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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
07.01.01  Expand sub section  Prostaglandins and oxytocics
Carboprost (Hemabate)
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Formulary
Red
Injection- secondary care only 
   
Dinoprostone (Prostin E2)
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Formulary
Red

Available as:
- Injection
- Vaginal tablet (Prostin E2)
- MR pessaries (Propess)- SFH only
- Vaginal gel
NB: Prostin E2® vaginal gel and vaginal tablets are not bioequivalent. See NUH guidelines.

 
Link  Link to reviews
   
Ergometrine Maleate
(Ergometrine)
View adult BNF View SPC online View childrens BNF
Formulary
Red
Injection- secondary care only
 
   
Ergometrine Maleate and Oxytocin (Syntometrine)
View adult BNF View SPC online View childrens BNF
Formulary
Red
Injection- secondary care only 
   
Gemeprost
View adult BNF View SPC online View childrens BNF
Formulary
Red
Pessary- secondary care only
  • Stored in freezer. Should be allowed to warm upto room temperature for 30 mins before use 
  •    
    Misoprostol
    (Gynae)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Tablets
  • Unlicensed use 
  • Link  DTB review on use for postpartum haemorrhage, 2010
    Link  Link to reviews
       
    Oxytocin (Syntocinon)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection- secondary care only 
       
    07.01.01.01  Expand sub section  Drugs affecting the ductus arteriosus
    07.01.01.01  Expand sub section  Maintenance of patency
    Alprostadil (Prostin VR)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Infusion- secondary care only
     
       
    07.01.01.01  Expand sub section  Closure of ductus arteriosus
    Ibuprofen (Pedea injection)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Intravenous solution, 10mg/2ml
  • For use in neonates for the treatment of PDAs only 
  •    
     ....
     Non Formulary Items
    Carbetocin  (Pabel®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Indometacin  (Indocid PDA)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Red
    Injection- secondary care only (unlicensed)
  • Ibuprofen is first line for PDA treatment.
  •  
    Misoprostol vaginal delivery system  (Mysodelle)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Non-formulary (no formal assessment, APC May 2014)
  • for induction of labour
  • Link  Link to reviews
    Link  MHRA: reports of excessive uterine contractions (tachysystole)
     
      
    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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