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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 9: Nutrition and blood - Full Chapter
09.02.01.01  Expand sub section  Oral potassium
Potassium Chloride (Sando-K®)
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First Choice
Green

Tablet

  • 1 tablet = 12mmol of K+
  • Link to SPC.
 
Potassium Chloride (Kay-Cee-L®)
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Formulary
Green

Syrup

  • 1mL = 1mmol of K+
  • Link to SPC.
 
   
Potassium Chloride modified release tablets
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Formulary
Red

Tablet MR (1 tablet = 8 mmol of K+)

  • RED for use by specialists (APC Sept 2020)
  • Slow K discontinued 2020
  • Available as parallel import, not licensed in UK, which is extremely expensive in primary care (up to £250 per prescription).
  • BNF states that modified release potassium chloride tablets are less suitable for prescribing. Can cause GI side effects (nausea, vomiting, abdominal pains, diarrhoea).
  • Use Sando K or Kay-Cee-L instead
 
   
09.02.01.01  Expand sub section  Potassium removal
Polystyrene Sulphonate Resins (Calcium Resonium®)
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Restricted Drug Restricted
Amber 2
  • Powder available as a 300g tub, containing a 15g scoop
  • Enema 30g/100ml available on a named patient basis (unlicensed) for use only in patients who are nil by mouth.
  • NG tube administration is perfectly acceptable. Add the 15g to approx 150mL of water. It's like super-fine sand so settles out but resuspends on stirring and does not stick to anything. Flush afterwards, as always.
  • See local guidelines below for dosing and administration information.
  • Primary care prescribing can be undertaken in acute episodes of hyperkalaemia under specialist advice.
 
Patiromer calcium (Veltassa®)
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Formulary
Red

Powder for oral suspension

At NUH: For use in accordance with NICE TA623 for treating hyperkalaemia.

At SFH: On Consultant Endocrinologist/ renal advice for treating hyperkalaemia in accordance with NICE TA623.

 
Link  Hyperkalaemia (acute) treatment price comparison
Link  Link to reviews
Link  NICE TA623: Patiromer for treating hyperkalaemia
   
Polystyrene Sulphonate Resins (Resonium A®)
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Restricted Drug Restricted
Red

Powder

  • Contains sodium polystyrene sulfonate.
  • Alternative to calcium resonium if concerned about hypercalcaemia.
 
Link  Hyperkalaemia (acute) treatment price comparison
   
Sodium zirconium cyclosilicate (Lokelma®)
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Formulary
Red

Powder for oral suspension

  • For use in accordance with NICE TA599 for treating hyperkalaemia.
  • At SFH - Endocrine or Renal consultant initiation only. Expensive and benefits over calcium resonium uncertain. 
 
Link  Hyperkalaemia (acute) treatment price comparison
Link  NICE TA599: Sodium zirconium cyclosilicate for treating hyperkalaemia
   
 ....
 Non Formulary Items
Potasium Chloride  (Klofer®)

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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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