There are several national shortages presently. Prescribers are advised to review the advice from the British Menopause Society and if unsure consult their medicines management pharmacist to discuss an alternative product. (Aug 2019)
Oestrogen only HRT tablet (Elleste-Solo, Premarin)
Elleste-Solo®- Estradiol tablet 1mg and 2mg (First choice oral estradiol only product) Premarin®- Conjugated oestrogens tablet
Oestrogen only HRT patch (Estradot, Evorel, Elleste-Solo)
Unlicensed 25mg and 50mg implants were available from abroad but do not have satisfactory quality assurance.
Femapak® (Combined cyclical HRT)
Fematrix® (Oestrogen only HRT patch)
Discontinued Aug 2012
FemSeven® (Oestrogen only HRT patch)
FemSeven® Conti (Combined continuous HRT patch)
FemSeven® Sequi (Combined cyclical HRT patch)
FemTab® (Oestrogen only HRT tablet)
FemTab® Sequi (Combined cyclical HRT tablet)
Harmogen® (Oestrogen only HRT tablet)
Hormonin® (Oestrogen only HRT tablet)
Indivina® (Combined continuous HRT tablet)
Novofem® (Combined cyclical HRT tablet)
Contains same active ingredients as Elleste Duet® (see above).
Nuvelle® (Combined cyclical HRT tablet)
Ovestin® (Oestrogen only HRT tablet)
Progynova® (Oestrogen only HRT tablet)
APC July 2011
Progynova® TS (Oestrogen only HRT patch)
APC July 2011
Sandrena® (Estradiol gel)
Oestrogel® is topical oestrogen gel of choice (see above)
Tridestra® (Combined cyclical HRT tablet)
Trisequens® (Combined cyclical HRT tablet)
Zumenon® (Oestrogen only HRT tablet)
Section Title (top level)
Section Title (sub level)
First Choice item
Non Formulary section
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Link to adult BNF
Link to children's BNF
Link to SPCs
Scottish Medicines Consortium
High Cost Medicine
Cancer Drugs Fund
Traffic Light Status Information
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.
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.
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.
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
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.
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.