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 Formulary Chapter 16: Miscellaneous - Full Chapter
16.01  Expand sub section  Other items
Aromatherapy in Labour
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Formulary For use in accordance with Aromatherapy in Labour guideline (BHTCG 500 - awaited) 
   
Barium Sulphate 100% (Baritop® 100)
(suspension)
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Restricted Drug Restricted
Red
Restricted - prescribing by Radiology team only 
   
Barium sulphate 98% (E-Z-HD® 100)
(Powder for oral suspension)
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Restricted Drug Restricted
Red
Restricted - prescribing by Radiology team only 
   
Bone Cement Low Viscosity with Gentamicin
(sterile powder, 40g)
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Formulary
Red
Medical Device 
   
Bone Cement with Gentamicin (Palacos R®)
(sterile powder, 20g, 40g)
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Formulary
Red
Medical Device 
   
Bone Cement with Gentamicin and Vancomycin (Copal G+V®)
(sterile powder)
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Formulary
Red
Medical Device 
   
Carbex®
(solution and granules)
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Restricted Drug Restricted
Red
Restricted - prescribing by Radiology team only 
   
Dibotermin alfa (InductOs)
(powder, solvent and matrix for implantation matrix)
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Restricted Drug Restricted
Red Specialist Centre

FOR ALL PRESCRIBING - HIGH COST DRUG compliance form required - see link from Formulary homepage. Compliance to be verified if form not available.

Restricted - to consultant Spinal Orthopaedic surgeons prescribing for stem cell mobilisation in accordance with NHSE SSC 1653, NHSE Clinical Commissioning Policy 16063/P. 

BHT is a specialist centre.

 
Link  NHSE Clinical Commissioning Policy: Bone Morphogenetic Protein-2 in spinal fusion (16063/P)
   
Elosulfase alfa 5mg/5ml
(concentrate for solution for infusion)
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Restricted Drug Restricted
Red
High Cost Medicine

Restricted - prescribing by consultant paediatricians in accordance with NICE HST2 and the Managed Access Scheme on initiation by a Highly Specialised Service for treating mucopolysaccharidosis type IVa


 
Link  Managed access agreement - Elosulfase alfa for treating mucopolysaccharidosis type IVa
Link  NICE HST2: Elosulfase alfa for treating mucopolysaccharidosis type IVa
   
Eptotermin Alpha (Osigraft®)
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Restricted Drug Restricted
Red
Restricted - to prescribing by Consultant Orthopaedic surgeons for treatment of non-union fractures in patients who have been assessed but found unsuitable for bone autograft. Named patient approval required. 
   
Ethanol 60%, Chloroform 30%, Glacial acetic acid 10% (Carnoy's solution)
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Restricted Drug Restricted
Red
unlicensedunlicensed - Low Risk

Restricted - prescribing by Oral and Maxillofacial Surgery team, for the treatment of odontogeniuc keratocysts and cystic ameloblastoma. 
   
Fibrin Sealant (Tisseel®)
(Ready to use syringe)
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Restricted Drug Restricted
Red
Restricted - for use by:
1. Spinal surgeons
2. Anterior segment procedures in Ophthalmology
3. Cardiology Consultants for use in patients at increased risk of bleeds during device implant or box change procedures 
   
Gadopentetic acid dimeglumine 2mmol in 1litre (Magnevist®)
(intra-articular injection, 20mL prefilled syringe)
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Restricted Drug Restricted
Red
Restricted - for use as a diagnostic contrast agent in MRI when patients have nil, mild or moderate renal impairment, in line with MHRA advice 
Link  MHRA Drug Safety Update - February 2018: Gadolinium-containing contrast agents: Omniscan and iv Magnevist no longer authorised, MultiHance and Primovist for use only in liver imaging
   
Gadoteric acid (Dotarem®)
(intravenous injection, 5mL, 10mL, 15mL, 20mL vials, 20mL prefilled syringe)
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Restricted Drug Restricted
Red
Restricted - for use as diganostic contrast agent in MRI when patients have severe renal impairment, in line with MHRA advice. 
   
Gadoxetic acid disodium 0.25mmol/1mL (Primovist®)
(solution for injection, prefilled syringe)
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Restricted Drug Restricted
Red
Restricted - prescribing by Radiology team only, for contrast-enhanced liver MRI 
Link  MHRA Drug Safety Update - February 2018: Gadolinium-containing contrast agents: Omniscan and iv Magnevist no longer authorised, MultiHance and Primovist for use only in liver imaging
   
In-Check DIAL device
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Formulary In primary care may be prescribed on FP10, in secondary care order from supplies 
   
Iobitridol 300, 350 mgI/mL (Xenetix®)
(injection)
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Restricted Drug Restricted
Red
Restricted - to prescribing by Consultant Radiologist only. 
   
Iodixanol injection 270, 320 mgI/mL (Visipaque®)
(injection, 100mL)
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Restricted Drug Restricted
Red
Restricted - prescribing by Consultant Radiologist only 
   
Iohexol 300, 350 (Omnipaque®)
(injection)
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Restricted Drug Restricted
Red

For use in radiology only.

 
   
Iopamidol 61.24%w/v, 20mL, 50mL, 100mL (Gastromiro®)
(oral/rectal solution)
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Restricted Drug Restricted
Red
Restricted - prescribing by Radiology team only 
   
Lipiodol
(injection)
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Restricted Drug Restricted
Red
Restricted - to prescribing by Radiology team only. 
   
Methacholine Chloride 32mg/1mL
(inhalation)
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Restricted Drug Restricted
Red
unlicensedunlicensed - Medium Risk
Bronchial provocation testing - Restricted to Respiratory Lab only. To be used in accordance with BHT SOP for Methacholine Challenge Testing 
   
Patent Blue V 2.5%
(solution for injection)
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Restricted Drug Restricted
Red
unlicensedunlicensed - Medium Risk
Restricted:
1. For use in Theatre 1 for sentinel node biopsy in breast cancer surgery and,
2. For use by Plastic surgeons for sentinel node biopsy in malignant melanoma. Named patient basis. 
   
Phoxillium® 1.2mmol/L
(phosphate solution)
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Restricted Drug Restricted
Red
Restricted - to prescribing by Consultant Anaesthetists only, for critically ill patients who require continuous renal replacement therapy (CRRT) and are not contraindicated for RCA and in accordance with Continuous Renal Replacement Therapy (CRRT) using Citrate - Secondary Care guideline (BHTCG 404FM)  
Link  Continuous Renal Replacement Therapy (CRRT) using Citrate - Secondary Care guideline (BHTCG 404FM)
Link  Renal Replacement Therapy (RRT) during citrate shortage in COVID-19 - Secondary Care guideline (BHTCG 345FM)
   
Physostigmine 1mg/1mL
(injection)
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Restricted Drug Restricted
Red
Restricted for use on St Andrews ward only. 
   
PrismOcal B22®
(bicarbonate buffered dialysis solution)
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Restricted Drug Restricted
Red
Restricted - to prescribing by Consultant Anaesthetists only, for critically ill patients who require continuous renal replacement therapy (CRRT) and are not contraindicated for RCA and in accordance with Continuous Renal Replacement Therapy (CRRT) using Citrate - Secondary Care guideline (BHTCG 404FM)  
Link  Continuous Renal Replacement Therapy (CRRT) using Citrate - Secondary Care guideline (BHTCG 404FM)
Link  Renal Replacement Therapy (RRT) during citrate shortage in COVID-19 - Secondary Care guideline (BHTCG 345FM)
   
Prismocitrate 18/0®
(solution)
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Restricted Drug Restricted
Red
Restricted - to prescribing by Consultant Anaesthetists only, for critically ill patients who require continuous renal replacement therapy (CRRT) and are not contraindicated for RCA and in accordance with Continuous Renal Replacement Therapy (CRRT) using Citrate - Secondary Care guideline (BHTCG 404FM) 
Link  Continuous Renal Replacement Therapy (CRRT) using Citrate - Secondary Care guideline (BHTCG 404FM)
Link  Renal Replacement Therapy (RRT) during citrate shortage in COVID-19 - Secondary Care guideline (BHTCG 345FM)
   
Sodium amidotrizoate/Meglumine amidotrizoate 100mg/660mg in 1mL (Gastrografin®)
(gastroenteral solution)
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Restricted Drug Restricted
Red
Restricted - to use by Radiology team only. 
   
Sodium Hypochlorite 320mg (Milton®)
(tablet)
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Restricted Drug Restricted
Red
Restricted - for use by Ophthalmology team only for disinfection of diagnostic contact lenses. 
   
Sulphur hexafluoride 8microlitres/1mL (Sonovue®)
(intravenous injection)
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Restricted Drug Restricted
Red
Restricted - for use as a diagnostic contrast agent for Stress Echocardiography and the LV Endocardial enhancement. Consultant Cardiologists only 
   
Taurolidine/Citrate 4% with Heparin 500units (Taurolock®Hep 500)
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Restricted Drug Restricted
Red
CAUTION - always double check you have selected the correct Taurolock product.

Restricted - prescribing by Renal Physicians only for locking haemodialysis and haemofiltration lines 
   
Taurolidine/Citrate 4% with Urokinase 25,000units (Taurolock®Urokinase 25,000)
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Restricted Drug Restricted
Red
CAUTION - always double check you have selected the correct Taurolock product.

Restricted - prescribing by Renal Physicians only for locking haemodialysis and haemofiltration lines 
   
Iopamidol 6g in 20L (Niopam 300®)
(injection)
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Restricted Drug Restricted
Red

Restricted - prescribing by Radiology team only

 
   
 ....
 Non Formulary Items
Gadofosveset 244mg/1mL (0.25mmol/1mL)  (Ablavar®)
(injection)

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Non Formulary
Black

unlicensedunlicensed - Low Risk

Restricted - prescribing by Consultant Radiologists only

 
Gadopentetic acid dimeglumine  (Magnevist®)
(intravenous injection, 10mL, 15mL, 20mL vials, 10mL, 15mL prefilled syringe)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Black
Link  MHRA Drug Safety Update - February 2018: Gadolinium-containing contrast agents: Omniscan and iv Magnevist no longer authorised, MultiHance and Primovist for use only in liver imaging
 
  
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

Black

Not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.
Drugs which have been evaluated and rejected by the Medicines Value Group (MVG)
Drugs defined as ‘Low Priority’ by the South Central Priorities Committee
New drugs which have not as yet been evaluated by the MVG
Any drug not listed in the Buckinghamshire Formulary  

Red

Drugs which should only be prescribed in secondary care by a specialist.
Require specialist knowledge and/or equipment for patient selection and initiation
Require long term on-going monitoring and dose adjustment to ensure efficacy and minimise toxicity by a specialist
Designated as “hospital only“ by product licence, NICE, DoH or BNF
May need further evaluation by a specialist
Are hospital initiated clinical trial materials  

Red Specialist Centre

As for ‘red’ (above) with the addition of the following:
Designated by NHS England to require initiation by or in prior agreement with a Specialist Centre. Continuation where appropriate by BHT (or other secondary care provider)
Detailed requirements for Specialist Centre initiation to be described in the wording of the formulary restriction  

Amber Protocol

Drugs which should be initiated in secondary care by the specialist with follow-on prescription and monitoring according to a drug specific Shared Care Protocol(SCP). Prescribing may be continued in primary care following the SCP
Require specialist knowledge and/or equipment for patient selection and initiation
Require short or medium term (eg. 3 to 6 months) specialist monitoring of efficacy or toxicity. The need for stabilisation will vary with different drugs and patients, but is usually a minimum of 2 months (see principles for shared care)
Require significant long term monitoring
Require ongoing communication between the GP and the specialist
Have clearly defined consultant, GP and patient responsibilities documented in a shared care protocol (see responsibilities for amber protocol drugs)  

Amber Initiation

Drugs suitable for primary care prescribing following specialist initiation
Require specialist knowledge and/or equipment for patient selection
Monitoring does not require specialist knowledge or equipment
If the drug is one with which the primary care prescriber is unfamiliar the specialist is expected to provide sufficient information on the drug indication, dose, duration , monitoring and any further necessary dose adjustments
Require the first prescription to be written by the specialist  

Amber Recommended

Drugs suitable for primary care prescribing following specialist recommendation
As for amber initiation except that:- The first prescription may be written by the GP after specialist recommendation.  

Green

Drugs for which primary care prescribers would normally take full responsibility for prescribing and monitoring
Drugs not included in the Traffic Light list but included on joint formulary.
New drugs classified as red or amber but as greater experience regarding their safety and efficacy is established may move to Green after re-consideration by the MVG and APC.  

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