netFormulary
 Report : A-Z of formulary items 05/08/2021 18:51:59
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Section Name Details
04.07.03 Pregabalin 20mg/mL  

Initiation by the Pain, Diabetes, Neurology, Spinal or Palliative Care teams, continuation by GPs. For treatment of neuropathic pain in accordance with the Neuropathic pain  management in adults guideline BHTCG714FM.  The Specialist team prescribes the first 28 days’ supply. 

19.20.02 3M® Kind Removal Silicone Tape 

2.5cm x 5m

In secondary care restricted - use only upon tissue viability recommendation.

In primary care restricted - recommendation by Tissue Viability nurse, and where suitable to continue after hospital initiation.

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

In secondary care obtain from Pharmacy.

13.05.02 5-Methoxypsoralen 20mg  5-MOP unlicensedunlicensed - High Risk
Dose: 1.2mg/kg,
Tablets 2.5 hours pre UVA
Capsules requested to replace tabs
13.05.02 5-Methoxypsoralen 20mg  5-MOP unlicensedunlicensed - High Risk
Not available yet
13.05.02 8-Methoxypsoralen 10mg 8-MOP unlicensedunlicensed - High Risk
Restricted - only for use in patients who cannot take the capsules.
Dose: 0.6mg/kg,
Tablets 2 hours pre UVA
13.05.02 8-Methoxypsoralen 10mg 8-MOP unlicensedunlicensed - High Risk
Dose: 0.6mg/kg,
Capsules 1 hour pre UVA,
05.03.01 Abacavir / Dolutegravir / Lamivudine 600mg/50mg/300mg Triumeq® Preferred fixed dose combination
Where possible, consider switch to generic Kivexa and dolutegravir - March 2017
05.03.01 Abacavir / Lamivudine 600mg/300mg Kivexa® Preferred first line NRTI backbone. Generic preferred March 2017
05.03.01 Abacavir 100mg/5mL 
05.03.01 Abacavir 300mg 
10.01.03 Abatacept 125mg Orencia® FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not yet available.

Restricted - to prescribing by Consultant Rheumatologists only for the treatment of rheumatoid arthritis, as the preferred choice when abatacept IV is recommended in accordance with Biologics for Rheumatoid Arthritis guideline (BHTCG 749FM) and NICE TA 375.

NOTE If patients fail to respond to one route they may NOT try the alternative route.

Red Specialist Centre For treatment of JIA in accordance with NHS England Clinical Commissioning Policy Biologic Therapies for the treatment of Juvenile Idiopathic Arthritis (JIA) (July 2015) E03X04. Prescribing by consultant paediatric rheumatologist under 'shared care' with a Specialized Service Paediatric Rheumatology consultant in accordance with requirements defined in Policy E03X04.
10.01.03 Abatacept 250mg Orencia® FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage

Restricted - to Rheumatology consultant prescribing only, in accordance with Biologics for Rheumatoid Arthritis guideline (BHTCG 749FM) and NICE TA 195 and NICE TA 375.

NOTE If patients fail to respond to one route they may NOT try the alternative route.

Red Specialist Centre For treatment of JIA in accordance with NHS England Clinical Commissioning Policy Biologic Therapies for the treatment of Juvenile Idiopathic Arthritis (JIA) (July 2015) E03X04. Prescribing by consultant paediatric rheumatologist under 'shared care' with a Specialized Service Paediatric Rheumatology consultant in accordance with requirements defined in Policy E03X04.
02.09 Abciximab 10mg/5mL 

Restricted - prescribing by Consultant Cardiologists in accordance with NICE TA 47. Guidance on the use of glycoprotein IIb/IIIa inhibitors in the treatment of acute coronary syndromes. This has been partially updated by NICE CG 94 - Unstable angina and NSTEMI: the early management of unstable angina and non-ST-segment-elevation myocardial infarction.


NOTE: Abciximab is no longer licensed in the UK. Tirofiban is the formulary product of choice (see tirofiban entry).

08.01.05 Abemaciclib 50mg, 100mg, 150mg 

FOR ALL PRESCRIBING - NICE Compliance form required via Blueteq


1. Prescribing by the Oncology team with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer in accordance with NICE TA 563.


2. Prescribing by the Oncology team in combination with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer in accordance with NICE TA 579. CDF funded for this indication until December 2021.

08.03.04.02 Abiraterone Actetate 500mg  Restricted - prescribing by Consultant Oncologists (prostate) only

1. For patients with castration resistant metastatic prostate cancer in accordance with NICE TA259. NICE compliance form required - see link from Formulary homepage

2. For the treatment of metastatic hormone-relapsed prostate cancer before chemotherapy is indicated in accordance with NICE TA387 and NHSE SSC 1637. A completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.
04.10.01 Acamprosate Calcium 333mg 

Initiation by the Drug and Alcohol team and continuation by GPs. Use in accordance with  560FM Acamprosate for treatment of alcohol dependency in adults 18 years and over Amber Initiation guideline

06.01.02.03 Acarbose 50mg 
06.01.06 Accu-Chek® Performa Nano 

Alternative glucose meter for  type 2 diabetes patients who require a small meter with a pre and post meal tagging facility. Used for blood glucose monitoring in gestational diabetes patients. For existing patients prior to switching to Wavesense Jazz(R) if an app is required.

06.01.06 Accu-Chek®Mobile 

Alternative glucose meter for  type 2 diabetes patients who have a specific need e.g. dexterity problems, occupational drivers/travelers/where visual prompts required. 

02.08.01 ACD-A Anticoagulant Citrate Dextrose 

 Restricted - for use in theatres for cell salvage.


02.08.02 Acenocoumarol 1mg 

Restricted - for use in accordance with Anticoagulants, oral (warfarin, acenocoumarol, phenindione) when doses adjusted by Anticoagulation service & prescribed by GP Shared Care protocol (BHTCG 797FM)

06.01.06 Acensia Microfil®   Restricted - only for Type 1 diabetics and patients on insulin with a history of diabetic ketoacidosis.
11.06 Acetazolamide 250mg 

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

11.06 Acetazolamide 250mg 

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

11.06 Acetazolamide 500mg e.g. Diamox®
12.01.01 Acetic Acid 2% Earcalm® Restricted - to prescribing in Primary Care only and in accordance with the Primary care antibiotics guideline.
11.08.02 Acetylcholine Chloride 1% 
18 Acetylcysteine 2g/10mL  Restricted - for use:
1. In paracetamol overdose and
2. On ITU, Spinal and Respiratory wards, via nebulisation as a mucolytic, for ventilated patients at risk of chest sepsis.
11.08.01 Acetylcysteine 5%  unlicensedunlicensed - Low Risk
Restricted - In secondary care Phone Pharmacy to Order
03.07 Acetylcysteine 600mg  Restricted - prescribing by Respiratory Team. Cardiology team may prescribe for renoprotection of patients undergoing contrast enhanced MRI.
11.08.01 Acetylcysteine/Hypromellose 5%/0.35% e.g. Ilube®
05.03.02.01 Aciclovir 200mg, 400mg, 800mg  Tablets can be dispersed in water
05.03.02.01 Aciclovir 200mg/5mL 
05.03.02.01 Aciclovir 250mg, 500mg, 1g  In secondary care restricted - Haematology, Oncology, solid organ transplant patients, Specialist Sexual Health consultants (GUM and Contraception), suspected viral encephalitis and Dermatology (eczema herpeticum cases). For other uses Microbiology approval required
11.03.03 Aciclovir 3% 

Supplies will cease as of June 2019, use ganciclovir 0.15% gel as an alternative product.

13.10.03 Aciclovir 5% 
13.05.02 Acitretin 10mg, 25mg 
03.01.02 Aclidinium Bromide 375micrograms/metered inhalation Eklira Genuair® (Equivalent to 322micrograms aclidinium per inhalation)

To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)

03.01.04 Aclidinium/ formoterol 340 micrograms/ 12 micrograms / inhalation Duaklir Genuair®

To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)


19.05.04 Actico® Cohesive Short-Stretch  10cm x 6m is the most common in use.
In primary care this size only available as stock through the On-line Non-Prescription Ordering System (ONPOS)

6cm x 6m
8cm x 6m
12cm x 6m

In secondary care all sizes are restricted to: use by Dermatology team or on recommendation of Tissue Viability only
In primary care unusal sizes should be recommended by a specialist e.g. tissue viability or lymphoedema specialist
BNF A5.8.7
19.04.01 Acticoat® Flex 3 

5cm x 5xm (66800396)
10cm x10cm (66800399)
10cm x 20cm (66800409)
10cm x 120cm (66800435)
Restricted - to use in secondary care for Paediatrics, Spinal Outpatients, Dermatology, Burns and Plastics


BNF A5.3.3
In secondary care obtain from Pharmacy

19.21 Actiglide®  one size
19.04.02 Actilite®   5cm x 5cm (CR4281)
10cm x10cm (CR3849)
10cm x 20cm (CR3852)
Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.3.1
In secondary care obtain from Pharmacy
19.21 ActiLymph® Hosiery  For chronic oedema/lymphoedema.
In community, use European class RAL hosiery for patients with returning oedema. Other hosiery products can be sourced following advice from Lymphoedema or Tissue Viability.
BNF A5.9.1
18 Activated charcoal 50g/250mL  Reduction of absorption of toxic substances by the GI tract that are adsorbed by charcoal
19.12.01 Active Heal Hydrogel  

Restricted - not for nursing homes.

8g, 15g

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

BNF A5.2.1
In secondary care obtain from Supplies.

19.04.02 Activon Tulle®   5cm x 5cm (CR3658)
10cm x10cm (CR3761)
Both available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.3.1
In secondary care obtain from Pharmacy
01.05.03 Adalimumab 40mg Imraldi®, Amgevita®, Humira®

FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage. NICE compliance to be confirmed if form not yet available.


Note: ALL prescribing of adalimumab must include generic and brand name. Imraldi® is first choice preperation. Amgevita® is second choice preperation in those intolerant to citrate element (switch application via Blueteq).


1. Restricted - prescribing by Gastroenterologists only in accordance with NICE TA187.
2. Restricted - prescribing by Gastroenterologists in accordance with Biologics in Ulcerative Colitis guideline (BHTCG 633FM) and NICE TA 329.
NOTE: In NICE TA329 adalimumab is the first choice biologic for adult use and infliximab for paediatric use. In NICE TA163 infliximab is approved for acute exacerbations. If a patient on infliximab for NICE TA163 continues treatment long term in accordance with NICE TA329, infliximab should be the drug of choice and switching to adalimumab should not take place. Also note that NICE TA329 recommends titrating up to weekly dosing for adalimumab. This is in contrast to current Thames Valley Priorities Committee recommendations and supersedes them.

see section 10.01.03 (for Rheumatology) and 13.05.03 (for Dermatology)

10.01.03 Adalimumab 40mg Imraldi®, Amgevita®, Humira®

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.


Note: ALL prescribing of adalimumab must include generic and brand name. Imraldi® is first choice preperation. Amgevita® is second choice preparation in those intolerent to citrate element (switch application via Blueteq).


Red Traffic Light 


1. Restricted - to Rheumatology consultant prescribing only, in accordance with Biologics for Rheumatoid Arthritis guideline (BHTCG 749FM) and NICE TA 375 and TA 195.
2. Restricted - to Rheumatology consultant prescribing only, in accordance with Biologics for Ankylosing Spondylitis guideline (BHTCG 737FM) and NICE TA 143.
3. Restricted - to prescribing by Rheumatology or Dermatology consultants only, in accordance with Biologics for Psoriatic arthritis guideline (BHTCG 740FM) and NICE TA 199

Red Specialist Centre 


4. Restricted - prescribing by consultant opthalmologists following initiation by Specialist Centre.
For treatment continuation for non-infectious uveitis in adult patients in accordance with NICE TA460, NHSE Clinical Commissioning Policy D12/P/b, July 15 and NHSE Interim Clinical Commissioning Policy Statement 170010/PS. BHT Opthalmology consultants will prescribe as outreach to the Specialist Centre delivered as part of a provider network. Name of Specialist centre and clinician involved in MDT to be communicated to Formulary Team prior to initiating treatment at BHT. If treatment is continued at BHT, the biologic will be administered by Rheumatology
5. Restricted - For treatment of JIA in accordance with NHS England Clinical Commissioning Policy Biologic Therapies for the treatment of Juvenile Idiopathic Arthritis (JIA) (July 2015) E03X04. Prescribing by consultant paediatric rheumatologist under 'shared care' with a Specialized Service Paediatric Rheumatology consultant in accordance with requirements defined in Policy E03X04.

See section 01.05.03 (Gastroenterology) and 13.05.03 (Dermatology)

13.05.03 Adalimumab 40mg Imraldi®, Amgevita®, Humira®

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.


Note: ALL prescribing of adalimumab must include generic and brand name. Imraldi® is first choice preperation. Amgevita® is second choice preperation in those intolerant to citrate element (switch application via Blueteq).



Red Traffic Light  FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.
1. Restricted - to prescribing by Dermatology consultants only, in accordance with Biologics for Psoriasis guideline (BHTCG 738FM) and NICE TA 146.
2. Restricted - to prescribing by Rheumatology or Dermatology consultants only, in accordance with Biologics for Psoriatic arthritis guideline (BHTCG 740FM) and NICE TA 199.

Red Specialist Centre 
3. Restricted - prescribing by consultant opthalmologists following initiation by Specialist Centre. For treatment continuation for moderate to severe hidradenitis suppurativa in accordance with NICE TA 392 AND NHSE SSC 1643 September 2016. BHT Dermatology consultants will prescribe as outreach to the Specialist Centre delivered as part of a provider network. Name of Specialist centre and clinician involved in MDT to be communicated to Formulary Team prior to initiating treatment at BHT.
4. Restricted - prescribing by consultant dermatologists following initiation by Specialist Centre. For treatment of plaque psoriasis in children and young people in accordance with NICE TA 455. BHT Dermatology consultants will prescribe as outreach to the Specialist Centre delivered as part of a provider network. Name of Specialist centre and clinician involved in MDT to be communicated to Formulary Team prior to initiating treatment at BHT.

See section 01.05.03 (Gastroenterology) and 10.01.03 (Rheumatology)

13.06.01 Adapalene 0.1% 
13.06.01 Adapalene/Benzoyl Peroxide 0.1%/ 2.5%  Epiduo®

For use in accordance with the Bucks Acne Treatment Algorithm (see link above). 


05.03.03 Adefovir Dipivoxil 10mg  Restricted - not routinely commissioned. An Individual Funding Request is required before commencing treatment.
02.03.02 Adenosine 130mg in 130mL  unlicensedunlicensed - Medium risk
02.03.02 Adenosine 6mg/2mL 
02.07.03 Adrenaline / Epinephrine  For emergency resuscitation only

To be used in line with Resuscitation Council guidance.
03.04.03 Adrenaline / Epinephrine 150micrograms Emerade®

All prescribing to ensure patient has 2 devices. Prescriptions may be written for up to 2 devices per patient at one time for adults and children.
Restricted in secondary care to prescribing by middle grade doctors and above.

Note NOTE: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously.

03.04.03 Adrenaline / Epinephrine 150micrograms (Child) Jext® All prescribing to ensure patient has 2 devices. Prescriptions may be written for up to 2 devices per patient at one time for adults and children.
Restricted in secondary care to prescribing by middle grade doctors and above.

NOTE: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously.
03.04.03 Adrenaline / Epinephrine 150micrograms (Child) Epipen® Jr Restricted - 2nd Choice adrenaline auto-injector pen, only to be used when there are supply issues with the Jext brand.

All prescribing to ensure patient has 2 devices. Prescriptions may be written for up to 2 devices per patient at one time for adults and children.
Restricted in secondary care to prescribing by middle grade doctors and above.

NOTE: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously.
03.04.03 Adrenaline / Epinephrine 1mg/mL (1 in 1000) 
03.04.03 Adrenaline / Epinephrine 1mg/mL (1 in 1000) Minijet® Adrenaline 1 in 1000 21 gauge needle for i.m. injection for hospital use only.
03.04.03 Adrenaline / Epinephrine 300micrograms Emerade®

All prescribing to ensure patient has 2 devices. Prescriptions may be written for up to 2 devices per patient at one time for adults and children.
Restricted in secondary care to prescribing by middle grade doctors and above.

Note NOTE: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously.

03.04.03 Adrenaline / Epinephrine 300micrograms (Adult) Jext® All prescribing to ensure patient has 2 devices. Prescriptions may be written for up to 2 devices per patient at one time for adults and children.
Restricted in secondary care to prescribing by middle grade doctors and above.

NOTE: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously.
03.04.03 Adrenaline / Epinephrine 300micrograms (Adult) Epipen® Restricted - 2nd Choice adrenaline auto-injector pen, only to be used when there are supply issues with the Jext brand.

All prescribing to ensure patient has 2 devices. Prescriptions may be written for up to 2 devices per patient at one time for adults and children.
Restricted in secondary care to prescribing by middle grade doctors and above.

NOTE: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously.
03.04.03 Adrenaline / Epinephrine 500micrograms Emerade®

All prescribing to ensure patient has 2 devices. Prescriptions may be written for up to 2 devices per patient at one time for adults and children.
Restricted in secondary care to prescribing by middle grade doctors and above.

Note NOTE: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously.

14.04 Adsorbed Diphtheria [low dose], Tetanus and Inactivated Poliomyelitis Vaccine Revaxis® For children over 10 years and adults

In primary care as part of the routine national UK immunisation schedule
14.04 Adsorbed Diphtheria [low dose], Tetanus, Pertussis (Acellular, Component) and Inactivated Poliomyelitis Vaccine Repevax® For children 3-10 years

In primary care as part of the routine national UK immunisation schedule

08.01.05 Afatinib 20mg, 30mg, 40mg, 50mg  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage.

Restricted - prescribing by Consultant Oncologist (Lung) only for treatment of adults with locally advanced or metastatic non-SCLC if tests positive for EGFR-TK mutation. Patients has not previously had a EGFR-TK inhibitor in line with NICE TA 310
11.08.02 Aflibercept 4mg/0.1mL 

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.

FOR ALL INDICATIONS - to be used as described in the intravitreal injections algorithm (BHTCG 653FM) (see link above) and based upon the principle that 'when all clinical considerations are equal, priority will be given to the product with greatest experience and lowest long term treatment costs'

Restricted - prescribing by consultant Ophthalmologists:
1. As an alternative to ranibizumab, as a 1st line treatment for wet Age Related Macular Degeneration (AMD) in accordance with NICE TA294.
2. As a 1st line alternative to ranibizumab, for Central Retinal Vein Occlusion in accordance with NICE TA305
3. As an alternative 1st and 2nd line anti VEGF to 1st choice ranibizumab for treating visual impairment caused by diabetic macular oedema in accordance with NICE TA 346
4. Treatment of visual impairment due to macular oedema secondary to Branch Retinal Vein Occlusion (BRVO) in accordance with NICE TA 409.
5. For treatment of visual impairment due to myopic choroidal neuvascularisation (CNV) in accordance with NICE TA 486.

04.03.04 Agomelatine 25mg 

Red Traffic Light  For Generalised Anxiety Disorder: prescribing by Psychiatry team only. Used in accordance with guideline BHTCG 131FM.



Amber For treatment of depression, initiation by Psychiatry team, continuation by GPs in accordance with Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).  Patients should remain under the care of an Oxford Health specialist until all scheduled LFT monitoring is complete and results are normal (minimum of 24 weeks, or for 24 weeks from the date of a dose increase). Only at this point, and only if the patient is well, should a patient be discharged back to GP care.

06.01.06 Albustix® 
13.11.01 Alcohol Hand Rubs  In secondary care see hospital policy on hand disinfection
08.01.05 Alectinib 150mg Alecensa®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.


Restricted to prescribing by Oncologists only for untreated ALK-positive advanced non-small-cell lung cancer in accordance with NICE TA 536.

08.02.03 Alemtuzumab 12mg/1.2mL  FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

1. Restricted - prescribing by Consultant Neurologists and Clinical Nurse Specialist for Neurology for the treatment of adults with relapsing remitting multiple sclerosis with active disease in accordance with NICE TA312
06.06.02 Alendronic Acid 70mg 

2nd line option for primary and secondary fracture prevention. To be used in accordance with the Fracture prevention in adults greater than 50 years old guideline (BHTCG 567FM).

06.06.02 Alendronic Acid 70mg 

1st line for primary and secondary fracture prevention. To be used in accordance with the Fracture prevention in adults greater than 50 years old guideline (BHTCG 567FM).

09.06.04 Alfacalcidol 250nanograms, 1microgram 
09.06.04 Alfacalcidol 2micrograms/1mL  1 drop contains approx. 100nanograms
09.06.04 Alfacalcidol 2micrograms/1mL 
A2.03 Alfamino 

In primary care - 1st choice for children with severe CMPA (from birth to 2 years)

15.01.04.03 Alfentanil 1mg/2mL, 5mg/10mL, 25mg/50mL 
15.01.04.03 Alfentanil 5mg/1mL 
07.04.01 Alfuzosin Hydrochloride 10mg 
07.04.01 Alfuzosin Hydrochloride 2.5mg 
19.04.02 Algivon®   5cm x 5cm (CR3831)
10cm x 10cm (CR3659)
Both available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)


BNF A5.3.1
In secondary care obtain from Pharmacy
03.04.01 Alimemazine Tartrate 10mg 

Amber Recommentation  Recommendation by Paediatrics, Spinal and Haematology teams, continuation by GPs. 

Red Traffic Light  When prescribed in accordance with Guidelines for the sedation of children undergoing MRI or CT scan (BHTCG 343).

03.04.01 Alimemazine Tartrate 30mg/5mL 

Amber Recommentation  Recommendation by Paediatrics, Spinal and Haematology teams, continuation by GPs. 


Red Traffic Light  When prescribed in accordance with Guidelines for the sedation of children undergoing MRI or CT scan (BHTCG 343).

03.04.01 Alimemazine Tartrate 7.5mg/5mL 

Amber Recommentation  Recommendation by Paediatrics, Spinal and Haematology teams, continuation by GPs. 


Red Traffic Light  When prescribed in accordance with Guidelines for the sedation of children undergoing MRI or CT scan (BHTCG 343).

02.12 Alirocumab 75mg/ml, 150mg/ml Praulent®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form is required. 

Prescribing initiation and continuation by Consultant Chemical Pathologists (Lipidologists) only.

For treatment of primary hypercholesterolaemia (heterozygous familial and non-familial) and mixed dyslipidaemia in accordance with NICE TA 393 (alirocumab) and Bucks guideline 104FM Lipid Modification for Non-Familial Hypercholesterolaemia (for adults).

13.05.01 Alitretinoin 10mg, 30mg  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage

Restricted - prescribing by Dermatology consultants only in accordance with NICE TA 177 Alitretinoin for the treatment of Chronic Hand Eczema
10.01.04 Allopurinol 100mg, 300mg  1st Choice prophylaxis for gout
04.07.04.01 Almotriptan 12.5mg  In accordance Buckinghamshire's Headache Management Guidelines (BHTCG 721FM)(see link above)
09.06.05 Alpha Tocopheryl Acetate 500mg/5mL Vitamin E Green Traffic Light  Dose according to specialist recommendation in Cystic Fibrosis and RDA in other conditions (green on TLL)

Red Specialist Centre Restricted - for treatment continuation in metabolic disorders, only after initiation by tertiary specialist centres (e.g. Oxford - John Radcliffe)
09.06.05 Alpha Tocopheryl Acetate 50mg, 200mg Vitamin E unlicensedUnlicensed -

Vitamin E tablets are not prescribable in primary care, use the liquid instead
13.09 Alphosyl 2 in 1® 
07.04.05 Alprostadil 10 micrograms, 20 micrograms Caverject® Dual Chamber

Red Traffic Light  For all psychological indications

Amber Recommentation For patients who meet SLS criteria AND only if oral phosphodiesterase type-5 inhibitors are unsuitable (contraindicated or ineffective). The maximum frequency of dosing should be two times per month in line with TVPC policy 34 http://www.fundingrequests.cscsu.nhs.uk/wp-content/uploads/2020/06/TVPC34-Erectile-Dysfunction-BU.pdf. 


If problems wth supply, please use Viridal® Duo.

07.04.05 Alprostadil 10 micrograms, 20 micrograms Viridal® Duo

 Red Traffic Light  For all psychological indications

Amber Recommentation For patients who meet SLS criteria AND only if oral phosphodiesterase type-5 inhibitors are unsuitable (contraindicated or ineffective). The maximum frequency of dosing should be two times per month in line with TVPC policy 34 http://www.fundingrequests.cscsu.nhs.uk/wp-content/uploads/2020/06/TVPC34-Erectile-Dysfunction-BU.pdf. 


For use while supply problems exist with Caverject® Dual Chamber

07.04.05 Alprostadil 250, 500, 1000 micrograms MUSE®

 Red Traffic Light  For all psychological indications

Amber Recommentation For patients who meet SLS criteria AND only if oral phosphodiesterase type-5 inhibitors are unsuitable (contraindicated or ineffective). The maximum frequency of dosing should be two times per month in line with TVPC policy 34 http://www.fundingrequests.cscsu.nhs.uk/wp-content/uploads/2020/06/TVPC34-Erectile-Dysfunction-BU.pdf. 

02.10.02 Alteplase 10mg 

Restricted - for use in Radiology only.


See also Chapter 11 for use in Ophthalmology

11.99.99.99 Alteplase 10mg 

Prescribing by Ophthalmology Consultants for


 


1. Intravitreal or sub-retinal use after sub-retinal bleed (unlicensed use). Usual dose range 25-50 microgram (in 0.05 - 0.1mL). Pharmacy to supply Alteplase 10mg vial. Reconstitute in Ophthalmic theatre immediately prior to use. If further dilution required use water for injections or sodium chloride 0.9%.


 


2. Treatment of anterior chamber fibrinous inflammation. Dose: 10micrograms/0.1mL

02.10.02 Alteplase 2mg Actilyse Cathflo®

For unblocking of central venous access devices (CVADs).

02.10.02 Alteplase 50mg  1. Restricted - for use in PE
2. Restricted - prescribing by Stroke team and A&E senior physicians in accordance with NICE TA264.
A2.03 Althera 

In primary Care - 2nd choice for mild to moderate CMPA and severe non-IG E mediated CMPA (from birth to 2 years)

19.21 Altipress® 40 Leg Ulcer Kit  

Restricted - not for nursing homes.

Kit containing;
2 x Altipress® White inner stockings (10 mmHg)
1 x Altipress® Soft Beige outer stocking (30 mmHg)

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

In secondary care obtain from Supplies.

19.21 Altipress® Compression Liner 

Provides 10mmHg at the ankle.

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

In secondary care obtain from Supplies.

BNF A5.9.1

A2.02.02.03 Altraplen Compact  125ml

 ** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.01 Altraplen protein (formerly known as Nutriplen Protein) 200ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.04.01.03 Altrashot 120ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 

07.04.04 Alum Bladder Washout 10%  unlicensedUnlicensed - Medium Risk
Restricted - in secondary care Phone Pharmacy to Order
12.01.01 Aluminium Acetate 13%  unlicensedUnlicensed - Low risk

In primary care this is a pharmaceutical special
12.01.01 Aluminium Acetate 8%  unlicensedUnlicensed

In primary care this is a pharmaceutical special
13.11.06 Aluminium Chloride hexahydrate 20% 
04.09.01 Amantadine Hydrochloride 100mg 
04.09.01 Amantadine Hydrochloride 50mg/5mL 
02.05.01 Ambrisentan 5mg  Restricted - prescribing by Respiratory consultants only after initiation in a Specialist centre. May be continued in BHT via shared care between Specialist centre and BHT via a network model.

For pulmonary arterial hypertension in accordance with NHSE Specialised Commissioning Policy A11/P/b, June 2014: National policy for targeted therapies for the treatment of pulmonary hypertension in adults.

The name of the Specialist centre and consultant initiating drug to be communicated to Pharmacy formulary team prior to prescribing.
05.01.04 Amikacin 100mg/2mL  Restricted:
1. Microbiology approval required and phone Pharmacy to order.
2. When used via inhalation for cystic fibrosis, prior NHSE IFR approval needed and as such is non formulary – contact BHT Formulary Team
05.01.04 Amikacin 500mg/2mL  In secondary care restricted - Ophthalmology only.
Microbiology approval required for all other uses.
Can be used to prepare Amikacin ophthalmic preparations
02.02.03 Amiloride Hydrochloride 5mg 
03.01.03 Aminophylline 225mg Phyllocontin Continus®
03.01.03 Aminophylline 250mg/10mL 
02.03.02 Amiodarone Hydrochloride 100mg, 200mg 

Restricted - initiation in secondary care with continuation by GPs in accordance with Amiodarone for use in Cardiology - Shared Care Protocol (BHTCG 632FM)

02.03.02 Amiodarone Hydrochloride 300mg/10mL 
02.03.02 Amiodarone Hydrochloride150mg/3mL 
04.02.01 Amisulpride 100mg/1mL 

Restricted - only for use when patient cannot swallow ordinary tablets.


To be initiated by Consultant Psychiatrists and continued by GPs in accordance with the treatment of psychosis and schizophrenia algorithm (BHTCG 726FM)

04.02.01 Amisulpride 50mg, 200mg 

Restricted - To be initiated by Consultant Psychiatrists with continuation by GPs in accordance with the treatment of psychosis and schizophrenia algorithm (BHTCG 726FM)

04.03.01 Amitriptyline Hydrochloride 10mg, 25mg, 50mg 

Amber Recommentation For treatment of depression in accordance with the Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM). For existing patients in exceptional cases when safer alternatives are not suitable.

Green Traffic Light  For treatment of neuropathic pain in accordance with Neuropathic pain management in adults guideline BHTCG 714FM.

04.03.01 Amitriptyline Hydrochloride 25mg/5mL, 50mg/5mL 

Amber Recommentation For treatment of depression in accordance with the Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM). For existing patients in exceptional cases when safer alternatives are not suitable.

Green Traffic Light  For treatment of neuropathic pain in accordance with Neuropathic pain management in adults guideline BHTCG 714FM. 

02.06.02 Amlodipine 5mg, 10mg 
05.01.01.03 Amoxicillin 125mg/5mL, 250mg/5mL 
05.01.01.03 Amoxicillin 250mg, 500mg 
05.01.01.03 Amoxicillin 250mg, 500mg, 1g 
05.01.01.03 Amoxicillin 3g 
05.02.03 Amphotericin (liposomal) 50mg AmBisome®

Restricted  to prescribing by haematology, oncology, ophthalmology, GUM and / or on advice by Microbiology.                                                                                           


See Antifungal Therapy Guidelines for Haematology / Oncology (BHTCG 203FM) and Ophthalmic Infections (BHTCG 372).

11.03.02 Amphotericin 0.15%  unlicensedunlicensed - Medium Risk
In secondary care restricted -Microbiology approval required. Named patient basis and Phone Pharmacy to Order (normally available within one week)
05.02.03 Amphotericin 50mg Fungizone®

Restricted - contact a Pharmacist to order. See Ophthalmic Infections (BHTCG 372).

08.01.05 Amsacrine 75mg/1.5mL 
12.03.03 Amylmetacresol/Dichlorobenzyl Strepsils® In community patients to purchase OTC
09.01.04 Anagrelide 0.5mg  Restricted- prescribing by consultant Haematologists.
For treatment of essential thrombocythaemia in patients who have not responded adequately or tolerate other drugs (e.g. hydroxycarbamide)
10.01.03 Anakinra Kineret® Restricted - For treatment of JIA in accordance with NHS England Clinical Commissioning Policy Biologic Therapies for the treatment of Juvenile Idiopathic Arthritis (JIA) (July 2015) E03X04. Prescribing by consultant paediatric rheumatologist under 'shared care' with a Specialized Service Paediatric Rheumatology consultant in accordance with requirements defined in Policy E03X04.
27.17 Anal irrigation system Peristeen transanal irrigation system®

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system Qufora Irrisedo Mini® monthly set

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system Aquaflush Lite® monthly set

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system Aquaflush Quick®

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system Navina Classic®

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system Qufora® IrriSedo Bed system

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system Qufora Irrisedo Cone Toilet System®

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system IryPump S®

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system Navina Smart®

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation.

27.17 Anal irrigation system Aquaflush Compact® Monthly set

To be initiated on the recommendation of Specialist Continence Nurse led bowel management service or Specialist in bowel management with continuation by GPs. For management of  bowel dysfunction in accordance with TVPC policy 3a Anal Irrigation Systems for the Management of Faecal Incontinence/ constipation. 

08.03.04.01 Anastrozole 1mg  In secondary care restricted to prescribing by Consultants in Breast Surgery or Breast Oncology.
In primary care, may be prescribed by GPs if recommended by Consultants in Breast Surgery or Breast Oncology.
05.02.04 Anidulafungin 100mg 

Restricted  to prescribing by haematology, oncology, ITU and / or on advice by Microbiology in accordance with Appropriate Use of Anidulafungin guideline (BHTCG 743) or Antifungal Therapy Guidelines for Haematology / Oncology (BHTCG 203FM)    

11.04.02 Antazoline Sulfate/Xylometazoline 0.5%/0.05%  In primary care consider if more suitable for patients to purchase over the counter choices
13.08.01 Anthelios®XL SPF 50+ 

Only Prescribable for ACBS conditions.


For skin protection against ultraviolet radiation and/or visible light in abnormal cutaneous photosensitivity causing severe cutaneous reactions in genetic disorders (including xeroderma pigmentosum and porphyrias), severe photodermatoses (both idiopathic and acquired) and in those with increased risk of ultraviolet radiation causing severe adverse effects due to chronic disease (such as haematological malignancies), medical therapies and/or procedures.

14.05.03 Anti-D (Rh0) Immunoglobulin 

Supplied via the Blood Bank

08.02.02 Antilymphocyte Globulin (equine)(alg) 100mg/5mL  Restricted - Renal Patients Only, Phone Pharmacy to Order
08.02.02 Antithymocyte Immunoglobulin (equine) 100mg/5mL  Restricted - Renal Patients Only, Phone Pharmacy to Order
08.02.02 Antithymocyte Immunoglobulin (rabbit) 25mg Thymoglobuline® Restricted - Renal Patients Only, Phone Pharmacy to Order
01.07.01 Anusol®  
02.08.02 Apixaban 2.5mg, 5mg 

NOTE: Tablets can be dissolved/crushed and administered via nasogastric/PEG tubes.


Amber For treatment of DVT and PE and prevention of recurrent DVT and PE in adults unsuitable for warfarin, for whom dalteparin would otherwise be considered, in accordance with NICE TA 341 and the Dabigatrin, Rivaroxaban, Apixaban and Edoxaban for DVT and PE - Amber Initiation guideline (BHTCG 295FM).

Initiation by or on the advice of  consultant Haematologists or DOAC pharmacists with continuation by GPs.  Any consultant may refer DVT/PE cases to Haematology / DOAC service for a decision about treatment after dalteparin has already been initiated. 

 
Green For preventing stroke and systemic embolism in adults with non-valvular atrial fibrillation in accordance with Dabigatran, Rivaroxaban, Edoxaban and Apixaban for Atrial Fibrillation guideline (BHTCG 313FM).

06.01.06 Apollo Twist® 

For primary care for all Type 2 diabetics

04.09.01 Apomorphine 30mg/3mL APO-go® Pen Restricted - to prescribing by Consultant Neurologists for the treatment of Parkinson's disease in accordance with Apomorphine for use in Parkinson's Disease - Hospital Only guideline (BHTCG 352FM) and NICE CG35.
04.09.01 Apomorphine 50mg/5mL APO-go® PFS Restricted - to prescribing by Consultant Neurologists for the treatment of Parkinson's disease in accordance with Apomorphine for use in Parkinson's Disease Hospital - Only guideline (BHTCG 352FM) and NICE CG35.
04.09.01 Apomorphine Hydrochloride 20mg/2mL, 50mg/5mL  Restricted - to prescribing by Consultant Neurologists for the treatment of Parkinson's disease in accordance with Apomorphine for use in Parkinson's Disease - Hospital Only guideline (BHTCG 352FM) and NICE CG35.
11.08.02 Apraclonidine 0.5% e.g. Iopidine®
11.08.02 Apraclonidine 1% e.g. Iopidine®
10.01.03 Apremilast titration pack, 30mg Otezla®

Initiation pack contains a 14-day starter pack of apremilast 4 x 10 mg (pink) with 4 x 20 mg (brown) and 19 x 30 mg (beige) tablets.


FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage.

Restricted - to Rheumatology consultant prescribing only in accordance with Biologics and Apremilat in Psoriatic Arthritis algorithm (BHTCG 740FM)  and NICE TA 433 when biologics are deemed unsuitable


See section 13.5.3 for use in Dermatology


13.05.03 Apremilast titration pack, 30mg Otezla®

Initiation pack contains a 14-day starter pack of apremilast 4 x 10 mg (pink) with 4 x 20 mg (brown) and 19 x 30 mg (beige) tablets.

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.

Restricted - to prescribing by Dermatology Specialists doctors only, in accordance with Biologics for Psoriasis guideline (BHTCG 738FM) and NICE TA 419.

See section 10.1.3 for use in rheumatology

04.06 Aprepitant 80mg, 125mg  Restricted - prescribing by Consultant Oncologists for chemotherapy induced nausea and vomiting for patients on highly emetogenic regimens (FEC 100 or Cisplatin >70mg/m2) only, in accordance with TVCN/CINV guidelines.
02.11 Aprotinin 500,000 kallikrein inactivator units/50mL  unlicensedunlicensed
A2.03 Aptamil Pepti 1 

In primary care 1st choice for mild-moderate CMPA and severe non-IG E mediated CMPA (from birth to 6 months)

A2.02.02.03 Aptamil Pepti 2  In primary care 1st choice for mild-moderate CMPA in children aged 6 months to 2 years
A2.03 Aptamil Pepti 2 

In primary care 1st choice for mild-moderate CMPA and severe non-IG E mediated CMPA (from 6 months - 2 years)

19.04.01.03 Aquacel Ag+ Extra®   5cm x 5cm (413566)
10cm x 10cm (413567)

In primary care, sizes listed above are available as stock through the On-line Non-Prescription Ordering System (ONPOS)

15cm x15cm (413568)
In primary care available on prescription only

BNF A5.3.3
In secondary care obtain from Pharmacy
19.04.01.03 Aquacel Ag® Ribbon 

2cm x 45cm (413571)
1cm x 45cm (413570)
Both available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)


BNF A5.3.3
In secondary care obtain from Pharmacy

19.02 Aquacel Extra®  5cm x 5cm (420671)
10cm x 10cm (420672)
15cm x 15cm (420673)
4cm x 20cm (420821)
All sizes available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)


BNF A5.2.4
In secondary care obtain from Pharmacy
19.10.01 Aquacel® Foam adhesive Green Traffic Light 
16.9cm x 20cm (sacral)(420626)(ONPOS)

Sizes below are 2nd Choice if Biatain Silicone® not appropriate or contraindicated:
8cm x 8cm (420804)(ONPOS)
10cm x 10cm (420680)(ONPOS)
12.5cm x 12.5cm (420619)(ONPOS)
17.5cm x 17.5cm (420621)(ONPOS)(in secondary care may only be stocked in Spinal Outpatients)
10cm x 20cm (421150)(In primary care available on prescription only)
19.8cm x 14cm (heel)(420625) 2nd Choice if Tegaderm® Heel not working or contraindicated. (In primary care available on prescription only)

In primary care most sizes available as stock through the On-line Non-Prescription Ordering System (ONPOS) except 19.8cm x 14cm (heel) and 10cm x 20cm which are prescription only.

In secondary care all above, restricted to prescribing only by TV Nurse, Dermatology, Burns and Plastics and Spinal teams.

Red Traffic Light 
25cm x 30cm (420624) restricted - to be prescribed in secondary care only. Maybe stocked on Ward 16 only at SMH

BNF A5.2.4
In secondary care obtain from Pharmacy
19.02 Aquacel® Ribbon  2cm x 45cm (S7503)
1cm x 45cm (420127)
All sizes available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)


BNF A5.2.4
In secondary care obtain from Pharmacy
09.06.07 AquADEKs® liquid  Restricted - initiation by Consultant Paediatricians with continuation by GPs for cystic fibrosis patients requiring Vitamin K supplementation, who cannot swallow tablets and to be used in accordance with Vitamin Supplementation for Paediatric Cystic Fibrosis Patients - Primary/Secondary Care guideline (BHTCG 378FM) (see link above)
Note this product is in the process of being discontinued. Please switch patients to DEKAs Plus liquid if not available
13.02.01.01 Aqueous Cream BP 
01.06.03 Arachis Oil 
13.09 Arachis Oil  In secondary care restricted for adults only
02.08.01 Argatroban 250mg in 2.5mL  

Prescribing on the advice of a consultant Haematologist for HIT in accordance with interim guidance on diagnosis and management of thrombosis and thrombocytopenia occurring after COVID-19 vaccination : guidance-version-07-on-mngmt-of-thrombosis-with-thrombocytopenia-occurring-after-c-19-vaccine_20210330_.pdf (b-s-h.org.uk)

09.08.01 Arginine 100mg/mL  unlicensedUnlicensed

Restricted - to initiation by Consultant Paediatricians for the treatment of metabolic disorders on the advice of tertiary centres in accordance with NHS England commissioning of highly specialised metabolic disorder services.
09.08.01 Arginine 500mg  unlicensedUnlicensed

Restricted - to initiation by Consultant Paediatricians for the treatment of metabolic disorders on the advice of tertiary centres in accordance with NHS England commissioning of highly specialised metabolic disorder services.
09.08.01 Arginine 5g/10mL  unlicensedUnlicensed

Restricted - to initiation by Consultant Paediatricians for the treatment of metabolic disorders, on the advice of the tertiary care centre, in accordance with NHS England commissioning of highly specialised metabolic disorder services.
04.02.01 Aripiprazole 10mg, 15mg 

Initiation by Psychiatry team with continuation by GPs for treatment of;

1. Psychosis and schizophrenia in adults in accordance with Treatment of Psychosis and Schizophrenia algorithm (BHTCG 726FM).

2. Schizophrenia in people aged 15 to 17 years in accordance with NICE TA 213.

3. Up to 12 weeks for moderate to severe manic episodes in bipolar disorder in adolescents aged 13 to 18 years in accordance with NICE TA 292.

4. Augmentation in depression in accordance with Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressatns treatment algorithm (BHT 572FM). 


NOTE: Only for use when patient cannot swallow ordinary tablets.  NB an oral solution 1mg/ml is also available but should be reserved for patients with swallowing difficulties or to facilitate doses less than 5mg (smallest tablet size).

04.02.01 Aripiprazole 1mg/1mL 

NOTE: Ony for patients with swallowing difficulties or to facilitate doses less than 5mg (smallest tablet size).

Initiation by Psychiatry team with continuation by GPs for treatment of;

1. Psychosis and schizophrenia in adults in accordance with Treatment of Psychosis and Schizophrenia algorithm (BHTCG 726FM).

2. Schizophrenia in people aged 15 to 17 years in accordance with NICE TA 213.

3. Up to 12 weeks for moderate to severe manic episodes in bipolar disorder in adolescents aged 13 to 18 years in accordance with NICE TA 292. 

4. Augmentation in depression - in accordance with  Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressants treatment algorithm (BHT 572FM). 

04.02.01 Aripiprazole 400mg  Restricted- prescribing by Consultant Psychiatrists only in accordance with Oxford Health Psychosis and Schizophrenia guideline.
04.02.01 Aripiprazole 5mg, 10mg, 15mg, 30mg 

Initiation by Psychiatry team with continuation by GPs for treatment of;

1. Psychosis and schizophrenia in adults in accordance with Treatment of Psychosis and Schizophrenia algorithm (BHTCG 726FM).

2. Schizophrenia in people aged 15 to 17 years in accordance with NICE TA 213.

3. Up to 12 weeks for moderate to severe manic episodes in bipolar disorder in adolescents aged 13 to 18 years in accordance with NICE TA 292.

4. Augmentation in depression in accordance with Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressants treatment algorithm (BHT 572FM). 

NB an oral solution 1mg/ml is also available but should be reserved for patients with swallowing difficulties or to facilitate doses less than 5mg (smallest tablet size).

04.02.01 Aripiprazole 7.5mg/1mL (9.75mg/1.3mL vial)  Restricted - prescribing by Psychiatric (Mental Health Trust) team only and for use in accordance with:

NICE TA213 - Aripiprazole for the treatment of schizophrenia in people aged 15 to 17 years (see link above) or,
NICE TA292 - Aripiprazole is recommended as an option for treating moderate to severe manic episodes in adolescents aged 13-18 years, with bipolar 1 disorder, within its marketing authorisation (ie. up to 12 weeks of treatment for moderate to severe manic episodes in bipolar disorder)(see link above)
16.01 Aromatherapy in Labour  For use in accordance with Aromatherapy in Labour guideline (BHTCG 500 - awaited)
08.01.05 Arsenic Trioxide Trisenox®

FOR ALL PRESCRIBING - NICE compliance form via BLUETEQ required - see link from Formulary homepage.


Restricted to prescribing by Haematology team. For the treatment of acute promyelocytic leukaemia in accordance with NICE TA 526.

05.04.01 Artemether / Lumefantrine 20mg/120mg Riamet® Tablets may be crushed just before administration.

Restricted - for use by Microbiology and Haematology teams in patients diagnosed with uncomplicated falciparum malaria and still able to take oral medication.
05.04.01 Artesunate 60mg 

unlicensedunlicensed - MEDIUM risk

Restricted- for treatment of severe malaria under advice of Oxford Infection Disease team only

09.06.03 Ascorbic Acid 1g 
09.06.03 Ascorbic Acid 50mg, 250mg, 500mg 
09.06.03 Ascorbic Acid/Zinc Sulfate 1g/10mg  For use on ITU only
04.02.03 Asenapine 5mg, 10mg  Restricted - prescribing by Mental Health Trust only
01.01.01 Asilone  Aluminium hydroxide 420mg/simeticone 135mg/light magnesium oxide 70mg in 5mL
08.01.05 Asparaginase 10,000units  unlicensedUnlicensed - High Risk
Restricted - Haematology Consultants only
08.01.05 Asparaginase 5,000units  Restricted - Haematology Consultants only
02.09 Aspirin (antiplatelet) 300mg 

See Antiplatelet guideline (BHTCG 708FM);


 Link  Antiplatelets and Rivaroxaban 2.5 mg for Secondary Prevention of OVE - Primary/Secondary Care guideline (BHTCG 708FM)

02.09 Aspirin (antiplatelet) 75mg, 300mg 

See Antiplatelet guideline (BHTCG 708FM);


 Link  Antiplatelets and Rivaroxaban 2.5 mg for Secondary Prevention of OVE - Primary/Secondary Care guideline (BHTCG 708FM)



 

04.07.01 Aspirin 150mg, 300mg 
04.07.01 Aspirin 300mg 
04.07.01 Aspirin 300mg 
04.07.01 Aspirin 75mg, 300mg 
10.02.01 Ataluren 125mg, 250mg, 100mg 

Restricted - prescribing by OUH specialist centre only, not prescribable by BHT. For treatment of Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in accordance with SSC 1633 NICE HST3 and NHSE Aug 16.


05.03.01 Atazanavir 150mg, 300mg  When used with ritonavir- 3rd agent
05.03.01 Atazanavir/cobicistat 300mg/150mg  Evotaz® Preferred 3rd agent
02.04 Atenolol 25mg, 50mg, 100mg 
02.04 Atenolol 25mg/5mL 
02.04 Atenolol 5mg/10mL 
08.01.05 Atezolizumab 1200mg/20mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

1. Prescribing by Consultant Oncologists only for the treatment of locally advanced or metastatic urothelial cancer in accordance with NICE TA 492 and NHSE SSC 1805, November 2017. CDF funded for this indication until December 2020.

2. Restricted to prescribing by Consultant Oncologists for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy in accordance with NICE TA 520.

3. Restricted to prescribing by Oncologists only for treating locally advanced or metastatic urothelial carcinoma after platinum containing chemotherapy in accordance with NICE TA 525.

4. Restricted to prescribing by the Oncology team for the treatment of metastatic non-squamous non-small-cell lung cancer in accordance with NICE TA 584 in combination with bevacizumab, paclitaxel and carboplatin.

5. Restricted to prescribing by the Oncology team for untreated extensive-stage small-cell lung cancer in accordance with NICE TA 638 in combination with carboplatin and etoposide.

6.  Restricted to prescribing by the Oncology team for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer, in accordance with NICE TA 639 in combination with nab-paclitaxel.

7. Restricted to prescribing by the Oncology team for treating advanced or unresectable hepatocellular carcinoma in accorance with NICE TA 666 in combination with bevacizumab.

04.04 Atomoxetine 10mg, 18mg, 25mg, 40mg, 60mg, 80mg 

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).

04.04 Atomoxetine 4mg/mL 

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).

02.12 Atorvastatin 10mg, 20mg, 40mg, 80mg 

Use in accordance with  Lipid Modification for Non-Familial Hypercholesterolaemia (for adults) - Primary/Secondary Care guideline (BHTCG 104FM)

05.01.08 Atovaquone 150mg/mL Wellvone®

Second line to co-trimoxazole in the treatment and prophylaxis of PCP.

15.01.05 Atracurium Besilate 25mg/2.5mL, 50mg/5mL, 250mg/25mL 
19.08 Atrauman®  5cm x 5cm
7.5cm x 10cm
10cm x 20cm
20cm x30cm

In primary care available as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.1.1
In secondary care obtain from Supplies
11.05 Atropine Sulphate 0.5%  In secondary care restricted - if for Paediatric use: Consultant Only to prescribe.
In secondary care Phone Pharmacy to Order
11.05 Atropine Sulphate 1% 
11.05 Atropine Sulphate 1% 
15.01.03 Atropine Sulphate 1mg/5mL, 1mg/10mL, 3mg/10mL 
15.01.03 Atropine Sulphate 400micrograms/1mL, 600micrograms/1mL, 1mg/1mL 
15.01.03 Atropine Sulphate 600micrograms/1mL  See National Resus Guidelines
18 Atropine Sulphate 600micrograms/1mL  Toxicity with organophosphates and carbamates
Bradycardia
07.04.05 Avanafil 50mg, 100mg, 200mg  

4th line PDE5 inhibitor if generic sildenafil, tadalafil  and vardenafil are not suitable (contraindicated or ineffective) and SLS criteria are met. The quantity prescribed for erectile dysfunction should be limited to 2 doses per month in line with TVPC policy 34  http://www.fundingrequests.cscsu.nhs.uk/wp-content/uploads/2020/06/TVPC34-Erectile-Dysfunction-BU.pdf.

In secondary care restricted to initial dose calibration for Spinal in-patients followed by weekend leave (2 doses).

09.01.04 Avatrombopag Doptelet® 20mg 

FOR ALL PRESCRIBING: NICE compliance form required via Blueteq.


 


Prescribing by the Haematology team for treatment of thrombocytopenia in people with chronic liver disease needing a planned invasive procedure in accordance with NICE TA 626

08.01.05 Avelumab 200mg/10mL 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required. 

    • For the treatment of metastatic Merkel cell carcinoma in accordance with NICE TA 517.
    • Use with axitinib for untreated advanced renal cell carcinoma in accordance with NICE TA 645. 
08.01.05 Axicabtagene ciocleucel Yescarta®

For use at commissioned CAR-T treatment centres only in accordance with NICE TA 559 and NHSE SSC 1953. CDF funded for this indication until February 2022.

08.01.05 Axitinib 1mg, 3mg, 5mg, 7mg 

Restricted - prescribing to be initiated by Consultant Oncologist (renal) or their SDU Lead, with continuation by all Consultant Oncologists in accordance with NICE TA 333.

A2.02.02.01 Aymes ActaGain 2.4 Complete Maxi 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.01.02 Aymes Actasolve Smoothie 216ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.01 Aymes Complete 200ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.01.02 Aymes Savoury 257mL

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.01 Aymes Shake 230ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 

A2.02.02.03 Aymes Shake Compact 157ml

 


** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.01.02 Aymes Shake Extra 325ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

08.01.03 Azacitidine 100mg  FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not yet available.

Restricted - prescribing by Consultant Haematologists in accordance with NICE TA 218.
01.05.03 Azathioprine  for preparations see section 08.02.01
10.01.03 Azathioprine  

See section 08.02.01

When prescribed by Rheumatology in accordance with Azathioprine for use in Rheumatology, Dermatology, Gastroenterology and Respiratory Medicine - Shared Care protocol (BHTCG 787FM)

13.05.03 Azathioprine 

for preparations see Section 08.02.02

Restricted - to be used in accordance with Azathioprine for use in Rheumatology, Dermatology, Gastroenterology and Respiratory Medicine - Shared Care protocol (BHTCG 787FM)

08.02.01 Azathioprine 15mg/5mL, 50mg/5mL 

unlicensedUnlicensed - Medium Risk

Amber Traffic Light  Amber Protocol - to be used in accordance with Azathioprine for use in Rheumatology, Dermatology, Gastroenterology and Respiratory Medicine - Shared Care protocol (BHTCG 787FM)
Red Traffic Light  Restricted - for all uses other than in accordance with Shared Care Protocol above
In primary care this is a pharmaceutical special

13.05.03 Azathioprine 15mg/5mL, 50mg/5mL 

unlicensedUnlicensed - Medium Risk

Amber Traffic Light  Amber Protocol - to be used in accordance with Azathioprine for use in Rheumatology, Dermatology, Gastroenterology and Respiratory Medicine - Shared Care protocol (BHTCG 787FM)
Red Traffic Light  Restricted - for all uses other than in accordance with Shared Care Protocol above
In primary care this is a pharmaceutical special

08.02.01 Azathioprine 25mg, 50mg 

Amber Traffic Light Amber Protocol - to be used in accordance with Azathioprine for use in Rheumatology, Dermatology, Gastroenterology and Respiratory Medicine - Shared Care protocol (BHTCG 787FM)
Red Traffic Light Restricted - for all uses other than in accordance with Shared Care Protocol above

08.02.01 Azathioprine 50mg 
13.06.01 Azelaic Acid 15% Finacea®
13.06.01 Azelaic Acid 20% Skinoren®
05.01.05 Azithromycin 200mg/5mL 

In secondary care restricted - for use by Paediatric, Obstetric & Gynaecology and Genitourinary medicine consultants only.

In primary care = a 1st line choice for Chlamydia

Microbiology approval required for all other uses

Note Not to use for COVID infections in line with CAS alert Dec 2020 https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103125

 

05.01.05 Azithromycin 250mg 

In secondary care restricted - for use by Paediatric, Obstetric & Gynaecology and Genitourinary medicine consultants OR in accordance with Guideline 133 - Management and antibiotic therapy for respiratory tract conditions in adults

In primary care = a 1st line choice for Chlamydia

Microbiology approval required for all other uses.

Note Not to use for COVID infections in line with CAS alert Dec 2020 https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103125

 

05.01.05 Azithromycin 500mg 

Restricted - to be prescribed only on advice from Consultant Microbiologist for the treatment of CAP or enteric fever in patients who are nil by mouth

Phone Pharmacy to Order

Note Not to use for COVID infections in line with CAS alert Dec 2020 https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103125 

05.01.02.03 Aztreonam 1g, 2g  In secondary care restricted - Microbiology approval required
08.02.04 Bacillus Calmette-Guerin 81mg ImmuCyst® Restricted - prescribing by consultant urologists only, for use in accordance with Bucks best possible practice non muscle invasive bladder cancer care pathway 2010
14.04 Bacillus Calmette-Guerin Vaccine 

The brand available is BCG AJV vaccine.
Reconstitute with solvent supplied.
Dose 0.1mL
(except children younger than 1 year: Dose is 0.05mL)


In primary care - only in accordance with the national UK immunisation schedule in patients in risk groups

10.02.02 Baclofen 10mg  1st Choice skeletal muscle relaxant
10.02.02 Baclofen 10mg/20mL, 10mg/5mL,   Restricted - to Spinal unit. Available on a named patient basis
10.02.02 Baclofen 50micrograms/1mL  Test Dose
10.02.02 Baclofen 5mg/5mL 
10.02.02 Baclofen 72mg/12mL  unlicensedUnlicensed - High Risk

Restricted - to Spinal unit. Available on a named patient basis
11.08.01 Balanced Salt Solution  
11.08.01 Balanced Salt Solution Plus  Restricted - for use by Consultant Ophthalmologist, Larry Benjamin and may be prescribed by other consultant ophthalmologists for patients deemed to be at risk.
01.05.01 Balsalazide Sodium 750mg Colazide® Restricted - initiation in secondary care with continuation by GPs.
10.01.03 Baricitinib 2mg, 4mg 

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.

Restricted - to Rheumatology consultant prescribing only, in accordance with Biologics for Rheumatoid Arthritis guideline (BHTCG 749FM) and NICE TA 466.

Note See section 13.5.3 for use in Dermatology.

13.05.03 Baricitinib 2mg, 4mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

For treatment of atopic dermatitis in accordance with NICE TA 681
• Baricitinib and dupilumab are equal first lint options. When the first line option has proven ineffective, or there is intolerance or contraindications, the alternative agent may be used.
• Prescribing by Dermatology.

Note See section 10.01.03 for use in Rheumatology.

16.01 Barium Sulphate 100% Baritop® 100 Restricted - prescribing by Radiology team only
16.01 Barium sulphate 98% E-Z-HD® 100 Restricted - prescribing by Radiology team only
A2.06.01 Barkat®  

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

500G loaf is 1.25 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Barkat®  

In primary care - Less cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

Consider switching to Glutafin Select Sliced seeded loaf

400g loaf is 1 unit.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Barkat®  

In primary care - Less cost effective choice for patients with coeliac disease or dermatitis herpetiformis.
Consider switching to EnerG Rice Loaf sliced

612G loaf is 1.5 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Barkat®  

In Primary care - a cost effective choice for people with coeliac disease or dermatitis herpetiformis

500 G = 2 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

06.01.01.03 BD Autoshield 

2nd Choice
For use in patients who require insulin or GLP1 analogue administration by a healthcare professional from a pen device


Use in the trust to be authorised for named patients by a Diabetes Specialist Nurse (DSN) so that staff training is assured.

13.04 Beclometasone Dipropionate 0.025%  Potency: Potent
03.02 Beclometasone Dipropionate 100micrograms, 200micrograms 
03.02 Beclometasone Dipropionate 100micrograms/metered inhalation  Restrict - prescribe aerosol inhaler first line and if compliance problems consider Easi-breathe inhaler
03.02 Beclometasone Dipropionate 50micrograms, 100micrograms, 200micrograms, 250micrograms per metered inhalation Clenil Modulite® see above for link to:
Asthma - Inhaled Treatment Algorithm - Adults (BHTCG 803FM)
12.02.01 Beclometasone Dipropionate 50micrograms/metered spray  1st choice steroid spray

In primary care adults may purchase this over the counter

See guideline above
13.04 Beclometasone Dipropionate in White Soft Paraffin 0.0025%, 0.00625%  Potency - Mild
unlicensedunlicensed - Low Risk

In primary care this is a pharmaceutical special. Not recommended in dermatology referral guideline.
03.02 Beclometasone Dipropionate/Formoterol Fumarate 100micrograms/6micrograms per metered inhalation Fostair® To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above).
This must ONLY be used with a spacer. If used without a spacer the lung deposition of the drugs is inadequate.
01.05.02 Beclometasone Diproprionate 5mg Clipper® Restricted - Consultant gastroenterologist prescribing only for the treatment of mild or moderate ulcerative colitis in active phase, as add-on therapy to 5-ASA containing drugs in patients who are non-responders to 5-ASA therapy in active phase. TO BE USED ONLY AFTER A COURSE OF PREDNISOLONE HAS BEEN TRIED.
03.02 Beclometasone diproprionate/Formoterol fumarate 100micrograms/6micrograms per metered inhalation Fostair NEXTHaler® To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)
03.01.04 Beclomethasone dipropionate / Formoterol fumrate / Glycopyrronium bromide 87micrograms/5micrograms/9micrograms Timbow®

Restricted - For patients with COPD in GOLD group D who require treatment with an ICS LAMA and LABA inhaler following exacerbations, as depicted in the Key steps in the management of COPD guideline (BHTCG 220FM).


The choice between Trimbow® and Trelegy Ellipta® will depend on the suitability of the device for an individual patient.

05.01.09 Bedaquiline 100mg 

FOR ALL PRESCRIBING: NICE compliance form via Blueteq required.

Restricted - prescribing by OUH specialists only, not prescribable by BHT. Use in multidrug-resistant TB in accordance with NHSE SSC 1645.


03.04.02 Bee and Wasp Allergen Extracts  Bee venom injection 100micrograms/vial
Wasp venom maintenance kit subcutaneous injection 120micrograms/vial
10.01.03 Belimumab 120mg, 400mg  FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Consultant Rheumatologists, under shared care with a Specialist Centre. In BHT this is generally OUH. Prescribing is in accordance with NICE TA 397 and NHSE SSC 1705.
08.01.01 Bendamustine 25mg, 100mg  FOR ALL PRESCRIBING: NICE compliance to be verified.
Restricted - prescribing by Oncologists only, in accordance with NICE TA 216.
02.02.01 Bendroflumethiazide 2.5mg  Restricted - when used for hypertension to be prescribed in accordance with Clinical Management of Hypertension in Adults (BHTCG 227) and only for continuation in stable patients and NOT to be initiated for the treatment of hypertension.
02.02.01 Bendroflumethiazide 5mg  Restricted - not for use in hypertension. Only for use with loop diuretics to cause diuresis.

NOTE: Use 2.5mg only when treating hypertension (see entry above)
03.04.02 Benralizumab 30mg/mL 

FOR ALL PRESCRIBING - NICE Compliance form required via Blueteq


Restricted - Prescribing by Consultant Respiratory Physicians following initiation by a Specialist Centre for the treatment of severe eosinophilic asthma in accordance with NICE TA 565.


BHT will prescribe this as an outreach centre as part of a provider network.

05.01.01 Benzathine Benzypenicillin 1.2megaunits, 2.4megaunits 

Restricted - for treatment of syphilis only, in accordance with Antibiotic Treatment of Sexually Transmitted Infections secondary care guideline (BHTCG 224).

10.01.04 Benzbromarone  unlicensedUnlicensed - High Risk
Restricted - to prescribing by Consultant Rheumatologists for treatment of chronic gout in patients with mild to moderate renal impairment who are intolerant or have contraindications to, allopurinol and febuxostat. To be prescribed in accordance with Management of Gout- Primary/Secondary Care guideline (BHTCG 777FM)(see above)
12.03.03 Benzocaine/Cetylpyridinium Chloride 10mg/1.4mg Merocaine® In community encourage patient to purchase OTC.
13.11.07 Benzoic Acid 0.15%/Malic Acid 2.25%/Salicylic Acid 0.0375%/Propylene Glycol 40% Aserbine® In secondary care restricted - Phone Pharmacy to Order
13.06.01 Benzoyl Peroxide 10%/Potassium Hydroxyquinoline Sulfate 0.5% Quinoderm®
13.06.01 Benzoyl Peroxide 2.5%, 5% PanOxyl® Currently these products are not available due to manufacturing delays

In primary care - if not available recommend switch to Quinoderm® (see below)
13.06.01 Benzoyl Peroxide 4% Brevoxyl®
13.06.01 Benzoyl Peroxide 5% PanOxyl® Currently unavailable due to manufacturing delays

In primary care - if not available recommend switch to Quinoderm® (see below)
13.06.01 Benzoyl Peroxide 5%/Potassium Hydroxyquinoline Sulfate 0.5% Quinoderm®
13.06.01 Benzoyl Peroxide/Clindamycin 5%/1%  Duac Once Daily®

For use in accordance with the Bucks Acne Treatment Algorithm (see link above). 


12.03.01 Benzydamine hydrochloride 0.15% Difflam®
12.03.01 Benzydamine hydrochloride 0.15% Difflam®
05.01.01.01 Benzylpenicillin 600mg, 1.2g 
18 Berlin Blue soluble (Prussian Blue) **** 

Thallium toxicity


See holding centres on www.toxbase.org.uk

04.06 Betahistine Dihydrochloride 8mg 
11.04.01 Betamethasone 0.1% 
06.03.02 Betamethasone 4mg/1mL 
06.03.02 Betamethasone 500micrograms 
13.04 Betamethasone Dipropionate 0.05% Diprosone® Potency: Potent
13.04 Betamethasone Dipropionate 0.05%/Salicylic acid 3% Diprosalic® Potency: Potent
13.04 Betamethasone Dipropionate 0.05%/Salicylic acid 3% in alcoholic basis Diprosalic® Potency: Potent
13.04 Betamethasone Dipropionate 0.064%/Clotrimazole 1% Lotriderm® Potency: Potent
12.01.01 Betamethasone Sodium Phosphate 
12.02.01 Betamethasone Sodium Phosphate 0.1% 
12.01.01 Betamethasone Sodium Phosphate 0.1% with Neomycin Sulphate 0.5% 
12.02.03 Betamethasone Sodium Phosphate 0.1% with Neomycin Sulphate 0.5% 
11.04.01 Betamethasone Sodium Phosphate/Neomycin Sulfate 0.1%/0.5% e.g. Betnesol N® 1st Choice - combined steroid/antibiotic preparation
13.04 Betamethasone Valerate 0.025% 

Potency: Moderate

13.04 Betamethasone Valerate 0.1%  Potency: Potent
13.04 Betamethasone Valerate 0.1%  Potency: Potent
13.04 Betamethasone Valerate 0.1%  Potency: Potent
13.04 Betamethasone Valerate 0.1%/Clioquinol 3%  Potency: Potent
13.04 Betamethasone Valerate 0.1%/Fucidic Acid 2% Fucibet® Potency: Potent

In secondary care restricted - Dermatology only. Microbiology approval required for all other uses.
13.04 Betamethasone Valerate 0.1%/Neomycin Sulphate 0.5%  Potency: Potent
11.06 Betaxolol 0.25%  Restricted - only to be prescribed if recommended by Consultant Ophthalmologist.

If cardio-selectivity required this is 1st Choice, otherwise 2nd Choice beta-blocker eye drop
11.04.01 Bethamethasone 0.1% 
11.04.01 Bethamethasone Sodium Phosphate/Neomycin Sulfate 0.1%/0.5% e.g. Betnesol N® 1st Choice - combined steroid/antibiotic preparation
08.01.05 Bevacizumab 100mg/4mL, 400mg/16mL  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage.

Restricted - prescribing by Consultant Oncologists (gastro/colorectal) only in accordance with NICE TA 212.
11.08.02 Bevacizumab 5mg/0.2mL 

unlicensedunlicensed - High Risk


FOR ALL PRESCRIBING - High cost drug form required - see Blueteq website.
Restricted - prescribing by consultant Ophthalmologists for non-clearing vitreal haemorrhage. In line with TVPC policy 96 for rare, sight threatening eye conditions which involve neo vascularisation. • Multifocal choroidopathy (including punctuate inner choroidopathy and multiple evanescent white dot syndrome)
• Atypical choroiditides (including histoplasmosis, tuberculous, syphilitic, etc.).
• CNV in angioid streaks
• CNV in pseudoxanthoma elasticum (also known as Gronblad-Strandberg syndrome)
• CNV in vitelliform macular dystrophy
• CNV in serpiginous choroiditis
• CNV in choroidal sarcoma
• CNV in Stargardt’s Disease
• Intravitreal uveitis
• Toxoplasma chorioretinitis
• Von Hippel-Lindau syndrome

02.12 Bezafibrate 200mg 
02.12 Bezafibrate 400mg 
19.04.01.01 Biatain® Ag  adhesive NOTE: to be replaced with Biatain® Ag Silicone low adherence dressing, see entry below.

12.5cm x12.5cm (9632)
This size only available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

18cm x 18cm (9635) In primary care available on prescription only

BNF A5.3.3
In secondary care obtain from Pharmacy
19.04.01.01 Biatain® Ag Silicone low adherence 7.5cm x 7.5cm (9636)
10cm x 10cm (9637)
12.5cm x 12.5cm (9638)
Above sizes only available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

15cm x15cm (9639) In primary care available on prescription only.
17.5cm x17.5cm (9640) In primary care available on prescription only.


BNF A5.3.3
In secondary care obtain from Pharmacy
19.10.02 Biatain® Non-Adhesive 

10cm x 20cm (3412)


In primary care available as stock through the On-line Non-Prescription Ordering System (ONPOS).

BNF A5.2.5
In secondary care obtain from Pharmacy.

19.10.03 Biatain® Silicone  12.5cm x 12.5cm (3436)
15cm x 15cm (3437)(In primary care available on prescription only)
17.5cm x 17.5cm (3438)(In primary care available on prescription only)

12.5cm x 12.5cm available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.2.5
In secondary care to be ordered through Pharmacy
19.10.03 Biatain® Silicone Lite  5cm x 5cm (3452)

In secondary care - restricted for use by Dermatology only or on Tissue Viability recommendation.

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.2.5
In secondary care to be ordered through Pharmacy
08.03.04.02 Bicalutamide 50mg, 150mg 

Prescribing on the recommendation of a specialist, continuation by GPs.


For treatment of  tumour flare in prostate cancer.  Use in accordance with guideline BHTCG 789FM Gonadorelin analogues for use in prostate cancer.  

05.03.01 Bictegravir/Emtricitabine/Tenofovir 50mg/200mg/25mg (Biktarvy®) Biktarvy®

Prescribing by HIV and Specialist Sexual Health teams after discussion at MDT for the treatment of HIV in accordance with NHSE Comissioning policy 170131P, BHIVA and NHSE guidelines.


NHSE Commissioning policy 170131P

11.06 Bimatoprost 100micrograms/1mL  2nd Choice of prostaglandin analogue eye drops if 300microgram/mL product no longer available.

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs.

NOTE: Branded Lumigan®, bimatoprost 300micrograms/mL eyedrops are being discontinued by the manufacturer. A generic equivalent is planned but not yet available. If the 300micrograms/mL (0.03%) strength cannot be obtained the GP may transfer prescribing to the 100micrograms/mL (0.01%) strength, which has a similar effect. This has been agreed with BHT Ophthalmologists. A small number of patients may need 300microgram/mL bimatoprost preservative-free unit dose eyedrops. Such patients will be identified by BHT Ophthalmologists and a request for a repeat prescription will be made in the discharge letter to the GP.

11.06 Bimatoprost 300micrograms/1mL  Restricted - only for use if patient has an established allergy to preservatives or is using more than 6 drops daily in the affected eye(s)
11.06 Bimatoprost 300micrograms/1mL  2nd Choice of prostaglandin analogue eye drops

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs.

NOTE: Branded Lumigan®, bimatoprost 300micrograms/mL eyedrops are being discontinued by the manufacturer. A generic equivalent is planned but not yet available. If the 300micrograms/mL (0.03%) strength cannot be obtained the GP may transfer prescribing to the 100micrograms/mL (0.01%) strength, which has a similar effect. This has been agreed with BHT Ophthalmologists. A small number of patients may need 300microgram/mL bimatoprost preservative-free unit dose eyedrops. Such patients will be identified by BHT Ophthalmologists and a request for a repeat prescription will be made in the discharge letter to the GP.
11.06 Bimatoprost/Timolol 300micrograms/5mg in 1mL  Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs
11.06 Bimatoprost/Timolol 300micrograms/5mg in 1mL  Restricted - to initiation by Consultant Ophthalmologists with continuaton by GPs for patients who have an established allergy to preservatives or who are using more than 6 drops daily in the affected eye(s).
08.01.05 Binimetinib 50mg, 75mg 

FOR ALL PRESCRIBING - NICE Compliance form required via Blueteq


Prescribing by the Oncology team in combination with Encorafenib for the treatment of unresectable or metastatic BRAF V600 mutation-positive melanoma in adults in accordance with NICE TA 562.

19.24.02 Biobrane®  12.5cm 38cm
25cm x 38cm
38cm x 50cm
Restricted - Burns and Plastics Consultant only prescribing for use in Paediatrics for burns over 5% total body surface area.

In secondary care obtain from Pharmacy
19.09.01 Bioclusive®   10.2cm x 12.7cm
12.7cm x 17.8cm
5.1cm x 7.6cm

Restricted - for use in secondary care only.
Film dressings to be reviewed and rationalised

BNF A5.2.2
In secondary care obtain from Supplies
12.03.05 Biotene Oralbalance® 
09.08.01 Biotin 5mg   unlicensedUnlicensed - Medium Risk

Restricted - to prescribing by Consultant Paediatricians on the recommendation of tertiary Paediatric Specialists only.
06.01.01.02 Biphasic Insulin Aspart 100units/mL  NOTE: Prescribe all insulins by brand
NovoMix® 30 (3mL cartridge, 3mL FlexPen prefilled disposable injection device)
06.01.01.02 Biphasic Insulin Lispro 100units/mL  NOTE: Prescribe all insulins by brand
Humalog® Mix25 10mL vial, Humalog® Mix25 and Mix50 (3mL cartridge, 3mL KwikPen prefilled disposable injection device)
Humalog Mix25 and Mix50 KwikPen restricted to Type 2 diabetes patients who cannot self administer isophane insulin using 10mL vials or 3mL cartridges and in accordance with NICE CG 87 Type 2 diabetes - newer agents (a partial update of CG66): short guideline and Bucks Trust local adaptation.
06.01.01.02 Biphasic Isophane Insulin 100units/mL human NOTE: Prescribe all insulins by brand
Humulin M3® (10mL vial, 3mL cartridge)
Insuman® Comb 15, 25 and 50

Humulin M3 KwikPen restricted to Type 2 diabetes patients who cannot self-administer biphasic isophane insulin using 10mL vials or 3mL cartridges and in accordance with NICE CG 87 Type 2 diabetes - newer agents (a partial update of CG 66): short guideline and Bucks Trust local adaptation.
01.06.02 Bisacodyl 10mg 
01.06.02 Bisacodyl 5mg 
01.06.02 Bisacodyl 5mg 
01.01 Bismuth Subsalicylate  Pepto-Bismol® Restricted - to prescribing in Primary Care only and in accordance with the Primary care antibiotics guideline
02.04 Bisoprolol fumarate 1.25mg, 2.5mg, 5mg, 10mg 
02.08.01 Bivalirudin 250mg  Restricted - prescribing by Cardiologists only for patients intolerant to first line treatment options for ACS STEMI and in accordance with NICE TA 230 Bivalirudin for the treatment of ST-segment-elevation myocardial infarction.
08.01.02 Bleomycin 15,000units 
08.01.05 Blinatumomab 38.5 micrograms 

FOR ALL PRESCRIBING - a completed and approved NICE compliance form, via BLUETEQ, is required.


Restricted to prescribing by the Oncology team for the treatment of acute lymphoblastic leukaemia in remission with minimal residual disease activity in accordance with NICE TA 589.


https://www.nice.org.uk/guidance/TA589


Blinatumomab for treating acute lymphoblastic leukaemia in remission with minimal residual disease activity


 


 

05.03.03.02 Boceprevir 200mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Consultant Gastroenterologists and Associate Specialist Gastroenterology in accordance with NICE TA 252 (see link below for Telaprevir) and NICE TA 253.

16.01 Bone Cement Low Viscosity with Gentamicin  Medical Device
16.01 Bone Cement with Gentamicin Palacos R® Medical Device
16.01 Bone Cement with Gentamicin and Vancomycin Copal G+V® Medical Device
08.01.05 Bortezomib 3.5mg  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not available.

Restricted to prescribing by consultant Haematologists:
1. In accordance with TVCN protocols
2. For multiple myeloma in accordance with NICE TA 228.
3. In combination with dexamethasone or dexamethasone and thalidomide for induction treatment of patients with previously untreated multiple myeloma in accordance with NICE TA 311
4. Treatment for previously untreated mantle cell lymphoma in accordance with NICE TA 370
02.05.01 Bosentan 62.5mg, 125mg  Restricted - prescribing by Respiratory consultants only after initiation in a Specialist Centre. May be continued in BHT via shared care between Specialist centre and BHT via a network model.

For pulmonary arterial hypertension in accordance with NHSE Specialised Commissioning Policy A11/P/b, June 2014: National policy for targeted therapies for the treatment of pulmonary hypertension in adults.

The name of the Specialist centre and consultant initiating drug to be communicated to Pharmacy Formulary Team prior to prescribing.
08.01.05 Bosutinib 100mg, 500mg Bosulif®

FOR ALL PRESCRIBING: NICE compliance form via Blueteq required.

Restricted - prescribing by consultant Haematologists. For previously treated chronic myeloid leukaemia in accordance with NICE TA 401 and NHSE SSC 1661.


 

18 Botulinum antitoxin **** 

Botulism


See holding centres on www.toxbase.org.uk

04.09.03 Botulinum Toxin Type A 100unit, 50 Unit  Xeomin®

NOTE: When writing prescriptions for botulinum toxin Type A or B, both the GENERIC and BRAND name MUST be included. 
 
1. Restricted - for use by Consultant Neuro-rehabilitation medicine, for spasticity.
2. Restricted - for use by Consultant surgeons in Spinal Injuries.

04.09.03 Botulinum Toxin Type A 300units, 500unit  Dysport®

Not to be used for the treatment of hyperhidrosis.

NOTE: When writing prescriptions for botulinum toxin Type A or B, both the GENERIC and BRAND name MUST be included.

1. Restricted - prescribing by Opthalmology, consultant Neurologists and Spinal Unit Specialist Clinic.
2. Restricted - prescribing by colorectal surgeons. For use (unlicensed)when glyceryl trinitrate and diltiazem ointments have failed, in line with the poisiton statement on the management of anal fissures produced by the Association of Coloproctology in 2008.
3. Restricted - prescribing by Paediatric consultant for cerebral palsy spasticity.

11.99.99.99 Botulinum Toxin Type A 300units, 500units e.g. Dysport® NOTE: When writing prescriptions for botulinum toxin Type A or B, both the GENERIC and BRAND name MUST be included.

Restricted - Ophthalmology consultant only prescribing.

See Section 04.09.03
04.09.03 Botulinum Toxin Type A 50 Unit, 100unit  Botox®

NOTE: When writing prescriptions for botulinum toxin Type A or B, both the GENERIC and BRAND name MUST be included.

1. Restricted - prescribing by Urogynaecology and Urology Consultants for treatment of detrusor overactivity. .
2. Restricted - prescribing by Neuro-rehabilitation consultants for Spasticity.
3. Restricted - prescribing by Neurology and Chronic Pain consultants in accordance with NICE TA 260. ALL PRESCRIBING in accordance with NICE - NICE compliance form required - see Blueteq website or  link from Formulary home page.

04.09.03 Botulinum Toxin Type A 50 Units, 100 Units  Xeomin®

For treatment of chronic sialorrhoea in accordance with NICE TA 605.


Prescribing by consultant Neurologists and NeuroRehab.

04.09.03 Botulinum Toxin Type B 10,000units/2mL NeuroBloc® NOTE: When writing prescriptions for botulinum toxin Type A or B, both the GENERIC and BRAND name MUST be included.

Restricted - prescribing by Consultant Neurologists
1. When resistance to Botulinum toxin type A has been confirmed
2. For cervical dystonia (spasmodic torticollis) in accordance with the SPC and MHRA advice Feb 2013
08.01.05 Brentuximab 50mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Haematology team. For:
1. Treatment of CD30-positive Hodgkin lymphoma in accordance with NICE TA 524, June 17 and NHSE SSC 1744, May 17.
2. Treatment of systemic anaplastic large cell lymphoma in accordance with NICE TA 478.
3. Treatment of CD30-positive cutaneous T-cell lymphoma in accordance with NICE TA 577. 
4. Use in combination for untreated systemic anaplastic large cell lymphoma in accordance with NICE TA 641. 


 

08.01.05 Brigatinib 30mg, 60mg, 90mg 

FOR ALL PRESCRIBING - NICE Compliance form required via Blueteq

Restricted - prescribing by the Oncology team;

1. for the treatment of ALK-positive advanced non-small-cell lung cancer after crizotinib in accordance with NICE TA 571.

2.  for ALK-positive advanced non-small-cell lung cancer that has not been previously treated with an ALK inhibitor in accorance with NICE TA 670.

13.11.06 Brilliant Green and Crystal Violet Paint Bonnies Blue unlicensedUnlicensed - Low Risk
11.06 Brimonidine Tartrate 0.2% 

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

13.06.03 Brimonidine Tartrate 5mg/g (Brimonidine 3mg/g) 

For the treatment of rosacea where persistent, constant, severe erythema is the predominant symptom and there is no prominent telangiectasia and used in accordance with the Rosacea Treatment Pathway (BHTCG 724FM).

11.06 Brimonidine Tartrate/Timolol 0.2%/0.5% 

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

11.06 Brinzolamide 10mg/1mL 

2nd Choice topical carbonic anhydrase inhibitor
Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

11.06 Brinzolamide/Brimonidine 10mg/2mg in 1mL  Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs for use in adults with open angle glaucoma/intra-ocular hypertension for whom beta blockers and prostaglandin analogues are unsuitable and the use of the two components (brinzolamide/brimonidine) as separate entities in inappropriate
11.06 Brinzolamide/Timolol 10mg/5mg in 1mL 

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

13.05.03 Brodalumab 210mg Kyntheum®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required. 


Restricted - prescribing by Dermatology Consultants only for the treatment of moderate to severe plaque psoriasis in accordance with Biologics in Psoriasis guideline (BHTCG 738FM) and NICE TA 511.

11.08.02 Brolucizumab 120mg/mL 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by consultant Ophthalmologists; 

  • As an option for treating wet age-related macular degeneration in accordance with NICE TA 672 and in accordance with guideline 653FM Intravitreal Injections used in Ophthalmology Algorithm (awaiting approval).
04.09.01 Bromocriptine  In secondary care - restricted to Consultant only prescribing.
For preparations see Section 06.07.01
06.07.01 Bromocriptine 1mg, 2.5mg 
03.02 Budesonide 200micrograms, 400micrograms per metered inhalation Pulmicort®

 

May be used off label in accordance with the Interim Position Statement: Inhaled budesonide for adults (50 years and over) with COVID-19 whereby;

Potentially eligible patients will:

  • Have COVID-19 symptoms, with symptom onset within the last 14 days, AND
  • Be COVID-19 positive, confirmed by a recent PCR test, AND
  • Be aged 65 or over, or aged 50 or over with one or more co-morbidities consistent with the long-term conditions referenced in the flu vaccine list.

Dose: 800 micrograms (2 x 400 micrograms) twice daily (a total daily dose of 1,600 micrograms).

A single inhaler should be used for a maximum of 14 days (or until the inhaler is used up, if sooner).

Refer to the Interim Position Statement: Inhaled budesonide for adults (50 years and over) with COVID-19 for full details, including patient exclusion criteria.

01.05.02 Budesonide 2mg Budenofalk®

For treatment of active ulcerative colitis limited to the rectum and the sigmoid colon. As first line corticosteroid enema for new patients and an option for existing patients who have previously received another corticosteroid enema and who require a second course of treatment. This would be following discussion with the patient.


01.05.02 Budesonide 3mg Budenofalk® In secondary care restricted to recommendation by Consultant Gastroenterologists with continuation by GPs

In primary care usual maximum total course 8 weeks (BNF)
03.02 Budesonide 500micrograms/2mL 
03.02 Budesonide/Formoterol Fumarate 100micrograms/6micrograms, 200micrograms/6micrograms per metered inhalation Symbicort 100/6, 200/6 Turbohaler® To be used in accordance with BHT COPD and asthma guideline.

see above for links to:
Asthma - Inhaled Treatment Algorithm - Adults (BHTCG 803FM)
COPD guideline (BHTCG 220FM)
03.02 Budesonide/Formoterol fumarate 200micrograms/ 6micrograms per metered inhalation Symbicort 200/6 ® To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)
03.02 Budesonide/Formoterol fumarate 400micrograms/12micrograms per metered inhalation Symbicort 400/12 Turbohaler® To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)
02.02.02 Bumetanide 1mg 
02.02.02 Bumetanide 1mg/5mL 
02.02.02 Bumetanide 2mg/4mL 
02.02.02 Bumetanide 5mg  Restricted - recommendation in secondary care with continuation by GPs
15.02 Bupivacaine Hydrochloride 0.125%   Restricted - to be prescribed in accordance with The management of continuous epidural infusions - Aged 16 years and older guideline (BHTGG 334FM) (awaited)
15.02 Bupivacaine Hydrochloride 0.25% (25mg/10mL)  Double wrapped ampoules are available
15.02 Bupivacaine Hydrochloride 0.5% (50mg/10mL)  Double wrapped ampoules are available
15.02 Bupivacaine Hydrochloride/ Glucose 0.5% (20mg)/320mg in 4ml Marcain Heavy®
15.02 Bupivacaine Hydrochloride/Adrenaline (Epinephrine) 0.25%/1:200,000 
15.02 Bupivacaine Hydrochloride/Adrenaline (Epinephrine) 0.5%/1:200,000 
15.02 Bupivacaine Hydrochloride/Fentanyl 0.1%/2micrograms in1mL 
04.07.02 Buprenorphine 200micrograms 
04.07.02 Buprenorphine '35' patch (releasing 35 micrograms/hour for 72 hours), '52.5' patch (releasing 52.5 micrograms/hour for 72 hours) and '70' patch (releasing 70 micrograms/hour for 72 hours) Transtec® Restricted - for use when patient is unable to tolerate oral treatment
04.10.03 Buprenorphine 400micrograms, 4mg, 8mg 

Restricted - initiation by CAMS team in accordance with NICE TA114 - Methadone and buprenophine for management of opioid dependence and NICE CG 52 Drug misuse in over 16s: opioid detoxification.

04.10.03 Buprenorphine/Naloxone 2mg/500micrograms, 8mg/2mg  Restricted - initiation by CAMS team only
04.03.04 Bupropion Hydrochloride 150mg Zyban®

Red Traffic Light Restricted to secondary care consultant initiation and continuation as monotherapy or augmentation in treatment resistant depression, only where all other options have been excluded - see Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

 

Green Traffic Light For prescribing as part of the smoking cessation program - see section 04.10.02 Nicotine dependence. 

04.10.02 Bupropion Hydrochloride 150mg Zyban® In primary care - only to be prescribed as 3rd line treatment if 1st line treatment with nicotine replacement therapy (NRT) has not been successful and 2nd line treatment with varenicline is not appropriate. To be used in accordance with NRT guideline

In secondary care - only to be supplied to inpatients for continuation of existing treatment in accordance with NRT guideline.
04.01.02 Buspirone Hydrochloride 5mg, 10mg  Restricted - initiation by Psychiatric (Mental Health Trust) team only.

When used for Generalised Anxiety Disorder, use in accordance with guideline BHTCG 131FM (see link above)
08.01.01 Busulfan 2mg 
03.04.03 C1-Esterase Inhibitor 500units  Restricted - prescribed only on advice of Specialist Centre consultant immunologists for:

1. acute life threatening attacks of hereditary angioedema

2. administration for prophylaxis in HAE/AAE patient undergoing planned surgery, obstetric (including pregnancy) or dental work or similar trauma with a risk of upper airway blockage (intubation or trauma to mouth/throat) or significant morbidity or mortality risk from uncontrolled swellings in accordance with NHSE clinical commissioning policy B/B09/P/b. BHT acute Medicine / A&E consultants will prescribe as outreach to the specialist centre delivered as part of a provider network. Name of Specialist Centre and clinician involved to be communicated to Formulary Team prior to initiating treatment at BHT.

3. Prophylactic treatment of hereditary angiodema (HAE) types I and II in accordance with NHSE SSC 1658, NHSE Clinical Commissioning Policy 16045/P. Prior approval via BLUETEQ is required.
08.01.05 Cabazitaxel 60mg in 1.5ml  FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.
Restricted - prescribing by Consultant Oncologists (prostate) only
Treatment of hormone-relapsed metastatic prostate cancer treated with Docetaxel in accordance with NICE TA 391 and NHSE SSC 16 37.
04.09.01 Cabergoline 500micrograms, 1mg, 2mg  Restriction - recommendation by Consultant Endocrinologists and continuation by GPs.
06.07.01 Cabergoline 500micrograms, 1mg, 2mg  Restricted - initiation by consultant endocrinologists and continuation by GPs.

In secondary care - also for use in lactation supression as a SINGLE dose in accordance with Guideline 437 Induction of Labour (IOL) for fetal death from 20 weeks gestation or Guideline 662 Termination of pregnancy (TOP) for fetal abnormality
08.01.05 Cabozantinib 20mg, 40mg, 60mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

1. Restricted- prescribing by Oncology team. For treatment of advanced renal cell carcinoma in accordance with NICE TA 463.


2. Restricted - prescribing by Oxford University Hospitals (OUH) only, for the treatment of medullary thyroid cancer in accordance with NICE TA 516


3. Prescribing by Consultant Oncologists for the treatment of untreated advanced renal cell carcinoma in accordance with NICE TA 542.

03.05.01 Caffeine 5mg/mL  equivalent to caffeine citrate 10mg/mL
03.05.01 Caffeine Citrate 20mg/1mL Peyona® Each mL contains 20mg caffeine citrate (equivalent to 10mg caffeine)
Restricted - prescribing by paediatrics team in NICU only in accordance with Neonatal Dosage Guidelines (BHTCG 69)
19.05.05 Calaband®  7.5cm x 6m (3607)

In secondary care obtain from Pharmacy
13.03 Calamine 
13.05.02 Calcipotriol 50micrograms/g 
13.05.02 Calcipotriol 50micrograms/g 
13.05.02 Calcipotriol 50micrograms/g /Betamethasone 0.05% Enstilar®

Use in accordance with the Psoriasis topical treatment algorithm.


Maximum treatment duration of 4 weeks without a break.

13.05.02 Calcipotriol 50micrograms/g /Betamethasone 0.05% Dovobet®

Use in accordance with the Psoriasis topical treatment algorithm.


Maximum treatment duration of 4 weeks without a break.

06.06.01 Calcitonin (salmon) / Salcatonin 
06.06.01 Calcitonin (salmon) / Salcatonin 100units/1mL, 400units/2mL 
13.05.02 Calcitriol 3micrograms/g Silkis®
09.05.01.01 Calcium 102mg/5mL (2.55mmol/5mL)  unlicensedUnlicensed
Calcium 20.4mg/mL (0.51mmol/mL) Ca2+

Restricted - for use in paediatric patients only. Adults requiring a soluble form of calcium should use soluble/dispersible tablets.
09.05.02.02 Calcium Acetate 1g  contains Calcium 250mg or Ca2+ 6.2mmol
unlicensedUnlicensed
Restricted - initiation in secondary care with continuation by GPs.
09.06.04 Calcium and Ergocalciferol Calcium and Vitamin D
09.05.01.01 Calcium Carbonate 1.25g  Calcium 500mg or 12.5mmol Ca2+ per tablet

Cacit® used in Secondary care
Calceos® brand recommended in Primary care
09.05.01.01 Calcium Carbonate 1.25g Calcichew® Calcium 500mg or 12.5mmol Ca2+ per tablet
09.05.01.01 Calcium Chloride 10%  Ca2+ 680micromol/mL or calcium 27.3mg/mL
18 Calcium Chloride 10%  Ca2+ 680micromol/mL or calcium 27.3mg/mL

Calcium channel blocker toxicity
Systemic effects of hydrofluoric acid
08.01 Calcium Folinate 15mg folinic acid Red Traffic Light  Restricted - for use in accordance with Uveitis guideline (BHTCG 374FM)

Amber Traffic Light  Restricted - Retain only for Methotrexate rescue therapy
08.01 Calcium Folinate 15mg/2mL, 30mg/30mL, 50mg/5mL, 100mg/10mL, 300mg/30mL, 350mg/35mL folinic acid Restricted - Retain only for Methotrexate rescue therapy
18 Calcium folinate 300mg/30mL ***  toxicity with methotrexate
toxicity with methanol and formic acid
18 Calcium gluconate   Local infiltration for hydrofluoric acid
09.05.01.01 Calcium Gluconate 10%  225micromol/mL
09.05.01.01 Calcium Gluconate 1g 
13.10.01.01 Calcium Gluconate 2.5%  In secondary care restricted - for use in A&E and Plastics for burns only
18 Calcium gluconate 2.5%  Prevention of transdermal adsorption of hydrofluoric acid
08.01 Calcium Levofolinate 50mg/5mL, 175mg/17.5mL levofolinic acid
09.02.01.01 Calcium Polystyrene Sulphonate  Calcium Resonium®
A2.04.01.02 Calogen 200ml; 500ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 

A2.04.01.02 Calogen®   Initiation on the recommendation of a Dietitian only.

Should not be sent as a routine TTO - Discontinue on discharge.
13.07 Camellia sinensis Catephen®

For the at home treatment of external genital and perianal warts as a second line option after the patient has tried podophyllotoxin or if podophyllotoxin is unavailable.

06.01.02.03 Canagliflozin 100mg, 300mg 

Use in accordance with NICE TA 315, NICE TA 390 and the Management of Type 2 Diabetes: Blood-Glucose Lowering Therapy guideline (BHTCG 667FM) (see link above)


Joint 1st line SGLT2 inhibitor (with empagliflozin) for glycaemic control in patients with or without established cardiovascular disease (CVD)

02.05.05.02 Candesartan Cilexetil 4mg, 8mg, 16mg, 32mg  1st Choice 'sartan for heart failure and hypertension. Restricted to patients who cannot take an ACE inhibitor.
04.08.01 Cannabidiol 100mg/mL Epidyolex®

Initiation by Specialist Paediatric Neurology Centres and continued at BHT under shared care agreement.  


To be used with clobazam for  treating seizures associated with Dravet syndrome (NICE TA 614) and Lennox- Gastaut syndrome (NICE TA 615) and NHSE SSC 2111


Cannabidiol with clobazam for treating seizures associated with Dravet syndrome NICE TA 614


Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome NICE TA 615


 

08.01.03 Capecitabine 150mg, 500mg  1. Restricted - metastatic breast cancer.
2. Restricted - prescribing by Oncologists only, in accordance with NICE TA 191.

NICE compliance form required - see link from Formulary homepage
10.03.02 Capsaicin 0.025% Zacin® For the symptomatic treatment of knee and hand osteoarthritis as an adjunct to core treatments in line with Bucks Osteoarthritis treatment algorithm (BHTCG 819FM).

Capsaicin 0.025% cream should be prescribed for three months maximum after which it should be stopped. It should not be added as a repeat prescription on GP computer systems.
10.03.02 Capsaicin 0.075% Axsain®






For treatment of localised (superficial, cutaneous) neuropathic pain in patients who wish to avoid, or cannot tolerate oral treatments, or where down titration of oral agents is being attempted, in accordance with guideline 714FM Neuropathic pain management in adults and guideline 375FM Chronic pain treatment in adult spinal patients.


The treatment is for six weeks only. Sometimes a second course may be needed. It should not be on repeat prescription.


02.05.05.01 Captopril 12.5mg, 25mg, 50mg 
02.05.05.01 Captopril 1mg/1mL  Restricted - to initiation by paediatric consultants with continuation by GPs
04.02.03 Carbamazepine 100mg, 200mg, 400mg  For use in bipolar disorder. 
See section 4.8.1 for use in epilepsy
04.08.01 Carbamazepine 100mg, 200mg, 400mg  For use in epilepsy.
WARNING: Prescribe by brand to ensure patient is maintained on a specific manufacturer's product. In secondary care the usual brands stocked are Tegretol® or MYLAN
See section 4.2.3 for use in bipolar disorder
04.02.03 Carbamazepine 100mg/5mL  For use in bipolar disorder. 

See section 4.8.1 for use in epilepsy
04.08.01 Carbamazepine 100mg/5mL  For use in epilepsy.
WARNING: Prescribe by brand to ensure patient is maintained on a specific manufacturer's product. In secondary care the usual brands stocked are Tegretol® or MYLAN
See section 4.2.3 for use in bipolar disorder
04.08.01 Carbamazepine 125mg, 250mg  WARNING: Prescribe by brand to ensure patient is maintained on a specific manufacturer's product. In secondary care the usual brand stocked is Tegretol®
04.02.03 Carbamazepine 200mg, 400mg 

For use in bipolar disorder. 

See section 4.8.1 for use in epilepsy


04.08.01 Carbamazepine 200mg, 400mg  For use in epilepsy.
WARNING: Prescribe by brand to ensure patient is maintained on a specific manufacturer's product. In secondary care the usual brands stocked are Tegretol® or MYLAN
See section 4.2.3 for use in bipolar disorder
16.01 Carbex®  Restricted - prescribing by Radiology team only
06.02.02 Carbimazole 5mg, 20mg 
03.07 Carbocisteine 375mg  In secondary care restricted - Respiratory Team

In primary care review effectiveness after 4-6 weeks
03.07 Carbocisteine 750mg/10ml 

As second line to carbocisteine capsules where carbocisteine capsules cannot be swallowed.

In secondary care restricted - Respiratory Team

In primary care review effectiveness after 2-4 weeks


11.08.01 Carbomer 980 0.2%  1st Choice - Preserved ocular lubricant for Meibomian gland dysfunction/tear lipid abnormalities

In primary care prescribe: Clinitas Gel®
11.08.01 Carbomer 980 0.2% e.g. Viscotears®
08.01.05 Carboplatin 50mg/5mL, 150mg/15mL, 450mg/45mL, 600mg/60mL 
07.01.01 Carboprost 250micrograms/1mL (trometamol salt) 
08.01.05 Carfilzomib 10mg, 30mg, 60mg  

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted- prescribing by Haematology team.   For previously treated multiple myeloma in accordance with NICE TA657.

12.03.01 Carmellose Sodium Orabase® This product has now been d/c when stocks are used up we will be unable to use it
11.08.01 Carmellose Sodium 0.5% e.g. Celluvisc® Celluvisc® brand restricted - for use by hospital ophthalmology team only for contact lens diagnostics. For all other indications generic product to be used.
11.08.01 Carmellose Sodium 0.5% 
11.08.01 Carmellose Sodium 1%  2nd Choice - Preservative-Free ocular lubricant
08.01.01 Carmustine 100mg 
08.01.01 Carmustine 7.7mg  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage
Restricted - prescribing by Oncologists only, in accordance with NICE TA 121 Carmustine implants and temozolomide for the treatment of newly diagnosed high grade glioma.
A2.05.02 Carobel 

1st Choice thickener for children aged under 3 years.

Initiation on recommendation of SALT or dietition only

Note Product does not contain starch - see MHRA DSU April 2021 https://www.gov.uk/drug-safety-update/polyethylene-glycol-peg-laxatives-and-starch-based-thickeners-potential-interactive-effect-when-mixed-leading-to-an-increased-risk-of-aspiration

02.04 Carvedilol 3.125mg, 6.25mg, 12.5mg, 25mg  2nd Choice after bisoprolol
05.02.04 Caspofungin 50mg, 70mg 

Restricted  to prescribing by haematology, oncology and / or on advice by Microbiology in accordance with Antifungal Therapy Guidelines for Haematology / Oncology (BHTCG 203FM) 

05.01.02.01 Cefaclor 125mg/5mL, 250mg/5mL  In secondary care restricted - to TTO & Outpatient prescriptions. Inpatient use restricted to Paediatrics and Obs & Gynae. May be initiated in secondary care, with continuation by GPs.

In primary care - not listed in primary care guideline for any indications
05.01.02.01 Cefaclor 375mg  In secondary care restricted - to TTO & Outpatient prescriptions. Inpatient use restricted to Paediatrics and Obs & Gynae. May be initiated in secondary care, with continuation by GPs.

In primary care - not listed in primary care guideline for any indications
05.01.02.01 Cefalexin 125mg/5mL, 250mg/5mL  In secondary care restricted - to TTO & Outpatient prescriptions. Inpatient use restricted to Paediatrics and Obs & Gynae.

In primary care only indicated as 3rd line choice for UTI in pregnancy and as 2nd line choice for UTI in children
05.01.02.01 Cefixime 100mg/5mL  Restricted - to prescribing in Primary Care only for use in pelvic inflammatory disease in accordance with the Primary Care management of infection guidelines (see link above) and 2nd line in paed UTI.
05.01.02.01 Cefixime 200mg  Restricted - to prescribing in Primary Care only for use in pelvic inflammatory disease in accordance with the Primary Care management of infection guidelines (see link above) and 2nd line in paed UTI.
05.01.02.01 Cefotaxime 500mg 

Red Traffic Light  In secondary care restricted - Ophthalmology and Paediatrics only. Microbiology approval required for all other uses.

Green Traffic Light  In primary care for use as a stat dose in suspected meningitis when penicillin allergic.

05.01.02.01 Cefradine 250mg, 500mg  In secondary care restricted - to TTO & Outpatient prescriptions. Inpatient use restricted to Paediatrics and Obs & Gynae. Microbiology approval required for all other uses.

In primary care - not listed in primary care guideline for any indications
05.01.02.01 Cefradine 500mg, 1g  In secondary care restricted - Paediatrics and Obs & Gynae. Microbiology approval required for all other uses
05.01.02.01 Ceftazidime 250mg, 500mg, 1g, 2g  In secondary care restricted - Haematology, Paediatrics, respiratory patients (severe Pseudomonas infections only) and Ophthalmology OR in accordance with guideline 133 Management and antibiotic therapy for respiratory tract conditions in adults.

Microbiology approval required for all other uses.
11.03.01 Ceftazidime 5%  unlicensedunlicensed - High Risk
Restricted - named patient basis and available at SMH only
05.01.02 Ceftazidime/Avibactam 2g/500mg Zavicefta®

Restricted - Prescribing only on the advice of Consultant Microbiologists, in conjunction with Colindale, the National Reference Laboratory. For the treatment of complicated gram-negative infections if a person's infection does not respond to commonly used antimicrobials and when there is a known resistance to other antimicrobials.

05.01.02 Ceftolozane/Tazobactam 1g/500mg Zerbaxa®

Restricted - Prescribing only on the advice of Consultant Microbiologists in conjunction with Colindale, the National Reference Laboratory. For the treatment of complicated intra-abdominal infections and complicated urinary tract infections if a person's infection does not respond to commonly used antimicrobials and when there is a known resistance to other antimicrobials.

05.01.02.01 Ceftriaxone 

Prescribing by the OPAT team/Microbiologists in conjunction with the team responsible for the patient. Patient's will remain under the supervision of the OPAT team.


For patients who are unable to receive suitable oral antibiotics and need to continue on IV formulation. Patients should be deemed suitable to self-administer/ambulate and be otherwise using hospital services. This product is used to avoid admission or to expedite earlier discharge.

05.01.02.01 Ceftriaxone 250mg, 1g, 2g  In secondary care restricted: - Paediatrics; suspected meningitis or meningococcal septicaemia; serious orthopaedic infections; cellulitis; pelvis inflammatory disease; enteric fever and sexually transmitted infections. Also for use in accordance with:
- Guidelines for antibiotic treatment of infections within Obstetrics & Gynaecology (BHTCG 207)
- OPAT guideline 103 (Empirical short course home antibiotic regimens)
- guideline 133 Management and antibiotic therapy for respiratory tract conditions in adults
- Investigation and Antimicrobial treatment of Infective Endocarditis in Adults (BHTCG 236)
Microbiology approval required for all other uses

In primary care not listed in local antibiotic guide.
05.01.02.01 Cefuroxime 125mg, 250mg  Restricted - may be prescribed by GPs if recommended by secondary care.

In secondary care restricted - to Ophthalmology, Paediatrics and Obs & Gynae.

In primary care not listed in local antibiotic guide
05.01.02.01 Cefuroxime 125mg/5mL  Restricted - may be prescribed by GPs if recommended by secondary care.

In secondary care restricted - to Ophthalmology, Paediatrics and Obs & Gynae.

In primary care not listed in local antibiotic guide
05.01.02.01 Cefuroxime 250mg, 750mg, 1.5g  In secondary care restricted - to Ophthalmology, Paediatrics and Obs & Gynae
11.03.01 Cefuroxime 5%  unlicensedunlicensed - High Risk
Restricted - named patient basis and available at SMH only
11.08.02 Cefuroxime 50mg e.g. Aprokam® Restricted - prescribing by Ophthalmology team only as a stat dose immediately after cataract surgery.
10.01.01 Celecoxib 100mg, 200mg  In secondary care restricted - to prescribing by Consultant Rheumatologists only.
Use in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
08.01.05 Cemiplimab 350mg 

FOR ALL PRESCRIBING - PRIOR APPROVAL VIA BLUETEQ REQUIRED


Restricted to prescribing by consultant Oncologists for treating metastatic or locally advanced cutaneous squamous cell carcinoma in accordance with NICE TA 592


CDF funded for this indication until July 2021.

08.01.05 Ceritinib 150mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required. 

1. Restricted - prescribing by Consultant Oncologists (lung) only. As an option for treating advanced anaplastic lymphoma kinase positive non small cell lung cancer in adults who have previously had crizotinib in accordance with NICE TA 395 and NHSE SSC 15 38.


2. Restricted - prescribing by Consultant Oncologists (lung) only. For the treatment of untreated ALK positive non small cell lung cancer in accordance with NICE TA 500.

10.01.03 Certolizumab Pegol 200mg Cimzia®

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not yet available.

NOTE: use restricted in BHT to patients with a low number of co-morbidities and low risk of infection and is subject to further audit.

Restricted - prescribing by Consultant Rheumatologists,
1. in accordance with Biologics for Rheumatoid Arthritis guideline (BHTCG 749FM), NICE TA 375 and NICE TA 415.
2. in accordance with Biologics for Ankylosing Spondylitis (AS) and non-radiographic axial spondyloarthritis (AxS) (BHTCG 737FM) and NICE TA 383.


Restricted - prescribing by Consultant Rheumatologists and Consultant Dermatologists,
3. in accordance with Biologics for Psoriatic Arthritis (BHTCG 740FM) and NICE TA 445

13.05.03 Certolizumab pegol 200mg 

FOR ALL PRESCRIBING - NICE Compliance form required via Blueteq


Restricted to prescribing by Consultant Dermatologists and Consultant Rheumatologists:
1. For the treatment of psoriatic arthritis in accordance with Biologics for Psoriatic Arthritis guideline (BHTCG 740FM) and NICE TA 445.


Restricted to prescribing by Consultant Dermatologists
2. For the treatment of severe plaque psoriasis in accordance with Biologics in Psoriasis algorithm (BHTCG 738FM) and NICE TA 574. 

03.04.01 Cetirizine Hydrochloride 10mg  In primary care available to purchase over the counter
03.04.01 Cetirizine Hydrochloride 5mg/5mL  In primary care available to purchase over the counter
13.02.01 Cetraben®  In Primary care all sizes available.
In Secondary care 50g and 500g available
08.01.05 Cetuximab 100mg/20mL, 500mg/100mL  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage

Restricted - prescribing by Consultant Oncologists only. For treatment of EGFR-expressing, RAS wild-type metastatic colorectal cancer in accordance with NICE TA 439 and NHSE SSC 1759.
04.01.01 Chloral Hydrate 500mg 
04.01.01 Chloral Hydrate 500mg/5mL  Chloral mixture, BP 2000
unlicensedUnlicensed - Low Risk
Restricted - for initiation in secondary care and continuation by GPs for neurology patients with complex needs and for sedation prior to MRI scans.
04.01.01 Chloral Hydrate 50mg  unlicensedUnlicensed - Medium Risk
08.01.01 Chlorambucil 2mg 
11.03.01 Chloramphenicol 0.5% 
11.03.01 Chloramphenicol 0.5% 
11.03.01 Chloramphenicol 0.5% Eykappo®

As an alternative to single dose units in patients unable to tolerate preservatives in eye drops.

11.03.01 Chloramphenicol 1% 
05.01.07 Chloramphenicol 1g  In secondary care restricted - Microbiology approval required
05.01.07 Chloramphenicol 250mg  In secondary care restricted - Microbiology approval required

In primary care no indications for use identified in local antibiotic guidelines.
12.01.01 Chloramphenicol 5% 
04.01.02 Chlordiazepoxide Hydrochloride 5mg, 10mg  Restricted - use for alcohol detoxification only
04.01.02 Chlordiazepoxide Hydrochloride 5mg, 10mg  Restricted - use for alcohol detoxification only
07.04.04 Chlorhexidine 0.02% 
11.03.02 Chlorhexidine 0.2% 

unlicensed Unlicensed special - medium risk


Prescribing by the Ophthalmology team on the advice of Microbiology for the treatment of severe fungal keratitis, in combination with Natamycin 5% eye drops or Voriconazole 1% eye drops or Voriconazole 50 micrograms/0.1mL, 100 micrograms/0.1mL for intracameral or intrastromal or intravitreal injection.


Use in accordance with Ophthalmic infections guideline (BHTCG 372FM).

13.11.03 Chlorhexidine 2% in 70% Sani-cloth®

Available via Supplies.

For peripheral line insertion, venepuncture and hub and connection port cleaning.


13.11.02 Chlorhexidine Acetate 0.05% 
11.03.01 Chlorhexidine Digluconate 0.02%  unlicensedunlicensed - Low Risk
Restricted - named patient basis and available at SMH only
19.04.04 Chlorhexidine Gauze Dressing BP Bactigras® 5cm x 5cm (66007456)
10cm x10cm (66007457)
15cm x 20cm (66007461)
15cm x 1m (66007505)
In secondary care restricted - to use in secondary care for superficial low exudate wounds. Only allowed as stock in Burns, Plastics, Dermatology, Podiatry, Spinal Unit and Diabetic Clinics/Wards.

May be continued in Primary Care when initiated by hospital consultant or Tissue Viability.

BNF A5.3.4
In secondary care obtain from Pharmacy
13.11.02 Chlorhexidine Gluconate 0.5% in Denatured Ethanol 70%  500ml spray bottle restricted to podiatry for pre and post intervention skin disinfection
13.11.02 Chlorhexidine Gluconate 0.05% Unisept®
12.03.04 Chlorhexidine Gluconate 0.2%  Plain or Mint flavour available

In primary care can be purchased over the counter
12.03.04 Chlorhexidine Gluconate 1% 
13.11.02 Chlorhexidine Gluconate 1% in pourable water-miscible basis Hibitane Obstetric®
13.11.02 Chlorhexidine Gluconate 2% Clinell® unlicensedunlicensed - low risk

Restricted - for skin cleansing in patients receiving inpatient care in ICU.
13.11.02 Chlorhexidine Gluconate 2% in Isopropyl Alcohol 70%  unlicensedunlicensed - low risk

In secondary care restricted - only for disinfection prior to trauma and orthopaedic surgery
13.11.02 Chlorhexidine Gluconate 2% in Isopropyl Alcohol 70% ChloraPrep® In secondary care restricted -
1. to areas where central venous catheters, mid and PICC lines are inserted
2. to prepare skin pre-operatively for breast surgery
13.11.02 Chlorhexidine Gluconate 2% in Isopropyl Alcohol 70% ChloraPrep with Tint® Restricted - to central venous catheter, mid-line and PICC line insertion and cardiac day surgery procedures.
13.11.02 Chlorhexidine Gluconate 4% in a surfactant solution 
12.02.03 Chlorhexidine Hydrochloride 0.1% with Neomycin Sulphate 0.5% Naseptin® When used for MRSA decolonisation, this is 2nd Choice in accordance with, Suppression of MRSA Colonisation - patients only (BHTCG 14B) and Eradication of MRSA Colonisation - patients only (BHTCG 14C)

NOTE: contains nut oil and should NOT be given to a patient with a nut allergy.
10.01.03 Chloroquine  see Section 05.04.01
05.04.01 Chloroquine Phosphate 250mg (chloroquine base 155mg) Avloclor® In secondary care restricted - for use by Haematology and Microbiology.

In primary care malaria prophylaxis should be on private Rx
05.04.01 Chloroquine Sulphate   In secondary care restricted - for use by Haematology and Microbiology.
05.04.01 Chloroquine Sulphate 200mg (chloroquine base 150mg)  In secondary care restricted - for use by Haematology and Microbiology.

In primary care malaria prophylaxis should be on private Rx
05.04.01 Chloroquine Sulphate 68mg/5mL (chloroquine base 50mg/5mL) Nivaquine® In secondary care restricted - for use by Haematology and Microbiology.

In primary care malaria prophylaxis should be on private Rx
02.02.01 Chlorothiazide 250mg/5mL  unlicensedunlicensed
Restricted - for use in Paediatrics only
03.04.01 Chlorphenamine Maleate 10mg/1mL 
03.04.01 Chlorphenamine Maleate 2mg/5mL  In primary care available to purchase over the counter
03.04.01 Chlorphenamine Maleate 4mg  In primary care available to purchase over the counter
04.06 Chlorpromazine Hydrochloride  for preparations see Section 4.2.1
04.02.01 Chlorpromazine Hydrochloride 25mg, 50mg, 100mg  Green Traffic Light  Restricted - for treatment of nausea or for prescribing in Palliative Care.

Amber Traffic Light  Amber Initiation - restricted to initiation in secondary care with continuation by GPs, when used for traditional antipsychotic treatment
04.02.01 Chlorpromazine Hydrochloride 25mg/1mL, 50mg/2mL 
04.02.01 Chlorpromazine Hydrochloride 25mg/5mL, 100mg/5mL  Green Traffic Light  Restricted - for treatment of nausea or for prescribing in Palliative Care, when patient cannot swallow ordinary tablets.

Amber Traffic Light  Amber Initiation - restricted to initiation in secondary care with continuation by GPs, when used for traditional antipsychotic treatment
12.03.01 Choline Salicylate 8.7% Bonjela® Adult In primary care may be purchased over the counter
06.05.01 Chorionic Gonadotrophin 5000units   Restricted - brand depends on availability. In secondary care Phone Pharmacy to Order
03.02 Ciclesonide 80micrograms, 160micrograms per metered inhalation Alvesco®

For asthma prophylaxis in patients who have unacceptable side effects (dysphonia, oropharyngeal candidiasis, cough, throat irritation and reflex bronchospasm) caused by standard and high dose corticosteroid inhalers (budesonide, fluticasone or beclometasone) despite thorough post-dose mouth rinsing, use of a spacer and treatment of candidiasi.

10.01.03 Ciclosporin 

see Section 08.02.02
All products containing ciclosporin to be prescribed by brand name to minimise the risk of inadvertent switching between brands, and to reflect advice in the British National Formulary.
When prescribed by Rheumatology in accordance with Shared Care protocol (BHTCG 788FM)

13.05.03 Ciclosporin  for preparations see Section 08.02.02

All products containing ciclosporin should be prescribed by brand name to minimise the risk of inadvertent switching between brands, and to reflect advice in the British National Formulary
01.05.03 Ciclosporin 100mg/1mL  Neoral®

Restricted. Prescribe by brand name to minimise the risk of inadvertent switching between brands, and to reflect advice in the British National Formulary. 

08.02.02 Ciclosporin 100mg/1mL Neoral® All products that contain ciclosporin should be prescribed by brand name to minimise the risk of inadvertent switching between brands, and to reflect advice in the British National Formulary.
01.05.03 Ciclosporin 10mg, 25mg, 50mg, 100mg Neoral®

Restricted. Prescribe by brand name to minimise the risk of inadvertent switching between brands, and to reflect advice in the British National Formulary. 

08.02.02 Ciclosporin 10mg, 25mg, 50mg, 100mg Neoral® NeoralAll products that contain ciclosporin should be prescribed by brand name to minimise the risk of inadvertent switching between brands, and to reflect advice in the British National Formulary.
11.04.02 Ciclosporin 1mg/mL Verkazia®

For the treatment of vernal keratoconjunctivitis (VKC)

11.04.02 Ciclosporin 1mg/ml e.g. Ikervis®

1. For treatment of severe keratitis in adult patients with dry eye disease that has not improved despite treatment with tear substitutes in accordance with NICE TA369 and the Ocular Lubricants Guideline (BHTCG 371FM)
2. For treatment of severe vernal keratitis as a steroid sparing agent


Initiation by consultant Ophthalmologists in the corneal clinic.
• Two months’ supply to be prescribed by the consultant at initiation followed by GP continuation of prescribing.
• Duration of treatment, any temporary or permanent treatment withdrawal to be communicated to the GP.

08.02.02 Ciclosporin 50mg/1mL, 250mg/5mL Sandimmun® Sandimmun
All products that contain ciclosporin should be prescribed by brand name to minimise the risk of inadvertent switching between brands, and to reflect advice in the British National Formulary
01.05.03 Ciclosporin 50mg/1mL, 250mg/5mL  Sandimmun®

Restricted. Prescribe by brand name to minimise the risk of inadvertent switching between brands and to reflect advice in the British National Formulary. 

09.05.01.02 Cinacalcet 30mg, 60mg, 90mg 

Restricted - Prescribing by Consultant Endocrinologists:


1) For the treatment of secondary hyperparathyroidism in patients with end-stage renal disease on maintenance dialysis therapy in accordance with NICE TA 117.


2) For the treatment of complex primary hyperparathyroidism in adults in accordance with NHSE policy 16034/P.

01.07.02 Cinchocaine Hydrochloride 0.5%, Hydrocortisone 0.5% 
01.07.02 Cinchocaine hydrochloride 0.5%, Prednisolone Hexanoate 0.19% Scheriproct®
01.07.02 Cinchocaine Hydrochloride 5mg, Hydrocortisone 5mg 
01.07.02 Cinchocaine Hydrochloride 5mg, Prednisolone Hexanoate 1.3mg Scheriproct®
04.06 Cinnarizine 15mg 
11.03.01 Ciprofloxacin 0.3%  2nd Choice quinolone (see Ofloxacin below)
05.01.12 Ciprofloxacin 100mg/50mL, 200mg/100mL, 400mg/200mL  In secondary care restricted to:
1. Inpatient urology and respiratory patients where no other suitable alternative,
2. Use by Ophthalmology and Obstetrics & Gynaecology and
3. Treatment of enteric fever as described in the secondary care guideline for Antimicrobial Therapy for Infectious Gastroenteritis (BHTCG 204)

Also restricted for 2nd line use only as per Antibiotic Flashcard or for use as per specific Trust Guidelines or if approved by Microbiology.
100mg/50ml available for paediatrics only
05.01.12 Ciprofloxacin 250mg, 500mg  Where dose is a whole tablet and patient cannot swallow it - disperse in water.

In secondary care restricted to:
1. TTO & Outpatient prescriptions,
2. Inpatient urology and respiratory patients where no other suitable alternative,
3. Use by Ophthalmology and Obstetrics & Gynaecology and
4. Treatment of enteric fever as described in the secondary care guideline for Antimicrobial Therapy for Infectious Gastroenteritis (BHTCG 204)

Also restricted for 2nd line use only as per Antibiotic Flashcard or for use as per specific Trust Guidelines or if approved by Microbiology.

In primary care indicated for acute pyelonephritis, acute prostatitis & on private Rx for travellers' diarrhoea.
05.01.12 Ciprofloxacin 250mg/5mL  In secondary care restricted to:
1. TTO & Outpatient prescriptions,
2. Inpatient urology and respiratory patients where no other suitable alternative,
3. Use by Ophthalmology and Obstetrics & Gynaecology and
4. Treatment of enteric fever as described in the secondary care guideline for Antimicrobial Therapy for Infectious Gastroenteritis (BHTCG 204)

Also restricted for 2nd line use only as per Antibiotic Flashcard or for use as per specific Trust Guidelines or if approved by Microbiology.

In primary care indicated for acute pyelonephritis, acute prostatitis & on private Rx for travellers' diarrhoea.
05.01.12 Ciprofloxacin 400mg in glucose 5% infusion  In secondary care restricted to:
1. Inpatient urology and respiratory patients where no other suitable alternative,
2. Use by Ophthalmology and Obstetrics & Gynaecology and
3. Treatment of enteric fever as described in the secondary care guideline for Antimicrobial Therapy for Infectious Gastroenteritis (BHTCG 204)

Also restricted for 2nd line use only as per Antibiotic Flashcard or for use as per specific Trust Guidelines or if approved by Microbiology.
15.01.05 Cisatracurium 10mg/5mL 
08.01.05 Cisplatin 10mg/10mL, 50mg/50mL, 100mg/100mL 
04.03.03 Citalopram 10mg, 20mg, 40mg 

Depression - see Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

  • a first line option in primary and secondary care.

 

Generalised Anxiety Disorder - see GAD guideline (BHTCG 131FM).

  • may be used second line when sertraline has been ineffective.
04.03.03 Citalopram 40mg/1mL 

Depression - see Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

  • a first line option in primary and secondary care.

 

Generalised Anxiety Disorder - see GAD guideline (BHTCG 131FM).

  • may be used second line when sertraline has been ineffective.
08.02.04 Cladribine 10mg Mavenclad®

Prescribe by BRAND name.         


FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.


Restricted - Prescribing by Consultant Neurologists and Clinical Nurse Specialist for Neurology for the treatment of adults with relapsing-remitting multiple sclerosis with active disease in accordance with NICE TA 616.


https://www.nice.org.uk/guidance/TA616


See section 08.01.03 for use in Oncology

08.01.03 Cladribine 10mg/10mL 
05.01.05 Clarithromycin 125mg/5mL, 250mg/5mL 
05.01.05 Clarithromycin 250mg, 500mg 
05.01.05 Clarithromycin 500mg 
13.06.01 Clindamycin 1% in Aqueous Alcholic basis Dalacin T®
13.06.01 Clindamycin 1% in Aqueous basis Dalacin T®
07.02.02 Clindamycin 2%  In primary care only recommended when other choices not suitable
05.01.06 Clindamycin 300mg/2mL, 600mg/4mL  In secondary care restricted - Microbiology approval required for use in patients over 85 years of age, but caution in prescribing for any patient over 65 years due to increased risk of Clostridium difficile associated diarrhoea
05.01.06 Clindamycin 75mg, 150mg  In secondary care restricted - Microbiology approval required for use in patients over 85 years of age, but caution in prescribing for any patient over 65 years due to increased risk of Clostridium difficile associated diarrhoea

In primary care 2nd/3rd line choice in cellulitis. No other indications for use identified in primary care antibiotic guidelines.

NOTE: If patient cannot swallow capsules they can be opened, dispersed in water and administered.
05.01.06 Clindamycin 75mg/5mL  unlicensedUnlicensed - Medium risk
In secondary care restricted - Microbiology approval required for use in patients over 85 years of age, but caution in prescribing for any patient over 65 years due to increased risk of Clostridium difficile associated diarrhoea. Use in accordance with Recommended Empirical Antibiotic Regimens for Common Hospital Infectious Conditions (BHTCG 279)

NOTE: If patient cannot swallow capsules they can be opened and dispersed in water and administered. Only prescribe suspension if patient cannot swallow capsules or manage to open and disperse contents of capsule.

19.05.06 CliniFast® Blue 

7.5cm x 10m [EGP020]

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

BNF A5.8.3.
In secondary care obtain from Supplies.

19.05.06 CliniFast® Green 

5cm x 10m 

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

BNF A5.8.3.
In secondary care obtain from Supplies.

19.05.06 CliniFast® Yellow 

10.75cm x 10m [EGP021]

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

BNF A5.8.3.
In secondary care obtain from Supplies.

19.14 CliniSorb® Odour Control Dressing  10cm x 10cm (2305)
Restricted - Wound to be assessed for reasons for odour before prescribing

BNF A5.2.3
In secondary care obtain from Pharmacy
04.08.01 Clobazam 10mg  Prescribing generically or by brand is discretionary
13.04 Clobetasol Propionate 0.05%  Potency: Very Potent

In primary care try to avoid using very potent topical steroids
13.04 Clobetasol Propionate 0.05% in thickened alcoholic basis Dermovate® Potency: Very Potent

In primary care try to avoid using very potent topical steroids
13.04 Clobetasol Propionate 0.05% Shampoo Etrivex® Levon® Potency: Very Potent

Second choice after Dermovate® scalp application when this is not available

In primary care try to avoid using very potent topical steroids
13.04 Clobetasol Propionate 0.05%/Neomycin Sulphate 0.5%/Nystatin 100,000units/g  Potency: Very Potent

In primary care try to avoid using very potent topical sterpoids
13.04 Clobetasone Butyrate 0.05%  Potency: Moderate
13.04 Clobetasone Butyrate 0.05%/Oxytetracycline 3%/Nystatin 100,000units/g Trimovate®

Not commercially available. Available as unlicensed special.


Potency: Moderate

In primary care useful for flexural psoriasis

06.05.01 Clomifene Citrate 50mg  In primary care patients who cannot access hospital treatment on the NHS may need a private prescription.
04.03.01 Clomipramine Hydrochloride 10mg, 25mg, 50mg 

Amber Recommentation For treatment of depression in accordance with Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM). Prescribing on specialist recommendation. 

Green Traffic Light  For treatment of neuropathic pain in accordance with Neuropathic pain management in adults guideline BHTCG 714FM.

04.03.01 Clomipramine Hydrochloride 75mg 

For treatment of depression in accordance with Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

Prescribing on specialist recommendation.  Standard release clomipramine is preferred to modified release clomipramine. In most patients the long half-life of clomipramine  immediate release preparation is sufficient to allow once daily dosing (usually given at night).

04.08.01 Clonazepam 1mg/1mL  For preparations see Section 04.08.02

Unlicensed - Medium risk
Prescribing generically or by brand is discretionary
04.08.02 Clonazepam 1mg/1mL  unlicensedUnlicensed - Medium Risk

Clonazepam 1mg/1mL in solvent, for dilution with 1mL water for injections immediately before injection
04.02.03 Clonazepam 500micrograms, 2mg  For use in acute mania on the advice of the  Oxford Health psychiarist / PIRLS team.

NOTE: tablets disperse quite easily in water and are a more cost effective option for patients who cannot swallow tablets. If giving down an NG tube, disperse in 30mL water before administration. The large volume of water is to stop the clonazepam sticking to the NG tubing.  

See 4.8.1 for use in epilepsy
04.08.01 Clonazepam 500micrograms, 2mg  Prescribing generically or by brand is discretionary

NOTE: tablets disperse quite easily in water and are a more cost effective option for patients who cannot swallow tablets. If giving down an NG tube, disperse in 30mL water before administration. The large volume of water is to stop the clonazepam sticking to the NG tubing.

See 4.2.3 for use in acute mania
04.08.01 Clonazepam 500micrograms/5mL  Prescribing generically or by brand is discretionary

Restricted - initiation by Psychiatric team only for use when patient cannot swallow tablets.

NOTE: Clonazepam tablets disperse easily in water and are a more cost effective option for patients who cannot swallow the tablets.
02.05.02 Clonidine Hydrochloride 100micrograms 


Green Traffic Light  NOTE: Restricted when used for ADHD treatment - see below


Red Traffic Light  Restricted - prescribing by Consultant Paediatricians/Consultants treating ADHD only.

02.05.02 Clonidine Hydrochloride 150micrograms/1mL 
02.05.02 Clonidine Hydrochloride 25micrograms  In secondary care - restricted to prescribing for Spinal patients only.
02.05.02 Clonidine Hydrochloride 2mg/1mL  unlicensedunlicensed - Moderate risk
Restricted - to prescribing by Spinal Consultants only.
02.09 Clopidogrel 300mg 

Use in accordance with Antiplatelet guideline (BHTCG 708FM). 


 Link  Antiplatelets and Rivaroxaban 2.5 mg for Secondary Prevention of OVE - Primary/Secondary Care guideline (BHTCG 708FM)


 

02.09 Clopidogrel 75mg 

Restricted - Prescribing in accordance with Antiplatelet guideline (BHTCG 708FM); 


 Link  Antiplatelets and Rivaroxaban 2.5 mg for Secondary Prevention of OVE - Primary/Secondary Care guideline (BHTCG 708FM)

07.02.02 Clotrimazole 1% 
13.10.02 Clotrimazole 1% 
13.10.02 Clotrimazole 1% 
13.10.02 Clotrimazole 1% in Macrogol 400 
07.02.02 Clotrimazole 10%  Use in accordance with Management of Infection Guidance for Primary Care
07.02.02 Clotrimazole 100mg  Restricted - to prescribing in Primary Care only and in accordance with the Primary care antibiotics guideline - daily pessaries recommended in vaginal candadiasis in pregnancy
07.02.02 Clotrimazole 500mg 
04.02.01 Clozapine 25mg, 100mg 

Restricted - prescribing by Consultant Psychiatrist (Mental Health Trust) only in accordance with the treatment of psychosis and schizophrenia algorithm (BHTCG 726FM).

04.02.01 Clozapine 50mg/1mL 

Restricted - prescribing by Psychiatric (Mental Health Trust) team in accordance with the treatment of psychosis and schizophrenia algorithm (BHTCG 726FM).


Only for use when patient cannot swallow ordinary tablets.

13.05.02 Coal Tar (Crude) in White Soft Paraffin 1%, 2%, 5%, 10%, 15%  unlicensedunlicensed - Medium Risk

In primary care this is a pharmaceutical special
13.09 Coal Tar 1%/Coconut Oil 1%/Salicylic Acid 0.5% Capasal®
13.05.02 Coal Tar and Salicylic Acid Ointment BP  unlicensedunlicensed
(Coal Tar 2%, Salicylic Acid 2%)

In primary care this is a pharmaceutical special
13.09 Coal Tar Extract 2% T/Gel® In primary care 1st choice for mild disease
13.05.02 Coal Tar Solution 12%/Salicylic Acid 2%/ Precipitated Sulphur 4% in Coconut Oil emollient basis Sebco®
13.09 Coal Tar Solution 12%/Salicylic Acid 2%/Precipitated Sulphur 4% in Coconut Emollient  Sebco® See Section 13.05.02
13.05.02 Coal Tar Solution 2.5%/Arachis Oil Extract of Coal Tar 7.5%/Tar 7.5%/Cade Oil 7.5%/Light Liquid Paraffin 35% Polytar Emollient®
13.05.02 Coal Tar Solution 3%/Salicylic Acid 3% in Aqueous Cream  Molloy's Mix
unlicensedunlicensed - Medium Risk

In primary care this is a pharmaceutical special. When a patient is started on Molloy's Mix in hospital, it may be substituted in primary care by Coal Tar 5% (Evorex®) with a urea-based ointment (i.e. Hydromol®).
13.05.02 Coal Tar Solution 5% Exorex®
02.02.04 Co-amilofruse (amiloride/furosemide) 2.5mg/20mg, 5mg/40mg 
05.01.01.03 Co-Amoxiclav 125mg/31mg, 250mg/62mg 
05.01.01.03 Co-Amoxiclav 250/125, 500/125 
05.01.01.03 Co-Amoxiclav 400mg/57mg 
05.01.01.03 Co-Amoxiclav 600mg (500mg/100mg), 1.2g (1g/200mg)  
19.05.03 Coban® 2   Two layer system - one size

Restricted - to recommendation by Tissue Viability or Lymphoedema Nurse only

BNF A5.8.8
In secondary care obtain from Supplies
19.05.03 Coban® 2 Lite  Two layer system (reduced compression)- one size

Restricted - to recommendation by Tissue Viability or Lymphoedema Nurse only

BNF A5.8.8
In secondary care obtain from Supplies
04.09.01 Co-Beneldopa 12.5/50 (benserazide 12.5mg/levodopa 50mg)  Restricted - only for use in patients who cannot swallow the ordinary tablets
04.09.01 Co-Beneldopa 12.5/50 (benserazide 12.5mg/levodopa 50mg) 
04.09.01 Co-Beneldopa 25/100 (benserazide 25mg/levodopa 100mg) 
04.09.01 Co-Beneldopa 25/100 (benserazide 25mg/levodopa100mg)  Restricted - only for use in patients who cannot swallow the ordinary capsules
04.09.01 Co-Beneldopa 25/100 (benserazide 25mg/levodopa100mg) Madopar CR®
04.09.01 Co-Beneldopa 50/200 (benserazide 50mg/levodopa 200mg) 
05.03.01 Cobicistat / Emtricitabine / Darunavir / Tenofovir alafenamide 150mg/200mg/800mg/10mg Symtuza®

Restricted - Prescribing by HIV and Specialist Sexual Health teams for the treatment of HIV infection in adults and adolescents (aged 12 years and older with body weight at least 40kg) in accordance with NHS England Clinical Commissioning Policy 16043/P and F03/P/b.

05.03.01 Cobicistat 150mg  Restricted for BHT HIV MDT
11.07 Cocaine 4%  unlicensedunlicensed - Low Risk
In secondary care restricted - Consultant Only Prescribing and Phone Pharmacy to Order
15.02 Cocaine Hydrochloride 10% 
04.09.01 Co-Careldopa 10/100 (carbidopa 10mg/levodopa 100mg) 
04.09.01 Co-Careldopa 12.5/50 (carbidopa 12.5mg/levodopa 50mg) Sinemet® 12.5mg/50mg
04.09.01 Co-Careldopa 25/100 (carbidopa 25mg/levodopa 100mg) 
04.09.01 Co-Careldopa 25/100 (carbidopa 25mg/levodopa 50mg) 
04.09.01 Co-Careldopa 25/250 (carbidopa 25mg/levodopa 250mg) 
04.09.01 Co-Careldopa 50/200 (carbidopa 50mg/levodopa 200mg) 
04.09.01 Co-Careldopa with Entacapone (levodopa/carbidopa/entacapone) 50mg/12.5mg/200mg, 75mg/18.75mg/200mg, 100mg/25mg/200mg, 125mg/31.25mg/200mg, 150mg/37.5mg/200mg, 200mg/50mg/200mg Sastravi® Restricted - recommendation by Clinical Nurse Specialist (Parkinson's) or Neurology team

Where suitable the separate component parts may be used at the discretion of the Parkinson's nurses

New patients suitable for the combined product will be initiated on Sastravi®. Existing patients on Stalevo® will be switched to Sastravi®.

Switching of existing patients from Stalevo® to Sastravi® may be undertaken by the GP.
13.02.01 Coconut Oil BPC 
13.06.02 Co-Cyprindiol 2000/35 cyproterone acetate 2mg/ethinylestradiol 35micrograms)
01.06.02 Co-danthramer 25/200 in 5mL  Contains Dantron 25mg, Poloxamer '188' 200mg/5mL
Restricted - for use in patients requiring palliative care
01.06.02 Co-danthramer Strong 75/1000 in 5mL  Contains Dantron 75mg, poloxamer '188' 1g in 5mL
Restricted - for use in patients requiring palliative care
01.06.02 Co-danthrusate 50/60  Contains Dantron 50mg, Docusate Sodium 60mg
Restricted - for use in patients requiring palliative care
01.06.02 Co-danthrusate 50/60  Contains Dantron 50mg, Docusate Sodium 60mg in 5mL
Restricted - for use in patients requiring palliative care
01.04.02 Codeine Phosphate 15mg, 30mg 
04.07.02 Codeine Phosphate 15mg, 30mg 
03.09.01 Codeine Phosphate 15mg/5mL  Codeine Linctus BP
04.07.02 Codeine Phosphate 15mg/5mL  See section 03.09.01
01.04.02 Codeine Phosphate 25mg/5mL  see Section 04.07.02
04.07.02 Codeine Phosphate 25mg/5mL 
04.07.02 Codeine Phosphate 60mg/1mL 
10.01.04 Colchicine 500micrograms 

Use in accordance with Management of Gout Guideline (BHTCG 777FM)

09.06.04 Colecalciferol 10000 units/mL Thorens® To be used in accordance with Vitamin D testing and treatment in children guideline (BHTCG 739FM)- see above.
09.06.04 Colecalciferol 2,400units/mL Invita D3®

2nd choice colecalciferol oral drops in paediatric patients 0months to 12 years when colecalciferol 10,000Units/mL oral drops (Thorens®) are unavailable. Use in accordance with Vitamin D Testing and Treatment in Children guideline (BHTCG 739FM) (see above)

09.06.04 Colecalciferol 20,000units  

Restricted - 1st Choice product for the treatment of Vitamin D deficiency in accordance with Vitamin D Testing and Treatment in Adults guideline (BHTCG 785FM) (see above)

09.06.04 Colecalciferol 25,000units (625micrograms)/mL  InVita D3® NOTE: does NOT contain peanut, gelatine or lactose.

Restricted - 2nd Choice product for use in patients who cannot manage capsules, in accordance with Vitamin D Testing and Treatment in Adults guideline (BHTCG 785FM) and in Children guideline (BHTCG 739FM) (see above).
09.06.04 Colecalciferol 800units (20micrograms Vitamin D) 

Restricted - for use in the following groups of vitamin D deficient patients with osteoporosis, who are not able to take the standard calcium (600mg) and vitamin D (400 unit) tablet for the prevention of fragility fractures:
• Patients intolerant of or who have contraindications to calcium containing products.
• Patients who develop hypercalcaemia after taking calcium containing products
• Patients with an adequate dietary calcium intake
• Patients with primary hyperparathyroidism who are not candidates for operative treatment and who have coexisting Vitamin D deficiency or insufficiency

Restricted - for use in accordance with Vitamin D Testing and Treatment in Adults (BHTCG 785FM) (see above)

09.06.04 Colecalciferol/Calcium Carbonate 10micrograms (400units)/1.25g Calceos®

In secondary care Adcal-D3® preferred. 

Restricted - for use in accordance with Vitamin D Testing and Treatment in Adults (BHTCG 785FM) (see above)

09.06.04 Colecalciferol/Calcium Carbonate 10micrograms (400units)/1.5g Adcal-D3 Dissolve® Restricted - only for use in secondary care for:
1. patients who require calcium and colecalciferol administration via a PEG
2. covert administration after authorisation from a medical practitioner in accordance with Mental Capacity Act 2005.

NOTE: For patients discharged from secondary care on Adcal-D3 Dissolve® effervescent tablets, a switch to Calfovit D3® powder is recommended.
09.06.04 Colecalciferol/Calcium Carbonate 10micrograms (400units)/1.5g Adcal-D3®

In secondary care Adcal-D3® preferred. Use Calceos® effervescent tablets which dissolve easily, if required for administration via a PEG tube.

In primary care Accrete® preferred

Restricted - for use in accordance with Vitamin D Testing and Treatment in Adults (BHTCG 785FM) (see above)

09.06.04 Colecalciferol/Calcium Phosphate 20micrograms (800units)/3.1g (calcium 1.2g) Calfovit D3® Restricted - for use in primary care only

NOTE: If patients are discharged from secondary care on Adcal-D3 Dissolve® effervescent tablets, a switch to Calfovit D3® powder is recommended.
02.12 Colesevelam Hydrochloride 625mg 

Restricted - initiation by Consultant Gastroenterologists or tertiary centre for Bile Acid Malabsorption (BAM) with continuation by GPs for BAM, in patients for whom colestyramine is ineffective or not tolerated. Patients to receive first 3 months from hospital and following a review in secondary care, treatment is then either stopped or continued by GPs.


 


Green Note: if colestyramine (Questran® and Questran Light®) are not available, patients may be switched to colesevelam (if available), without referral to Gastroenterology, during the colestyramine shortage period.

02.12 Colestyramine 4g 

Questran® or Questran light®

01.09.02 Colestyramine 4g sachet  For preparations see section 2.12
05.01.07 Colistimethate Sodium 1,662,500IU Colobreathe® Restricted - prescribing by consultant Paediatricians specialising in Cystic Fibrosis for the management of chronic pulmonary infection due to Pseudomonas aeruginosa in patients with cystic fibrosis aged 6 years and older, if nebulised colistin is not tolerated or if clinical progress is unsatisfactory. To be used in accordance with NICE TA276.
05.01.07 Colistimethate Sodium 1million units Colomycin® and generic brands

For uses other than cystic fibros, initiation in secondary care, with approval from Microbiology, and continuation by GPs.
 
 

05.01.07 Colistimethate Sodium 1million units Colomycin® Restricted - prescribing by Respiratory Physicians, Consultant Paediatricians and Consultant Microbiologists for use in cystic fibrosis only.

NOTE: Colomycin® injection is licensed for nebulisation and may be given by inhalation as a nebulised solution as an adjunct to standard antibacterial therapy in cystic fibrosis patients with severe pseudomonal chest infections.
05.01.07 Colistimethate Sodium 1million units Promixin® Restricted - prescribing by Consultant Paediatricians for the treatment of cystic fibrosis in children in accordance with Clinical Commissioning Policy Statement: Inhaled Therapy for Adults and Children with Cystic Fibrosis, April 2013 (see link below)

NOTE: Promixin® 1million units is therapeutically equivalent to 2million units standard colistimethate sodium (eg. Colomycin®) ONLY if Promixin is nebulised via the I-Neb® device.

13.10.05 Collodion Flexible BP 
01.01.01 Co-magaldrox 195/220  Aluminium hydroxide / magnesium hydroxide mixture 220mg/195mg in 5mL
Low sodium
19.11.02 Comfeel® Plus Transparent  5cm x 7cm
10cm x10cm


In primary care available as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.2.4
In secondary care obtain from Pharmacy
A2.02.02.01 Complan Shake 230ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

06.01.06 Continuous glucose monitoring 

FOR ALL PRESCRIBING - a completed and approved High Cost Drugs form, via BLUETEQ, is required.


Use in accordance with TVPC64 Continuous glucose monitoring for adults with type 1 Diabetes (Dec 2018) or TVPC89 Continuous glucose monitoring for paediatric patients with Type 1 diabetes (June 2019).

06.01.01 Continuous Subcutaneous Insulin Infusion  NOTE: Prescribe all insulins by brand
Using short-acting insulins (soluble insulin, insulin aspart, insulin glulisine and insulin lispro)

Restricted - prescribing by Consultant Diabetologists only. To be used in accordance with NICE TA151 and local clinical guideline (to be finalised).
NOTE: Currently each patient receives funding approval on an individual basis from the CCGs. Pumps and consumables purchased by CCGs/specialist commissioning. Insulins provided by secondary and primary care.
01.04.02 Co-Phenotrope 2.5/0.025  Contains diphenoxylate 2.5mg, atropine sulphate 25micrograms
06.03.02 Cortisone Acetate 25mg 
19.01.01 Cosmopor E®  5cm x 7.2cm This size only - Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

8cm x 10cm
8cm x 15cm
10cm x 20cm
10cm x 25cm
10cm x 35cm

BNF A5.1.2
In secondary care obtain from Supplies
05.01.08 Co-trimoxazole 240mg/5mL, 480mg/5mL  In secondary care restricted - for use in Rheumatology for PCP prophylaxis for patients receiving oral/iv cyclophosphamide or for use in Genitourinary Medicine. Microbiology approval required for all other uses. May be recommended by secondary care for prescribing by GPs
05.01.08 Co-trimoxazole 480mg 

In secondary care restricted - for use in Rheumatology for PCP prophylaxis for patients receiving oral/iv cyclophosphamide, in patients with suspected / confirmed pertussis or for use in Genitourinary Medicine. Microbiology approval required for all other uses. May be recommended by secondary care for prescribing by GPs.

05.01.08 Co-trimoxazole 480mg/5mL  In secondary care restricted - for use in Genitourinary Medicine only. Microbiology approval required for all other uses.
05.01.08 Co-trimoxazole 960mg  Restricted - only to be prescribed for patients with pneumocystis pneumonia (PCP) to aid compliance.
19.05.01.01 Crepe  Restricted - only for use in secondary care only at Stoke Mandeville Hospital

In secondary care obtain from Supplies
08.01.05 Crizotinib 200mg,250mg Xalkori®

FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage or via Blueteq. NICE compliance to be verified if form not available
Restricted - prescribing by consultant Oncologists (Lung) only, for:
1. Untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer in accordance with NICE TA 406
2. Previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer, in accordance with NICE TA 422 and NHSE SSC 1680.
3. For treating ROs1-positive advanced non-small-cell lung cancer in accordance with NICE TA 529. CDF funded for this indicaton until April 2023.


 

13.03 Crotamiton / Hydrocortisone 10%/0.25% 
13.03 Crotamiton 10% 
13.03 Crotamiton 10% 
09.01.02 Cyanocobalamin 50 micrograms 

Available to purchase over the counter (OTC).

See British Society of Haematology (BSH) guidance on Vitamin B12 replacement during the COVID-19 pandemic

Note NOTE: Cyanocobalamin liquid, Cytacon® tablets, and Cytamen® injection are not available on prescription on the NHS.

04.06 Cyclizine 50mg 
04.06 Cyclizine 50mg/1mL 
11.05 Cyclopentolate Hydrochloride 0.5%, 1% 
11.05 Cyclopentolate Hydrochloride 0.5%, 1% 
08.01.01 Cyclophosphamide 4g/200mL  Restricted - unlicensedunlicensed - High Risk, name patient basis only.
08.01.01 Cyclophosphamide 500mg, 1g  Also see Section 10.01.03 (Rheumatology)
10.01.03 Cyclophosphamide 500mg, 1g  For inpatient treatment of systemic vasculitis, lupus nephritis, see section 08.01.01
When prescribed by Rheumatology see guideline for the use of oral continuous cyclophosphamide in Rheumatology (BHTCG 101FM)
08.01.01 Cyclophosphamide 50mg  Also see Section 10.01.03 (Rheumatology)
10.01.03 Cyclophosphamide 50mg  For inpatient treatment of systemic vasculitis, lupus nephritis see section 08.01.01
When prescribed by Rheumatology see guideline for the use of oral continuous cyclophosphamide in Rheumatology (BHTCG 101FM)
03.04.01 Cyproheptadine Hydrochloride 4mg >
06.04.02 Cyproterone Acetate 50mg 
08.03.04.02 Cyproterone Acetate 50mg, 100mg 
08.01.03 Cytarabine 100mg/5mL 
08.01.03 Cytarabine 500mg/5mL, 1g/10mL 
02.08.02 Dabigatran etexilate 110mg, 150mg 

Amber For treatment of DVT and PE and prevention of recurrent DVT and PE in adults unsuitable for warfarin, for whom dalteparin would otherwise be considered, in accordance with NICE TA 341 and the Dabigatrin, Rivaroxaban, Apixaban and Edoxaban for DVT and PE - Amber Initiation guideline (BHTCG 295FM).

Initiation by or on the advice of  consultant Haematologists or DOAC pharmacists with continuation by GPs.  Any consultant may refer DVT/PE cases to Haematology / DOAC service for a decision about treatment after dalteparin has already been initiated. 

 
Green For preventing stroke and systemic embolism in adults with non-valvular atrial fibrillation in accordance with Dabigatran, Rivaroxaban, Edoxaban and Apixaban for Atrial Fibrillation guideline (BHTCG 313FM).

02.08.02 Dabigatran etexilate 75mg, 110mg  Restricted - to prescribing by Orthopaedic team for use in accordance with the VTE Policy and VTE Risk Assessment for Total Hip and Knee Replacement (THR and TKR).
08.01.05 Dabrafenib 50mg, 75mg  

FOR ALL PRESCRIBING - NICE compliance form via BLUETEQ is required


1. Restricted - prescribing by Oxford University Hospitals (OUH) only, in accordance with NICE TA321.


2. Restricted - Prescribing by Consultant Oncologists for adjuvant treatment of resected BRAF V600 mutation-positive melanoma in accordance with NICE TA 544.

08.01.05 Dacarbazine 200mg, 500mg 
05.03.03.02 Daclatasvir 30mg, 60mg Daklinza®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Consultant Gastroenterologists/Hepatologists and Associate Specialist (Gastroenterology), as part of Thames Valley ODN in accordance with NICE TA 364 or NHSE Commissioning Policy statement 1524, June 2015 - Hepatitis C with cirrhosis and NHSE SSC 1615. All patients will be discussed in the ODN MDT.

08.01.05 Dacomitinib Vizimpro®

FOR ALL PRESCRIBING - a completed and approved NICE compliance form, via BLUETEQ, is required.
Restricted to prescribing by the Oncology  team for the treatment of untreated EGFR mutation-positive non-small-cell lung cancer in accordance with NICE TA 595.


https://www.nice.org.uk/guidance/TA595

08.01.02 Dactinomycin 500micrograms  unlicensedunlicensed
02.08.01 Dalteparin Sodium 10,000units/1mL Fragmin® To be used for treatment and prevention of DVT and PE.
1. Restricted - for hospital only use when prescribed for treatment doses (exceeding 5000units daily) and for all indications for use within obstetrics and gynaecology.
02.08.01 Dalteparin Sodium 2500units/0.2mL, 5000units/0.2mL Fragmin® To be used for treatment and prevention of DVT and PE.
2. Restricted - to prescribing in accordance with, Dalteparin for prophylactic use in Surgery, Oncology, Haematology and Medicine amber initiation guideline (BHTCG 116FM)
NOTE: for amber initiation the first 6 weeks supply to be provided by hospital.
02.08.01 Dalteparin Sodium 2500units/0.2mL, 5000units/0.2mL, 10,000units/0.4mL, 12,500units/0.5mL, 15,000units/0.6mL, 18,000units/0.72mL Fragmin® To be used for treatment and prevention of DVT and PE.
1. Restricted - for hospital only use when prescribed for treatment doses (exceeding 5000units daily) and for all indications for use within obstetrics and gynaecology.
02.08.01 Danaparoid Sodium 750mg/0.6mL  Restricted - prescribing only on the advice of a Consultant Haematologist, for heparin induced thrombocytopenia (HIT)
06.07.02 Danazol 100mg, 200mg 
15.01.08 Dantrolene Sodium 20mg  BNF states hospital only
18 Dantrolene Sodium 20mg ***  Neuroleptic malignant syndrome (NMS)
Other drug-related hyperpyrexia (consult TOXBASE)
10.02.02 Dantrolene Sodium 25mg, 100mg 

2nd Choice skeletal muscle relaxant for treatment of spasticity. Baseline and ongoing LFTs to be undertaken by the Specialist. In exceptional circumstances e.g. if the patient cannot attend the hospital, the Specialist will provide written instructions to the GP to confirm the requirements for baseline and ongoing LFT monitoring. 

06.01.02.03 Dapagliflozin 5mg, 10mg 

Green  Use in accordance with NICE TA 288, NICE TA 390, NICE TA 418 and the Management of Type 2 Diabetes: Blood-Glucose Lowering Therapy Guideline (BHTCG 667FM) (see link above)

2nd line SGLT2 inhibitor for glycaemic control in patients with or without cardiovascular disease (CVD).

 

Amber Recommentation Restricted - prescribing on the recommendation of the Heart failure team or GP with special interest in Cardiology, continuation by GPs.  For treatment of symptomatic chronic heart failure with reduced ejection fraction in accordance with NICE TA 679 and the Dapagliflzon for heart failure guideline (guideline awaiting approval).  

06.01.02.03 Dapaglifozin Forxiga®

For treatment of Type 1 Diabetes as an adjunct to insulin in accordance with NICE TA 597.


Prescribing on the recommendation of consultant Diabetologists, continuation by GPs.


https://www.nice.org.uk/guidance/TA597

05.01.10 Dapsone 50mg, 100mg  Restricted - Dermatology and Specialist Sexual Health consultants (GUM and Contraception). Microbiology approval required for all other uses.
05.01.07 Daptomycin 350mg, 500mg  Restricted - Microbiology approval required
08.01.05 Daratumumab 100mg/5mL, 400mg/20mL 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required. 


1. Restricted to prescribing by Consultant Haematologists in accordance with NICE TA 510. CDF funded for this indication until November 2020.


2. Restricted to prescribing by Consultant Haematologists with bortezomib and deamethasone for previously treated multiple myeloma in accordance with NICE TA 573. CDF funded for this indication until January 2021.

09.01.03 Darbepoetin Alfa 10, 15, 20, 30, 40, 50, 60, 80, 100, 150micrograms  Red Traffic Light  for Oxford Renal patients

Amber Traffic Light  Amber Initiation - for all other patients restricted to prescribing by Haematologists only, in accordance with NICE TA 142.

NICE compliance form required - see link from Formulary homepage
07.04.02 Darifenacin 7.5mg, 15mg 

Solifenacin 5mg or 10mg tablets and trospium 20mg tablets are joint first choice  options for treatment of overactive bladder.


Use in accordance with guideline 110FM Medical management of overactive bladder and 114FM Management of urinary incontinence in adult females (see links above).

08.03.04.02 Darolutamide 300mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Consultant Oncologists (prostate) only,  in combination with androgen deprivation therapy for treating hormone-relapsed non-metastatic prostate cancer in accordance with NICE TA 660.

05.03.01 Darunavir 150mg, 400mg, 600mg, 800mg Prezista® TWICE DAILY dose- restricted for BHT HIV MDT.
ONCE DAILY dose- does not require BHT HIV MDT approval
When used with ritonavir- preferred 3rd agent
05.03.01 Darunavir/cobicistat 800mg/150mg Rezolsta®

Preferred 3rd agent


Avoid in pregnancy - see link below.

05.03.03.02 Dasabuvir 250mg Exviera®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Consultant Gastroenterologists/Hepatologists and Associate Specialist (Gastroenterology), as part of ODN in accordance with NHSE Commissioning Policy statement 1524, June 2015 - Hepatitis C with cirrhosis.

08.01.05 Dasatinib 20mg, 50mg, 80mg, 100mg, 140mg  FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required in accordance with NHSE SSC 1670. NICE compliance to be verified if form not yet available.

1. Restricted - prescribing by Consultant Haematologists for treating imatinib-resistant or intolerant CML in accordance with NICE TA 425.
2. Restricted- prescribing by Consultant Haematologists for untreated CML in accordance with NICE TA 426.
08.01.02 Daunorubicin 20mg 
09.01.03 Deferasirox 125mg, 250mg, 500mg Exjade® Restricted - prescribing by consultant Haematologists following discussion / agreement with Specialist Centre defined in the NHSE SSC letter 1654, Dec 16.

For iron-overload for transfused and non-transfused patients with chronic inherited anaemias in accordance with NHSE Clinical Commissioning Policy 16070/P Aug 16 and SCL 1654, Dec 16.

The name of Specialist Centre and Specialist Centre consultant(s) involved in treatment to be communicated to Formulary Team prior to initiating new patients. The same information is required for existing patients.
09.01.03 Deferiprone 500mg Ferriprox® Restricted - prescribing by consultant Haematologists following discussion / agreement with Specialist Centre defined in the NHSE SSC letter 1654, Dec 16.

For iron-overload for transfused and non-transfused patients with chronic inherited anaemias in accordance with NHSE Clinical Commissioning Policy 16070/P Aug 16 and SCL 1654, Dec 16.

The name of Specialist Centre and Specialist Centre consultant(s) involved in treatment to be communicated to Formulary Team prior to initiating new patients. The same information is required for existing patients.
08.03.04.02 Degarelix 80mg, 120mg Firmagon® Restricted - prescribing initiation by consultant Oncologists only. For continuation by GPs once amber guideline is in place (guideline awaiting).

For treatment of advanced hormone-dependent prostate cancer in accordance with NICE TA 404. Degarelix will be reserved for patients with spinal metastases with / or impending spinal cord compression.
09.06.07 DEKAs Plus® liquid  Restricted - initiation by Consultant Paediatricians with continuation by GPs for cystic fibrosis patients requiring Vitamin K supplementation, who cannot swallow tablets and to be used in accordance with Vitamin Supplementation for Paediatric Cystic Fibrosis Patients - Primary/Secondary Care guideline (BHTCG 378FM) (see link above)
05.01.09 Delamanid 50mg 

FOR ALL PRESCRIBING: NICE compliance form via Blueteq required.

Restricted - prescribing by OUH Specialists only, not prescribable by BHT. Use in multidrug-resistant TB in accordance with NHSE SSC 1645.


05.01.03 Demeclocycline Hydrochloride 150mg 
06.06.02 Denosumab 120mg/1.7mL XGEVA® WARNING: - There are TWO brands of denosumab, each a different strength - take extra care when prescibing and administering.

NOTE: XGEVA® is administered monthly

Restricted - prescribing by Consultant Endocrinologists, Consultant Haematologists and Consultant Oncologists for preventing skeletal-related events in adults with bone metastases from breast cancer and solid tumours other than prostate if bisphosphonates would otherwise be prescribed, in accordance with NICE TA 265 and guideline BHTCG 305FM Denosumab for bone metastases in solid tumours.
06.06.02 Denosumab 60mg/1mL Prolia®

Prescribing on the recommendation  of the Medicines for Older People , Rheumatology and Endocrinology teams with continuation by GPs in accordance with: Denosumab for primary and secondary fracture prevention in people over 50 years Amber Recommendation guideline (BHTCG 401FM).


3rd line agent in patients > 50 years at high risk of fracture who are unsuitable for at least two oral bisphosphonates.


WARNING: 


1. There are TWO brands of denosumab, each a different strength - take extra care when prescibing and administering.


2. There is an increased risk of multiple, vertebral fractures after stopping or delaying ongoing Denosumab 60mg (Prolia®) treatment. Do NOT stop or delay denosumab without prior specialist advice.  Use 'Advice and Guidance' via ERS;



  • at the end of a treatment cycle.

  • if there are concerns about serious side effects prior to giving the next injection (mark request as ‘urgent’).


See MHRA DSU Aug 2020  https://www.gov.uk/drug-safety-update/denosumab-60mg-prolia-increased-risk-of-multiple-vertebral-fractures-after-stopping-or-delaying-ongoing-treatment.
 

07.02.02 Dequalinium chloride 10mg  

July 2021-formulary addition in line with Medicines supply notification MSN/2021/030.  Alternative product to clindamycin 2% vaginal cream or metronidazole 0.75% vaginal gel.  MSN_2021_030 Dalacin (clindamycin) 2% vaginal cream

13.02.01 Dermol 500® 
13.02.01 Dermol® 
18 Desferrioxamine Mesilate 500mg ***  Toxicity with iron
09.01.03 Desferrioxamine Mesilate 500mg, 2g  Red Specialist CentreRestricted - prescribing by consultant Haematologists following discussion / agreement with Specialist Centre defined in the NHSE SSC letter 1654, Dec 16.

For iron-overload for transfused and non-transfused patients with chronic inherited anaemias in accordance with NHSE Clinical Commissioning Policy 16070/P Aug 16 and SCL 1654, Dec 16.

The name of Specialist Centre and Specialist Centre consultant(s) involved in treatment to be communicated to Formulary Team prior to initiating new patients. The same information is required for existing patients.

Red Traffic LightRestricted- prescribing by consultant Haematologists for other indications not listed in the NHSE Policy
15.01.02 Desflurane 
06.05.02 Desmopressin 100micrograms, 200micrograms 
06.05.02 Desmopressin 10micrograms/metered spray 
06.05.02 Desmopressin 120micrograms, 240micrograms  Restricted - as a 2nd line choice for children with primary nocturnal enuresis who cannot swallow tablets
06.05.02 Desmopressin 4micrograms/1mL 
07.03.02.01 Desogestrel 75micrograms  Restricted - prescribe only for women:in whom oestrogens are not suitable AND
below 35 years AND
declined or unsuitable for LARCs AND
in whom there is evidence of poor compliance with other pills, demonstrated by the use of emergency hormonal contraception or unwanted pregnancy.
OR it may be used prior to using an implant with the same progestogen in order to ascertain tolerance of that same progestogen.

In primary care Cerelle brand preferred
11.04.01 Dexamethasone 0.1% Eythalm®

As an alternative to single dose units in patients unable to tolerate preservatives in eye drops.

11.04.01 Dexamethasone 0.1% e.g. Maxidex®
11.04.01 Dexamethasone 0.1% 
06.03.02 Dexamethasone 2mg 

Note: soluble tablets are currently cheaper than plain 2mg tablets and are therefore recommended for all uses - Oct 16


06.03.02 Dexamethasone 2mg/5mL  NOTE: Before prescribing dexamethasone solution consider prescribing dexamethasone tablets which are soluble and less expensive.
06.03.02 Dexamethasone 3.3mg/1mL dexamethasone base NOTE: There are several preparations of intravenous dexamethasone available in different concentrations. Check carefully that the preparation administered provides the prescribed dose.

Dexamethasone injection 3.3mg/mL is available.
(Dexamethasone injection 4mg/mL is no longer available and is non-formulary)

Most prescriptions for dexamethasone injection will be 4mg (or a multiple of), so please follow one of the options below:
1. The patient can be converted to 3.3mg (or multiples of, as appropriate) - doctors will need to rewrite the prescription so that this dose can be given OR
2. Use 1.2mL of dexamethasone injection 3.3mg/mL (approximately equal to 4mg dexamethasone injection)
06.03.02 Dexamethasone 500micrograms, 2mg  Note for 2mg tablets: Use soluble 2mg tablets as they are currently cheaper than plain 2mg tablets - Oct 16
11.04.01 Dexamethasone 700micrograms e.g. Ozurdex® FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.

FOR ALL RED INDICATIONS - to be used as described in the intravitreal injections algorithm (BHTCG 653FM) (see link below) and based upon the principle that 'when all clinical considerations are equal, priority will be given to the product with greatest experience and lowest long term treatment costs'

Red Traffic Light Restricted - prescribing by Consultant ophthalmologists
1. in accordance with NICE TA 229.
2. as a second line option in pseudophakic diabetic macular oedema patients for whom anti VEGF treatment fails or is unsuitable due to intolerance or contraindications in accordance with NICE TA 349

Red Specialist Centre  3. Restricted - prescribing by consultant ophthalmologists following initiation by Specialist Centre.
For treatment continuation for non-infectious uveitis in adult patients in accordance with NICE TA460, NHSE Clinical Commissioning Policy D12/P/b, July 15 and NHSE Interim Clinical Commissioning Policy Statement 170010/PS. BHT Ophthalmology consultants will prescribe as outreach to the Specialist Centre delivered as part of a provider network. Name of Specialist centre and clinician involved in MDT to be communicated to Formulary Team prior to initiating treatment at BHT.
12.01.01 Dexamethasone with Antibacterial Otomize® Dexamethasone 0.1% /neomycin sulphate (3250units/1mL)/glacial acetic acid 2.0%
12.01.01 Dexamethasone with Antibacterial Sofradex® Dexamethasone 0.05%/framycetin sulphate 0.5%/gramicidin 0.005%
11.04.01 Dexamethasone/Neomycin/Polymyxin B sulphate 0.1%/0.35%/6000units/g e.g. Maxitrol® 2nd choice -steroid/antibiotic combination preparation
In secondary care restricted - Consultant to prescribe if Betnesol-N ointment considered unsuitable.
11.04.01 Dexamethasone/Neomycin/Polymyxin B sulphate 0.1%/0.35%/6000units/mL e.g. Maxitrol® 2nd choice -steroid/antibiotic combination preparation
In secondary care restricted - Consultant to prescribe if Betnesol-N ointment considered unsuitable.
04.04 Dexamfetamine 1mg/1ml 

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).


Restricted for use in patients who require an immediate release formulation but cannot swallow tablets.

04.04 Dexamfetamine Sulphate 5mg, 10mg, 20mg 

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).

09.02.02.02 Dextran 40® 
09.02.02.02 Dextran 70® 
04.07.02 Dextromoramide 5mg  In secondary care restricted - Palliative Care only
04.07.02 Diamorphine Hydrochloride 5mg, 10mg, 30mg, 100mg, 500mg 
06.01.06 Diastix®  Restricted to patients who cannot use blood glucose testing
10.02.02 Diazepam  see Section 04.01.02
04.01.02 Diazepam 10mg/2mL 
04.01.02 Diazepam 10mg/2mL 
04.08.02 Diazepam 10mg/2mL (emulsion)  Oral preparations see Section 04.01.02
04.08.02 Diazepam 10mg/2mL (solution)  Oral preparations see Section 04.01.02
04.01.02 Diazepam 2.5mg/1.25mL, 5mg/2.5mL, 10mg/2.5mL 
04.08.02 Diazepam 2.5mg/1.25mL, 5mg/2.5mL, 10mg/2.5mL  Oral preparations see Section 04.01.02
04.01.02 Diazepam 2mg, 5mg, 10mg 
04.01.02 Diazepam 2mg/5mL 
04.01.02 Diazepam 5mg/5mL  In secondary care - Restricted - prescribing by Psychiatric (Mental Health Trust) team only.

In primary care - Nationally Blacklisted & so not prescribable.
02.05.01 Diazoxide 300mg/20mL  Restricted - for ITU only
06.01.04 Diazoxide 50mg  Restricted - initiation by Endocrinologists only for the treatment of intractable hypoglycaemia, with continuation by GPs
06.01.04 Diazoxide 50mg/ml  Restricted- prescribing by paediatrics team only for intractable hypoglycaemia and congenital hyperinsulinaemia
16.01 Dibotermin alfa InductOs

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.

10.03.02 Diclofenac 1.16%  In primary care consider patient purchasing - often cheaper than paying a prescription charge.
10.01.01 Diclofenac Sodium (equivalent to diclofenac sodium 50mg)  Restricted - for use when patient cannot swallow and in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
11.08.02 Diclofenac Sodium 0.1%  In secondary care restricted - use in theatres and if patient requires preservative free preparation
11.08.02 Diclofenac Sodium 0.1%  Restricted - only for use if Ketorolac unavailable
10.01.01 Diclofenac Sodium 12.5mg, 25mg, 50mg, 100mg  Use in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
13.08.01 Diclofenac Sodium 3% in Sodium Hyaluronate basis Solaraze® To be used in accordance with Treatment of Actinic Keratoses (BHTCG 365FM)
10.01.01 Diclofenac Sodium 75mg/2mL Dyloject® Unavailable as temporarily withdrawn due to market recall

Restricted - to prescribing by Consultant Anaesthetists in accordance with:
Oral Premedication Prior to Surgery - Adult and Paediatric patients (BHTCG 55)and
Post-Operative Analgesic Ladder for Adults (BHTCG 49FM)


10.01.01 Diclofenac Sodium 75mg/3mL Voltarol® Use in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
10.01.01 Diclofenac Sodium EC 25mg, 50mg  3rd Choice NSAID
Use in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
10.01.01 Diclofenac Sodium SR 75mg, 100mg  Used instead of non-SR preparation where long acting formulation required or if compliance is an issue.
Use in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
18 Dicobalt edetate 300mg/20mL  Cyanide toxicity
08.03.01 Diethylstilbestrol 1mg, 5mg  Restricted - initiation in secondary care with continuation by GPs, for treatment of Breast and Prostate cancer.
13.04 Diflucortolone Valerate 0.1% Nerisone® Potency: potent
13.04 Diflucortolone Valerate 0.3% Nerisone Forte® Potency: Very Potent

2nd line to Clobetasol Propionate 0.05% (Dermovate®) if there are supply problems

In primary care try to avoid using very potent topical steroids
02.01.01 Digoxin 100micrograms/1mL, 500micrograms/2mL 
02.01.01 Digoxin 50micrograms/1mL  Do not dilute (from BNF)
02.01.01 Digoxin 62.5micrograms, 125micrograms, 250micrograms 
02.01.01 Digoxin specific antibody fragments 40mg Digifab® Stock held in A&E

If used in accordance with National Poisoning Information Centre (Toxbase) recommendations. FOR ALL PRESCRIBING - completion of Compliance form required. If Compliance form not yet available confirmation that National Poisoning Information Centre recommendations are met, is required.
18 Digoxin specific antibody fragments 40mg *** Digifab® Stock held in A&E

If used in accordance with National Poisoning Information Centre (Toxbase) recommendations. FOR ALL PRESCRIBING - completion of Compliance form required. If Compliance form not yet available confirmation that National Poisoning Information Centre recommendations are met, is required.
04.07.02 Dihydrocodeine Tartrate 10mg/5mL 
04.07.02 Dihydrocodeine Tartrate 30mg 
04.07.02 Dihydrocodeine Tartrate 50mg/1mL 
05.04.02 Diloxanide Furoate 500mg  Restricted - to be prescribed only on advice from Consultant Microbiologist for the treatment of amoebiasis.

Phone Pharmacy to Order
01.07.04 Diltiazem 2%  unlicensedunlicensed: Low Risk.
Restricted - prescribing by colorectal surgeons for the treatment of patients with an anal fissure resistant to topical glyceryl trinitrate 0.4% used twice daily or experiencing severe side effects (headache) from it.
02.06.02 Diltiazem 60mg  THREE TIMES DAILY dosing
02.06.02 Diltiazem Hydrochloride Viazem® XL
02.06.02 Diltiazem Hydrochloride 120mg, 180mg, 200mg, 240mg, 300mg  ONCE DAILY dosing
Viazem XL capsule 120mg, 180mg, 240mg, 300mgTildiem LA capsule 200mg
02.06.02 Diltiazem Hydrochloride 90mg, 120mg, 180mg  TWICE DAILY dosing
Adizem SR capsule 90mg, 120mg, 180mg
08.02.04 Dimethyl Fumarate 120mg, 240mg Tecfidera® Prescribe by BRAND name.

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Consultant Neurologists and Clinical Nurse Specialist for Neurology for the treatment of adults with relapsing-remitting multiple sclerosis with active disease in accordance with NICE TA320
13.05.03 Dimethyl fumarate 30mg, 120mg  Skilarence®

Prescribe by BRAND name.

FOR ALL PRESCRIBING - NICE compliance form via BLUETEQ required - see link from Formulary homepage. NICE compliance to be verified if form not available.

Restricted- prescribing by Dermatology consultants and Dermatology speciality doctors only. For the treatment of severe plaque psoriasis in accordance with NICE TA 475 and the updated Apremilast, dimethyl fumarate and biologics in psoriasis algorithm (BHTCG 738FM).

See section 8.2.4 for use in neurology

13.10.04 Dimeticone 4% Hedrin® For use in secondary care only
07.01.01 Dinoprostone 1mg, 2mg 
07.01.01 Dinoprostone 3mg 
07.01.01 Dinoprostone 5mg/0.5mL 
07.01.01 Dinoprostone releasing approximately 10mg over 24 hours Propress® Restricted - to prescribing by Obstetrics team for induction of labour in first time mothers only, in accordance with Induction of Labour (BHTCG 415) The dinoprostone 3mg tablet to be used for induction of labour in women who are giving birth for the second or subsequent time.
08.02.03 Dinutuximab beta 4.5mg/mL Qarziba®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.


Restricted - prescribing by Oxford University Hospital (OUH) Consultant Oncologists. For the treatment of neuroblastoma in accordance with NICE TA 538.

13.07 Diphencyprone (strengths from 0.001% - 6%)  Restricted - Dermatology consultants only.
unlicensedunlicensed - Moderate risk.
14.04 Diphtheria, Tetanus, Pertussis (Acellular), Poliomyelitis (inactivated), Hepatitis b (rDNA) and Haemophilus Influenzae Type b (Hib) vaccine  Infanrix® HEXA For children under 10 years.

In primary care as part of the routine national UK immunisation schedule

14.04 Diphtheria, tetanus, pertussis (acellular, component) and poliomyelitis (inactivated) Vaccine Boostrix-IPV® For use from 28 weeks gestation onwards in pregnancy (National Immunisation programme)
13.02.01 Diprobase® 
13.02.01 Diprobase® 
02.09 Dipyridamole 200mg 

see Antiplatelet guideline (BHTCG 708FM);


 Link  Antiplatelets and Rivaroxaban 2.5 mg for Secondary Prevention of OVE - Primary/Secondary Care guideline (BHTCG 708FM)

11.99.99.99 Disodium Edetate 0.37%  unlicensedunlicensed - Low Risk
In secondary care restricted - name patient basis, Phone Pharmacy to Order
06.06.02 Disodium Etidronate 200mg  unlicensedunlicensed - Low Risk

In secondary care restricted for treatment of heterotopic ossification in Spinal Cord Injury only.

Not for use in osteoporosis.
06.06.02 Disodium Pamidronate 15mg, 30mg, 90mg 
02.03.02 Disopyramide 100mg  Restricted - initiation in secondary care with continuation by GPs
02.03.02 Disopyramide 250mg  Restricted - initiation in secondary care with continuation by GPs
04.10.01 Disulfiram 200mg 

Initiation by the Drug and Alcohol team and continuation by GPs. Use in accordance with  562FM Disulfiram for treatment of alcohol dependency in adults 18 years and over Amber Initiation guideline

13.05.02 Dithranol in Lassar's Paste 0.1%, 0.25%, 0.5%, 1%, 2%  unlicensedunlicensed - Medium Risk
In secondary care phone Pharmacy to check availability of strength required

In primary care this is a pharmaceutical special
13.05.02 Dithranol 0.1%, 0.25%, 0.5%, 1%, 2% Dithrocream® In secondary care Phone Pharmacy to Order 0.1% and 0.25% strengths
13.05.02 Dithranol 1%, 3% in lipid-stabilised basis Micanol®
02.07.01 Dobutamine 250mg/50ml 
08.01.05 Docetaxel 20mg/0.5ml/80mg/2ml  1. Restricted - in accordance with NICE guidelines. For nsclc - 2nd line treatment
2. Restricted - prescribing by Consultant Oncologists (Prostate) for the treatment of hormone naïve metastatic prostate cancer in combination with androgen deprivation therapy in accordance with NHS England Clinical Commissioning Policy B15/PS/a
01.06.02 Docusate Sodium 100mg 
01.06.02 Docusate Sodium 12.5mg/5mL, 50mg/5mL 
05.03.01 Dolutegravir 50mg  TWICE DAILY dose- restricted for BHT HIV MDT.
ONCE DAILY dose- does not require BHT HIV MDT approval. Preferred 3rd agent
Consider raltegravir as a more cost-effective option - March 2017.
05.03.01 Dolutegravir 50mg, Lamivudine 300mg tablets  Dovato®

Use in accordance with NHSE Clinical Commissioning policy 200301P :  Dolutegravir / lamivudine for the treatment of HIV-1 infected adults and adolescents  https://www.england.nhs.uk/wp-content/uploads/2020/03/1920-Dolutegravir-lamivudine-for-the-treatment-of-HIV-infected-adults-and-adolescents-over-12-years-of-age-060.pdf

05.03.01 Dolutegravir 50mg, Rilpivirine 25mg tablets  Juluca®

Restricted to BHT HIV MDT. To be used in accordance with NHSE Clinical Commissioniing policy 200 0P : Dolutegravir-rilpivirine for treating HIV-1 in adults https://www.england.nhs.uk/wp-content/uploads/2020/03/1806-Dolutegravir-rilpivirine-for-treating-HIV-1-in-adults.pdf

04.06 Domperidone 10mg  Restricted - MHRA have advised domperidone should only be used for nausea and vomiting. Its use is contraindicated in patients with underlying cardiovascular conditions and risk factors. Dose and duration have been revised to a maximum of 10mg three times daily for one week in adults. For more details see MHRA link below
04.06 Domperidone 5mg/5mL  Restricted - MHRA have advised domperidone should only be used for nausea and vomiting. Its use is contraindicated in patients with underlying cardiovascular conditions and risk factors. Dose and duration have been revised to a maximum of 10mg three times daily for one week in adults. For more details see MHRA link below
04.11 Donepezil Hydrochloride 5mg, 10mg 

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217 - Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and in accordance with Alzheimer's Disease shared care protocol (BHTCG 786FM)

04.11 Donepezil Hydrochloride 5mg, 10mg 

Restricted - to patients who cannot swallow ordinary tablets AND
Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217 - Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and in accordance with Alzheimer's Disease shared care protocol (BHTCG 786FM)

02.07.01 Dopamine Hydrochloride 200mg/5mL  For dilution and use as an infusion
02.07.01 Dopamine Hydrochloride 200mg/5mL, 400mg/10mL  For dilution and use as an infusion
02.07.01 Dopexamine Hydrochloride 50mg/5mL  For dilution and use as an infusion
05.03.01 Doravirine 100mg 

Restricted for BHT HIV MDT. 


Use in accordance with NHSE Policy 190P Doarvirine for treating HIV-1 in adults https://www.england.nhs.uk/wp-content/uploads/2019/11/1822-Policy-for-publication.pdf

05.03.01 Doravirine 100mg, lamivudine 300mg, tenofovir disoproxil 245mg Delstrigo®

Restricted for BHT HIV MDT.  Use in accordance with NHSE Policy 190137P Doarvirine for treating HIV-1 in adults https://www.england.nhs.uk/wp-content/uploads/2019/11/1822-Policy-for-publication.pdf


 

03.07 Dornase Alfa 2.5mg (2500units)/2.5mL 
11.06 Dorzolamide 2% 

1st Choice topical carbonic anhydrase inhibitor
Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

11.06 Dorzolamide/Timolol maleate 2%/0.5%

As an alternative to single dose units in patients unable to tolerate preservatives in eye drops.


Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs for patients who have an established allergy to preservatives or who are using more than 6 drops daily in the affected eye(s).


2 brands available:
• Cosopt iMulti® 10mL - can be used for 2 months from date of 1st opening
• Eylamdo® 5mL - can be used for 28 days from date of 1st opening

11.06 Dorzolomide/Timolol 2%/0.5% 

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs

11.06 Dorzolomide/Timolol 2%/0.5% e.g. Cosopt® Restricted - to initiation by Consultant Ophthalmologists with continuaton by GPs for patients who have an established allergy to preservatives or who are using more than 6 drops daily in the affected eye(s).
13.02.01 DoubleBase® 
03.05.01 Doxapram Hydrochloride 100mg/5mL 
03.05.01 Doxapram Hydrochloride 2mg/mL in glucose 5%  
07.04.01 Doxazosin   see Section 02.05.04
02.05.04 Doxazosin 1mg, 2mg, 4mg 
08.01.02 Doxorubicin Hydrochloride (encapsulated in liposomes) 20mg, 50mg  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not available.

Red Traffic Light Restricted - prescribing by Consultant Oncologists for recurrent ovarian cancer in accordance with NICE TA 389.

Red Specialist Centre Restricted - prescribing by Oxford University Hospitals (OUH) Consultant Oncologists, To be used in combination with olaratumab as an option for advanced soft tissue sarcoma in adults in accordance with NICE TA 465.
08.01.02 Doxorubicin Hydrochloride 10mg/5mL, 50/25mL  FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not available.

Restricted - prescribing by Oxford University Hospitals (OUH) Consultant Oncologists, To be used in combination with olaratumab as an option for advanced soft tissue sarcoma in adults in accordance with NICE TA 465.
12.03.01 Doxycycline   Restricted - available for use as mouthwash
BNF states for recurrent aphthous ulceration, a 100mg dispersible tablet can be stirred into a small amount of water then rinsed around the mouth for 2-3 minutes 4 times daily usually for 3 days; it should preferably not be swallowed (unlicensed indication)
05.01.03 Doxycycline 100mg 
05.01.03 Doxycycline 100mg  NOTE: much greater cost - only prescribe when standard oral formulation is unsuitable
13.02.02 Drapolene® 
02.03.02 Dronedarone 400mg  Restricted - prescribing as a 2nd/3rd line medicine by Consultant Cardiologists only in accordance with NICE TA197 and Dronedarone for Cardiology - hospital only guideline (BHTCG 123FM)
03.01.05 Drug Delivery Device Haleraid 120®, Haleraid 200®
03.01.05 Drug Delivery Device Volumatic®, Volumatic® and mask
03.01.05 Drug Delivery Device Aerochamber Plus Flow-Vu®

First choice.


Dishwasher safe, does not need to be primed before use.


Includes a visual tool to help count breaths. 


First choice for all new patients.


To replace the Aerochamber Plus® for all existing users at annual review.

03.01.05 Drug Delivery Device AeroChamber Plus®

Infant with mask, child with mask, adult with or without mask 

06.01.02.03 Dulaglutide 0.75mg, 1.5mg Trulicity®

Treatment of adults with type 2 diabetes in accordance with NICE NG 28 and 109FM GLP-1 agonists for adults with type 2 diabetes guideline.


2nd choice GLP-1 agonist for type 2 diabetes without athersclerotic cardiovascular disease (ASCVD).


3rd choice for type 2 diabetes with ASCVD.


Initiation by Diabetes consultants or Diabetes Specialist Nurses (DSN)s or by primary care health professionals who have received training and are operating under the direct award for insulin.

04.03.04 Duloxetine 30mg, 60mg 

Green Traffic Light Used as an alternative first line option when an SSRI is contraindicated for the treatment of Generalised Anxiety Disorder in accordance with guideline BHTCG 131FM.

Green Traffic Light Used as a third line option in accordance with the Depression in Adults and Older Adults guideline BHTCG 573FM and Antidepressants treatment algorithm BHT 572FM.

04.07.03 Duloxetine 60mg 

On the recommendation of the Pain, Diabetes, Neurology, Spinal or Palliative Care teams, continuation by GPs for treatment of neuropathic pain in accordance with the Neuropathic pain management in adults guideline BHTCG714FM 

19.11.01 DuoDERM® Extra Thin 

5cm x 10cm (S163)
7.5cm x 7.5cm (S160)
10cm x 10cm (S161)
15cm x15cm (S162)

BNF A5.2.4
In secondary care obtain from Supplies

19.11.01 DuoDERM® Signal  10cm x 10cm (S166)
In primary care available as stock through the On-line Non-Prescription Ordering System (ONPOS)

14cm x14cm (S167)
20cm x 20cm (S168)
In primary care on prescription only.

BNF A5.2.4
In secondary care obtain from Pharmacy
13.05.03 Dupilumab 300mg Dupixent®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.


Restricted to prescribing by Dermatology Consultants for the treatment of moderate to severe atopic dermatitis in accordance with NICE TA 534.

08.01.05 Durvalumab 120mg/2.4mL, 500mg/10mL Imfinzi®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via Blueteq, is required


Restricted to prescribing by Consultant Oncologists for the treatment of locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation in accordance with NICE TA 578. CDF funded for this indication until September 2021

13.02.01 E45® 
09.01.03 Eculizumab 300mg  FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form required. NHS England criteria to be verified if form not available.

Restricted

1. prescribing by Renal Consultants after initiation by Specialist Centre for recurrence of C3 glomerulopathy post-transplant, in accordance with NHSE SSC 1687, Jan 2017, and NHSE Clinical Commissioning Policy 16054/P.

2. prescribing by Consultant Paediatricians for the treatment of atypical haemolytic uraemic syndrome in accordance with NICE HST1.

Name of Specialist Centre organisation and consultant to be communicated to the BHT Formulary Team before prescribing is initiated in BHT.
02.08.02 Edoxaban 15mg, 30mg, 60mg 

Amber For treatment of DVT and PE and prevention of recurrent DVT and PE in adults unsuitable for warfarin, for whom dalteparin would otherwise be considered, in accordance with NICE TA 341 and the Dabigatrin, Rivaroxaban, Apixaban and Edoxaban for DVT and PE - Amber Initiation guideline (BHTCG 295FM).

Initiation by or on the advice of  consultant Haematologists or DOAC pharmacists with continuation by GPs.  Any consultant may refer DVT/PE cases to Haematology / DOAC service for a decision about treatment after dalteparin has already been initiated. 

 
Green For preventing stroke and systemic embolism in adults with non-valvular atrial fibrillation in accordance with Dabigatran, Rivaroxaban, Edoxaban and Apixaban for Atrial Fibrillation guideline (BHTCG 313FM).

10.02.01 Edrophonium Chloride 10mg/1mL 
15.01.06 Edrophonium Chloride 10mg/1mL 
05.03.01 Efavirenz 600mg  Alternative 3rd agent
05.03.03.02 Elbasvir/Grazoprevir 50mg/100mg Zepatier®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Consultant Gastroenterologists/Hepatologists and Associate Specialists (Gastroenterology), as part of Thames Valley ODN in accordance with NICE TA 413.

A2.01.01.02 Elemental Extra 028 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

06.04.01.01 Elleste-Duet® 1mg, 2mg 

First line oral sequential hormone replacement therapy (HRT) for oestrogen deficiency symptoms in peri-menopausal women.

16.01 Elosulfase alfa 5mg/5ml 

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


09.01.04 Eltrombopag 25mg, 50mg  FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.

Restricted - prescribing by Consultant Haematologists only for Chronic Idiopathic Thrombocytopenic purpura (ITP) in accordance with NICE TA 293.
01.04.02 Eluxadoline 75mg, 100 mg   For the treatment of irritable bowel syndrome with diarrhoea in accordance with NICE TA 471

Restricted- prescribing initiation by Gastroenterology team, for continuation by GP in accordance with IBS algorithm (guideline in progress).

The hospital will supply the first month’s treatment.
The patient will be reviewed after one month’s treatment by the consultant to confirm whether eluxadoline has been effective. If not it will be discontinued. If effective, it will be continued by the GP.
05.03.01 Elvitegravir/ cobicistat/ emtricitabine/ tenofovir 150mg/150mg/200mg/10mg Genvoya® Preferred fixed dose combination
11.04.02 Emedastine 0.05% 
06.01.02.03 Empagliflozin 10mg, 25mg 

Use in accordance with NICE TA 336, NICE TA 390 and the Management of Type 2 Diabetes: Blood-Glucose Lowering Therapy guideline (BHTCG 667FM) (see link above)


Joint 1st line SGLT2 inhibitor (with canagliflozin) for glycaemic control in patients with or without established cardiovascular disease (CVD)

05.03.01 Emtricitabine 200mg Emtriva® Restricted for BHT HIV MDT
05.03.01 Emtricitabine/ Rilpivirine/ Tenofovir 200 mg/25 mg/25 mg Odefsey® Preferred fixed dose combination
05.03.01 Emtricitabine/Rilpivirine/Tenofovir Disoproxil 200mg/25mg/245mg Eviplera® Preferred fixed dose combination
13.02.01 Emulsifying Ointment BP 
13.10.05 Enbucrilate Sterile Tissue Adhesive 500mg unit LiquiBand®
08.01.05 Encorafenib 50mg, 75mg 

FOR ALL PRESCRIBING - NICE Compliance form required via Blueteq

Restricted - prescribing by the Oncology team;

1. in combination with Binimetinib for the treatment of unresectable or metastatic BRAF V600 mutation-positive melanoma in adults in accordance with NICE TA 562.

2. in combination with Cetuximab for previously treated BRAF V600E mutation-positive metastatic colorectal cancer in accordance with NICE TA 668.

A2.06.01 Ener-G 

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

612G loaf = 1.5 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Ener-G 600g Seattle Brown loaf (sliced)

In primary care - a LESS cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

Consider switching to Barkat Wholemeal bread sliced

500G loaf is 1.25 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Ener-G 

In primary care - less cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

Consider switching to EnerG Rice Loaf sliced

612G loaf is 1.5 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Ener-G 

In primary care - less cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

Switch to Ener-G rice loaf sliced

612g loaf is 1.5 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Ener-G®  280g Dinner rolls

In primary care - a Less cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

Consider switching to Lifestyle Bread Rolls (white, brown or high fibre)

280G rolls = 0.75 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.04.01.03 Enshake 310ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.02 Ensure Plus Creme 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 

A2.02.02.01 Ensure Plus Fibre 200ml

 ** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 


 

A2.02.01.02 Ensure Plus Juce 220ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.03 Ensure Compact 125ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.01 Ensure Plus Milkshake Style 220ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details**


1st choice in secondary care.  To be switched to Aymes Shake in Primary Care immediately after discharge.  The exception to this rule is if the patient / carer is unable to prepare Aymes Shake or the patient is tube fed.

A2.02.02.01 Ensure Plus Yoghurt style 200ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 

A2.02.02.01 Ensure Shake 250ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.01 Ensure Twocal 200ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 

04.09.01 Entacapone 200mg 

For treatment of Parkinson’s Disease as a 1st line COMT inhibitor.


Initiation on the recommendation of a consultant Neurologist or CNS Parkinson’s Disease, continuation by GPs.

05.03.03 Entecavir 500micrograms, 1mg  FOR ALL PRESCRIBING - NICE compliance form required - see link on Formulary homepage.

Restricted - to prescribing by Consultant Gastroenterologists or Associate Specialists of Gastorenterology in conjunction with Hepatitis B clinic and in accordance with NICE TA 153 and BHT Clinical Guideline on Hepatitis B.
08.01.05 Entrectinib 100mg, 200mg 

FOR ALL PRESCRIBING : prior funding approval required via NICE compliance form (Blueteq).

For treating;

    • ROS1-positive advanced non-small-cell lung cancer in accordance with NICE TA 643
    • NTRK fusion-positive solid tumours in accordance with NICE TA 644
08.03.04.02 Enzalutamide 40mg  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not available.
Restricted - prescribing by Consultant Oncologists (Prostate) for:
1. Treatment of metastatic hormone-relapsed prostate cancer in adults whose disease has progressed during, or after, docetaxel-containing chemotherapy, in accordance with NICE TA316
2. Treatment of metastatic castration-resistant hormone relapsed prostate cancer before chemotherapy is indicated in accordance with NICE TA 377
12.02.02 Ephedrine Hydrochloride 0.5% 
03.01.01.02 Ephedrine Hydrochloride 15mg  In secondary care restricted to use by Spinal Unit for management of postural hypotension
02.07.02 Ephedrine Hydrochloride 30mg/10mL 
02.07.02 Ephedrine Hydrochloride 30mg/1mL 
13.02.01 Epimax®  In Primary care the first choice basic emollient.

Note - patients may be prescribed an alternative if it is not found suitable
08.01.02 Epirubicin Hydrochloride 10mg/5mL, 50mg/25mL, 100mg/50mL, 200mg/100mL 
02.02.03 Eplerenone 25mg, 50mg  For intolerance (gynaecomastia) to Spironolactone in male patients with chronic heart failure (unlicensed indication).
See Clinical Guideline for Investigation and Management of Heart Failure within Primary Care (BHTCG 707) (see link above)
02.02.03 Eplerenone 25mg, 50mg  To reduce the risk of cardiovascular mortality and morbidity post myocardial infarction, in accordance with NICE CG 172.

At 12 months post MI, switch to spironolactone 25mg daily. Restricted - initation by Consultant Cardiologists with continuation by GPs.

09.01.03 Epoetin ALFA 1000, 2000, 3000, 4000, 5000, 6000units Eprex® Red Traffic Light for Oxford Renal patients

Amber Traffic Light Amber Initiation - for all other patients restricted to prescribing by Haematologists only, in accordance with NICE TA 142.

NICE compliance form required - see link from Formulary homepage
09.01.03 Epoetin BETA 1000, 2000, 3000, 5000, 6000units NeoRecormon® Red Traffic Light for Oxford Renal patients

Amber Traffic Light Amber Initiation - restricted to paediatric use with prescribing by Haematologists only, in accordance with NICE TA 142.

NICE compliance form required - see link from Formulary homepage

09.01.03 Epoetin beta 500units NeoRecormon® Restricted - prescribing by Paediatricians only and only for use in NICU.
Phone Pharmacy to Order
02.08.01 Epoprostenol 500micrograms  Red Traffic Light 1. Restricted - for use on NICU, ITU and SCBU only

Red Specialist Centre 2. Restricted - prescribing by Respiratory consultants only after initiation in a Specialist Centre. May be continued in BHT via shared care between Specialist centre and BHT via a network model. For pulmonary arterial hypertension in accordance with NHSE Specialised Commissioning Policy A11/P/b, June 2014: National policy for targeted therapies for the treatment of pulmonary hypertension in adults. The name of the Specialist centre and consultant initiating drug to be communicated to Pharmacy Formulary Team prior to prescribing.
16.01 Eptotermin Alpha Osigraft® 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.
04.07.04.02 Erenumab 70mg/1mL, 140mg/1mL  Aimovig®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

For prevention of migraine in accordance with NICE TA 682 and the Migraine Prophylaxis : CGRP monoclonal antibodies for preventing migraine guideline (pending).
• Prescribe by brand name.
• Prescribing by consultant Neurologists.

09.06.04 Ergocalciferol 7.5mg (300,000units/1mL)  Restricted - for use in accordance with Vitamin D Testing and Treatment in Adults (BHTCG 785FM) (see above)
07.01.01 Ergometrine maleate 500micrograms/1mL 
07.01.01 Ergometrine Maleate/Oxytocin 500micrograms/5units in 1mL Syntometrine®
08.01.05 Eribulin 0.88mg, 1.32mg  Restricted- prescribing by consultant Oncologists (Breast). For locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens in accordance with NICE TA 423 and NHSE SSC 1701.
08.01.05 Erlotinib 25mg, 100mg, 150mg  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not available.

NOTE: Erlotinib may only be prescribed following prior approval from CCG.

Restricted - prescribing by Consultant Oncologist (Lung) only:
1. For the treatment of non-small-cell lung cancer that has progressed after prior chemotherapy in accordance with NICE TA 374.
2. As 1st line treatment of locally advanced or metastatic EGFR-TK mutation positive non-SCLC, in accordance with NICE TA258.
05.01.02.02 Ertapenem 1g  Restricted - Microbiology approval required and administration by OPAT team only.
06.01.02.03 Ertugliflozin 5mg, 10mg 

Use in accordance with NICE TA 572, NICE TA 583 and the Management of Type 2 Diabetes: Blood-Glucose Lowering Therapy Guideline (BHTCG 667FM) (see link above)


Joint 2nd line SGLT2 inhibitor (with dapagliflozin) for glycaemic control in patients without established cardiovascular disease (CVD)

05.01.05 Erythromycin 125mg/5mL, 250mg/5mL, 500mg/5mL 
05.01.05 Erythromycin 1g  Restricted - for use as a prokinetic agent on ICU. Can be filtered through a 0.2micron filter before addition to the infusion bag
05.01.05 Erythromycin 250mg, 500mg 
13.06.01 Erythromycin/Isotretinoin 2%/0.05% Isotrexin®

For use in accordance with the Bucks Acne Treatment Algorithm (see link above).


04.03.03 Escitalopram 5mg, 10mg, 20mg 

For use in accordance with;

1. Generalised Anxiety Disorder guideline (BHTCG 131FM). 

2. Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressants treatment algorithm (BHT 572FM). (1st line for specialists treating severely ill patients, 2nd line in primary care).

02.04 Esmolol Hydrochloride 100mg/10mL 
02.04 Esmolol Hydrochloride 2.5g/10mL 
06.04.01.01 Estradiol Valerate 1mg, 2mg 
06.04.01.01 Estradiol /Norethisterone Acetate 1mg/500micrograms Kliovance®

2nd choice oestrogen and progestogen continuous combined HRT.


Use also in accordance with the Management of Premature Ovarian Insufficiency guideline (BHTCG 422FM)

06.04.01.01 Estradiol /Norethisterone Acetate 2mg/1mg Kliofem®
06.04.01.01 Estradiol 0.06% Oestrogel® Pump-Pack

First choice transdermal estrogen, when a gel is preferred to a patch and when daily administration is preferred to bi-weekly.
For use in:
• HRT for oestrogen deficiency symptoms in post-menopausal women.
• Prevention of osteoporosis in post- menopausal women at high risk of fracture (Bucks Osteoporosis guideline)
• Management of Premature Ovarian insufficiency (POI) in accordance with the Management of Premature Ovarian Insufficiency guideline (BHTCG 422FM). For POI this does not prevent referral to Endocrinology when required.

06.04.01.01 Estradiol 100 micrograms/ 24 hours Progynova® TS Restricted- prescribing by cancer care investigators as part of STUDY STAMPEDE Arm L only
07.02.01 Estradiol 10micrograms, 25 micrograms Vagifem®
06.04.01.01 Estradiol 25mg, 50mg, 100mg  In primary care needs to be personally administered and reclaimed on FP34.

Requires expertise to administer it.
06.04.01.01 Estradiol releasing approx. 25micrograms/24hours, 37.5micrograms/24hours, 50micrograms/24hours, 75micrograms/24hours, 100micrograms/24hours Estradot®

Third choice transdermal estrogen.
For use in:
• HRT for oestrogen deficiency symptoms in post-menopausal women.
• Prevention of osteoporosis in post- menopausal women at high risk of fracture (Bucks Osteoporosis guideline)
• Management of Premature Ovarian insufficiency (POI) in accordance with the Management of Premature Ovarian insufficiency guideline (BHTCG 422FM). For POI this does not prevent referral to Endocrinology or Gynaecology when required.

06.04.01.01 Estradiol releasing approx. 25micrograms/24hours, 50micrograms/24hours, 75micrograms/24hours, 100micrograms/24hours Estraderm MX®

Second choice transdermal estrogen.
For use in:
• HRT for oestrogen deficiency symptoms in post-menopausal women.
• Prevention of osteoporosis in post- menopausal women at high risk of fracture (Bucks Osteoporosis guideline)
• Management of Premature Ovarian insufficiency (POI) in accordance with the Management of Premature Ovarian insufficiency guideline (BHTCG 422FM). For POI this does not prevent referral to Endocrinology or gynaecology when required

06.04.01.01 Estradiol releasing approx. 25micrograms/24hours, 50micrograms/24hours, 75micrograms/24hours, 100micrograms/24hours Evorel®

First choice transdermal estrogen patch


For use in: 


• HRT for oestrogen deficiency symptoms in post-menopausal women.
• Prevention of osteoporosis in post-menopausal women at high risk of fracture (Bucks Osteoporosis guideline)
• Management of Premature Ovarian Insufficiency (POI) in accordance with the Management of Premature Ovarian Insufficiency guideline (BHTCG 422FM). For POI, this does not prevent referral to Endocrinology or Gynaecology when required.


Evorel 50micrograms/24 hours, 75micrograms/24 hours, 100micrograms/24 hours are due to go out of stock from October 2019 and 25micrograms/24 hours from February 2020 with anticipated resupply date in mid 2020.


See following UK Medicine Information guidance on suitable alternative options. Prescribers should seek specialist advice for more complex patients and consider prioritising the use of transdermal HRT therapy for women at increased risk of venous thrombosis https://www.sps.nhs.uk/articles/shortage-of-evorel-hormone-replacement-therapy-hrt-patch-range/

06.04.01.01 Estradiol/Norethisterone Acetate releasing 50micrograms/170micrograms in 24 hours Evorel® Conti

1st choice oestrogen and progestogen continuous combined HRT.


Use also in accordance with the Management of Premature Ovarian Insuffiency guideline (BHTCG 422FM).


Evorel Conti is due to go out of stock from end of October 2019 with anticipated resupply date in mid 2020.      


See following UK Medicine Information guidance on suitable alternative options. Prescribers should seek specialist advice for more complex patients and consider prioritising the use of transdermal HRT therapy for women at increased risk of venous thrombosis


https://www.sps.nhs.uk/articles/shortage-of-evorel-hormone-replacement-therapy-hrt-patch-range/

07.02.01 Estriol 0.01% Gynest®
07.02.01 Estriol 0.1% Ovestin®
10.01.03 Etanercept 25mg, 50mg Enbrel®, Benepali® FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.

NOTE:
ALL prescribing of etanercept must include generic and brand name.
Benepali® is first choice etanercept preparation.

1. Restricted - to Rheumatology consultant prescribing only in accordance with NICE TA 35.
2. Restricted - to Rheumatology consultant prescribing only in accordance with Biologics for Ankylosing Spondylitis guideline (BHTCG 737FM) and NICE TA 143.
3. Restricted - to prescribing by Rheumatology or Dermatology consultants only, in accordance Biologics for Psoriatic arthritis guideline (BHTCG 740FM) and NICE TA 199.
4. Restricted - to Rheumatology consultant prescribing only, in accordance with Biologics for Rheumatoid Arthritis guideline (BHTCG 749FM) and NICE TA 375 and NICE TA 195.

Red Specialist Centre 5. For treatment of JIA in accordance with NHS England Clinical Commissioning Policy Biologic Therapies for the treatment of Juvenile Idiopathic Arthritis (JIA) (July 2015) E03X04. Prescribing by consultant paediatric rheumatologist under 'shared care' with a Specialized Service Paediatric Rheumatology consultant in accordance with requirements defined in Policy E03X04.

See section 13.05.03 (for Dermatology)
13.05.03 Etanercept 25mg, 50mg Enbrel®, Benepali®

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.

NOTE:
ALL prescribing of etanercept must include generic and brand name.
Benepali® is first choice etanercept preparation for the treatment of patients greater than 18 years with plaque psoriasis(NICE TA103) or psoriatic arthritis (NICE TA199). See entry above

Benepali® is first choice etanercept preparation for the treatment of patients greater than 18 years with plaque psoriasis (NICE TA 103)and psoriatic arthritis (NICE TA 199)
- as the first choice for new patients
- as an option in patients already established on Enbrel® if the clinician decides that it is appropriate and the patient consents to switching

Enbrel® is the treatment of choice for initiation in patients who are less than 18 years of age.

Red Traffic Light 
1. Restricted - to Dermatology or Rheumatology consultant prescribing only in accordance with Biologics for Psoriatic arthritis guideline (BHTCG 740FM) and NICE TA 199.
2. Restricted - to Dermatology consultant prescribing only in accordance with Biologics for Psoriasis guideline (BHTCG 738FM) and NICE TA 103.

Red Specialist Centre
3. Restricted - prescribing by consultant dermatologists following initiation by Specialist Centre. For treatment of plaque psoriasis in children and young people in accordance with NICE TA 455. BHT Dermatology consultants will prescribe as outreach to the Specialist Centre delivered as part of a provider network. Name of Specialist centre and clinician involved in MDT to be communicated to Formulary Team prior to initiating treatment at BHT.

See section 10.01.03 ( for Rheumatology)

09.05.01.02 Etelcalcetide 2.5mg/0.5mL, 5mg/1mL, 10mg/2mL  Restricted - prescribing by Oxford Renal team only
As an option for treating secondary hyperparathyroidism in adults with chronic kidney disease on haemodialysis in accordance with NICE TA 448.
05.01.09 Ethambutol Hydrochloride 100mg, 400mg 
18 Ethanol (Absolute alcohol) 2mL ***  Toxicity with methanol and ethylene glycol
16.01 Ethanol 60%, Chloroform 30%, Glacial acetic acid 10% Carnoy's solution unlicensedunlicensed - Low Risk

Restricted - prescribing by Oral and Maxillofacial Surgery team, for the treatment of odontogeniuc keratocysts and cystic ameloblastoma.
02.13 Ethanolamine Oleate 5% 
07.03.01 Ethinylestradiol 20micrograms with Desogestrel 150micrograms Gedarel 20/150®
07.03.01 Ethinylestradiol 20micrograms with gestodene 75micrograms Millinette 20/75® Femodette® and Sunya 20/75® - restricted for continuation only
07.03.01 Ethinylestradiol 20micrograms with Norethisterone Acetate 1mg Loestrin 20®
07.03.01 Ethinylestradiol 30micrograms with Desogestrel 150micrograms Gedarel 30/150®
07.03.01 Ethinylestradiol 30micrograms with Drospirenone 3mg Yasmin® In secondary care restricted - for continuation only.

In primary care most patients recommended to switch to pills with lower DVT risks
07.03.01 Ethinylestradiol 30micrograms with Gestodene 75micrograms Millinette 30/75® Femodene®, Femodene ED® and Katya® - restricted for continuation only
07.03.01 Ethinylestradiol 30micrograms with levonorgestrel 150micrograms Rigevidon®, Ovranette® Microgynon 30®, Microgynon 30 ED® - restricted for continuation only
07.03.01 Ethinylestradiol 30micrograms with Norethisterone Acetate 1.5mg Loestrin 30®
07.03.01 Ethinylestradiol 35micrograms with Norethisterone 1mg Norimin®
07.03.01 Ethinylestradiol 35micrograms with Norethisterone 500micrograms Ovysmen®
07.03.01 Ethinylestradiol 35micrograms with Norgestimate 250micrograms Cilest®
07.03.01 Ethinylestradiol and Norelgestromin Evra® Releasing ethinylestradiol approx. 33.9micrograms/24hours and norelgestromin 203micrograms/24hours

Restricted - for use in patients suffering from malabsorption where the oral contraceptive may not be effective eg. irritable bowel disease.
04.08.01 Ethosuximide 250mg  May be prescribed generically
04.08.01 Ethosuximide 250mg/5mL  May be prescribed generically
15.02 Ethyl Chloride  
15.01.01 Etomidate 20mg/10mL Hypnomidate®
07.03.02.02 Etonogestrel 68mg Nexplanon®
08.01.04 Etoposide 100mg/5mL 
08.01.04 Etoposide 50mg, 100mg 
10.01.01 Etoricoxib 90mg  Restricted - to use in Rheumatology on the advice of consultant. To be used when other NSAIDs are proven to be ineffective or inappropriate for specific ankylosing spondylitis patients
05.03.01 Etravirine 100mg, 200mg Intelence®
13.11 Eusol and Liquid Paraffin  Restricted for use on leg ulcers
08.01.05 Everolimus 2.5mg, 5mg, 10mg  FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required
Restricted to:
1. Prescribing by consultant Oncologists (Breast). For treatment with exemestane of advanced breast cancer after endocrine therapy in accordance with NICE TA 421.
2. Prescribing by Oncology team. For treatment of advanced renal cell carcinoma that has progressed during or after treatment with vascular endothelial growth factor targeted therapy in accordance with NICE TA 432
3. Prescribing by Oncology team. For treatment of unresectable or metastatic neuroendocrine tumours in adults with progressive disease, in accordance with NICE TA 449, NHSE SSC 1757. Approval by MDT.
02.12 Evolocumab 140mg/ml Repatha®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form is required. 

Prescribing initiation and continuation by Consultant Chemical Pathologists (Lipidologists) only.

Red Traffic Light For treatment of primary hypercholesterolaemia (heterozygous familial and non-familial) and mixed dyslipidaemia in accordance with NICE TA 394 (evolocumab) and Bucks guideline 104FM Lipid Modification for Non-Familial Hypercholesterolaemia (for adults).

Red Specialist Centre For treatment continuation of homozygous familial hypercholesterolaemia for patients aged 12 years or over, after initiation by specialist centre in accordance with NHSE SSC 1649. BHT Lipidologists may prescribe as outreach to the Specialist Centre delivered as part of the provider network. Name of Specialist Centre delivered as part of a provider network. Name of Specialist Centre and clinician involved in MDT to be communicated to Formulary Team prior to prescribing at BHT.

06.04.01.01 Evorel® Sequi 

First line sequential hormone replacement therapy (HRT) transdermal patch for oestrogen deficiency symptoms in peri-menopausal women.

08.03.04.01 Exemestane 25mg  In secondary care restricted to prescribing by Consultants in Breast Surgery or Breast Oncology.
In primary care, may be prescribed by GPs if recommended by Consultants in Breast Surgery or Breast Oncology.
06.01.02.03 Exenatide 2mg  Bydureon® BCise

Green 

Treatment of adults with type 2 diabetes in accordance with NICE NG 28 and 109FM GLP-1 agonists for adults with type 2 diabetes guideline.

For existing patients meeting glycaemic and weight loss goals without side effects.

If existing patients do not meet treatment goals or do not tolerate exenatide, consider switching to another GLP-1 agonist as per ‘new patient’ choices.

Prescribing by Diabetes consultants or Diabetes Specialist Nurses (DSN)s or by primary care health professionals who have received training and are operating under the direct award for insulin.

 

Note  Bydureon 2 mg powder and solvent for prolonged-release suspension for injection in pre-filled pen is being replaced with  Bydureon BCise 2 mg prolonged-release suspension for injection in pre-filled pen from Dec 31st 2020.  From January 1st  2021, patients should be prescribed Bydureon BCise 2 mg prolonged-release suspension for injection in pre-filled pen and trained on the use of the new device. 

06.01.02.03 Exenatide 5micrograms/dose, 10micrograms/dose Byetta®

Green 


 Treatment of adults with type 2 diabetes in accordance with NICE NG 28 and 109FM GLP-1 agonists for adults with type 2 diabetes guideline.


For existing patients meeting glycaemic and weight loss goals without side effects.


If existing patients do not meet treatment goals or do not tolerate exenatide, consider switching to another GLP-1 agonist as per ‘new patient’ choices.


Prescribing by Diabetes consultants or Diabetes Specialist Nurses (DSN)s or by primary care health professionals who have received training and are operating under the direct award for insulin.

19.24.02 E-Z Derm®  8cm x 122cm (131700 non-perforated) (131710 meshed)
8cm x 61cm (131701 non-perforated) (131711 meshed)
8cm x 30cm (131702 non-perforated) (131712 meshed)
8cm x 10cm (131703 non-perforated) (131713 meshed)
17cm x 46cm (131704 non-perforated) (131714 meshed)

Restricted - Burns and Plastics Consultant only prescribing. Generally the meshed product is preferred.

In secondary care obtain from Pharmacy
02.12 Ezetimibe 10mg 

For treatment of primary heterozygous-familial (FH) or non-familial (NF) hypercholesterolaemia in accordance with NICE TA 385 and as adjuvant or monotherapy if there is intolerance or contraindication to statins

01.03.01 Famotidine 20mg, 40mg 

Alternative H2 receptor antagonist whilst there is a shortage of ranitidine (October 2019)

06.01.01.01 Fast acting insulin Aspart 100units/mL  NOTE: Prescribe all insulins by brand
Fiasp® (10mL vial)
Fiasp® Penfill (3mL cartridge)
Fiasp® FlexTouch (3mL prefilled pen)

1. For treatment of type 1 diabetics of 16 years or over who may or may not be receiving insulin via an insulin pump who :
- Have consistently failed to take insulin twenty minutes before a meal and/or
- Have poor diabetes control due to post prandial glucose (PPG) being off target
2. For treatment of pregnant women with diabetes and in gestational diabetes not meeting 1 hour post prandial glucose target of 7.8 mmol/L
10.01.04 Febuxostat 80mg, 120mg  Restricted - prescribing when recommended by Rheumatology team. Only for the management of chronic hyperuricaemia in gout, for people intolerant of allopurinol or for whom it is contraindicated and in accordance with Febuxostat Amber Recommendation guideline (BHTCG 781FM)(see below) and Management of Gout - Primary/Secondary Care guideline (BHTCG 777FM)(see above)
06.04.01.01 Femoston® 1mg/10mg, 2mg/10mg 

Second line oral sequential hormone replacement therapy (HRT) for oestrogen deficiency symptoms in peri-menopausal women when Elleste-Duet® is unsuitable due to intolerance or inefficacy. 

06.04.01.01 FemSeven® Sequi 

Second line sequential hormone replacement therapy (HRT) transdermal patch for oestrogen deficiency symptoms in peri-menopausal women when Evorel® Sequi is unsuitable due to intolerance or inefficacy.


*Currently out of stock and long term supply issue.  Anticipated resupply date mid 2020.

02.12 Fenofibrate 200mg, 267mg 
15.01.04.03 Fentanyl 100micrograms/2mL, 500micrograms/10mL 
04.07.02 Fentanyl releasing 12 micrograms, 25micrograms, 50micrograms, 75micrograms, 100micrograms per hour for 72 hours 

Matrifen® brand

Restricted to patients unable to manage oral opiates

09.01.01.02 Ferric Carboxymaltose 100mg/2mL, 500mg/10mL, 1g/20mL Ferinject®

1. Restricted - Prescribing by Consultant Gastroenterologists only. For treatment of iron deficiency anaemia in patients with severe liver impairment and who meet the criteria for use of Monofer® in accordance with guideline 802FM Iron deficiency in adults.


2. Prescribing by the Renal team.

09.01.01.01 Ferrous Fumarate (equivalent to 100mg iron) and Folic Acid 350micrograms Pregaday®
09.01.01.01 Ferrous Fumarate 140mg/5mL  Equivalent to 45mg/5mL

Preferred 1st choice syrup in primary care
09.01.01.01 Ferrous Fumarate 210mg  Equivalent to 68mg

In primary care 1st choice
09.01.01.01 Ferrous Sulphate 200mg 

Equivalent to 65mg iron.

Ferrous Fumarate 210mg tablets are 1st choice in primary care.

03.04.01 Fexofenadine Hydrochloride 120mg, 180mg  In secondary care restricted - prescribing by consultants only

In primary care - restricted for use where cetirizine, loratadine and chlorphenamine have been tried or are not suitable.
16.01 Fibrin Sealant Tisseel® 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
05.01.07 Fidaxomicin 200mg Dificlir® Restricted - on Consultant Microbiologist recommendation only.
Treatment of recurrent Closridium difficile infection (CDI) or for use in patients at high risk (elderly patients or those with severe CDI) of recurrent CDI.
10.01.03 Filgotinib 100mg, 200mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required. 

Restricted - to Rheumatology consultant prescribing only.  For treatment of moderate to severe rheumatoid arthritis in adults in accordance with NICE TA 676 and the Bucks Biologics in Rheumatoid Arthritis treatment algorithm (update in progress).

09.01.06 Filgrastim 30 million-units (300 micrograms)/0.5mL, 48 million-units (480micrograms)  Ratiograstim® or Tevagrastim® or Nivestim® -bio-similar brands
Restricted - for cytotoxic induced neutropenia and to be prescribed by brand name by Consultant Haematologist and Oncologist in accordance with TVCN protocol and BNF advice.
09.01.06 Filgrastim 30 million-units (300 micrograms)/0.5mL, 48 million-units (480micrograms)/0.5mL, Neupogen® Restricted - for stem cell harvesting and to be prescribed by brand name by Consultant Haematologist and Oncologist in accordance with TVCN protocol and BNF advice
09.01.06 Filgrastim 30 million-units (300 micrograms)/1 mL, Neupogen® Restricted - for stem cell harvesting and to be prescribed by brand name by Consultant Haematologist and Oncologist in accordance with TVCN protocol and BNF advice
06.04.02 Finasteride 5mg  See also section 13.9 for treatment in men with androgenic alopecia
A2.06.01 Finax®  

In Primary care - a cost effective choice for people with coeliac disease or dermatitis herpetiformis


1000g = 4 units


Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Finax®  Fibre Bread Mix

In Primary care - a cost effective choice for people with coeliac disease or dermatitis herpetiformis

1,000 G = 4 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

08.02.04 Fingolimod 500micrograms  FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Neurologists only in accordance with NHSE Clinical Commissioning Policy - Disease Modifying Therapies for Patients with MS (see link above) and NICE TA 254.
19.02 Flaminal® Forte 

15g tube, pack of 5.                     

In secondary care, restricted to prescribing only upon recommendation of TV, Dermatology, Burns and Plastics and Spinal teams.  Not to be kept as ward stock. Obtain from Pharmacy.          .                                   

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS). 

19.02 Flaminal® Hydro 

15g tube, pack of 5.                                         

In secondary care, restricted to prescribing only upon recommendation of TV, Dermatology, Burns and Plastics and Spinal teams.  Not to be kept as ward stock. Obtain from Pharmacy.          .                                   

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

19.24.02 Flammacerium®  Restricted - Burns and Plastics Consultant only prescribing

In secondary care obtain from Pharmacy
02.03.02 Flecainide acetate 150mg/15mL  BNF states only for use in hospital.
02.03.02 Flecainide acetate 50mg, 100mg  Restricted - initiation in secondary care with continuation by GPs
01.06.05 Fleet Phospho-soda® 
05.01.01.02 Flucloxacillin 125mg/5mL, 250mg/5mL 
05.01.01.02 Flucloxacillin 12g, 18g  Restricted - to prescribing by out-patient antimicrobial therapy (OPAT) team on the advice of microbiologists and in conjunction with the team responsible for the patient.

For patients with the following infections who are unable to receive suitable oral antibiotic(s) and who are suitable to receive OPAT:
- infections due to penicillinase producing staphylococci and other gram-positive organisms susceptible to this anti-infective including MSSA bacteriaemias associated with cellulitis, osteomyelitis, endocarditis and of unknown source
05.01.01.02 Flucloxacillin 250mg, 500mg 
05.01.01.02 Flucloxacillin250mg, 500mg, 1g 
07.02.02 Fluconazole 150mg Diflucan® See section 05.02
05.02.01 Fluconazole 50mg,150mg, 200mg 

See link above to: Antifungal Therapy Guidelines for Haematology/Oncology - Secondary Care guideline (BHTCG 203FM)

05.02.01 Fluconazole 50mg/25mL, 200mg/100mL 

In secondary care restricted - for use by Haematology and Oncology. Microbiology approval required for all other uses.
See link above to: Antifungal Therapy Guidelines for Haematology/Oncology - Secondary Care guideline (BHTCG 203FM)

05.02.01 Fluconazole 50mg/5mL, 200mg/5mL 

In secondary care restricted - Phone Pharmacy to Order
See link above to: Antifungal Therapy Guidelines for Haematology/Oncology - Secondary Care guideline (BHTCG 203FM)

05.02.05 Flucytosine 2.5g/250mL  In secondary care restricted - Microbiology approval required and Phone Pharmacy to Order
08.01.03 Fludarabine Phosphate 10mg 
08.01.03 Fludarabine Phosphate 50mg 
06.03.01 Fludrocortisone Acetate 100micrograms 
13.04 Fludroxycortide 0.0125% 

Potency: Moderate

13.04 Fludroxycortide 4micrograms/cm2  NOT TO BE USED FOR COSMETIC ONLY USE

Restricted - only for use in the following:
1. Wound care - only to be used for over granulation tissue on wounds/ulcers for 5 days and then review.
2. Eczema - for skin cracks/fissures in areas difficult to treat with conventional methods eg. hands and feet.
3. Painful keloid scars.

Note Branded Haelan® tape has been discontinued as of Nov 2016. This is now available as generic.
15.01.07 Flumazenil 500micrograms/5mL 
18 Flumazenil 500micrograms/5mL  Reversal of iatrogenic over-sedation with benzodiazepines.
Use with caution in patients with benzodiazepine poisoning, particularly in mixed drug overdoses; contraindicated in mixed TCA/benzodiazepine overdose.
12.01.01 Flumetasone 0.02% with Clioquinol 1% 
13.04 Fluocinolone Acetonide 0.0025% Synalar 1 in 10 Dilution® Potency: Mild

13.04 Fluocinolone Acetonide 0.00625% Synalar 1 in 4 Dilution® Potency: Moderate

13.04 Fluocinolone Acetonide 0.025% Synalar® Potency: Potent

11.04.01 Fluocinolone Acetonide 190 micrograms 

FOR ALL PRESCRIBING - High Cost Drug approval form required via Blueteq 


Restricted - prescribing by Consultant Ophthalmologists  
 
1) For the treatment of chronic diabetic macular oedema after an inadequate response to prior therapy in accordance with NICE TA 301 and the intravitreal injections algorithm (BHTCG 653FM) (see link below). 
 
2) For the prevention of relapse in recurrent non-infectious uveitis affecting the posterior segment of the eye in accordance with NICE TA 590, the Bucks Intravitreals algorithm (BHTCG 653FM) and Uveitis guideline

11.08.02 Fluorescein ophthalmic strip 
11.08.02 Fluorescein Sodium 10% 
11.08.02 Fluorescein Sodium 2% 
11.04.01 Fluorometholone/polyvinyl alcohol 0.1%/1.4% e.g. FML®
13.08.01 Fluorouracil 0.5%/Salicylic Acid 10% Actikerall® To be used in accordance with Treatment of Actinic Keratoses (BHTCG 365FM)
11.99.99.99 Fluorouracil 10mg/0.2mL  unlicensedunlicensed - Medium risk

Restricted for use in Ophthalmology
08.01.03 Fluorouracil 250mg/10mL, 500mg/20mL, 2.5g/100mL  25mg/1mL strength for cancer use
13.08.01 Fluorouracil 5% Efudix® Restricted - to prescribing by Dermatology team for squamous cell carcinoma.
13.08.01 Fluorouracil 5% Efudix® To be used in accordance with Treatment of Actinic Keratoses (BHTCG 365FM)
08.01.03 Fluorouracil 500mg/10mL, 2.5g/50mL, 5g/100mL  50mg/1mL strength for ophthalmic use
11.99.99.99 Fluorouracil 50mg/1mL  In secondary care restricted - Phone Pharmacy to order
04.03.03 Fluoxetine 20mg 

Second choice for depression if no response or not tolerating first choice anti-depressants, as per Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM). 

Long half life. Higher risk of interactions due to CYP2D6 inhibition. 

04.03.03 Fluoxetine 20mg (scored) Olena®

See Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

Oxford Health Drug & Therapeutics Group decision: for patients with swallowing difficulties, or for patients starting at 10mg (eg CAHMS patients), Olena® (a scored dispersible 20mg fluoxetine tablet) should be prescribed in preference to fluoxetine liquid as the community price of the liquid can be higher than the dispersible tablet.

Unless liquid is indicated, doses of 20mg or greater should be prescribed as capsules.

04.03.03 Fluoxetine 20mg/5mL 

See Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

Oxford Health Drug & Therapeutics Group decision: for patients with swallowing difficulties, or for patients starting at 10mg (eg CAHMS patients), Olena® (a scored dispersible 20mg fluoxetine tablet) should be prescribed in preference to fluoxetine liquid as the community price of the liquid can be higher than the dispersible tablet. 

04.02.01 Flupentixol 3mg  Restricted - to initiation in secondary care with continuation by GPs.


See Section 04.03.04 (depression)
04.03.04 Flupentixol 500micrograms, 1mg, 3mg 

See Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

04.02.02 Flupentixol Decanoate 200mg/1mL  Protocol in development

04.02.02 Flupentixol Decanoate 20mg/1mL, 40mg/2mL  Protocol in development
04.02.02 Fluphenazine Decanoate 25mg/1mL  Protocol in development
04.02.02 Fluphenazine Decanoate 50mg/0.5mL, 100mg/1mL  Protocol in development
10.01.01 Flurbiprofen 50mg, 100mg  Restricted - to use in Ophthalmology
08.03.04.02 Flutamide 250mg 

Prescribing on the recommendation of a specialist, continuation by GPs.


For treatment of  tumour flaire in prostate cancer. 

03.01.04 Fluticasone / Umeclidinium / Vilanterol 92micrograms/55micrograms/22micrograms Trelegy Ellipta®

Restricted - For patients with COPD in GOLD group D who require treatment with an ICS LAMA and LABA inhaler following exacerbations, as depicted in the Key steps in the management of COPD guideline (BHTCG 220FM).


The choice between Trimbow® and Trelegy Ellipta® will depend on the suitability of the device for an individual patient. 

12.02.01 Fluticasone Furoate 27.5 micrograms/metered spray Avamys® 3rd choice steroid spray

See guideline above
03.02 Fluticasone Propionate / Formoterol Fumarate 50micrograms/5micrograms, 125micrograms/5micrograms, 250micrograms/10micrograms Flutiform® To be used in accordance with:
Asthma - Inhaled Treatment Algorithm - Adults (BHTCG 803FM) (see link above) for patients who require ICS/LABA combination MDI
12.02.01 Fluticasone Propionate 400micrograms/metered unit dose Flixonase Nasule® Restricted - Prescribing by ENT Consultants and if funding approved by CCG, continuation by GPs, for severe nasal polyposis, refractory to steroid nasal sprays and in accordance with Intranasal Corticosteroid guideline (BHTCG 323)
03.02 Fluticasone Propionate 50micrograms, 125micrograms, 250micrograms Flixotide Evohaler® In secondary care - restricted to initiation by Respiratory team only
03.02 Fluticasone Propionate 50micrograms/blister Flixotide Accuhaler® In secondary care - restricted to initiation by Respiratory team only
12.02.01 Fluticasone Propionate 50micrograms/metered spray  In primary care restricted for use in children aged 4-5 years and for 4th line use in adults.

See guideline above
03.02 Fluticasone Propionate/Salmeterol 100micrograms/50micrograms per blister Seretide 100 Accuhaler® For treatment of asthma in accordance with Asthma - Inhaled Treatment Algorithm - Adults (BHTCG 803FM) linked above
03.02 Fluticasone Propionate/Salmeterol 250micrograms/50micrograms per blister Seretide 250 Accuhaler® For treatment of COPD and asthma in accordance with guidelines linked above: Key steps in management of COPD (GOLD 2017 (BHTCG 220FM) and Asthma - Inhaled Treatment Algorithm - Adults (BHTCG 803FM)

When used in COPD, only for existing patients prior to switching. Not for initiation in COPD patients
03.02 Fluticasone Propionate/Salmeterol 500micrograms/50micrograms per blister Seretide 500 Accuhaler® For treatment of COPD and asthma in accordance with guidelines linked above: Key steps in management of COPD (GOLD 2017 (BHTCG 220FM) and Asthma - Inhaled Treatment Algorithm - Adults (BHTCG 803FM)

When used in COPD, only for existing patients prior to switching. Not for initiation in COPD patients
03.02 Fluticasone Propionate/Salmeterol 50micrograms/25micrograms, 125micrograms/25micrograms, 250micrograms/25micrograms per metered inhalation Seretide 50, 125, 250 Evohaler® Seretide 50, 125 or 250 Evohaler – for treatment of asthma in accordance with Asthma - Inhaled Treatment Algorithm - Adults (BHTCG 803FM)

Seretide 250 – use in accordance with Key steps in management of COPD (GOLD 2017, (BHT220FM). Only for existing COPD patients prior to switching. Not for initiation in COPD patients
04.03.03 Fluvoxamine Maleate 50mg, 100mg 

Initiation by Psychiatry team, continuation by GPs. 

See Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

09.01.02 Folic Acid 15mg/1mL  unlicensedUnlicensed - Low Risk
09.01.02 Folic Acid 2.5mg/5mL 
09.01.02 Folic Acid 400micrograms, 5mg 
06.05.01 Follitropin Alfa 900units Gonal-F®
18 Fomepizole ***  For emergency treatment of ethylene glycol and methanol poisoning in accordance with National Poisoning Information Centre (Toxbase) recommendations.

FOR ALL PRESCRIBING - completion of Compliance form required. If Compliance form not yet available confirmation that National Poisoning Information Centre recommendations are met, is required.
02.08.01 Fondaparinux Sodium 2.5mg/0.5mL, 5mg/0.4mL, 7.5mg/0.6mL 

Restricted to:
1. Prescribing by acute medical team for suspected ACS. Refer to ICP for ACS.
2. Prescribing by Consultant Haematologists for patients intolerant of dalteparin (eg. due to heparin-induced thrombocytopenia (HITT), skin rash)

A2.02.02.03 Foodlink Complete with Fibre 260ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

09.06.07 Forceval®  Restricted - for use in accordance with Trust Refeeding Syndrome clinical guideline.

In primary care vitamin supplements can be purchased over the counter.
13.07 Formaldehyde Solution BP  Not easily available in primary care
03.01.01.01 Formoterol Fumarate 12micrograms/metered inhalation Oxis® Turbohaler To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)
03.01.01.01 Formoterol Fumarate 12micrograms/metered inhalation Atimos Modulite® To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)
03.01.01.01 Formoterol Fumarate 12micrograms/metered inhalation Easyhaler® Formoterol To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above). For existing patients only (not for new patients)
A2.02.02.03 Fortisip Compact 125ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.03 Fortisip Compact Protein 125ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

05.03.01 Fosamprenavir 700mg Telzir® Restricted for BHT HIV MDT
05.03.02.02 Foscarnet 6g/250mL  

For intravitreal injection (unlicensed use).



Prescribing and administration by Consultant Ophthalmologists only for the treatment of cytomegalovirus (CMV) retinitis and acute retinal necrosis (ARN) in conjunction with systemic therapy (valganciclovir) for patients with immediate sight-threatening disease.

11.03.03 Foscarnet 6g/250mL 

For intravitreal injection (unlicensed use).

Prescribing and administration by Consultant Ophthalmologists only for the treatment of cytomegalovirus (CMV) retinitis and acute retinal necrosis (ARN) in conjunction with systemic therapy (valganciclovir) for patients with immediate sight-threatening disease.

05.01.07 Fosfomycin Trometamol 3g  Restricted - to be prescribed on the recommendation of microbiology sensitivity results.

When results are given in response to a secondary care initiated sample, clear communication between the secondary care clinician and GP should take place.
12.01.01 Framycetin Sulphate  see Dexamethasone (Sofradex®) above
06.01.06 FreeStyle Libre®  

Amber Initiation by Diabetes, Paediatric  or Obstetric consultant  following confirmation via MDT that criteria in TVPC73: Flash Glucose Monitoring System (FreeStyle Libre®)  are met.  FreeStyle Libre® reader and 1 sensor are supplied by the hospital, with ongoing prescribing and supply from primary care thereafter. Patients are reviewed by the Specialist at six months and annually, to confirm via MDT that continuation criteria are met (via audited records).


Amber Recommentation EXISTING PATIENTS SELF-FUNDING: Diabetes, Paediatric or Obstetric consultant  to assess via MDT whether TVPC73: criteria were met prior to starting treatment. If met, primary care clinician may continue prescribing. Specialist review at six months and annually (via audited records).


Note  NOTE: For existing NHS funded patients on Freestyle Libre®,  GPs can switch prescribing to Freestyle Libre® 2 sensors after patients have been informed via a standard letter from the Diabetes team. An updated reader or update to the app is required (see Freestyle Libre® 2 entry). 


 

06.01.06 FreeStyle Libre® 2 

 Amber NEW PATIENTS: Freestyle Libre® 2 to be initiated for all new patients by the Diabetes, Paediatric or Obstetrics consultant following confirmation via MDT that criteria in TVPC73: Flash Glucose Monitoring System (FreeStyle Libre®)  are met.  FreeStyle Libre® reader and 1 sensor are supplied by the hospital, with ongoing prescribing and supply from primary care thereafter. Patients are reviewed by the Specialist at six months and annually, to confirm via MDT that continuation criteria are met (via audited records) 


Amber Recommentation EXISTING PATIENTS SELF-FUNDING: Diabetes, Paediatric or Obstetric consultant  to assess via MDT whether TVPC73: criteria were met prior to starting treatment. If met, primary care clinician may continue prescribing. Specialist review at six months and annually (via audited records).


Green EXISTING PATIENTS on Freestyle Libre®: Patients may be switched to Freestyle Libre® 2 at  follow-up clinics with specialists. In addition, GPs may prescribe Freestyle Libre® 2 sensors in line with formulary restrictions after patients have received a letter from the Diabetes team.  Patients need to obtain a FreeStyle Libre® 2 reader via www.freestylelibre.co.uk/replacement or update to the latest version of the FreeStyle LibreLink app (v.2.5) and access educational information via www.FreeStyleDiabetes.co.uk/progress 

06.01.06 FreeStyle Optium®  Restricted - only for use by patients using FreeStyle Optium beta-ketone test strips
06.01.06 FreeStyle Optium®  Restricted - only for Type 1 diabetics and patients on insulin with a history of diabetic ketoacidosis
04.07.04.02 Fremanezumab (Ajovy®) 225mg/1.5mL 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

For prophylaxis of migraine in accordance with NICE TA 631 and the Migraine Prophylaxis : CGRP monoclonal antibodies for preventing migraine guideline (pending).
• Prescribe by brand name.
• Prescribing by consultant Neurologists.

A2.02.02.03 Fresubin 2 kcal Drink 200ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.02.03 Fresubin 3.2kcal Drink 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.02.01.01 Fresubin Original 200ml In primary care initiation on the recoommendation of dietitian only. If request is from a dietitian check this is the correct product.

In Secondary Care Not stocked requires dietitian input regarding most approprtae alternative.

A2.05.02 Fresubin Thickened level 2 200ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 

A2.05.02 Fresubin Thickened level 3 200ml

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **


 

02.02.02 Furosemide 20mg, 40mg, 500mg 
02.02.02 Furosemide 20mg/2mL, 50mg/5mL 
02.02.02 Furosemide 250mg/25mL 
02.02.02 Furosemide 40mg/5mL 
02.02.02 Furosemide 80mg/8mL  In primary care - Not easily available.
13.10.01.02 Fusidic Acid 2%  In secondary care restricted - Dermatology only. Microbiology approval required for all other uses.
05.01.07 Fusidic Acid 250mg/5mL equivalent to sodium fusidate 175mg/5mL In primary care - no indications for use in primary care antibiotics guide

In secondary care used in penicillin resistant staphylococcus or according to local guidelines or on microbiology advice
11.03.01 Fusidic Acid MR 1% in gel basis  In secondary care, restricted to prescribing by Ophthalmology only
04.07.03 Gabapentin 100mg, 300mg, 400mg 

When used for neuropathic pain, use in accordance with Neuropathic pain management in adults guideline BHTCG 714FM 


MHRA Drug Safety Update - April 2019: Pregabalin (Lyrica), gabapentin (Neurontin) and risk of abuse and dependence: new scheduling requirements from 1 April


 


MHRA Drug Safety Update - October 17: Gabapentin (Neurontin): risk of severe respiratory depression


 


 

04.08.01 Gabapentin 100mg, 300mg, 400mg 

May be prescribed generically (see link to MHRA Epilepsy alert above).


For use with neuropathic pain, please refer to formulary chapter section 04.07.03  

04.07.03 Gabapentin 50mg/1mL 

When used for neuropathic pain, use in accordance with Neuropathic pain management in adults guideline BHTCG 714FM 


Before prescribing, consider opening gabapentin capsules (this is preferable and is more cost effective).



Restricted - only for use in patients who, cannot swallow capsules and are unable to manage opening the capsules.  


MHRA Drug Safety Update - April 2019: Pregabalin (Lyrica), gabapentin (Neurontin) and risk of abuse and dependence: new scheduling requirements from 1 April


MHRA Drug Safety Update - October 17: Gabapentin (Neurontin): risk of severe respiratory depression


 

04.08.01 Gabapentin 50mg/1mL 

May be prescribed generically (see link to MHRA Epilepsy alert above)


For use with neuropathic pain, please refer to formulary chapter section 04.07.03  



Before prescribing, consider opening gabapentin capsules (this is preferable and is more cost effective)



Restricted - only for use in patients who, cannot swallow capsules and are unable to manage opening the capsules.

04.08.01 Gabapentin 600mg  May be prescribed generically (see link to MHRA Epilepsy alert above)

Use 300mg capsules wherever possible
Restricted - only to be prescribed and used for patients residing in prison.
In secondary care Phone Pharmacy to Order
16.01 Gadopentetic acid dimeglumine 2mmol in 1litre Magnevist® Restricted - for use as a diagnostic contrast agent in MRI when patients have nil, mild or moderate renal impairment, in line with MHRA advice
16.01 Gadoteric acid Dotarem® Restricted - for use as diganostic contrast agent in MRI when patients have severe renal impairment, in line with MHRA advice.
16.01 Gadoxetic acid disodium 0.25mmol/1mL Primovist® Restricted - prescribing by Radiology team only, for contrast-enhanced liver MRI
04.11 Galantamine 4mg, 8mg, 12mg 

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217 - Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and in accordance with Alzheimer's Disease shared care protocol (BHTCG 786FM)

04.11 Galantamine 4mg/mL 

Restricted - to patients who cannot swallow ordinary tablets AND
Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217 - Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and in accordance with Alzheimer's Disease shared care protocol (BHTCG 786FM)

04.11 Galantamine 8mg, 16mg, 24mg 

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217 - Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and in accordance with Alzheimer's Disease shared care protocol (BHTCG 786FM)

04.07.04.02 Galcanezumab 120mg/1mL Emgality®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

For prevention of migraine in accordance with NICE TA 659 and the Migraine Prophylaxis : CGRP monoclonal antibodies for preventing migraine guideline (pending).
• Prescribe by brand name.
• Prescribing by consultant Neurologists.

 

19.01.01 Gamgee Roll Pink, Blue Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.5.1
In secondary care obtain from Supplies
19.01.01 Gamgee Roll (sterile) Rocialle® 45cm x 45cm
45cm x 90cm

Restricted - to use in secondary care by Burns and Plastics. Only to be used if sterile product required, otherwise use Gamgee roll (non-sterile)

BNF A5.5.1
In secondary care obtain from Supplies
11.03.03 Ganciclovir 0.15% in gel basis 
05.03.02.02 Ganciclovir 500mg  In secondary care restricted - GUM. Microbiology approval required for all other uses.
19.17 Gauze Swab  Clinimed® non-woven non-sterile gauze swab - 10cm x 10cm (packs of 100)

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)


In secondary care obtain from Supplies
19.17 Gauze Swab®   5cm x 5cm

Restricted in secondary care to use by Podiatry only

In secondary care obtain from Supplies
19.17 Gauze Swab®   7.5cm x 7.5cm 8-ply (packs of 5)

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

In secondary care obtain from Supplies
01.01.02 Gaviscon Advance  Contains 2.3mmol sodium and 1mmol potassium per 5mL

NOTE: Patients discharged from Secondary care who have been prescribed Gaviscon Advance® to be switched to Peptac® suspension in Primary care.
01.01.02 Gaviscon Infant  Contains 0.92mmol sodium per dose
NOTE: each half of the dual-sachet is identified as "one dose". To avoid errors prescribe with directions in terms of "dose"
08.01.05 Gefitinib 250mg 

FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage

Restricted - prescribing by Oncologists only in accordance with NICE TA 192.

09.02.02.02 Gelatin Gelaspan®
08.01.03 Gemcitabine 200mg, 1g  FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not available.

Restricted prescribing by Consultant Oncologists in accordance with NICE TA 25 and NICE TA116
08.01.05 Gemtuzumab ozogamicin 5mg 

FOR ALL PRESCRIBING - NICE Compliance form required via Blueteq


Prescribing by consultant Haematologists for untreated acute myeloid leukaemia in accordance with NICE TA 545.

A2.06.01 Genius Gluten Free®  6 x 535G Sandwich bread (white and brown)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

535G loaf is 1.25 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Genius® Gluten Free 535g (seeded brown farmhouse)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis


535g loaf is 1.25 unit


Prescribing of gluten free products restricted to bread and mixes 8 units/patient/month

11.03.01 Gentamicin 0.3% 
12.01.01 Gentamicin 0.3%  Genticin® Also see Hydrocortisone (Gentisone HC®) above
11.03.01 Gentamicin 1.5% 

unlicensedunlicensed - Low Risk
Restricted - named patient basis

05.01.04 Gentamicin 20mg/2mL. 80mg/2mL  See guidelines on use of gentamicin in adults (BHTCG 48)
and recently updated guidance on gentamicin dosing in neonates (BHTCG 19 and BHTCG 731)- see links below
05.01.04 Gentamicin 5mg/1mL  Can be used to prepare ophthalmic preparations
13.10.01.02 Gentamicin Sulfate 7.5mg/bead  In secondary care restricted - Surgical Directorate only
08.01.05 Gilteritinib 40mg 

FOR ALL PRESCRIBING: prior funding approval required via NICE compliance form (Blueteq).


For treating relapsed or refractory acute myeloid leukaemia in accordance with NICE TA 642

08.02.04 Glatiramer Acetate 20mg/1mL, 40mg/1mL Copaxone®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.


Restricted


1. Prescribing by Consultant Neurologists and clinical nurse specialists (MS) as a first line treatment option for adults with relapsing-remitting multiple sclerosis in accordance with: NHS England circular SSC1534.

2. Prescribing by Neurologists only for treating multiple sclerosis in accordance with NICE TA 527 and NHSE Clinical Commissioning Policy - Disease Modifying Therapies for Patients with MS (see link above)

05.03.03.02 Glecaprevir/ pibrentasvir 100mg/40mg Maviret®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Consultant Gastroenterologists/Hepatologists and Associate Specialist (Gastroenterology), as part of Thames Valley ODN and in accordance with NICE TA 499.

06.01.02.01 Glibenclamide 2.5mg, 5mg  Restricted - new patients not to be started on glibenclamide because long half life increases the risk of hypoglycaemia
06.01.02.01 Gliclazide 80mg  1st Choice Sulphonylurea
06.01.02.01 Glimepiride 1mg, 2mg  In secondary care restricted - Endocrinologist (Dr S Gardner) Consultant Only prescribing
06.01.04 Glucagon 1mg 
18 Glucagon 1mg  Toxicity with beta-blockers (beta-adrenoreceptor blockers)
Other indications eg. calcium channel blockers, seek NPIS advice.
19.24.02 Glucan Pro®  25g

Restricted - Burns and Plastics Consultant only prescribing

In secondary care obtain from Pharmacy
19.24.02 Glucan3000®  99g

Restricted - Burns and Plastics Consultant only prescribing

In secondary care obtain from Pharmacy
18 Glucarpidase **** Voraxaze

Methotrexate toxity


In hours: Clinigen Customer Services Department


Out of Hours: Clinigen Out of Ours (delivery within 7 hours)

06.01.01.03 GlucoRx FinePoint  all sizes 1st Choice in primary care for all Type 2 diabetics
06.01.06 GlucoRx HCT and Ketone 

For practice use only

06.01.06 GlucoRx Nexus Blue 

1st choice  for type 2 diabetes patients in primary care who require a meter with specific software features 

06.01.06 GlucoRx Nexus Mini Ultra 

1st choice  for type 2 diabetes patients in primary care who require a smaller meter. 


 

06.01.06 GlucoRx Nexus Voice 

1st choice for type 2 diabetes patients in primary care who require a voice response 

06.01.06 GlucoRx Nexus® 

1st Choice in primary care for all Type 2 diabetics for existing patients

06.01.06 GlucoRx Nexus® 

1st Choice in primary care for all Type 2 diabetics for existing patients

06.01.06 GlucoRx Q blood glucose test strips

1st choice in primary care for new patients

06.01.06 GlucoRx Q® blood glucose meter

1st choice in primary care for new patients

06.01.04 Glucose   In primary care may be purchased over the counter
06.01.04 Glucose   In primary care may be purchased over the counter
06.01.06 Glucose   In secondary care used as an Oral Glucose Tolerance Test - 75g lemon or plain flavour.

In primary care we tend to use Lucozade as a substitute - because this is more easily available. There are 2 types. Check the calorie content and use the appropriate dose below:
394mL of 73 Kcal/100mL
410mL of 70 KCal/100mL
06.01.04 Glucose 40% GlucoGel®

In secondary care restricted - to patients who cannot use Glucotabs or drink Polycal liquid.

09.02.02.01 Glucose 5%, 10%, 20%, 40%, 50% 
09.02.02.01 Glucose 50%   Used in hypoglycaemic emergencies
09.02.02.01 Glucose 50% 
06.01.04 Glucotabs  In primary care may be purchased over the counter
A2.06.01 Glutafin® 

In Primary care - LESS cost effective choice for people with coeliac disease or dermatitis herpetiformis

Consider switching to Barkat All Purpose Flour Mix
500g = 2 units


or


Consider switching to Finax Flour Mix (regular or course) 
900g = 4 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin®  2 x 175g Baguettes

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

2 x 175G = 1 unit

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® 350g High fibre loaf sliced

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis 


350g loaf is 0.75 units


Prescribing of gluten free products restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® 300g sliced loaf (fibre or white)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

300G loaf is 0.75 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® 

In Primary care - LESS cost effective choice for people with coeliac disease or dermatitis herpetiformis

Consider switching to Finax Fibre Bread Mix

1000 G = 4 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® 500g Bread mix

In Primary care - LESS cost effective choice for people with coeliac disease or dermatitis herpetiformis

Consider switching to Tobia White or Brown Teff Bread Mix
10000g = 4 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® Select 400g Fresh bread (brown or white)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

400g loaf is 1 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® Select 400g Sliced loaf (fibre, white or seeded)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

400G loaf is 1 unit.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® Select 

In Primary care - LESS cost effective choice for people with coeliac disease or dermatitis herpetiformis

Consider switching to Tobia White or Brown Teff Bread Mix

1000 G = 4 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® Select 

In Primary care - LESS cost effective choice for people with coeliac disease or dermatitis herpetiformis

Consider switching to Tritamyl Flour Mix

2000 G = 4 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutafin® Select 

In Primary care - LESS cost effective choice for people with coeliac disease or dermatitis herpetiformis

Consider switching to Finax Fibre Bread Mix
1000 G = 4 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Glutenex  

Product no longer available, switch to Tobia White or Brown Teff Bread Mix


1000g = 4 units


Gluten free items now restricted to bread and mixes 8 units/patient/month

11.06 Glycerin 50%  unlicensedunlicensed - Low Risk

In primary care is a pharmaceutical special. Not recommended.
11.06 Glycerin BP  unlicensedunlicensed - Low Risk
01.06.02 Glycerol (Glycerin) 1g, 2g, 4g 
01.07.04 Glyceryl Trinitrate 0.4% Rectogesic® In secondary care restricted - to initiation by colorectal surgeons and gastroenterologists

In primary care used in anal fissure
02.06.01 Glyceryl Trinitrate 400micrograms/spray 
02.06.01 Glyceryl Trinitrate 500micrograms 
02.06.01 Glyceryl Trinitrate 50mg/50mL 
18 Glyceryl Trinitrate 50mg/50mL  Hypertension
02.06.01 Glyceryl Trinitrate 5mg in 24hours, 10mg in 24hours 

Red Traffic Light  5mg/24 hours strength only: For administration of peripheral Total Parenteral Nutrition


Amber Protocol Traffic Light  Restricted- for use in autonomic dysreflexia as per BHTCG Management of Autonomic Dysreflexia in Adults guideline


Amber Initiation Traffic Light  Restricted - to initiation by secondary care consultants with continuation by GPs, for end stage heart failure


Green Traffic Light  angina prophylaxis

07.04.04 Glycine 1.5%  
15.01.03 Glycopyrronium 1mg/ml  

unlicensedunlicensed - Medium risk
Restricted - prescribing by consultant Paediatricians only. Supply on a named patient basis

Licensed product is first line. 

15.01.03 Glycopyrronium 320mcg/1mL Sialanar®

Restricted - prescribing by consultant Paediatrician only.

03.01.02 Glycopyrronium 50 micrograms/ capsule Seebri Breezhaler® To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)
13.12 Glycopyrronium Bromide  In secondary care restricted - Phone Pharmacy to Order
For iontophoresis
15.01.03 Glycopyrronium Bromide 1mg, 2mg 

unlicensedunlicensed - Medium risk
Restricted - prescribing by consultant Paediatricians only. Supply on a named patient basis


Licensed product is first line.

15.01.03 Glycopyrronium Bromide 200micrograms/1mL, 600micrograms/3mL  See section 15.01.06 for glycopyrronium with neostigmine metilsulfate
In primary care only used in syringe drivers for palliative care.
03.01.04 Glycopyrronium/Indacaterol 85 micrograms/ 43 micrograms / capsule Ultibro Breezhaler®

To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)


01.05.03 Golimumab 50mg  Simponi® FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage. NICE compliance to be confirmed if form not yet available.

Restricted - prescribing by Gastroenterologists in accordance with Biologics in Ulcerative Colitis guideline (BHTCG 633FM) and NICE TA 329. NOTE: In NICE TA329 adalimumab is the first choice biologic for adult use and infliximab for paediatric use.

see section 10.01.03 (for Rheumatology) and 13.05.03 (for Dermatology)
10.01.03 Golimumab 50mg Simponi®

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not yet available.

1. Restricted - to prescribing by Rheumatology or Dermatology consultants only, in accordance with Biologics for Psoriatic arthritis guideline (BHTCG 740FM) and NICE TA 220.
2. Restricted - to Rheumatology consultant prescribing only, in accordance with Biologics for Rheumatoid Arthritis guideline (BHTCG 749FM) and NICE TA 375.
3. Restricted - to Rheumatology consultant prescribing only in accordance with Biologics for Ankylosing Spondylitis (AS) and non-Radiographic Axial Spondyloarthritis (AxS) guideline (BHTCG 737FM), NICE TA 233 and NICE TA 497.

06.05.01 Gonadorelin 100micrograms  Restricted - HRF brand - Named Patient basis.
08.03.04.02 Goserelin 3.6mg, 10.8mg Zoladex®

Sub-cutaneous injection every 28 days.

For treatment of prostate cancer.  Use in accordance with guideline BHTCG 789FM Gonadorelin analogues for use in prostate cancer.


Non-formulary for endocrine uses  (section 06.07.02)


 

05.02.05 Griseofulvin 125mg, 500mg  In secondary care restricted - Paediatrics and Dermatology. Microbiology approval required for all other uses. Phone Pharmacy to Order

In primary care no indications listed in local antibiotics guideline
05.02.05 Griseofulvin 125mg/5mL  In secondary care restricted - Paediatrics and Dermatology. Microbiology approval required for all other uses. Phone Pharmacy to Order

In primary care no indications listed in local antibiotics guideline
02.05.03 Guanethidine Monosulfate 10mg/1mL  Restricted - prescribing by Chronic Pain Team
04.04 Guanfacine 1mg, 2mg, 3mg, 4mg 

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old)  Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).


As a 3rd line option (alternative to atomoxetine) when methylphenidate and lisdexamfetamine have been tried for six weeks at maximum tolerated doses and have been found to be ineffective, or if there has been intolerance to both agents.

13.05.03 Guselkumab 100mg Tremfya®

FOR ALL PRESCRIBING - completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required. 


Restricted - prescribing by Dermatology Consultants only for moderate to severe plaque psoriasis in accordance with Biologics in Psoriasis guideline (BHTCG 738FM) and NICE TA 521.

14.04 Haemophilus influenzae type B and Neisseria meningitidis group C vaccine Menitorix® In primary care as part of the routine national UK immunisation schedule
04.02.02 Haloperidol (as decanoate) 100mg/1mL  Protocol in development
04.02.02 Haloperidol (as decanoate) 50mg/1mL  Protocol in development
04.02.01 Haloperidol 10mg/5mL  Green Traffic Light  For uses other than traditional antipsychotic treatment.

Amber Traffic Light  Amber Initiation - restricted to initiation in secondary care with continuation by GPs, when used for traditional antipsychotic treatment
04.02.01 Haloperidol 500micrograms, 1.5mg, 5mg, 10mg  NOTE: In primary care if 500microgram required prescribe capsules and not tablets.

Green Traffic Light  For uses other than traditional antipsychotic treatment.

Amber Traffic Light  Amber Initiation - restricted to initiation in secondary care with continuation by GPs, when used for traditional antipsychotic treatment
04.02.01 Haloperidol 5mg/1mL  NOTE: Intravenous use is now an unlicensed use. All IV use restricted to Critical Care areas only.
04.02.01 Haloperidol 5mg/5mL  Restricted - for use in secondary care only.
09.06.01 Healthy Start Children's Vitamin Drops   Daily dose of 5 drops contains approx. 233micrograms Vitamin A 700units (233micrograms), Vitamin C 20mg and Vitamin D 300units (7.5microgams)
Restricted to prescribing by Paediatric team, Health Visitors, Women's and Children's team in accordance with DOH guidance and the Bucks Vitamin D guidelines. Service commissioned via BHT via District Nurses.
09.06.01 Healthy Start Vitamins for Women   Each tablet contains approx. Vitamin C 70mg, Vitamin D 10micrograms and Folic Acid 400micrograms.

Restricted to prescribing by Paediatric team, Health Visitors, Women's and Children's team in accordance with DOH guidance and the Bucks Vitamin D guidelines. Service commissioned via BHT via District Nurses.
01.03 Helicobacter Test INFAI®  In primary care the CCGs commission a service from GPs to test for helicobacter status. Within this service the kit to test for helicobacter can be ordered (free) from Stoke Mandeville Hospital Pharmacy using the specific form.
02.08.01 Heparin Calcium 5000units/0.2mL 
02.08.01 Heparin Sodium 10,000units/10mL, 20,000units/20mL 
02.08.01 Heparin Sodium 1000units/1mL 
02.08.01 Heparin Sodium 200units/2mL  Restricted - to initiation in secondary care with continuation by GPs
02.08.01 Heparin Sodium 25,000units/5mL  Restricted - For use in Renal Unit Only as detailed in the Renal Unit Policy for managing Dialysis Catheters.
02.08.01 Heparin Sodium 5000units/0.2mL 
02.08.01 Heparin Sodium 5000units/5mL 
02.08.01 Heparin Sodium 50units/5mL  Restricted - to initiation in secondary care with continuation by GPs
02.08.01 Heparin Sodium/Sodium Chloride 1000units/0.9% 
14.04 Hepatitis A and B vaccine 720units/20micrograms per 1mL Twinrix®, Twinrix® Paediatric (0.5mL) In primary care - should usually be issued on a private prescription if for holiday travel
14.04 Hepatitis A monodose i.m. injection 1440 Elisa units/1mL Havrix Monodose® Currently experiencing national shortage. Use Vaqta Adult as alternative - August 2017

In primary care - should usually be issued on a private prescription if for holiday travel
14.04 Hepatitis A monodose i.m. injection 720 Elisa units/1mL Havrix Junior Monodose® Currently experiencing national shortage. Use Vaqta Paediatric as alternative - August 2017

In primary care - should usually be issued on a private prescription if for holiday travel
14.04 Hepatitis A vaccine Single Component 25 units/0.5ml Vaqta® Paediatric Alternative to Havrix Junior Monodose as national shortage- August 2017.

In primary care - should usually be issued on a private prescription if for holiday travel
14.04 Hepatitis A vaccine Single Component 50 units/1ml Vaqta® Adult Alternative to Havrix Monodose as national shortage- August 2017.

In primary care - should usually be issued on a private prescription if for holiday travel
14.04 Hepatitis A vaccine with typhoid vaccine Hepatyrix® In primary care - should usually be issued on a private prescription if for holiday travel
14.05.02 Hepatitis B immunoglobulin  In secondary care phone laboratories to check availability
14.04 Hepatitis B vaccine 10micrograms/0.5mL, 20micrograms/1mL Engerix B® Currently experiencing global shortage. See Department of Health guidance - August 2017.

In primary care only as recommended in routine UK immunisation schedule, for at risk cohorts.
14.04 Hepatitis B vaccine 10micrograms/1mL HBvaxPRO® Currently experiencing global shortage. See Department of Health guidance - August 2017.

In primary care only as recommended in routine UK immunisation schedule, for at risk cohorts.
14.04 Hepatitis b vaccine 20 micrograms/0.5mL  Fendrix® Currently experiencing global shortage. See Department of Health guidance - August 2017.

In primary care only as recommended in routine UK immunisation schedule, for at risk cohorts.
12.03.04 Hexetidine Oraldene®
11.05 Homatropine Hydrobromide 1% 
14.04 Human Papilloma Virus (HPV) vaccine Cervarix®, Gardasil®, In primary care restricted - for use in girls according to the UK national immunisation schedule.

14.04 Human Papilloma Virus (HPV) vaccine Gardasil®

Prescribe by generic and brand name.


Prescribing by Consultants in Sexual health in accordance with the NHS England Service Specification Human Papillomavirus Programme for Men who have Sex with Men (HPV-MSM)

10.03.01 Hyaluronidase 1500units Hyalase®
02.05.01 Hydralazine Hydrochloride 20mg 
02.05.01 Hydralazine Hydrochloride 25mg, 50mg 
06.03.02 Hydrocortisone 100mg Solu-Cortef® Comes as a powder so must be made up with water for injection
13.04 Hydrocortisone 0.5%, 1%  Potency: Mild
1% is usual 1st choice mild potency
13.04 Hydrocortisone 1%  Potency: Mild
1st choice of mild potency
13.04 Hydrocortisone 1%/Clioquinol 3% Vioform-Hydrocortisone® Potency: Mild
13.04 Hydrocortisone 1%/Clotrimazole 1% Canesten HC® Potency: Mild
13.04 Hydrocortisone 1%/Miconazole Nitrate 2% Daktacort® Potency: Mild

In secondary care restricted - Paediatrics and Obstetrics & Gynaecology
13.04 Hydrocortisone 1%/Urea10% Alphaderm® Potency: Moderate
01.05.02 Hydrocortisone 10% Colifoam®
06.03.02 Hydrocortisone 100mg/1mL  Glass ampoules in case of latex allergy. Comes as a ready diluted form, so may be more suitable for GP emergency bags than Solu-Cortef®
06.03.02 Hydrocortisone 10mg, 20mg 
12.03.01 Hydrocortisone 2.5mg  In primary care hydrocortisone suspension is not recommended as unlicensed, consider licensed alrernatives (e.g. lozenges or soluble steroid tablets)
12.01.01 Hydrocortisone Acetate 1% with Gentamicin 0.3% Gentisone® HC
13.04 Hydrocortisone Acetate 1%/Fusidic Acid 2% Fucidin H® Potency: Mild

In secondary care restricted - Dermatology only. Microbiology approval required for all other uses.
10.01.02.02 Hydrocortisone Acetate 25mg/1mL 
11.04.01 Hydrocortisone sodium phosphate 3.35mg/mL Softacort®

As an alternative to Prednisolone 0.5% PF eye drops if they are unavailable.

12.03.04 Hydrogen Peroxide  In primary care use 1.5% (Peroxyl®) to avoid being charged as a pharmaceutical special
13.11.06 Hydrogen Peroxide Solution BP 3% (10 volume) 
13.11.06 Hydrogen Peroxide Sterile Solution BP 3% (10 volume)  unlicensedUnlicensed - Low Risk
13.02.01 Hydrous (Oily Cream) Ointment BP 
09.01.02 Hydroxocobalamin 1mg/1mL 
18 Hydroxocobalamin 5g **** Cyanokit®

Cyanide toxicity


See holding centres on www.toxbase.org.uk

08.01.05 Hydroxycarbamide 100mg, 500mg 
10.01.03 Hydroxychloroquine 200mg 

Amber protocol:


For use in Rheumatology and Dermatology in accordance with BHTCG 795.


For treatment of endocarditis in accordance with BHTCG 236 with Microbiology advice.

11.08.01 Hydroxypropyl Guar e.g. Systane®SDU 3rd Choice - Preservative-Free ocular lubricant
Licensed Medical Device
11.08.01 Hydroxypropyl Guar  e.g. Systane® 2nd Choice - Preserved ocular lubricant
Bottles to be discarded 28 days after opening in accordance with RPSGB and BNF advice
Licensed Medical Device
03.04.01 Hydroxyzine Hydrochloride 10mg, 25mg  Following concerns over the risk of possible cardiovascular adverse effects, the European Medicines Agency's (EMA) PRAC has completed a review of, and issued guidance on, medicines containing hydroxyzine. See links below
03.04.01 Hydroxyzine Hydrochloride 10mg/5mL  Following concerns over the risk of possible cardiovascular adverse effects, the European Medicines Agency's (EMA) PRAC has completed a review of, and issued guidance on, medicines containing hydroxyzine. See links below

Following discontinuation of the licensed product in April 2016, chlorphenamine suspension (OTC) may be used as a first line alternative and promethazine suspension as a second line alternative
A2.04.02 HyFiber  

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

01.02 Hyoscine Butylbromide 10mg Buscopan®
01.02 Hyoscine Butylbromide 20mg/1mL Buscopan®
04.06 Hyoscine Hydrobromide (releasing hyoscine approx. 1mg/72hours when in contact with skin)  In secondary care restricted - for patients with nausea and vomiting - not controlled by other post-operative nausea and vomiting drugs
Each system has a contact surface area measuring 2.5cm2 and hyoscine content of 1.5mg. The average amount of hyoscine absorbed from each system in 72 hours is 1mg
04.06 Hyoscine Hydrobromide 300 micrograms 
15.01.03 Hyoscine Hydrobromide 400micrograms/1mL, 600micrograms/1mL 
11.08.01 Hypromellose 0.3%, 10mL  Note: eye drops expire one week after opening.

Not recommended in primary care use unit dose product (Minims)
11.08.01 Hypromellose 0.32% e.g. Artelac® Restricted - only for use if patient required preservative-free formulation
11.08.01 Hypromellose 0.5%  1st Choice - Preserved ocular lubricant - for aqueous deficiency
06.06.02 Ibandronic Acid 150mg 

2nd line option for primary and secondary fracture prevention. To be used in accordance with the Fracture prevention in adults greater than 50 years old guideline (BHTCG 567FM) 

06.06.02 Ibandronic Acid 3mg/3mL 

Restricted- prescribing on the advice of Rheumatology, Endocrinology or Medicines for Older people team for primary and secondary fracture prevention. 

06.06.02 Ibandronic Acid 50mg 

Restricted - initiation by Consultant Breast Oncologists with continuation by GPs for:


1) Metastatic bone disease in cancer patients not receiving IV therapy, in accordance with Ibandronic Acid for treatment of metastatic bone disease in breast cancer (BHTCG 307FM)


2) Adjuvant treatment in early breast cancer in accordance with Zoledronic acid and Ibandronic acid for adjuvant treatment in early breast cancer patients guideline (BHTCG 834FM)

08.01.05 Ibrutinib 140mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

1. Restricted - prescribing by Consultant Haematologists For previously treated CML and untreated CML with 17p deletion or TP53 mutation in accordance with NICE TA 429 and NHSE SSC 1683.

2. Restricted - prescribing by Haematology team. For the treatment of Waldenstrom's macroglobulinaemia in accordance with NICE TA 491, Nov 17. CDF funded for this indication until September 2020.


3. Restricted - prescribing by Haematology team. For the treatment of relapsed or refractory mantle cell lymphoma in accordance with NICE TA 502. 

10.01.01 Ibuprofen 100mg/5mL  When used in adults, prescribe in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
07.01.01.01 Ibuprofen 10mg/2mL  2nd Choice
Restricted - unlicensedunlicensed, named patient basis
10.01.01 Ibuprofen 200mg, 400mg  1st Choice NSAID
Use in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
10.03.02 Ibuprofen 5%, 10%  In primary care consider patient purchasing - often cheaper than paying the prescription charge.
10.01.01 Ibuprofen SR 800mg  Use in accordance with NSAIDs in Adults - Primary/Secondary Care guideline (BHTCG 299FM)- see link above
03.04.03 Icatibant Firazyr® Restricted - prescribed only on advice of Specialist Centre consultant immunologists for:

1. acute life threatening attacks of hereditary angioedema

2. administration for prophylaxis in HAE/AAE patient undergoing planned surgery, obstetric (including pregnancy) or dental work or similar trauma with a risk of upper airway blockage intubation or trauma to mouth/throat) or significant morbidity or mortality risk from uncontrolled swellings.

In accordance with NHSE Clinical Commissioning Policy B/B09/9/b. BHT Acute Medicine / A&E consultants will prescribe as outreach to the Specialist centre delivered as part of a provider network. Name of Specialist centre and clinician involved to be communicated to Formulary Team prior to initiating treatment at BHT.
19.05.05 Ichthopaste®   7.5cm x 6m (4959)

In primary care available as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.8.9
In secondary care obtain from Pharmacy
08.01.02 Idarubicin Hydrochloride 5mg, 10mg 
08.01.02 Idarubicin Hydrochloride 5mg, 10mg 
02.08 Idarucizumab 2.5g in 50ml  Restricted - Prescribing on the recommendation of a consultant Haematologist only in accordance with Dabigatran - Guidance for Management of Overdose, Bleeding & Emergency/Elective Surgery (BHTCG 34FM) for rapid reversal of the anticoagulant effects of dabigatran in life or limb threatening situations.
It is not suitable for use in over-anticoagulation caused by rivaroxaban, apixaban or edoxaban
08.01.05 Idelalisib 100mg, 125mg  FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not yet available.

Restricted - prescribing by Consultant Haematologists in accordance with NICE TA 359.
08.01.01 Ifosfamide 1g, 2g 
02.05.01 Iloprost 100micrograms/1mL 

Red Traffic Light 1. Restricted - prescribing by Consultant vascular surgeons, rheumatologists and dermatologists only.
See Iloprost Infusion Protocol (BHTCG 684FM)

Red Specialist Centre 2. Restricted - prescribing by Respiratory Consultants only after initiation in a Specialist Centre. May be continued in BHT via shared care between Specialist centre and BHT via a network model.

For pulmonary arterial hypertension in accordance with NHSE Specialist Commissioning Policy A11/P/b, June 2014: National policy for targeted therapies for the treatment of pulmonary hypertension in adults. The name of the Specialist centre and consultant initiating drug to be communicated to Pharmacy Formulary team prior to prescribing.

02.05.01 Iloprost 10micrograms/mL Ventavis® Restricted - prescribing by Respiratory consultants only after initiation in a Specialist Centre. May be continued in BHT via shared care between Specialist centre and BHT via a network model.

For pulmonary arterial hypertension in accordance with NHSE Specialised Commissioning Policy A11/P/b, June 2014: National Policy for targeted therapies for the treatment of pulmonary hypertension in adults.

The name of the Specialist centre and consultant initiating drug to be communicated to Pharmacy Formulary Team prior to prescribing.
08.01.05 Imatinib 100mg, 400mg  FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not yet available.
1. Restricted - prescribing by Consultant Haematologists in accordance with NICE TA 251.
2. Restricted - prescribing by Haematology/Oncology consultants 1st Line in CML (NICE TA70 Leukaemia (chronic myeloid) and GIST (NICE TA 326 Imatinib for Adjuvant Treatment Gastro-intestinal Stromal Tumours (GIST) -review NICE TA 196).
3. Restricted - prescribing by Consultant Haematologists for treating imatinib-resistant or intolerant CML in accordance with NICE TA 425.
4. Restricted- prescribing by Consultant Haematologists for untreated CML in accordance with NICE TA 426.
04.03.01 Imipramine Hydrochloride 10mg, 25mg 

Amber Recommentation For treatment of depression in accordance with the Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM). Prescribing on specialist recommendation.

Green Traffic Light  For treatment of neuropathic pain in accordance with Neuropathic pain management in adults guideline BHTCG 714FM.

04.03.01 Imipramine Hydrochloride 25mg/5mL 

Amber Recommentation For treatment of depression in accordance with the Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM). Prescribing on specialist recommendation.

Green Traffic Light  For treatment of neuropathic pain in accordance with Neuropathic pain management in adults guideline BHTCG 714FM.

13.07 Imiquimod 5% Aldara®

Used for superficial basal cell carcinoma, actinic keratosis and  home treatment of external genital and perianal warts.



When used for the home treatment of external genital and perianal warts, Imiquimod is a 2nd line option when podophyllotoxin is unsuitable or unavailable.

16.01 In-Check DIAL device  In primary care may be prescribed on FP10, in secondary care order from supplies
03.01.01.01 Indacaterol 150micrograms/ inhalation Onbrez Breezhaler® To be used in accordance with BHT COPD guideline (BHTCG 220FM) (see above)
02.02.01 Indapamide 2.5mg  1st Choice thiazide for treatment of hypertension

For use in accordance with Clinical management of hypertension in adults (BHTCG 227)(see link above)
11.08.02 Indocyanine green 25mg/5mL  unlicensedunlicensed - High risk
Restricted - for diagnostic use by Ophthalmology team only.
10.01.01 Indometacin 100mg 

For prevention of post-ERCP pancreatitis.


07.01.01.01 Indometacin 1mg   1st Choice Closure of Ductus Arteriosus - refer to Guidelines on SCBU for closure of patent ductus arteriosus
10.01.01 Indometacin 25mg  1st choice treatment of acute attacks of gout. Also used in ankylosing spondylitis
10.01.01 Indometacin 25mg/5mL  unlicensedUnlicensed - Medium risk

In primary care this is a pharmaceutical special
NOTE: If treatment is to be continued in the community, ibuprofen liquid is a suggested alternative. Unlicensed indometacin is very costly.
10.01.01 Indometacin MR 75mg  1st choice treatment of acute attacks of gout. Also used in ankylosing spondylitis (more than the non MR product)
07.04.01 Indoramin 20mg 
13.11.01 Industrial Methylated Spirit BP 70%, 95% 
01.05.03 Infliximab 100mg Inflectra, Remsima, Remicade® FOR ALL PRESCRIBING: NICE compliance form required - see link from Formulary homepage.

NOTE:
ALL prescribing of infliximab must include generic and brand name.
Inflectra® is first choice infliximab biosimilar for all new patients, with Remsima® second choice only when first choice is more expensive or not available.
Infliximab biosimilars may be prescribed for patients currently receiving Remicade® brand when considered clinically appropriate by the relevant consultant and with consent of the patient.

1. Restricted - prescribing by Gastroenterologists only in accordance with NICE TA 163.
2. Restricted - prescribing by Gastroenterologists only in accordance with NICE TA187
3. Restricted - prescribing by Gastroenterologists in accordance with Biologics in Ulcerative Colitis guideline (BHTCG 633FM) and NICE TA 329.
NOTE: In NICE TA329 adalimumab is the first choice biologic for adult use and infliximab for paediatric use. In NICE TA163 infliximab is approved for acute exacerbations. If a patient on infliximab for NICE TA163 continues treatment long term in accordance with NICE TA329, infliximab should be the drug of choice and switching to adalimumab should not take place. Also note that NICE TA329 recommends titrating up to weekly dosing for adalimumab. This is in contrast to current Thames Valley Priorities Committee recommendations and supersedes them.

see section 10.01.03 (for Rheumatology) and 13.05.03 (for Dermatology)
10.01.03 Infliximab 100mg Inflectra, Remsima, Remicade®

NOTE:
ALL prescribing of infliximab must include generic and brand name.
Inflectra® is first choice infliximab biosimilar for all new patients, with Remsima® second choice only when first choice is more expensive or not available.
Infliximab biosimilars may be prescribed for patients currently receiving Remicade® brand when considered clinically appropriate by the relevant consultant and with consent of the patient.
Red Traffic Light  FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.
1. Restricted - to Rheumatology consultant prescribing only, in accordance with Biologics for Rheumatoid Arthritis guideline (BHTCG 749FM) and NICE TA 375 and 195.
2. Restricted - to prescribing by Rheumatology or Dermatology consultants only, in accordance with Biologics for Psoriatic arthritis guideline (BHTCG 740) and NICE TA 199.
3. Restricted - to prescribing by Rheumatology consultants only, in accordance with Biologics for Ankylosing Spondylitis (AS) and non-radiographic axial spondyloarthritis (AxS) guideline (BHTCG 737FM) and NICE TA 383.

Red Specialist Centre 4. Restricted - prescribing by consultant opthalmologists following initiation by Specialist Centre. For treatment continuation for severe refractory uveitis in adult patients in accordance with NHSE Clinical Commissioning Policy D12/P/b, July 15. BHT Opthamology consultants will prescribe as outreach to the Specialist Centre delivered as part of a provider network. Name of Specialist centre and clinician involved in MDT to be communicated to Formulary Team prior to initiating treatment at BHT. If treatment is continued at BHT, the biologic will be administered by Rheumatology.
5. For treatment of JIA in accordance with NHS England Clinical Commissioning Policy Biologic Therapies for the treatment of Juvenile Idiopathic Arthritis (JIA) (July 2015) E03X04. Prescribing by consultant paediatric rheumatologist under 'shared care' with a Specialized Service Paediatric Rheumatology consultant in accordance with requirements defined in Policy E03X04.

see Section 1.5.3 (for Gastroenterology) and 13.5.3 (for Dermatology)

13.05.03 Infliximab 100mg Inflectra, Remsima, Remicade®

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. NICE compliance to be verified if form not yet available.

NOTE:
ALL prescribing of infliximab must include generic and brand name.
Inflectra® is first choice infliximab biosimilar for all new patients, with Remsima® second choice only when first choice is more expensive or not available.
Infliximab biosimilars may be prescribed for patients currently receiving Remicade® brand when considered clinically appropriate by the relevant consultant and with consent of the patient.

1. Restricted - prescribing by Dermatologists only, in accordance with Biologics for Psoriasis guideline (BHTCG 738FM) and NICE TA 134.
2. Restricted - Rheumatology or Dermatology consultant prescribing only in accordance with Biologics for Psoriatic arthritis guideline (BHTCG 740FM) and NICE TA 199.

See Section 10.01.03 (for Rheumatology) and 01.05.03 (for Gastroenterology)

14.04 Influenza vaccine Fluarix Tetra® Restricted - only for use in Influenza Vaccination in Special Schools where Fluenz® is not appropriate.
14.04 Influenza vaccine inactivated  In secondary care the brand is selected each September to meet DoH guidelines. Occupational Health run an immunisation programme for staff each winter

In primary care only as recommended in routine UK immunisation schedule, for at risk cohorts.

14.04 Influenza vaccine, seasonal for intranasal use Fluenz Tetra®, Flumist®
08.01.05 Inotuzumab ozogamicin 1mg Besponsa®

FOR ALL PRESCRIBING - NICE compliance form via BLUETEQ required - see link from Formulary homepage.


Restricted to prescribing by Haematology team. For the treatment of relapsed or refractory B-cell acute lymphoblastic leukaemia in accordance with NICE TA 541.

06.01.01.01 Insulin Aspart 100units/mL  NOTE: Prescribe all insulins by brand
NovoRapid® (10mL vial, 3mL cartridge)
NovoRapid® FlexPen prefilled disposable injection device.
06.01.01.02 Insulin Degludec 100units/mL 

NOTE: Prescribe all insulins by brand
Tresiba® (3mL cartridge, 3mL FlexTouch prefilled disposable injection device)

Restricted - initiation on the recommendation of Consultant Diabetologists with continuation by GPs for the treatment:


• Type 1 diabetes: to be used if there is nocturnal hypoglycaemia, diabetic ketoacidosis (DKA) or poor 24 hour basal insulin cover with insulin glargine or if flexible administration time is required. 


• Type 2 diabetes: second line agent for nocturnal hypoglycaemia (despite dose adjustment) or poor 24 hour basal insulin cover on insulin glargine 300 Units/mL Toujeo® or if flexible dosing required.

06.01.01.02 Insulin Degludec 200units/mL Tresiba®

NOTE: Prescribe all insulins by brand
Tresiba® (3mL FlexTouch prefilled disposable injection device)

Amber Restricted- on the recommendation of Consultant Diabetologists or Diabetes Specialist Nurses. Dose titration advice and support to be provided by Diabetes Specialist Nurses with continuation by GPs.


Green Initiation may include Insulin initiating GP practices that have signed up to this service.


 


• In type 1 diabetes  to be used when more than 80 units of basal insulin is being used in order to reduce the number of injections.


• In type 2 diabetes,  2nd line High Strength Insulin for nocturnal hypoglycaemia (despite dose adjustment) or poor 24 hour basal insulin cover on insulin glargine or flexible dosing required. 


 


All discharge letters recommending a change to a high strength insulin should highlight clearly the unusual strength in an effort to reduce the risk of errors.

See also above Guideline for Using High Strength Insulins - Primary/Secondary Care Guideline (BHTCG 818FM).

06.01.01.02 Insulin Detemir 100units/mL  NOTE: Prescribe all insulins by brand
Levemir® (3mL cartridge, 3mL FlexPen prefilled disposable injection device)

NOTE: Glargine is the 1st choice long-acting insulin analogue.

For place in therapy of insulin detemir see Clinical Guidelines on intranet: Guidelines for using long acting insulin analogues in patients with diabetes.
06.01.01.02 Insulin Glargine 100units/mL  NOTE: Prescribe all insulins by brand
Lantus® (10mL vial, 3mL cartridge)
Lantus® Solostar 3mL prefilled disposable injection device.

Restricted - Lantus® SoloStar Prefilled disposable injection device for patients on more than 40 units of insulin glargine or unable to use other pen devices.
06.01.01.02 Insulin Glargine 300units/mL Toujeo®

NOTE: Prescribe all insulins by brand.
Toujeo® 300units/ml solution for injection 1.5ml pre-filled SoloStar pen; Toujeo®  300 units/ml solution for injection 3ml pre-filled DoubleStar pen.

Amber  Restricted - on the recommendation of Consultant Diabetologists or Diabetes Specialist Nurses. Dose titration advice and support to be provided by Diabetes Specialist Nurses with continuation by GPs.


Green Initiation may include Insulin initiating GP practices that have signed up to this service.


For type 2 diabetes 1st line agent for:


(a) Nocturnal hypoglycaemia (despite dose adjustment) or poor 24 hour basal insulin cover on 100 units/mL (Lantus) or flexible dosing required.


or


(b) When more than 80 units of basal insulin are used in order to reduce the number of injections.

All discharge letters recommending a change to a high strength insulin should highlight clearly the unusual strength in an effort to reduce the risk of errors.

See also above Guideline for Using High Strength Insulins - Primary/Secondary Care Guideline (BHTCG 818FM)

06.01.01.01 Insulin Glulisine 100units/mL  NOTE: Prescribe all insulins by brand
Apidra® (10mL vial, 3mL cartridge)
Apidra® Solostar (3mL prefilled disposable injection device)

06.01.01 Insulin human injection U-500 Concentrated 500units/mL Humulin R® HIGH STRENGTH - if prescribing take extreme care.
NOTE: Prescribe all insulins by brand
Humulin R® (10mL vial)
Humulin R® Kwikpen (3mL pre-filled pen)

unlicensedUnlicensed - High Risk
Restricted - prescribing by Diabetes Team only.
06.01.01.01 Insulin Lispro 100units/mL  NOTE: Prescribe all insulins by brand
Humalog® (10mL vial, 3mL cartridge)
Humalog® KwikPen (3mL prefilled disposable injection device)
06.01.01.01 Insulin Lispro 200units/mL 

NOTE: Prescribe all insulins by brand
Humalog® Kwikpen(3mL prefilled disposable injection device)

Amber Restricted- on the recommendation of Consultant Diabetologists or Diabetes Specialist Nurses. Dose titration advice and support to be provided by Diabetes Specialist Nurses with continuation by GPs.


Green Initiation may include Insulin initiating GP practices that have signed up to this service.


 


For treatment of type 1 or type 2 diabetes in patients receiving more than 60 units of prandial insulin as a single dose in order to reduce injection volume

All discharge letters recommending a change to a high strength insulin should highlight clearly the unusual strength in an effort to reduce the risk of errors.

See also above Guideline for Using High Strength Insulins - Primary/Secondary Care Guideline (BHTCG 818FM)

06.01.01.01 Insulin soluble (human) 100units/mL  NOTE: Prescribe all insulins by brand
Actrapid® (10mL vial)
Humulin S® (10mL vial, 3mL cartridge)
Insuman® Rapid (3mL cartridge)
19.24.02 Integra® Dermal  10cm x 25cm

Restricted - Burns and Plastics Consultant only prescribing

In secondary care obtain from Pharmacy
08.02.04 Interferon Alfa-2a 3million, 4.5million, 6milllion, 9million unit Roferon-A®
08.02.04 Interferon Alfa-2b 15million units IntronA®
08.02.04 Interferon Beta-1a 6 million units, 22 micrograms/0.5mL Rebif®

FOR ALL PRESCRIBING - a completed and approved NICE compliance form via BLUETEQ is required


Restricted to prescribing by Neurologists only in accordance with NICE TA 527.

08.02.04 Interferon Beta-1a 6million units, 30micrograms/0.5mL Avonex®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Neurologists only for RRMS and SPMS (Mutilple Sclerosis) and in accordance with NHSE Clinical Commissioning Policy - Disease Modifying Therapies for Patients with MS (see link above) and NICE TA 527.

08.02.04 Interferon Beta-1b 9.6million units (300micrograms) Extavia®

FOR ALL PRESCRIBING - a completed and approved NICE compliance form via BLUETEQ is required.


Restricted to prescribing by Neurologists only in accordance with NICE TA 527. 

08.02.04 Interferon Beta-1b 9.6milllion units (300micrograms) Betaferon® FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - for use in patients with Multiple Sclerosis only in accordance with NHSE Clinical Commissioning Policy - Disease Modifying Therapies for Patients with MS (see link above)
08.02.04 Interferon Gamma-1b 100micrograms/0.5mL  In secondary care restricted - Phone Pharmacy to Order
16.01 Iobitridol 300, 350 mgI/mL Xenetix® Restricted - to prescribing by Consultant Radiologist only.
06.02.02 Iodine and Iodide  iodine 5%, potassium iodide 10% unlicensedunlicensed - Low Risk

Total iodine 130mg/mL

In secondary care used in Gynae OP, Surgery and Colposcopy only.

In primary care this treatment is only used pre-op, BNF says little evidence of beneficial effects.
16.01 Iodixanol injection 270, 320 mgI/mL Visipaque® Restricted - prescribing by Consultant Radiologist only
19.04.03.01 Iodoflex® Paste  Both available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

A5.3.2
In secondary care obtain from Pharmacy

19.04.03.01 Iodosorb® Ointment  Both available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

A5.3.2
In secondary care obtain from Pharmacy
19.04.03.01 Iodosorb® Powder  Restricted - for use in secondary care by Dermatology only.



BNF A5.3.2
In secondary care obtain from Pharmacy
16.01 Iohexol 300, 350 Omnipaque®

For use in radiology only.

16.01 Iopamidol 61.24%w/v, 20mL, 50mL, 100mL Gastromiro® Restricted - prescribing by Radiology team only
16.01 Iopamidol 6g in 20L Niopam 300®

Restricted - prescribing by Radiology team only

08.01.05 Ipilimumab 50mg/10mL, 200mg/40mL  Restricted:
1. Prescribing by ORH Oncology consultants in accordance with TVCN protocol and NICE TA 268
2. Prescribing by Oxford University Hospitals (OUH) only, in accordance with NICE TA 319.
3. Prescribing by consultant oncologists (Melanoma) at OUH only. To be used In combination with nivolumab for treating advanced melanoma in accordance with NICE TA 400, Jul 16 and NHSE Letter ref 1640 from end Oct 2016.
12.02.02 Ipratropium Bromide 0.03% Rinatec® 21micrograms/metered spray
Restricted - Prescribing by ENT Consultants.
03.01.02 Ipratropium Bromide 20micrograms/metered inhalation 
03.01.02 Ipratropium Bromide 250micrograms/1mL, 500micrograms/2mL 
02.05.05.02 Irbesartan 150mg, 300mg Aprovel ® Restricted - initiation by Diabetic and Renal teams for use in diabetic nephropathy in patients intolerant of an ACE inhibitor
08.01.05 Irinotecan Hydrochloride 40mg/2mL, 100mg/5mL  Restricted - in accordance with NICE guidelines
09.01.01.02 Iron (as Iron Sucrose) 100mg/5mL Venofer®

For treatment of iron deficiency anaemia in patients who need only a small amount of IV iron and/or who are regularly attending hospital for other reasons e.g. use for renal patients on dialysis by Renal team in accordance with guideline 802FM Iron deficiency anaemia in adults.

09.01.01.02 Iron Isomaltoside 100mg/2mL Diafer®

Prescribing by Renal team only.

09.01.01.02 Iron Isomaltoside 100mg/mL, 200mg/2mL, 500mg/5mL, 1g/10mL Monofer® Prescribing by consultants only. For treatment of iron deficiency anaemia in patients who are unsuitable for oral iron due to intolerance, contraindications or inadequate response to an adequate trial of oral iron therapy or proven malabsorption in whom high doses of IV iron are required. This includes pre-op use for people listed for bowel surgery as there is not enough time to use oral iron.

All use is in accordance with guideline 802FM Iron deficiency anaemia in adults.
08.01.05 Isatuximab 100mg/5mL 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.

Restricted - prescribing by Haematology team. For use in accordance with Isatuximab with pomalidomide and dexamethasone for treating relapsed and refractory multiple myeloma NICE TA658.  CDF funded for this indication until January 2023.

05.02.01 Isavuconazole 

FOR ALL PRESCRIBING - Prior approval form required via Blueteq



Restricted to prescribing on the advice of Consultant Microbiologists and/or in conjunction with the Mycology Reference Laboratory. For the treatment of invasive fungal infections (aspergillosis/mucomycosis) in patients for whom other antifungal agents are inappropriate due to intolerance/resistance.

05.02.01 Isavuconazole 200mg  

FOR ALL PRESCRIBING - Prior approval form required via Blueteq



Restricted to prescribing on the advice of Consultant Microbiologists and/or in conjunction with the Mycology Reference Laboratory. For the treatment of invasive fungal infections (aspergillosis/mucomycosis) in patients for whom other antifungal agents are inappropriate due to intolerance/resistance.

04.03.02 Isocarboxazid 10mg 

*** PHENELZINE is FIRST LINE MAOI***

Initiation and stabilisation by the Psychiatry team, continuation by GPs, for the treatment of depression in accordance with Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

15.01.02 Isoflurane 
05.01.09 Isoniazid 50mg, 100mg 
05.01.09 Isoniazid 50mg/2mL 
05.01.09 Isoniazid 50mg/5mL  unlicensedUnlicensed - Medium Risk
06.01.01.02 Isophane Insulin 100units/mL  NOTE: Prescribe all insulins by brand
Insulatard® (10mL vial, 3mL cartridge)
Insulatard® InnoLet prefilled disposable injection device)
Humulin® I (10mL vial, 3mL cartridge)
Humulin® I-Pen prefilled disposable injection device.
Insuman Basal® (10mL vial, 3mL cartridge)
Insuman Basal® (pre-filled pen)

Humulin® I-Pen restricted to Type 2 diabetes patients who cannot self administer isophane insulin using 10mL vials or 3mL cartridges and in accordance with NICE CG 87 Type 2 diabetes - newer agents (a partial update of CG66): short guideline and Bucks Trust local adaptation
02.07.01 Isoprenaline 2mg/2mL  unlicensedunlicensed - High risk
13.11.01 Isopropyl Alcohol 70% 
02.06.01 Isosorbide Dinitrate 0.05% (500micrograms/1mL) 
18 Isosorbide Dinitrate 0.1% (1mg/1mL)  Hypertension
02.06.01 Isosorbide Mononitrate 10mg, 20mg 
02.06.01 Isosorbide Mononitrate 60mg  Restricted in secondary care - only for use if there is a shortage of immediate release 10mg, 20mg and 40mg tablets. Change to MR tablets on a mg to mg basis, eg. isosorbide mononitrate (ISMN) 20mg twice daily should be changed to isosorbide mononitrate MR 40mg daily.

In primary care restricted to use while ISMN 20mg has supply problems and in established patients. Usually switch 20mg bd to 50-60mg MR once daily.
13.06.01 Isotretinoin 0.05% Isotrex®
13.06.02 Isotretinoin 5mg, 10mg, 20mg 
01.06.01 Ispaghula Husk 3.5g/sachet 
05.02.01 Itraconazole 100mg 

In secondary care restricted - Haematology, Oncology, Ophthalmology and GUM. Microbiology approval required for all other uses

In primary care restricted - as stated in local antibiotic guideline

05.02.01 Itraconazole 10mg/1mL  In secondary care restricted - Haematology, Oncology and GUM. Microbiology approval required for all other uses.

In primary care restricted - as stated in local antibiotic guideline
19.09.02 IV3000®  10cm x12cm (central venous catheter)(SJ4008)
In primary care this one only is available as stock through the On-line Non-Prescription Ordering System (ONPOS)


7cm x 9cm (ported peripheral catheter)(SJ4006)
9cm x12cm (PICC line)(SJ66004009)
10cm x 14cm (SJ4925)

Restricted - for use in patients who have had skin reactions to Tegaderm dressings

BNF A5.2.2
In secondary care obtain from Supplies
02.06.03 Ivabradine 5mg, 7.5mg  FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary home page.

Restricted - initiation by Consultant Cardiologists with GP continuation and in accordance with Ivabradine for use in Chronic Stable Heart Failure amber initiation guideline (BHTCG 774FM) and NICE TA 267.

Note 5mg tablets are scored and can be halved if 2.5mg dose is needed
03.07 Ivacaftor Kalydeco® Restricted - prescribing by Respiratory and Paediatric consultants only after initiation in a Specialist centre and delivered as outreach as part of a provider network.

For Cystic Fibrosis in accordance with NHSE Clinical Commissioning Policy A01/P/c and SSC 1541, October 2015.

The name of the Specialist centre and consultant initiating Ivacaftor to be communicated to Pharmacy Formulary Team prior to prescribing.
13.06 Ivermectin 10mg/g 

For topical treatment of mild to moderate papulo pustular rosacea (PPR) in adults as third line to metronidazole 0.75% cream/gel and azelaic acid 15% gel when these are ineffective, not tolerated or where there are contraindications. For use in accordance with Rosacea Treatment Pathway (BHTCG 724FM)

05.05.06 Ivermectin 3mg  unlicensedUnlicensed - Medium risk

Restricted - prescribing by consultant Dermatologists only or on approval from Microbiology.
08.01.05 Ixazomib 2.3mg, 3mg, 4mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required. 


Restricted - Prescribing by consultant Haematologists in accordance with NICE TA 505.


CDF funded for this indication until December 2019. 

10.01.03 Ixekizumab 80mg Taltz®

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.


Restricted - prescribing by Consultant Dermatologists and Consultant Rheumatologists. For the treatment of active psoriatic arthritis after inadequate response to DMARDs in accordance with NICE TA 537 and Biologics for Psoriatic arthritis guideline (BHTCG 740FM)

13.05.03 Ixekizumab 80mg Taltz®

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage.



1. Restricted- prescribing by Consultant Dermatologists. For the treatment of moderate to severe plaque psoriasis in accordance with NICE TA 442 and in accordance with Biologics for Psoriasis guideline (BHTCG 738FM)


2. Restricted - prescribing by Consultant Dermatologists and Consultant Rheumatologists. For the treatment of active psoriatic arthritis after inadequate response to DMARDs in accordance with NICE TA 537 and Biologics for Psoriatic arthritis guideline (BHTCG 740FM)

A2.01.01.01 Jevity 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.01.02.01 Jevity 1.5 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.01.02.02 Jevity Plus 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.01.02.02 Jevity Plus HP 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.01.02.02 Jevity Promote 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

A2.06.01 Just GF bakery 4 x 65g x 6 Good white rolls

In primary care - a less cost effective choice for patients with coeliac disease or dermatitis herpetiformis

Consider switching to Lifestyle Bread Rolls (white, brown or high fibre)

4 x 65g = 0.65 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Just GF bakery 6 x 600g white sandwich bread

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

600G loaf is 1.5 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Just® GF bakery 6 x 380g

In primary care - LESS cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

Consider switching to Genius Gluten Free Sandwich bread.
535G loaf is 1.25 units.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 8 x 400g Fresh white loaf (sliced)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

400G loaf is 1 unit.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 6 x 400g Part Baked white loaf

In primary care - a LESS cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

Consider switching to Lifestyle Bread (white)

400g loaf is 1 unit.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 6 x 400g White loaf and fibre loaf (sliced or unsliced)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

400G loaf is 1 unit.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 6 x 5 x 75g Part Baked Rolls (white or fibre)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

Consider switching to Lifestyle Bread Rolls (white, brown or high fibre)

5 x 80g = 1 unit

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 6 x 5 x 85g Rolls (white or fibre)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

5 x 85G = 1 unit

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 6 x 400g Part Baked fibre loaf (sliced or unsliced)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

400G loaf is 1 unit

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 

In Primary care - LESS cost effective choice for people with coeliac disease or dermatitis herpetiformis

Consider switching to Tritamyl Flour Mix

2,000 G = 4 units

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 8 x 5 x 85g Fresh rolls (white or fibre)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

5 x 85G = 1 unit

Gluten free items now restricted to bread and mixes 8 units/patient/month

A2.06.01 Juvela® GF 8 x 400g Fresh fibre loaf (sliced)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis.

400G loaf is 1 unit.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

19.02 Kaltostat®  5cm x 5cm
7.5cm x 12cm

In primary care - Tissue Viability (TV) recommendation only. In primary care TV have the ability to order as stock from "specialist" ONPOS list
In secondary care - restricted, only for use in areas treating surgical patients.

BNF A5.2.6
In secondary care obtain from Pharmacy
19.02 Kaltostat® cavity dressing 2g rope
Restricted - Renal use only
Not for use in Primary Care


BNF A5.2.6
In secondary care obtain from Pharmacy
19.02 Kaltostat®  10cm x 20cm
15cm 25cm
Not for use in Primary Care
In secondary care - restricted, only for use in areas treating surgical patients.


BNF A5.2.6
In secondary care obtain from Pharmacy
10.03.02 Kaolin Poultice 
19.24.01 Kapitex ® Laryngeo Foam Tracheostomy  Small
Large
19.05.01.01 K-Band®  10cm x 4m (stretched)

In secondary care not recommended for stock on general wards.
In primary care available as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.8.2
In secondary care obtain from Supplies
19.12.02 KerraLite® Cool 

Restricted - not for nursing homes.

6cm x 6cm
12cm x 8.5cm

Both available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.2.1
In secondary care obtain from Pharmacy

19.01.03.01 KerraMax  10cm x 10cm
20cm x 22cm
20cm x 30cm
20cm x 50cm

BNF A5.1.2

In primary care available via ONPOS
19.01.03 Kerramax Care 

 20cm x 50cm


Available from ONPOS


15.01.01 Ketamine 200mg/20mL, 500mg/10mL  Restricted - treated as a CD in this Trust. Order, store and record all issues as per a controlled drug.

NOTE: This product is currently unavailable.
04.01.01 Ketamine 50mg/5mL 

unlicensedunlicensed - low risk

Prescribing by Pain or ICU consultants, anaesthetists and pain specialist nurses in acordance with the Administration of Ketamine for acute pain (patients over 16 years) guideline (BHTCG 330).

Restricted - treated as a CD in this Trust. Order, store and record all issues as per a controlled drug. 

15.01.01 Ketamine 50mg/5mL  unlicensedunlicensed - Low Risk
NOTE: The licensed product is not available at present.

Restricted - treated as a CD in this Trust. Order, store and record all issues as per a controlled drug.
13.09 Ketoconazole 2% 
13.10.02 Ketoconazole 2% 
06.01.06 Keto-Diastix®  Restricted - only for Type 1 diabetics and patients on insulin with a history of diabetic ketoacidosis; and where the individual cannot use blood test monitoring
11.08.02 Ketorolac Trometamol 0.5%  Note: if used to treat macular oedema this is an unlicensed use and patient details to be recorded.
09.06.07 Ketovite®  Restricted - must be recommended by a dietitian
09.06.07 Ketovite®  Restricted - must be recommended by a dietitian
19.05.03 K-Four®   Layer 1 - K-Soft 10cm x 3.5m, K-Soft Long 10cm x 4.5m
Layer 2 - K-Lite 10cm x 4.5m, K-Lite Long 10cm x 5.25m
Layer 3 - K-Plus 10cm x 8.7m, K-Plus Long 10cm x 10.25m
Layer 4 - Ko-Flex 10cm x 6m, Ko-Flex Long 10cm x 7m
Use of Layers 3 and 4 restricted in secondary care to use by Dermatology team or on recommendation of Tissue Viability
In primary care available as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.8.6, 5.8.7, 5.8.8
In secondary care obtain from Supplies
01.02 Kolanticon®  Not to be used for new initiations, can be used as a cost effective alternative to dicycloverine
02.04 Labetalol Hydrochloride 100mg/20mL 
02.04 Labetalol Hydrochloride 50mg, 100mg 200mg, 400mg 
04.08.01 Lacosamide 50mg, 100mg, 150mg, 200mg  May be prescribed generically

Restricted - initiation by consultant Neurologists only and continuation in primary care, for use as an adjunct (add on) treatment for refratory epilepsy not controlled by three antiepileptic agents in combination.
11.08.01 Lacri-Lube®   See Ocular Lubricants - Primary/ Secondary care Guideline (BHTCG 371FM)
01.06.04 Lactulose 
05.03.01 Lamivudine 100mg Zeffix® Restricted - prescribing by Gastroenterologists, HIV and Specialist Sexual Health teams only in accordance with NICE TA 96
05.03.01 Lamivudine 150mg, 300mg 
05.03.01 Lamivudine 25mg/5mL, 50mg/5mL  Restricted to the prevention of maternal to foetal HIV transmission. See protocol by Obs & Paed Depts
04.02.03 Lamotrigine 25mg, 50mg, 100mg, 200mg   Restricted - for bipolar depression only only on the initiation  or recommendation of a consultant Psychiatrist.
See 4.8.1 for use in epilepsy
04.08.01 Lamotrigine 25mg, 50mg, 100mg, 200mg  Prescribing generically or by brand is discretionary

See 4.2.3 for bipolar depression
04.02.03 Lamotrigine 5mg, 25mg, 100mg   Restricted - for bipolar depression only only on the initiation  or recommendation of a consultant Psychiatrist.
See 4.8.1 for use in epilepsy
04.08.01 Lamotrigine 5mg, 25mg, 100mg  Prescribing generically or by brand is discretionary

See 4.2.3 for bipolar depression
03.04.03 Lanadelumab 300mg/2mL 

PRIOR APPROVAL via a Blueteq form required. Prescribing by consultants in Acute Medicine following initiation by Immunology consultants at Specialist Centres (e.g. OUH).  For routine prevention of hereditary angioedema attacks in accordance with NICE TA 606 

08.03.04.03 Lanreotide 60mg Somatuline Autogel®

Red Traffic Light 
1. Restricted - prescribing by Oncology team.
2. Restricted - prescribing by Paediatric consultants for insulin resistance (Congenital Hyperinsulinism (CHI)) in paediatric patients (as shared care with tertiary referral centres)(Unlicensed Use)

Amber Traffic Light  Shared Care (Amber) Protocol - Restricted - prescribing by Consultant Paediatricians and Endocrinologists for the treatment of acromegaly (Oxfordshire shared care protocol)
Amber Traffic Light  Amber Recommendation - restricted to recommendation by Palliative Care Team.

01.03.05 Lansoprazole 15mg, 30mg 
01.03.05 Lansoprazole 15mg, 30mg  In secondary Care restricted - for use in patients who cannot swallow because they are in ITU or have a NG/PEG tube and paediatric patients.

In primary care only for use in patients unable to swallow the capsules

NOTE: Lansoprazole FasTabs are the most cost effective dispersible tablet.
08.01.05 Larotrectinib sulfate 20mg/1mL 

FOR ALL PRESCRIBING: NICE compliance form required via Blueteq. 


Prescribing by the Oncology team;


Larotrectinib for NTRK fusion-positive solid tumours in accordance with NICE TA 630.


NICE TA 630: Larotrectinib for treating NTRK fusion-positive solid tumours

19.24 Larvae Therapy 

Restricted - use by Dermatology, Burns and Plastics, Podiatry and Tissue Viability only

In secondary care obtain from Pharmacy

11.06 Latanoprost 50micrograms/1mL  Restricted - only for use if patient has an established allergy to preservatives or is using more than 6 drops daily in the affected eye(s)
11.06 Latanoprost 50micrograms/1mL  1st Choice prostaglandin analogue eye drops
11.06 Latanoprost/Timolol 50micrograms/5mg in 1mL  Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs
11.06 Latanoprost/Timolol 50micrograms/5mg in 1mL e.g. Fixapost®

Restricted - to initiation by Consultant Ophthalmologists with continuation by GPs for patients who have an established allergy to preservatives or who are using more than 6 drops daily in the affected eye(s).

19.24 Leech Therapy  Restricted - use in secondary care by Plastics team only

In secondary care obtain from Pharmacy
10.01.03 Leflunomide 10mg, 20mg, 100mg 

Restricted - to initiation by Consultant Rheumatologists in accordance with Leflunomide for use in Rheumatology Shared Care protocol (BHTCG 790FM).

08.02.04 Lenalidomide 1.5mg, 5mg, 7.5mg, 10mg, 15mg, 25mg 

FOR ALL PRESCRIBING - NICE compliance form required - see link from Formulary homepage. (NICE compliance to be verified if form not yet available.)

 

Restricted -

Prescribing by Consultant Haematologists for:
1. Relapsed or refractory myeloma in accordance with NICE TA 171 and TVCN protocol. 

NICE TA 171: Lenalidomide for the treatment of multiple myeloma in people who have received at least 2 prior therapies 

2. Myelodysplastic syndromes in accordance with NICE TA 322.

NICE TA 322: Lenalidomide for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality

3. With rituximab for previously treated follicular lymphoma in accordance with NICE TA 627. 

NICE TA 627: Lenalidomide with rituximab for previously treated follicular lymphoma

4. For maintenance treatment after an autologous stem cell transplant for newly diagnosed multiple myeloma in accordance with NICE TA 680.

NICE TA 680: Lenalidomide maintenance treatment after an autologous stem cell transplant for newly diagnosed multiple myeloma

 

Prescribing by the Oncology team for:
5. For the treatment of previously untreated multiple myeloma in combination with dexamethasone in accordance with NICE TA 587.

NICE TA 587: Lenalidomide plus dexamethasone for previously untreated multiple myeloma

6. In combination with dexamethasone for the treatment of multiple myeloma after 1 treatment with bortezomib in accordance with NICE TA 586.

NICE TA 586: Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib

09.01.06 Lenograstim 13.4million units (105mg), 33.6million units (263mg)  Restricted - to prescribing only by Consultant Paediatric Oncologists in accordance with Oxford protocol (shared care from tertiary referral centre)
08.01.05 Lenvatinib 4mg, 10mg 

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.


1. Restricted to prescribing by Oncology team in combination with everolimus for the treatment of previously treated advanced renal cell carcinoma in accordance with NICE TA 498.


2. Restricted - prescribing by Oxford University Hospitals (OUH) Consultant Oncologists for treating differentiated thyroid cancer after radioactive iodine in accordance with NICE TA 535.


3. Restricted to prescribing by Oncologists for untreated advanced hepatocellular carcinoma in accordance with NICE TA 551.

05.03.02 Letermovir Prevymis

Prescribing by the Haematology team for preventing cytomegalovirus (CMV) reactivation and disease in adult CMV-seropositive recipients [R+] of an allogeneic haematopoietic stem cell transplant (HSCT) in accordance with NICE TA 591.

08.03.04.01 Letrozole 2.5mg  In secondary care restricted to prescribing by Consultants in Breast Surgery or Breast Oncology.
In primary care, may be prescribed by GPs if recommended by Consultants in Breast Surgery or Breast Oncology.
19.01.01 Leukomed T Plus®  5cm x 7.2cm
8cm x 10cm
8cm x 15cm
10cm x 20cm
10cm x 25cm
10cm x 30cm
10cm x 35cm

Restricted - for use in secondary care only
To be reviewed and rationalised

BNF A5.1.2
In secondary care obtain from Supplies
04.08.01 Levetiracetam 100mg/mL  May be prescribed generically

1. Restricted - recommendation by neurology Consultants. See NICE TA76 The clinical effectiveness of newer drugs for epilepsy in adults and TA79 The clinical effectiveness and cost effectiveness of newer drugs for epilepsy in children (both TA76 and TA79 replaced by NICE CG 137 - see link above)
04.08.01 Levetiracetam 250mg, 500mg, 750mg, 1g  May be prescribed generically

1. Restricted - recommendation by neurology Consultants. See NICE TA76 The clinical effectiveness of newer drugs for epilepsy in adults and TA79 The clinical effectiveness and cost effectiveness of newer drugs for epilepsy in children (both TA76 and TA79 replaced by NICE CG 137 - see link above)
2. Restricted - initiation by Consultant Psychiatrist (Mental Health Trust)
04.08.01 Levetiracetam 500mg/5mL 

May be prescribed generically


 


Red Restricted - prescribing on the advice of the Neurology team. The IV formulation to be used when oral levetiracetam is not possible. See NICE TA76 The clinical effectiveness of newer drugs for epilepsy in adults and TA79 The clinical effectiveness and cost effectiveness of newer drugs for epilepsy in children (both TA76 and TA79 replaced by NICE CG 137 - see link above).

Amber Prescribing on the recommendation of Palliative care Consultants for managing seizures in patients in the community who cannot swallow and require a syringe driver.

15.02 Levobupivacaine 25mg/10mL  Restricted - Consultant Anaesthetists for use in theatres for surgical anaesthesia where large doses (more than 100mg) are required.
15.02 Levobupivacaine 50mg/10mL  Restricted - Consultant Anaesthetists for use in theatres for surgical anaesthesia where large doses (more than 100mg) are required.
04.02.01 Levomepromazine 25mg 
04.02.01 Levomepromazine Hydrochloride 25mg/1mL 
07.03.05 Levonorgestrel 1.5mg 

Use in accordance with Contraception (summary of key messages) guideline (BHTCG 783FM)

In primary care may also be purchased over the counter

07.03.02.03 Levonorgestrel 13.5mg Jaydess®

Levonogestrel-releasing IUDs should be prescribed by brand (see MHRA drug safety update, link below)

Restricted - to be used in accordance with Contraception (Summary of Key Messages) (BHTCG 783FM) - see link above

In secondary care restricted - to Family Planning and Obs & Gynae Consultants/SPRs only
In primary care GP must have undergone training on insertion.

07.03.02.03 Levonorgestrel 19.5mg Kyleena®

Levonorgestrel-releasing IUDs should be prescribed by brand (see MHRA drug safety update, link below)


Restricted - to be used in accordance with Contraception (Summary of key messages) (BHTCG 783FM) - see link above


In secondary care restricted - to Family Planning and Obs & Gynae Consultants/SPRs only.


In primary care GP must have undergone training on insertion.

07.03.02.03 Levonorgestrel 20micrograms per 24 hours Mirena®

Releasing levonorgestrel 20micrograms/24hours

Levonogestrel-releasing IUDs should be prescribed by brand (see MHRA drug safety update, link below)


In secondary care restricted - to Family Planning and Obs & Gynae Consultants/SPRs only.
In primary care GP must have undergone training on insertion.

Restricted - to be used in accordance with:


• Contraception (Summary of Key Messages) (BHTCG 783FM) - see link above
• Management of Premature Ovarian Insufficiency guideline (BHTCG 422FM). Mirena® is the first choice progestogen for POI.

07.03.02.03 Levonorgestrel 20micrograms per 24 hours Levosert®

Levonogestrel-releasing IUDs should be prescribed by brand (see MHRA drug safety update, link below)


Restricted - to be used in accordance with Contraception (Summary of key messages) (BHTCG 783FM) - see link above


In secondary care restricted to Sexual Health and Obs and Gynae Consultants / SpRs only.
In primary care restricted to GPs who have undergone training on insertion.




07.03.02.01 Levonorgestrel 30micrograms Norgeston®
06.02.01 Levothyroxine Sodium 25micrograms, 50micrograms, 100micrograms Thyroxine sodium Tablets can be crushed for administration in patients with swallowing difficulties or feeding tubes and in paediatrics.
In paediatrics, round dose to closest 25 micrograms
06.02.01 Levothyroxine Sodium 50micrograms/5mL  Restricted- for patients who are intolerant to the excipients of the tablets. Tablets can be crushed for administration in patients with swallowing difficulties or feeding tubes, and administration in children.
NOT to be prescribed in paediatrics
15.02 Lidocaine 5%  

1. Amber Restricted - Initiation by the Palliative Care team with continuation by GPs.
For management of neuropathic pain in palliative care (short term use):
(i) For patients who cannot swallow at the end of life when neuropathic pain remains an issue.
(ii) When all other oral products have proven ineffective or are not tolerated.


Discontinue if inadequate response after 2 to 4 weeks. If patient requires longer term use (>4 weeks), discuss again with the Palliative Care team. 



2. Red Traffic Light FOR ALL PRESCRIBING - Formulary compliance form required - see link from Formulary homepage.
Restricted - prescribing by spinal consultants or pain team for the treatment of localized neuropathic pain for spinal cord injury (SCI) patients who cannot tolerate, or who have failed to respond to, or are contra-indicated to maximum doses of oral treatment with tricyclic antidepressants, gabapentinoids, duloxetine and topical capsaicin 0.075% cream and in accordance with the chronic pain treatment in adult spinal patients guideline (BHTCG 375FM).

15.02 Lidocaine Hydrochloride 0.5% (50mg/10mL) 
02.03.02 Lidocaine Hydrochloride 1% 

For treatment of ventricular arrthythmias.

15.02 Lidocaine Hydrochloride 1%  
15.02 Lidocaine Hydrochloride 1% (100mg/10mL)  unlicensedunlicensed - Low Risk
15.02 Lidocaine Hydrochloride 1% (100mg/10mL, 200mg/20mL)  In primary care the maximum volume used is usually 5mL

When used as an intravenous infusion (unlicensed use), restricted to prescribing by the pain service on the advice of a consultant anaesthetist (pain specialist) in accordance with The Administration of Intravenous Lidocaine for Neuropathic Pain Management (BHTCG 673FM) Guideline
1.As a diagnostic tool for neuropathic pain. Where a positive response will guide subsequent management e.g. the use of membrane stabilising drugs
2.For the treatment of neuropathic pain where all other agents are ineffective or not tolerated at maximum doses.
3.To put a ceiling on high levels of neuropathic pain in patients taking very high doses of neuropathic pain agents
15.02 Lidocaine Hydrochloride 1% (20mg/2mL, 50mg/5mL)  In primary care the maximum volume used is usually 5mL
11.07 Lidocaine Hydrochloride 1% isotonic  unlicensedunlicensed (supplier Martindale)
Ophthalmic Consultants Anaesthetic use during intra-ocular surgery in Oph. Theatres. Named patient basis.
15.02 Lidocaine Hydrochloride 10% (10mg/dose) 
02.03.02 Lidocaine Hydrochloride 2% 

For treatment of ventricular arrthythmias.

15.02 Lidocaine Hydrochloride 2%  
02.03.02 Lidocaine Hydrochloride 2% (100mg/5mL) 

For treatment of ventricular arrthythmias.

15.02 Lidocaine Hydrochloride 2% (400mg/20mL)  In primary care the maximum volume used is usually 5mL
15.02 Lidocaine Hydrochloride 2% (40mg/2mL, 100mg/5mL)  In primary care the maximum volume used is usually 5mL
15.02 Lidocaine Hydrochloride 4% 
15.02 Lidocaine Hydrochloride 5%  
15.02 Lidocaine Hydrochloride/Adrenaline (Epinephrine) 0.5%/1:200,000  unlicensedunlicensed

May be used on cotton wool for epistaxis
15.02 Lidocaine Hydrochloride/Adrenaline (Epinephrine) 1%/1:200,000  unlicensedunlicensed - Low Risk
15.02 Lidocaine Hydrochloride/Adrenaline (Epinephrine) 1%/1:200,000 
15.02 Lidocaine Hydrochloride/Adrenaline (Epinephrine) 2%/1:200,000 
15.02 Lidocaine Hydrochloride/Adrenaline (Epinephrine) 2%/1:200,000  unlicensedunlicensed
15.02 Lidocaine Hydrochloride/Adrenaline (Epinephrine) 2%/1:80,000 
15.02 Lidocaine Hydrochloride/Chlorhexidine Gluconate 2%/0.25% in sterile lubricant basis  In primary care brands other than Instillagel are more cost effective, see ScriptSwitch
11.07 Lidocaine Hydrochloride/Fluorescein 4%/0.25% 
02.03.02 Lidocaine Hydrochloride/Glucose 0.2%/5% 

For treatment of ventricular arrthythmias.

02.03.02 Lidocaine Hydrochloride/Glucose 0.4%/5% 

For treatment of ventricular arrthythmias.

15.02 Lidocaine Hydrochloride/Phenylephrine Hydrochloride 5%/0.5%  May be used as a spray for epistaxis
15.02 Lidocaine Hydrochloride/Prilocaine Hydrochloride 2.5%/2.5% 
A2.06.01 Lifestyle®  

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

400g loaf = 1 unit.

Prescribing of all gluten free products now restricted to bread and mixes 8 units/patient/month

A2.06.01 Lifestyle®  5 x 80g Bread rolls (white, brown or high fibre)

In primary care - a cost effective choice for patients with coeliac disease or dermatitis herpetiformis

5 x 80G rolls = 1 unit

Gluten free items now restricted to bread and mixes 8 units/patient/month

06.01.02.03 Linagliptin 5mg Trajenta®

2nd line DPP-4 inhibitor for patients with renal impairment (eGFR <60ml/min/1.73m2) and declining renal function.


Use in accordance with Type 2 Diabetes blood glucose-lowering therapy guideline (BHTCG 667FM) (see link above) and NICE MG 87 Management of Type 2 Diabetes

05.01.07 Linezolid 100mg/5mL  In secondary care restricted - Microbiology approval required
Pharmacist to confirm ongoing microbiology approval – especially for extended periods of treatment. Maximum period of treatment 28 days
05.01.07 Linezolid 600mg 

1. Restricted - in line with Guidelien 698. Management and control of PVL staphylococcal infections.


In other cases:


2. Restricted - Microbiology approval required. Pharmacist to confirm ongoing microbiology approval – especially for extended periods of treatment. Maximum period of treatment 28 days.
3. Restricted - OPAT prescribers for follow on therapy for the treatment of skin and soft tissue infections in OPAT patients who are over 80 years of age and have type 1 penicillin allergy.

05.01.07 Linezolid 600mg/300mL  Restricted - Microbiology approval required
06.02.01 Liothyronine Sodium 20micrograms L-Tri-iodothyronine sodium)

Amber Traffic Light Amber Initiation - For use in Endocrinology. To be initiated by Consultant Endocrinologists with continuation by GPs in accordance with the Bucks Liothyronine review algorithm.

 

Red Traffic Light Restricted for use in Oncology (thyroid/parathyroid cancer) and for Psychiatric indications (see Depression in Adults and Older Adults guideline BHTCG 573FM and Antidepressant treatment algorithm BHT 572FM).

 

06.02.01 Liothyronine Sodium 20micrograms L-Tri-iodothyronine sodium
16.01 Lipiodol  Restricted - to prescribing by Radiology team only.
08.01.05 Liposomal cytarabine-daunorubicin 44mg/100mg Vyxeos®

FOR ALL PRESCRIBING - NICE Compliance form required via Blueteq


Prescribing by the Haematology team for the treatment of untreated acute myeloid leukaemia in accordance with NICE TA 552.

13.02.01 Liquid Paraffin/White Soft Paraffin Ointment (50:50) 
A2.04.01.02 Liquigen 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

04.05.01 Liraglutide 6mg/1mL Saxenda®

Prescribing by a specialist multidisciplinary Tier 3 weight management service, for management of overweight and obesity in accordance with NICE TA 664.

06.01.02.03 Liraglutide 6mg/mL Victoza®

Treatment of adults with type 2 diabetes in accordance with NICE  NG 28 and 109FM GLP-1 agonists for adults with type 2 diabetes guideline.


Liraglutide 1.8mg daily is 1st choice for type 2 diabetes with ASCVD.


Liraglutide 1.2mg daily is 3rd choice GLP-1 agonist for type 2 diabetes without athersclerotic cardiovascular disease (ASCVD). 


Initiation by Diabetes consultants or Diabetes Specialist Nurses (DSN)s or by primary care health professionals who have received training and are operating under the direct award for insulin. Not to be used for weight management in non-diabetics.

04.04 Lisdexamfetamine Mesilate 20mg, 30mg, 40mg, 50mg, 60mg, 70mg Elvanse®, Elvanse Adult®

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).

02.05.05.01 Lisinopril 2.5mg, 5mg, 10mg, 20mg 
04.02.03 Lithium Carbonate 200mg, 400mg Priadel®

Indications:

• The acute treatment of mania (see Lithium for Use in Psychiatric Services - Shared Care Protocol BHTCG 793FM).
• Prophylaxis in bipolar disorder (see Lithium for Use in Psychiatric Services - Shared Care Protocol (BHTCG 793FM).
• To augment antidepressants in treatment refractory recurrent depression (see Depression in Adults and Older Adults guideline BHTCG 573FM and Antidepressant treatment algorithm BHT 572FM).
• The control of aggressive behaviour or intentional self-harm.

04.02.03 Lithium Carbonate 250mg Camcolit 250®

Use in accordance with Lithium for use in Psychiatric services shared care protocol (BHTCG 793FM)

04.02.03 Lithium Carbonate 400mg Camcolit 400®

Indications:

• The acute treatment of mania (see Lithium for Use in Psychiatric Services - Shared Care Protocol BHTCG 793FM).
• Prophylaxis in bipolar disorder (see Lithium for Use in Psychiatric Services - Shared Care Protocol (BHTCG 793FM).
• To augment antidepressants in treatment refractory recurrent depression (see Depression in Adults and Older Adults guideline BHTCG 573FM and Antidepressant treatment algorithm BHT 572FM).
• The control of aggressive behaviour or intentional self-harm.

04.02.03 Lithium Carbonate 450mg Liskonum®

Indications:

• The acute treatment of mania (see Lithium for Use in Psychiatric Services - Shared Care Protocol BHTCG 793FM).
• Prophylaxis in bipolar disorder (see Lithium for Use in Psychiatric Services - Shared Care Protocol (BHTCG 793FM).
• To augment antidepressants in treatment refractory recurrent depression (see Depression in Adults and Older Adults guideline BHTCG 573FM and Antidepressant treatment algorithm BHT 572FM).
• The control of aggressive behaviour or intentional self-harm.

02.14 Lithium Chloride 0.15mmol/1mL  Restricted - for use in ITU for monitoring cardiac output.
04.02.03 Lithium Citrate 509mg (5.4mmol)/5mL Li-Liquid®

IMPORTANT NOTE: Lithium citrate (Li-Liquid) 509mg is equivalent to lithium carbonate 200mg

Indications:

• The acute treatment of mania (see Lithium for Use in Psychiatric Services - Shared Care Protocol BHTCG 793FM).
• Prophylaxis in bipolar disorder (see Lithium for Use in Psychiatric Services - Shared Care Protocol (BHTCG 793FM).
• To augment antidepressants in treatment refractory recurrent depression (see Depression in Adults and Older Adults guideline BHTCG 573FM and Antidepressant treatment algorithm BHT 572FM).
• The control of aggressive behaviour or intentional self-harm.

04.02.03 Lithium Citrate 520mg (5.4mmol)/5mL Priadel®

Use in accordance with Lithium for use in Psychiatric services shared care protocol (BHTCG 793FM)

11.04.02 Lodoxamide 0.1% 
04.03.01 Lofepramine 70mg 

Amber Recommentation For treatment of depression in accordance with Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM). Prescribing on specialist recommendation. 

Green Traffic Light For treatment of neuropathic pain in accordance with Neuropathic pain management in adults guideline (BHTCG 714FM).

04.03.01 Lofepramine 70mg/5mL 

Amber Recommentation For treatment of depression in accordance with Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM). Prescribing on specialist recommendation.

Green Traffic Light For treatment of neuropathic pain in accordance with Neuropathic pain management in adults guideline (BHTCG 714FM).

04.10.03 Lofexidine Hydrochloride 200micrograms  Restricted - to initiation by CAMS team only
08.01.01 Lomustine 40mg 
01.04.02 Loperamide Hydrochloride 1mg/5mL 
01.04.02 Loperamide Hydrochloride 2mg 
05.03.01 Lopinavir / Ritonavir 400mg/100mg Kaletra® Restricted for BHT HIV MDT
05.03.01 Lopinavir /Ritonavir 100mg/25mg, 200mg/50mg Kaletra® Restricted for BHT HIV MDT
03.04.01 Loratadine 10mg  In primary care available to purchase over the counter
03.04.01 Loratadine 5mg/5mL  In primary care available to purchase over the counter
04.01.02 Lorazepam 1mg, 2.5mg 
04.02.03 Lorazepam 1mg, 2.5mg  For use in acute mania on the advice of the Oxford Health psychiarist / PIRLS team.

04.01.02 Lorazepam 4mg/1mL 
04.02.03 Lorazepam 4mg/1mL  For use in acute mania on the advice of the  Oxford Health psychiarist / PIRLS team.

08.01.05 Lorlatinib 25mg, 100mg 

FOR ALL PRESCRIBING: NICE compliance form required via Blueteq.


Prescribing by the Oncology team
• Lorlatinib for previously treated ALK-positive advanced non-small-cell lung cancer in accordance with NICE TA 628.


NICE TA 628: Lorlatinib for previously treated ALK-positive advanced non-small-cell lung cancer

02.05.05.02 Losartan Potassium 12.5mg, 25mg, 50mg, 100mg  Restricted - to CONTINUATION in patients with diabetic nephropathy until reviewed for switching to irbesartan. Patients should be INITIATED on irbesartan which has a larger evidence base in early and late diabetic nephropathy.
03.01.05 Low Range Peak Flow Meter Mini-Wright®
04.02.01 Lurasidone Hydrochloride 18.5mg, 37mg, 74mg  Restricted - prescribing by Consultant Psychiatrists only for:
1. Patients with schizophrenia who cannot tolerate, or have contraindications to, commonly prescribed antipsychotics or aripiprazole.
2. Bipolar depression (OFF-LABEL use) . This needs to be approved by the Oxford Health team as per Oxford Health formulary requirements.
09.01.04 Lusutrombopag 3mg Mulpleo®<

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.


Prescribing by the Haematology team  for treatment of thrombocytopenia in people with chronic liver disease needing a planned invasive procedure in accordance with NICE TA 617 


Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure NICE TA 617

08.01.05 Lutetium (177Lu) oxodotreotide Lutathera®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required.


Restricted - prescribing by Oxofrd University Hospital (OUH) Consultant Oncologists. For the treatment of unresectable or metastatic neuroendocrine tumours.

05.01.03 Lymecycline 408mg (equivalent tetracycline300mg ) Tetralysal 300®
19.24.01 Lyofoam ® Tracheostomy  9cm x 6cm
19.10 Lyofoam®  15cm x 20cm

Restricted - for dressing of hypospadias operations

BNF A5.2.5
In secondary care obtain from Pharmacy
02.05.01 Macitentan 10mg 

Restricted - prescribing by Respiratory consultants only after initiation in a Specialist Centre. May be continued in BHT via shared care between Specialist Centre and BHT via a network model.

For pulmonary arterial hypertension in accordance with NHSE Specialised Commissioning Policy A11/P/b, June 2014: National policy for targeted therapies for the treatment of pulmonary hypertension in adults.

The name of the Specialist Centre and consultant initiating drug to be communicated to Pharmacy Formulary Team prior to prescribing.


01.06.04 Macrogol Oral Powder (Paediatric) 

NOTE: Do not confuse with Moviprep® (section 1.6.5)

01.06.04 Macrogol Oral Powder, Compound  NOTE: Do not confuse with Moviprep® (section 1.6.5)
01.06.05 Macrogols  Klean-Prep® Restricted - prescribing by Paediatric team for paediatrics with bowel obstruction.
01.06.05 Macrogols Moviprep®

NOTE: Do not confuse with Movicol Paediatric Plain® or Macrogol Oral Powder, compound, sachets (section 1.6.4)


For second line use as an alternative to Plenvu® prior to colonoscopy and flexible sigmoidoscopy.

01.06.05 Macrogols Plenvu®

For first line use as an alternative to Moviprep® prior to colonoscopy and flexible sigmoidoscopy.

18 Macrogols *** Moviprep®

NOTE: Do not confuse with Movicol Paediatric Plain® or Macrogol Oral Powder, compound, sachets (section 1.6.4)

For second line use as an alternative to Plenvu® prior to colonoscopy and flexible sigmoidoscopy.

01.06.05 Magnesium citrate Citramag® Restricted - prescribing by Renal physicians and Gastroenterologists for use in patients with chronic kidney disease (Grade 5 on haemodialysis) prior to endoscopy/colonoscopy when recommended by renal team.
01.06.05 Magnesium Citrate with Sodium Picosulfate 10mg/sachet (Picolax) 
09.05.01.03 Magnesium Glycerophosphate Mg2+ 1mmol/mL unlicensedUnlicensed - Low Risk.
YourMag® brand preferred
Restricted - to initiation in secondary care with continuation by GPs and to be used as per the restrictions for Magnesium glycerophosphate tablets, when use of the tablets is not practical.

Contains approximately: Mg2+ 24.25 mg/mL (1mmol/mL)

In primary care this is a pharmaceutical special
09.05.01.03 Magnesium Glycerophosphate  Mg2+ 4mmol

Initiation in secondary care with continuation by GPs. 


Maglyphos® brand (unlicensed Unlicensed - Low Risk) for patients requiring <4mmol magnesium and PEG/NG tube administration. 

Neomag® brand (licensed) to be used for all other patients. Each Neomag® chewable tablet contains Mg2+ 4mmol or magnesium 97mg.

01.06.04 Magnesium Hydroxide Mixture BP 415mg/5mL 
09.05.01.03 Magnesium L Aspartate Mg2+ 243mg (10mmol)

Restricted - In accordance with the refeeding guideline, in patients with a short gut, or for treatment of post chemotherapy induced Mg loss in children. Named Patient. An alternative to Magnesium glycerophosphate tablets in young children who cannot swallow large tablets.

Contains: Mg2+ 243mg (10mmol) and 2.706g sucrose per sachet

09.05.01.03 Magnesium Sulphate 50% (1g/2mL, 5g/10mL)  Mg2+ approx. 2mmol/mL
09.05.01.03 Magnesium Sulphate 50% (5g/10mL)  Mg2+ approx. 2mmol/mL
Restricted -for cardiac arrest trolleys
13.10.05 Magnesium Sulphate Paste BP 
01.01.01 Magnesium Trisilicate Mixture BP 
13.10.04 Malathion 0.5% in an aqueous basis Derbac-M® In primary care may be purchased over the counter
02.02.05 Mannitol 10%, 20% 
11.06 Mannitol 20%  see Section 02.02.05
03.07 Mannitol 40mg Bronchitol ® FOR ALL PRESCRIBING - NICE compliance to be verified.

Restricted - to prescribing by Respiratory consultants in accordance with NICE TA 266.
NOTE: Unlikely to be used in BHT as all adult CF patients are treated in Oxford or London.
05.03.01 Maraviroc 150mg, 300mg  Restricted for BHT HIV MDT after CCR-5 tropic testing
19.24.02 Matriderm®  52mm x 74mm x 1mm
105mm x 148mm x 1mm
210mm x 297mm x 1mm
210mm x 297mm x 2mm

Restricted - Burns and Plastics Consultant only prescribing

In secondary care obtain from Pharmacy
14.04 Measles, Mumps and Rubella (MMR) Vaccine  In primary care only as recommended in routine UK immunisation schedule
05.05.01 Mebendazole 100mg  In secondary care restricted - Microbiology approval required
05.05.01 Mebendazole 100mg/5mL  In secondary care restricted - Microbiology approval required
01.02 Mebeverine Hydrochloride 135mg 
19.19.01 Medi Derma-PRO® Skin Protectant ointment  

115g tube.

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.2.1
In secondary care obtain from Supplies

19.19.01 Medi Derma-S®  2g sachet barrier cream
28g, 90g tube barrier cream

All above, except 90g tube, available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

Apply sparingly. For each buttock, only a pea-sized quantity required.

In secondary care obtain from Supplies
19.19.02 Medi Derma-S®   1mL, 3mL foam applicator (sterile)
30mL non-sting pump spray

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

In secondary care obtain from Supplies
19.04.02 Medihoney® Antibacterial Wound Gel  Both available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

A5.3.1
In secondary care obtain from Pharmacy
06.01.06 Medisense Control®   Only for use within secondary care for blood glucose and ketone testing
08.03.02 Medroxyprogesterone Acetate 100mg, 400mg 
07.03.02.02 Medroxyprogesterone acetate 104mg in 0.65mL  Sayana Press®

As an alternative to IM medroxyprogesterone acetate injection for patients who wish to self administer (following training).

See video training links below for further information.


*Currently out of stock until at least the end of 2019.

07.03.02.02 Medroxyprogesterone Acetate 150mg/1mL Depo-Provera®
08.03.02 Medroxyprogesterone Acetate 500mg/2.5mL 
06.04.01.02 Medroxyprogesterone Acetate 5mg, 10mg 
10.01.01 Mefenamic Acid 250mg  Restricted - for treatment of menorrhagia/dysmenorrhoea -initiated by Obs/Gynae
10.01.01 Mefenamic Acid 500mg  Restricted - for treatment of menorrhagia/dysmenorrhoea initiated by Obs/Gynae
19.20.01 Mefix®  2.5cm x 5m (310276)
5cm x 5m (310576)

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.7.3
In secondary care obtain from Supplies
19.20.01 Mefix®  10cm wide
15cm wide

Restricted - for use in secondary care only

BNF A5.7.3
In secondary care obtain from Supplies
05.04.01 Mefloquine 250mg Lariam® In secondary care restricted - for use by Haematology and Microbiology.

In primary care malaria prophylaxis should be on private Rx
08.03.02 Megestrol Acetate 160mg 
04.01.01 Melatonin 1mg in1mL Kidmel® and Martindale

unlicensedUnlicensed - Low Risk.

Kidmel® and Martindale brands of melatonin liquid contain no excipients.


Red Traffic Light Restricted - prescribing by Paediatrics team only for Pre-EEG sedation or for hospital sleep disorder in paediatric patients receiving medicines via nasogastric tube.

 

Amber Protocol Restricted - initiation by Consultant Paediatricians or Child Mental Health Specialists with continuation by GPs, for the treatment of sleep disorders in children and young people, in accordance with Melatonin for sleep disorders in children and adolescents (up to 18 years) with neurodevelopmental disorders shared care protocol (BHTCG 608FM).

  • To be reserved for patients with severe oral sensitivity associated with ASD who cannot manage use of crushed, dissolved melatonin IR 3mg Syncrodin® tablets. 
04.01.01 Melatonin 2mg Circadin®

Initiation by Consultant Paediatricians or Child Mental Health Specialists with continuation by GPs, for the treatment of sleep disorders in children and young people, in accordance with Melatonin for sleep disorders in children and adolescents (up to 18 years) with neurodevelopmental disorders shared care protocol (BHTCG 608FM). 

Please note: Melatonin MR tablets can be halved (retaining modified release properties) or crushed (producing immediate release properties) and mixed with food or liquids.

04.01.01 Melatonin 3mg Syncrodin®

Red Traffic Light Restricted - prescribing by Paediatrics team only for Pre-EEG sedation.

 

Amber Protocol Restricted - -initiation by Consultant Paediatricians or Child Mental Health Specialists with continuation by GPs, for the treatment of sleep disorders in children and young people, in accordance with Melatonin for sleep disorders in children and adolescents (up to 18 years) with neurodevelopmental disorders shared care protocol (BHTCG 608FM). 

  • To be used when an immediate release formulation is required instead of crushing melatonin 2mg mr Circadin®.    
08.01.01 Melphalan 2mg 
08.01.01 Melphalan 50mg 
04.11 Memantine Hydrochloride 10mg, 20mg 

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217 - Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and in accordance with Alzheimer's Disease shared care protocol (BHTCG 786FM)

04.11 Memantine Hydrochloride 5mg per actuation, 10mg/mL 

Restricted - for patients who cannot swallow ordinary tablets AND
Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217 - Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and in accordance with Alzheimer's Disease shared care protocol (BHTCG 786FM)

09.06.06 Menadiol Sodium Phosphate equivalent to 10mg menadiol phosphate)  For ORAL treatment of elevated INR phytomenadione injection 2mg/0.2mL (Konakion MM Paediatric) should be prescribed and administered via the ORAL route.

Restricted - to be initiated in secondary care with continuation by GPs.
In primary care this product is used in CF, in patients where deficiency of vitamin K is established.
14.04 Meningococcal group B vaccine  To be used in accordance with the recommendations in the immunisation schedule.
14.04 Meningococcal group C conjugate vaccine  Brand available depends on supplier

In primary care only as recommended in routine UK immunisation schedule. Brands in use NeisVac-C & Menjugate.
14.04 Meningococcal polysaccharide A, C, W135 and Y vaccine(ACWY Vax)  In secondary care restricted - Occupational Health & around splenectomy

In primary care - only as recommended in routine UK immunisation schedule. Private prescription if holiday travel.
13.03 Menthol 1% in Aqueous cream 
05.04.04 Mepacrine Hydrochloride 100mg  unlicensedUnlicensed
19.15 Mepiform®   5cm x 7cm (293250)
9cm x 18cm (293450)
4cm x 31cm (293150)

Restricted to use by Burns and when requested by Tissue Viability

BNF A5.4.2
In secondary care obtain from Pharmacy
19.10.04 Mepilex® Border   NOTE: Biatain Silicone is an appropriate alternative.

7cm x 7.5cm (295260)
10cm x 12.5cm (295360)
15cm x 17.5cm (295460)
17cm x 20cm (295660)
Restricted - may only be prescribed for use by Burns, Plastics and Spinal wards.

BNF A5.2.3
In secondary care obtain from Pharmacy
19.10.04 Mepilex® Transfer   7.5cm x 8.5cm (329-5755)
10cm x 12cm (329-5748)
15cm x 20cm (292-4157)

Restricted - for use on fungating wounds only on the advice of woundcare specialist.

BNF A5.2.3
In secondary care obtain from Pharmacy
19.04.01.01 Mepilex® Ag Molnlycke

10cm x 10cm (5 per box)
10cm x 20cm (5 per box)
15cm x 15cm (5 per box)
20cm x 20cm (5 per box)
20cm x 50cm (5 per box)

In secondary care restricted to Burns and Plastics or on Tissue Viability recommendation only.

In primary care restricted to as recommended by Tissue Viability nurse, and where suitable to continue after hospital initiation.

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).

In secondary care obtain from Pharmacy.

19.04.01.01 Mepilex® Border Ag Molnlycke

7cm x 7.5cm (5 per box)
10cm x 12.5cm (5 per box)

In secondary care restricted to Burns and Plastics or on Tissue Viability recommendation only.

In primary care restricted to as recommended by Tissue Viability nurse, and where suitable to continue after hospital initiation.

Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS).


In secondary care obtain from Pharmacy.

19.08 Mepitel® 

2nd choice to Mepitel One


5cm x 7cm (290500)
8cm x 10cm (290700)
12cm x 15cm (291000)
20cm x32cm (292030)

In secondary care restricted to Paediatrics, Spinal Outpatients, Dermatology, Burns, Plastics and ICU/HDU and when requested by Tissue Viability.

In primary care restricted to specialist recommended (usually tissue viability)

BNF A5.2.3
In secondary care obtain from Pharmacy

19.08 Mepitel® One  

6cm x 7cm (289170)
9cm x 10cm (289270)
13cm x 15cm (289470)
24cm x 27.5cm (289670)

In secondary care restricted to Paediatrics, Spinal, Dermatology, Burns, Plastics and ICU/HDU and when requested by Tissue Viability.

In primary care restricted to specialist recommended (usually tissue viability)

BNF A5.2.3
In secondary care obtain from Pharmacy.

15.02 Mepivacaine Hydrochloride 3% Scandonest Plain®
03.04.02 Mepolizumab 100mg 

Restricted- prescribing by Consultant Respiratory Physicians after initiation by a specialist centre.

For treatment continuation of severe refractory eosinophilic asthma in adults in accordance with NICE TA 671, after initiation by specialist centre.

BHT Respiratory consultants may prescribe as outreach to the Specialist Centre delivered as part of a provider network. Name of Specialist centre and clinician involved in MDT to be communicated to Formulary Team prior to prescribing at BHT.

19.01.01 Mepore®  7cm x 8cm
10cm x 11cm
11cm x 15cm
All sizes - Available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.1.2
In secondary care obtain from Supplies
13.03 Mepyramine Anthisan® In secondary care restricted for management of extravasation with Taxenes only

In primary care, available to purchase over the counter
01.05.03 Mercaptopurine 

50mg tablet


100mg/5mL suspension


unlicensed unlicensed - high risk - 10mg tablet, 50mg/mL suspension


For use in accordance with Mercaptopurine for use in Gastroenterology shared care protocol (BHTCG 115FM)

08.01.03 Mercaptopurine 100mg/5mL 

Unlicensed preparation
For use in accordance with Mercaptopurine for use in Gastroenterology shared care protocol (BHTCG 115FM)


Red Use in Oncology



Amber Use in Gastroenterology

08.01.03 Mercaptopurine 10mg 

Red - Use in Oncology


Unlicensed - High Risk
Restricted - available on named patient basis only

08.01.03 Mercaptopurine 50mg 

For use in accordance with Mercaptopurine for use in Gastroenterology shared care protocol (BHTCG 115FM)


Note: Mercaptopurine 50mg tablets are scored and may be halved.


 


Red Use in Oncology


Amber Use in Gastroenterology (see chapter 01.05.03)

08.01.03 Mercaptopurine 50mg/5mL 

Unlicensed - High Risk


Use in Oncology

05.01.02.02 Meropenem 500mg, 1g 
01.05.01 Mesalazine 1.2g Mezavant® XL Restricted - Initiation by Consultant Gastroenterologists for induction and maintenance of remission, in NEW patients with mild to moderate active ulcerative colitis, when compliance is an issue.
01.05.01 Mesalazine 1g/100mL Pentasa®
01.05.01 Mesalazine 1g/metered application Asacol®
01.05.01 Mesalazine 250mg, 500mg 
01.05.01 Mesalazine 400mg, 800mg  1st Choice - Octasa MR®. (bioequivalent to Asacol MR®)
Octasa MR® to be prescribed 1st line instead of Asacol MR®.
If a patient is stabilised on Asacol MR® and prescriber does not wish the Asacol MR® brand to be changed, the Asacol MR® brand should be specified on the prescription.
01.05.01 Mesalazine 500mg Pentasa®
18 Mesna 1000mg/10mL ***  Cyclophosphamide toxicity
18 Mesna 400mg***  Cyclophosphamide toxicity
08.01 Mesna 400mg, 600mg 
08.01 Mesna 400mg/4mL, 1000mg/10mL 
19.01.01 Mesorb®   10cm x 10cm
10cm x 15cm
10cm x 20cm
15cm x 20cm
25cm x 20cm
20cm x 30cm
Restricted - for use in Primary Care only
All sizes available in primary care as stock through the On-line Non-Prescription Ordering System (ONPOS)

BNF A5.1.2
In secondary care obtain from Supplies
07.03.01 Mestranol 50micrograms with Norethisterone 1mg Norinyl-1®
13.02.02 Metanium® 
02.07.02 Metaraminol 2.5mg/1mL 

WARNING: Take extra care when prescribing and administering and note the strength is 2.5mg in 1mL.

06.01.02.02 Metformin Hydrochloride 500mg  Restricted - in accordance with NICE CG 66 -Type 2 Diabetes which recommends MR tablet for second line use after titration with metformin fails.
06.01.02.02 Metformin Hydrochloride 500mg, 850mg  See separate entry and restrictions when using to control weight gain in Oxfordshire Health paediatric patients receiving antipsychotic therapy.

1. For use in accordance with Type 2 Diabetes; blood-glucose-lowering therapy - Primary/Secondary Care guideline (BHTCG 667FM) (see link above)
2. Treatment of women with polycystic ovary syndrome (PCOS) as second line to hormonal contraceptives. Hormonal contraceptive first line choice is generally a combined oral contraceptive (not co-cyprindiol)
06.01.02.02 Metformin Hydrochloride 500mg/5mL  Restricted - to patients who cannot swallow metformin hydrochloride tablets.

06.01.02.02 Metformin Hydrochloride 850mg  Unlicensed Use

Restricted - prescribing and management by Oxfordshire Health only when used to control weight gain in paediatrics caused by antipsychotic therapy.
16.01 Methacholine Chloride 32mg/1mL  unlicensedunlicensed - Medium Risk
Bronchial provocation testing - Restricted to Respiratory Lab only. To be used in accordance with BHT SOP for Methacholine Challenge Testing
04.07.02 Methadone Hydrochloride 10mg/1mL 
04.10.03 Methadone Hydrochloride 1mg/1mL  Restricted for continuation of patients already on Methadone as part of their drug withdrawal scheme. For new patients refer to One Recovery Bucks. This strength is only to be prescribed for addicts.
04.07.02 Methadone Hydrochloride 5mg  In secondary care restricted - to initiation by specialist only with continuation by GPs.

Daily prescriptions recommended.
04.07.02 Methadone Oral Solution and Oral Concentrate  for preparations see 04.10.03
05.01.13 Methenamine Hippurate 1g  Third line antibiotics for prophylaxis of urinary tract infection as per Management of Infection Guidance - Primary Care guideline (updated guideline awaited).
Methenamine should be taken for 6 months then reviewed (with recurrence/ need).
10.02.02 Methocarbamol 750mg 

Prescribing on the recommendation of secondary care specialists with continuation by GPs.

01.05.03 Methotrexate  for preparations see section 10.01.03
08.01.03 Methotrexate 10mg/5mL, 15mg/5mL  Restricted - prescribing by consultants in secondary care only (cancer use)

Also see Section 10.01.03 (Rheumatology)

In primary care this is a pharmaceutical special
10.01.03 Methotrexate 2.5mg 

When prescribed by Rheumatology in accordance with Methotrexate for use in Rheumatology, Dermatology, Gastroenterology and Respiratory Medicine Shared Care protocol (BHTCG 794FM)

08.01.03 Methotrexate 50mg/2mL 
10.01.03 Methotrexate 50mg/mL (7.5mg, 10mg, 12.5mg, 15mg, 17.5mg, 20mg, 22.5mg, 25mg, 27.5mg, 30mg doses) Metoject® PEN

Restricted - prescribing by Consultant Rheumatologists and Dermatologists only, in accordance with Methotrexate for use in Rheumatology, Dermatology, Gastroenterology and Respiratory Medicine Shared Care protocol (BHTCG 794FM) for patients on oral methotrexate, with severe GI side effects despite regular folic acid (5mg, 6 days a week) or non-responders to oral therapy after an 8-12 week trial, in order to improve bioavailability.

08.01.03 Methotrexate 5mg/2mL,  
13.05.02 Methoxypsoralen  unlicensedunlicensed
13.05.02 Methoxypsoralen (puvapsoralen) 1.12%  unlicensedunlicensed - High Risk
01.06.01 Methycellulose '450', 500mg Celevac®
13.08.01 Methyl-5-aminolevulinate  Metvix® Restricted - for use by Dermatology team only.

Used as part of photodynamic therapy. Imported.
02.05.02 Methyldopa 125mg, 250mg, 500mg 
01.06.06 Methylnaltrexone Bromide 12mg/0.6mL Relistor® Restricted - Florence Nightingale Hospice prescribers only. For treatment of opioid induced constipation in advanced illness adult patients who are receiving palliative care, when response to usual laxative therapy has not been sufficient. Part of a Thames Valley wide assessment audit to look at the tolerability and effectiveness of this new drug in the hospice setting. The proposal is to use this after normal laxatives have been maximised for resistant cases.
04.04 Methylphenidate 5mg/5mL 

Unlicensed Unlicensed special

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).

Restricted for use in patients who require an immediate release formulation but cannot swallow tablets.

04.04 Methylphenidate Hydrochloride 10mg, 20mg, 30mg Equasym®XL

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).

Equasym®XL (IR:XL release profile = 30:70; duration of action up to 8 hours)

04.04 Methylphenidate Hydrochloride 18mg, 27mg, 36mg, 54mg Delmosart®, Concerta® XL, Xaggitin® XL

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol  (BHTCG 809FM) and ADHD in Adults Shared Care Protocol  (BHTCG 796FM).

Xaggitin®XL, Delmosart®, Concerta®XL (Concerta IR:XL release profile = 22:78; duration of action up to 12 hours).

Xaggitin XL and Delmosart are Oxford Health’s formulary choice when a 12-hour duration of action is required. Both are bioequivalent to Concerta XL®. Xaggitin XL is the most cost-effective preparation.

Concerta XL should only be prescribed in exceptional cases where:

  • Xaggitin XL or Delmosart have been deemed to be unsuitable. This includes patients who have switched from a stable dose of Concerta XL and experienced a clear change in symptom control
  • There are supply issues with both Xaggitin XL and Delmosart.
04.04 Methylphenidate Hydrochloride 5mg, 10mg, 20mg 

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).

04.04 Methylphenidate Hydrochloride 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, 60mg Medikinet®XL

Restricted - initiation by Consultant Paediatricians or Child or Adult Mental Health Specialists with continuation by GPs, for the treatment of neurodevelopmental disorders in accordance with ADHD in children and adolescents (6 to <18 years old) Shared Care Protocol (BHTCG 809FM) and ADHD in Adults Shared Care Protocol (BHTCG 796FM).

Medikinet®XL (IR:XL release profile = 50:50; duration of action at least 7 hours)

06.03.02 Methylprednisolone 100mg  In secondary care restricted - 100mg tablets prescribing restricted to Consultant Neurologists only.
06.03.02 Methylprednisolone 40mg, 125mg, 500mg, 1g Solu-Medrone®




NOTE: Methylprednisolone sodium succinate 53.0 mg equivalent to 40 mg of methylprednisolone.
06.03.02 Methylprednisolone Acetate 40mg/1mL, 80mg/2mL Depo-Medrone®
10.01.02.02 Methylprednisolone Acetate 40mg/1mL, 80mg/2mL Depo-Medrone®
10.01.02.02 Methylprednisolone Acetate/Lidocaine Hydrochloride 40mg/10mg in 1mL Depo-Medrone with Lidocaine®
18 Methylthioninium Chloride (Methylene Blue) 0.5%  Methaemoglobinaemia

04.07.04.02 Methysergide 1mg  In secondary care restricted - consultant only prescribing for refractory patients only
04.06 Metoclopramide Hydrochloride 10mg 
04.06 Metoclopramide Hydrochloride 10mg/2mL 
04.06 Metoclopramide Hydrochloride 5mg/5mL 
02.02.01 Metolazone 2.5mg, 5mg 

unlicensedunlicensed - low risk
Restricted - prescribing by Consultants in secondary care only.

02.04 Metoprolol Tartrate 50mg 
02.04 Metoprolol Tartrate 5mg/5mL 
05.04.02 Metronidazole  see section 05.01.11
07.02.02 Metronidazole 0.75%  In primary care only recommended when other choices not suitable
13.10.01.02 Metronidazole 0.75% 

Use in preference to metronidazole 0.75% gel as more cost effective.

13.10.01.02 Metronidazole 0.75% 

Use only if metronidazole cream is not available.


Metronidazole 0.75% cream is more cost effective.

05.01.11 Metronidazole 200mg, 400mg 
05.01.11 Metronidazole 200mg/5mL 
05.01.11 Metronidazole 500mg, 1g 
05.01.11 Metronidazole 500mg/100mL 
06.07.03 Metyrapone 250mg  In secondary care restricted - Phone Pharmacy to Order
10.02 Mexiletine 167mg  Namuscla®

 


FOR ALL PRESCRIBING - a completed and approved NICE compliance form, via BLUETEQ, is required.


Initiation by Specialist Neuroscience Centres with continuation by BHT via MDT shared care arrangements for treatment of non-dystrophic myotonic distrophic myotonic disorders.


 

02.03.02 Mexiletine 50mg 

Unlicensed unlicensed

Restricted - initiation in secondary care with continuation by GPs.  For treatment of ventricular arrthythmias.  

12.03.02 Miconazole 24mg/mL (20mg/g) Daktarin® Restricted - Paediatrics and Obstetrics & Gynaecology
13.10.02 Miconazole Nitrate 0.16% in an aerosol basis Daktarin® In secondary care restricted - Paediatrics and Obstetrics & Gynaecology
07.02.02 Miconazole Nitrate 1.2g Gyno-Daktarin 1®
07.02.02 Miconazole Nitrate 2%  In secondary care restricted - use by Paediatrics and Obstetrics & Gynaecology.
13.10.02 Miconazole Nitrate 2%  In secondary care restricted - Paediatrics and Obstetrics & Gynaecology
06.01.01.03 Microdot Dual 

1st Choice
For use in patients who require insulin or GLP1 analogue administration by a trained healthcare professional from a pen device.

06.04.01.02 Micronised progesterone 100mg, 200mg Utrogestan®

Green: 2nd line progesterone if 1st line Levonorgestrel Mirena® IUS is unsuitable. To be used as an adjunct to oestrogen in women with an intact uterus as HRT for management of oestrogen deficiency symptoms in peri and post-menopausal women.


Amber initiation: when used in accordance with Management of Premature Ovarian Insufficiency guideline (BHTCG 422FM).

19.20.01 Micropore®  2.5cm x 5m
5cm x 5m

BNF A5.7.3
In secondary care obtain from Supplies
19.20.01 Micropore® Tan  2.5cm x 9.1m
Restricted - for use on facial wounds only


BNF A5.7.3
In secondary care obtain from Supplies
15.01.04.01 Midazolam 10mg/2mL  In secondary care restricted - use of all 5mg/mL and 2mg/mL strengths is restricted to anaesthesia, intensive care sedation, palliative care and in clinical areas/situations where its use has been formally risk assessed.

In primary care restricted - only to be used in syringe drivers.
15.01.04.01 Midazolam 10mg/5mL  Restricted - use of all 5mg/mL and 2mg/mL strengths is restricted to anaesthesia and intensive care sedation and in clinical areas/situations where its use has been formally risk assessed.
15.01.04.01 Midazolam 2.5mg/0.5mL Buccolam® Restricted - prescribing only in accordance with Guidelines for the sedation of children undergoing MRI or CT scan (BHTCG 343)
04.08.02 Midazolam 2.5mg/0.5mL, 5mg/1mL, 7.5mg/1.5mL, 10mg/2mL  Buccolam® Restricted - prescribing only in accordance with Status epilepticus algorithm and Buccal midazolam treatment algorithm (BHTCG 384FM), AND
Adults: initiation by Consultant Neurologists only and,
Children: initiation by Consultant Paediatricians and Neurologists, teams from National Society for Epilepsy Centre and Ridgeway Partnership (for learning disabiltiy).
15.01.04.01 Midazolam 2.5mg/5mL 

Restricted to theatres with anaesthetic support and full resuscitation capabilitites for use in sedation of learning disability dental patients.

15.01.04.01 Midazolam 2mg/2mL, 5mg/5mL 
15.01.04.01 Midazolam 50mg/50mL  For ICU / HDU use 50mg/50mL vial
02.07.02 Midodrine 2.5mg, 5mg 

Restricted - Initiation by hospital consultants with continuation by GPs in accordance with amber initiation guideline (BHTCG 808FM) for use when all other corrective factors have failed and other treatment is ineffective or not tolerated
1. Initiation by consultant neurologists and spinal for the treatment of orthostatic hypotension due to autonomic dysfunction
2. Initiation by appropriate consultant e.g. cardiologists for unprovoked vasovagal syncope (where no reversible cause can be found)

08.01.05 Midostaurin 25mg Rydapt®

FOR ALL PRESCRIBING - a completed and approved HIGH COST DRUG compliance form, via BLUETEQ, is required. 


Restricted to prescribing by Haematologists only for untreated acute myseloid leukaemia in accordance with NICE TA 523.

07.01.02 Mifepristone 200mg  Restricted to Family Planning (Dr Curtis) or SMH Obs & Gynae Consultants only. Refer to hospital Pharmacy for specific supply details and records to be kept
02.01.02 Milrinone 10mg/10mL > Restricted - for ITU use only
05.01.03 Minocycline 100mg  Green Traffic Light  For the treatment of acne

Amber Traffic Light  Restricted - for treatment of dermatological conditions OTHER than acne in accordance with minocycline amber initiation guideline.

For all other uses - Microbiology approval required
05.01.03 Minocycline 50mg, 100mg   Green Traffic Light  For the treatment of acne

Amber Traffic Light  Restricted - for treatment of dermatological conditions OTHER than acne in accordance with minocycline AMBER initiation guideline

For all other uses - Microbiology approval required
02.05.01 Minoxidil 5mg  Use as 4th choice after Diazoxide, Hydralazine and Sodium Nitroprusside.
07.04.02 Mirabegron 25mg, 50mg 

SECOND CHOICE option for treatment of overactive bladder when solifenacin or trospium are deemed unsuitable.


Use in accordance with guideline  110FM Medical management of overactive bladder and 114FM Management of urinary incontinence in adult females (see links above).

04.03.04 Mirtazapine 15mg, 30mg 

See Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

May be used as a first line antidepressant if the sedative effects would be particularly beneficial, or where concomitant medical conditions or concurrent medication make an SSRI less suitable. 

04.03.04 Mirtazapine 15mg, 30mg, 45mg 

See Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

May be used as a first line antidepressant if the sedative effects would be particularly beneficial, or where concomitant medical conditions or concurrent medication make an SSRI less suitable.

04.03.04 Mirtazapine 15mg/1mL 

Cheaper to use orodispersible where this is clinically appropriate. See Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

May be used as a first line antidepressant if the sedative effects would be particularly beneficial, or where concomitant medical conditions or concurrent medication make an SSRI less suitable.

07.01.02 Misoprostol 100micrograms, 200micrograms  unlicensedUnlicensed (100micrograms)
Restricted to patients being treated under Cons. Obstetricians for late foetal death. Please refer to protocol in hospital dispensary. 100microgram tablet to be purchased from IDIS and recorded in unlicensed medicine file.
Unlicensed Use - see protocol 1/5/03
01.03.04 Misoprostol 200micrograms 
11.99.99.99 Mitomycin 200micrograms/1mL (0.02%), 400micrograms/1mL (0.04%)  unlicensedunlicensed - High Risk
In secondary care restricted - Phone Pharmacy to Order, only available at Stoke Mandeville Hospital
08.01.02 Mitomycin 2mg, 10mg, 40mg  Use 40mg strength for bladder instillations
08.01.02 Mitoxantrone 20mg/10mL, 25mg/12.5mL 
15.01.05 Mivacurium 10mg/5mL 
04.03.02 Moclobemide 150mg, 300mg 

Initiation and stabilisation by the Psychiatry team, continuation by GPs, for the treatment of depression in accordance with the Depression in Adults and Older Adults guideline (BHTCG 573FM) and Antidepressant treatment algorithm (BHT 572FM).

04.04 Modafinil 100mg, 200mg 
A2.03.02 Modulen IBD 

** See Buckinghamshire Adult Nutritional Supplement and Tube Feed Formulary at the top of this page for full details **

13.04 Mometasone Furoate  Potency: Potent

In primary care only use if betamethasone valerate not suitable
12.02.01 Mometasone Furoate 50micrograms/metered spray Nasonex® 2nd choice steroid spray

See guideline above
03.03.02 Montelukast 10mg 
03.03.02 Montelukast 4mg  Restricted - only for use in children who cannot manage chewable tablets.
03.03.02 Montelukast 4mg, 5mg 
04.07.02 Morphine Sulfate 10mg, 15mg, 30mg 
04.07.02 Morphine Sulphate 20mg, 30mg, 60mg 

Before prescribing, if patient has swallowing difficulties consider prescribing morphine sulphate (Zomorph®) capsules which can be opened and are more cost effective.

04.07.02 Morphine Sulphate 50mg/50mL 
04.07.02 Morphine Sulphate 100mg/5mL 
04.07.02 Morphine Sulphate 10mg, 20mg, 50mg Sevredol®
04.07.02 Morphine Sulphate 10mg, 30mg, 60mg, 100mg, 200mg Zomorph®