating antihistamines
Chlorphenamine
View adult BNF View SPC online View childrens BNF
Formulary
Green

Tablet, Oral solution, injection

  • OTC 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
 
Link  SFH: Anaphylaxis full policy
Link  SFH: Anaphylaxis quick guide
   
Hydroxyzine
View adult BNF View SPC online View childrens BNF
Formulary
Green
Tablet (syrup discontinued) 
Link  MHRA: QT prolongation with hydroxyzine
   
Promethazine (Phenergan)
View adult BNF View SPC online View childrens BNF
Formulary

Tablet, Elixir
when used as an antihistamine

OTC Patients should be advised to purchase a suitable product over the counter first line

for sedation in children (APC Jan 15)

 
Link  Link to reviews
Link  NICE Evidence summary: Promethazine for rapid tranquillisation in mental health settings
   
Alimemazine
View adult BNF View SPC online View childrens BNF
Formulary
Amber 2
Tablet, syrup
  • 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
     
  • Link  See unexpectedly expensive medicines list
       
     ....
     Non Formulary Items
    Clemastine  (Tevegil)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Clemastine liquid no longer available.
     
    Cyproheptadine  (Periactin)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    For use for the treatment of serotonin syndrome see chapter 18
     
    Diphenhydramine  (Nytol)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey

    No formal submission

     
    Ketotifen  (Zaditen®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
      
    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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