Poole

Treatment of actinic keratosis (AK) of mild to moderate severity on the face and scalp (Olsen grade 1 to 2) and of field cancerization in adults.

Treatment of superficial and/or nodular basal cell carcinoma (BCC) unsuitable for surgical treatment due to possible treatment-related morbidity and/or poor cosmetic outcome in adults.

 Commissioned by NHS England for:

• Juvenile idiopathic arthritis in line with NICE TA373.
• Paediatric indications where an adult NICE TA is available.

 Commissioned by CCG for the treatment of rheumatoid arthritis in line with NICE TA195 and TA375.

Commissioned by CDF in line with NICE TA563 and TA579 and CDF criteria.

For use in accordance with NICE TA259 and TA387 reccomendations.

10cm x 6m only: Seek specialist advice for when to use other widths

Available as a latex free option

 Commissioned by NHS England for non-infectious uveitis in line with NICE TA460 at specialist centres only.

Specialist centres in the South region:

• University Hospital Southampton NHS Foundation Trust
• Oxford University Hospitals NHS Foundation Trust
• University Hospital Bristol NHS Foundation Trust
  
  

Colecalciferol with calcium
Alternative preparations are available subject to patient preference

This is no longer licensed but is available through a patient access programme for oncological and transplant indications.

Refer to the medicines management team for commissioning arrangements.

NHS England commissioned for MS (TA312). Also commissioned by NHS England for CLL and pre-transplant immunosuppression (islet transplantation) only if provided at zero drug cost.

For use in osteoporosis

Binosto^® 70mg effervescent tablets are non-formulary - see below

Alternative option for cow’s milk protein allergy 

NICE CG32 Nutrition support in adults

Should be prescribed only after nutrition screening has taken place using a validated tool e.g. MUST (Malnutrition Universal Screening Tool) 

Restrict use to those patients with increased protein requirement. Use only under direction of dietitian. Not to be used for those with renal insufficiency

Tablets, (Injection - secondary care only).
Hospital initiation.

Not first line with regard to depression, as per the Dorset Primary Care Protocol for Depression (see link above)

Commissioned by NHS England for the treatment of Adult-Onset Still’s Disease refractory to second-line therapy in line with clinical commissioning policy 170056P via specilaist centres only.

Commissioned by NHS England in Cryopyrin Assoicated Periodic Syndrome via specilaist centres only in line with highly specialised criteria.

Restrict to patients in exceptional circumstances, this is a  Self Care Medicine

Solution (= application), aluminium chloride hexahydrate 20% in an alcoholic basis

Anthelios® XL SPF 50+ Melt-in cream is a borderline substance and regarded as a drug when prescribed 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 . Preparations with SPF less than 30 should not normally be prescribed.

Self Care Medicine for primary care

Commissioned by NHS England as per British Committee for Standards in Haemotology (BCSH) Guidelines.

Not recommended as initial treatments to prevent organ rejection in patients having a kidney transplant as per NICE TA481 and TA482.

Ointment, suppositories

On formulary at DCHFT.

Self Care Medicine for primary care.

• In accordance with NICE TA for prevention of VTE in patients undergoing hip or knee replacement surgery, as per licensed indications.
• • Note routine 1st line option at RBCH and DCH is LMWH

• For prevention of stroke or systemic embolism in patients with AF within NICE TA and local guidance, as per licensed indications.
• For the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism in accordance with NICE TA. 

In accordance with NICE guidance.

Prescribe by BRAND

The AproDerm® range is suitable from birth for those suffering from:

Eczema
Psoriasis and
Other Dry Skin Conditions as well as for those requiring a daily moisturiser or pre-bathing emollient

Paraffin free

Self Care Medicine - to be purchased when part of routine skin care in the absence of a moderate to severe skin condition. 

Cream, urea 10%

DCHFT: Not routinely stocked.

Self Care Medicine for primary care.

For treatment of Heparin-Induced Thrombocytopaenia (HIT)in critically unwell patients or those with severe renal impairment on advice of Consultant Haematologist.

Red when used in children with neuro-developmental disorders.

Use in accordance with NICE TA292 in moderate to severe manic episodes in adolescents with bipolar 1 disorder.

Commissioned by NHSE in line NICE TA526 recommendations.

This has been re-categorised as "red" for Scurvy only as per DMAG November 2017. 200mg twice a day is the most cost-effective dose.

Approved as Red at RBCH:

• Acute Corneal conditions 500mg twice a day for 6 week course (Eye Consultant only)
• Palliative Care consultant only: Tongue "descaling" where other options insufficient (1/4 x 1g tablet per dose)

Tablets, suppositories.

• Enteric coated tablets are non-formulary.

• Dual antiplatelet therapy in acute coronary syndrome.

Self Care Medicine for primary care.

Commissioned by CDF in line with CDF criteria and NICE TA492 recommendations.

Commissioned by NHSE in line with NICE TA520 and TA525 recommendations.

Use in combination with bevacizumab, paclitaxel and carboplatin, for the treatment of adult patients with EGFR activating mutations or ALK positive tumour mutations metastatic non-squamous non-small cell lung cancer (NSCLC) after failure of appropriate targeted therapies via MHRA Early Access to Medicines Scheme (EAMS). For eligible patients, clinicians can request an application form for registration with Roche by sending an email to welwyn.atezolizumabEAMS@roche.com. Off-label indication.

Use in combination with nab-paclitaxel for the treatment of adult patients with unresectable locally advanced or metastatic triple-negative breast cancer (TNBC) whose tumours have PD-L1 expression >1% and who have not received prior chemotherapy for metastatic disease via MHRA Early Access to Medicines Scheme (EAMS). For eligible patients, clinicians can request an application form for registration with Roche by sending an email to welwyn.atezolizumabEAMS@roche.com. Off-label indication.

Note (July 2018): The European Medicines Agency restricted the use of atezolizumab for untreated urothelial carcinoma. It should now only be used in adults with high levels of PD-L1. 

Commissioned by NHSE for the treatment of previously treated (with systemic cytotoxic chemotherapy) metastatic Merkel cell carcinoma in line with NICE TA517.

Available via CDF managed access agreement for the treatment of previously untreated (with systemic therapy) metastatic Merkel cell carcinoma - see link below.

Commissioned by NHS England in line with NICE TA333.

Calorie content is based on a sachet being made up with 200ml of full cream milk and contains approx. 385 Kcals.

If patient likes milky drinks, prescribe as a supplement to diet 1-2 servings/day.

Not suitable for patient with cow's milk intolerence or galactosaemia.

Not nutritionally complete.

If patient dislikes milky drinks choose from the juice style supplements instead.

Commissioned by NHS England in line with NICE TA218.

Azacitadine is not recommended for treating acute myeloid leukaemia with more than 30% bone marrow blasts as per NICE TA399.

Hospital use only - unlicensed
For severe refractory eczema

Unlicensed use: 0.5-3mg/kg daily dependent on TPMT activity

Commissioned by NHS England for use in CF as per policy A01/P/b.

Adult patients: specialist centre only (University Hospital Southampton)

Paediatric patients: PHFT use in line with network arrangements with UHS.

Not at DCH or RBCH.

Reserved for patients with severe eczema and infants under the age of 1 year. 

Bath oil,soya oil 82.95%, mixed lauromacrogols 15%

Excipients include butylated hydroxytoluene, propylene glycol, fragrance

Do not use soap or bubble baths etc when you wash as they can dry out the skin and make it more prone to irritation.

Use a leave-on emollient as a soap substitute and continue with standard eczema management, including regular leave-on emollients and topical corticosteroids when required

Self Care Medicine for primary care.

Reserved for patients with severe eczema and infants under the age of 1 year. 

Bath oil, soya oil 84.75%

Excipients include butylated hydroxytoluene, propylene glycol, fragrance

Do not use soap or bubble baths etc when you wash as they can dry out the skin and make it more prone to irritation.

Use a leave-on emollient as a soap substitute and continue with standard eczema management, including regular leave-on emollients and topical corticosteroids when required

Self Care Medicine for primary care.

Commissioned by NHS England at specialist centres only in line with NICE TA recommendations.

 Approved at RBCH and PHT for the long-term managment of chronic gout where:

• previous intolerance/failure of allopurinol and/or febuxostat
• renal impairment precludes use of allopurinol and/or febuxostat

Self Care Medicine for primary care.

For use in line with CDF criteria.

 Commissioned by NHS England for neurofibromatosis by NHS England as per national protocol (see NF2 service specification) at specialist centres only.

Not recommended as per NICE TA560 with carboplatin, gemcitabine and paclitaxel for treating the first occurence of platinum-sensitive advanced ovarian cancer.

A soft, absorbent polyurethane foam pad with a vapour-permeable film backing and a silicone adhesive border.

50mg - for use in advanced/metastatic disease.
150mg - for locally advanced disease as an alternative to LHRH and also as neo-adjuvant/adjuvant treatment prior to and after radiotherapy in accordance with locally agreed criteria and shared care guideline.

There is currently a supply problem with generic 50mg bicalutamide tablets which is expected to be resolved by the end of January 2018. GPs are requested to issue a 1 month prescription for the Casodex brand in the interim as this remains available at present.

Gel, lactoperoxidase, lactoferrin, lysozyme, whey colostrum, xylitol and other ingredients

Self Care Medicine for primary care.

Tablets, suppositories.
Tablets most cost effective option as at Feb'2015

• Alternative prescribing option.

Self Care Medicine for primary care.

Choline salicylate dental gel

Self Care Medicine for primary care.

For severe axillary hyperhidrosis that has not responded to topical therapy in accordance with local guidelines

Commissioned by NHSE in line with NICE TA478 and TA524 recommendations.

Commissioned by CDF in line with NICE TA577 and CDF criteria.

Commissioned by CDF in line with CDF criteria and NICE TA571 as monotherapy for the treatment of adult patients with ALK-positive advanced non-small cell lung cancer previously treated with crizotinib.

*prescribe by brand to ensure the patient receives the same inhaler at each dispensing*

If generic prescription - patients should be supplied with the combination inhaler they have been using or trained in 

March 2018: Non Formulary for new initiations

For substance misuse as per DMAG March 2018

Nasal spray and injection for in vitro fertilisation

Commissioned in accordance with NICE guidance.

DCHFT: Local formulary states that there is insufficient calcium for prevention of osteoporosis.

Not at DCHFT and RBCH

Energy supplement.

Calogen and Calogen extra contain some vitamins & minerals

To be used under direction of dietitian only.

Paediatric patients: not suitable in children under the age of 3, use with caution in children aged 3-6 years. 

Generally use as a second choice to 1.5kcal/ml sip feeds as not nutritionally complete. However these supplements do provide more calories per ml approx. 600kcal in 250ml so useful for those with very high calorie needs (when reconstituted with whole milk) e.g. CF Patients

Cream, hydrocortisone 1%, clotrimazole 1%
Potency: mild
Excipients include benzyl alcohol, cetostearyl alcohol

Self Care Medicine for primary care (15g tube).

There is a shortage of Carbagen® IR tablets and PR tablets. This shortage is expected to last until mid/late 2019.

Please see the SPS information here for further details.

Tablets, modified release tablets, liquid, suppositories.
Options based on licence.

Category 1: ensure patient is maintained on a specific manufacturer's product.

There is a shortage of Carbagen® IR tablets and PR tablets. This shortage is expected to last until mid/late 2019. Please see the SPS information here for further details.

Tegretol Chewtabs discontinuation: 100mg tablet was depleted by the end of October 2014 and 200mg tablet expected to be depleted by May 2015.

Commissioned in accordance with NICE TA457.

Preservative free

NOT RBCH - if admitted and patient supply not available convert to sodium hyaluronate 0.15% preservative-free whilst in-patient.

Self Care Medicine for primary care.

There is no good evidence to support the use of coxibs alone instead of NSAIDs co-prescribed with a PPI. Coxibs also have a higher CV risk than ibuprofen 1200mg/day or naproxen 1000mg/day (MeReC Extra no.30, Nov 2007).

Commissioned by NHS England in line with NICE TA395 and TA500.

Tablets, syrup.

Self Care Medicine for primary care.

Emollient cream; white soft paraffin 13.2%, light liquid paraffin 10.5%
Excipients include cetostearyl alcohol
Hydroxybenzoates (parabens) are no longer included as an excipient as per up to date SPC from manufacturer - BNF in the process of being updated.

Self Care Medicine - to be purchased when part of routine skin care in the absence of a moderate to severe skin condition.

For use in line with NICE TA recommendations.

PGH: For use as part of the paediatric sedation guideline only.

Self Care Medicine for primary care.

Treatment for Malaria is available on the NHS (red traffic light status). Patients requiring Malaria prevention must acquire this on a private prescription as per the DCCG Guidance on prescribing for overseas travel

Tablets, syrup.
Sedating option

Self Care Medicine for primary care.

For rheumatoid arthritis in accordance with NICE recommendations (CG79).

In accordance with NICE TA369 and Dorset Dry Eye Pathway for severe keratitis in adult patients with dry eye disease that has not improved despite treatment with tear substitutes.

Preservative-free

RBCH: Consultant initiation

Specialist use only - Dermatology and Palliative Care (both 'off-label' use).

Ointment, suppositories.

Brands include: Scheriproct^®

ENT use only: Treatent of ear infection

1st line - use licensed ear drops 1st line in ear.

2nd line - use eye drops in the ear - Off label use (UNLICENSED ROUTE)

Excipients include benzyl alcohol, cetostearyl alcohol, polysorbates, propylene glycol
May damage latex condoms and diaphragms

Tubular bandage for fixation/retention and wet and dry wrapping

Red Line 3.5cm x 1m

Green Line 5cm x 1m / 3m / 5m

Blue Line 7.5cm x 1m / 3m / 5m

Yellow Line 10.75 x 1m / 3m / 5m

Beige Line 17.5cm x 1m

Odour control via activated charcoal

CliniSorb is indicated for the management of malodorous wounds. It can be used on fungating wounds and a variety of other chronic wounds with good results.

• CliniSorb can be cut to size if necessary
• CliniSorb can be applied either side down
• A secondary dressing can be applied on top of CliniSorb if appropriate
• CliniSorb can be secured in place using adhesive tape or in a manner appropriate for the indication
• Change when necessary

Tablets.

• In accordance with NICE recommendations for the use of clopidogrel in the treatment of non-ST-segment-elevation in ACS (TA80), clopidogrel should be used for up to 12 months.

• Post stent insertion (unless follows acute coronary syndrome, see above):
  - clopidogrel should be used for 1 month following insertion of non-drug eluting stent.
  - clopidogrel should be used for 12 months following insertion of a drug-eluting stent.

• In accordance with NICE TA210 (Prevention of acute vascular events).
• <a href="http://www.dorsetccg.nhs.uk/Downloads/aboutus/medicines-management/Other%20Guidelines/Generic_clopidogrel_statement%20nov%2009.pdf" target=”_blank”

• Update from the Cardiology Working Group July 2017 : The interaction of omeprazole on the antiplatelet efficacy of clopidogrel is no longer considered clinically significant.

Cream, clotrimazole 1%

Self Care Medicine for primary care.

Solution, clotrimazole 1% in polyethylene glycol 400 (macrogol 400).

Self Care Medicine for primary care.

Hospital only.

Use following individual patient funding approval. For use with enteral tube. Commissioned by NHS England (for PD) but not routinely.

Tablets, linctus.

Self Care Medicine for primary care.

Prescribers should use a LICENSED product (e.g.  Fultium D3^®, Invita D3^®;Desunin^®)

In accordance with local guidance for the management of vitamin D deficiency and insufficiency in adults.

Not at DCHFT and RBCH.

Commissioned by NHS England for use in CF as per policy A01/P/b and NICE TA276.

Adult patients: specialist centre only (University Hospital Southampton)

Paediatric patients: DCH & PHFT use in line with network arrangements with UHS.

Not at RBCH.

The calories are based on a sachet made up with 200ml of full cream milk and contain approx. 385 kcals.

If your patient likes milky drinks prescribe as a supplement to diet 1-2 servings/day.

Not suitable for patient with cow’s milk intolerance or galactosaemia. Not nutritionally complete.

If your patient dislikes milky drinks choose from the juice style supplements instead.

• Protects wound margins and peri-wound skin from external factors including wound exudate, incontinence and friction, caused by urinary and/or faecal incontinence
• Preserves and maintains intact or irritated skin by building a moisture barrier with good permeability to oxygen and water vapour
• Prevention of incontinence dermatitis
• Prevents maceration by providing up to 96 hours of moisture barrier action
• Effective adjunctive skin therapy during treatment of chronic wounds  e.g. venous or arterial, diabetic foot or pressure ulcers, or whenever skin requires a protective shield

Cutimed Sorbact gel dressings reduce bacterial load in a wound by combining Cutimed Sorbact swab with an amorphous hydrogel to support moist wound healing in lower exuding or sloughy wounds. 

Available as 7.5cm x 15cm and 7.5cm x 7.5cm

All sizes approved for addition to the Joint Wound Formulary April 2018

Tablets.
Antihistamine option.

Self Care Medicine for primary care.

• In accordance with NICE TA for prevention of VTE in patients undergoing hip or knee replacement surgery, as per licensed indications.
  • Note routine 1st line option at RBCH and DCH is LMWH

• For prevention of stroke or systemic embolism in patients with AF within NICE TA and local guidance, as per licensed indications.
• For the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism in accordance with NICE TA. 

PHFT only:

For treatment of cellulitis when approved by microbiology

For treatment of bone and joint infections (including spinal abscess, discitis, osteomyelitis and septic arthritis) when approved by microbiology and who are suitable for discharge and:

• Compliance with daily IV or oral antibiotics is likely to be an issue and are therefore at risk of treatment failure and readmission
• Discharge with an IV cannula is likely to be a risk e.g. IVDU
• Is likely to decline treatment / self-discharge and therefore likely to have repeated readmissions
• Are identified as suitable for early discharge in which oral antibiotics would not be appropriate and were not requiring any other medical/therapy interventions.

for DVT in patients who are intravenous drug users.

Specialist initiation:

Please use in accordance with the relevant local shared care guidance.

for specialist indications, e.g. prevention of clotting in the extracorporeal circuit during haemodialysis, not listed above

• RBCH and PGH.
• DCHFT: Dalteparin not routinely used.

 When used with oral hypoglycaemics in patients with Type 2 Diabetes
 
  When used with insulin in patients with Type 2 Diabetes

Commissioned by NHS England (for dialysis-induced anaemia including via outpatients and only as per NICE CG114) and Trust Guidelines.

Treatment of hepatitis C commissioned in line with latest rate card from NHS England.

Commissioned by NHS England for iron chelation in thalassaemia and sickle cell - policy in progress.

Nov 18: Approved for use at RBCH as 2nd line agent 

An alternative to Flexitol® with 25% Urea content

Self Care Medicine for primary care.

Shower Emollient, benzalkonium chloride 0.1%, chlorhexidine hydrochloride 0.1%, liquid paraffin 2.5%, isopropyl myristate 2.5%

Excipients include cetostearyl alcohol

Self Care Medicine for primary care.

Lotion, benzalkonium chloride 0.1%, chlorhexidine hydrochloride 0.1%, liquid paraffin 2.5%, isopropyl myristate 2.5%

Excipients include cetostearyl alcohol

Self Care Medicine for primary care.

For iron poisoning.

RBCH: kept in ED resus and Pharmacy

 Octim^® nasal spray and Noqdirna^® 25mcg/50mcg oral lyophilisates (for idiopathic nocturia in adults) are non-formulary.

Commissioned by CCG for use in accordance with NICE TA229, TA 349 and TA460.

See Primary care protocol for anxiety disorders.

Commissioned by NHS England for treatment of MS at approved centres in accordance with NICE TA320.

Cream, dithranol 0.1%, 0.25%,0.5%,1% (P status), 2% (POM)
Preparations not available for NHS prescription 2%
Excipients include cetostearyl alcohol, chlorocresol

DCHFT: 0.25% and 2% also stocked.

Commissioned by NHS England for Cystic Fibrosis in line with policy A01/P/b.

 Amber if provided by primary care for Cystic Fibrosis prior to April 2013.

 For patients initiated after April 2013, Dornase Alfa is restricted to supply from secondary care.

• Adult patients: specialist centre only (University Hospital Southampton)
• Paediatric patients: PHFT use in line with network arrangements with UHS.

Not at DCH or RBCH.

Gel, isopropyl myristate 15%, liquid paraffin 15%

Self Care Medicine - to be purchased when part of routine skin care in the absence of a moderate to severe skin condition. 

In accordance with NICE TA91 or CDF policy.

Gel, benzoyl peroxide 5%, clindamycin 1% (as phosphate) in an aqueous basis
Excipients include disodium edetate

For use within acne guideline when required in combination with antibiotics

Choice should be based on selecting the most cost-effective option.

For paediatric patients. 

 Commissioned by CDF in line with NICE TA578 and CDF criteria.

Commissioned by NHS England for aHUS as per NHS England Policy E03/PS(HSS)/a: On recommendation from Newcastle specialist centre only.

Also commissioned by NHS England for paroxysmal nocturnal haemoglobinuria as per NHS National Specialised Commissioning Team (NSCT) Service Specification.

If patient dislikes or does not tolerate Modulen IBD then trial of Elemental 028 extra can be considered

Available in 2 flavours or the unflavoured one can be made more palatable using the flavour modjuls

Use liquid E028 for patients who need to take product away from home or who dislike the taste of powdered E028

Short bowel syndrome, intractable malabsorption, inflammatory bowel disease, bowel fistulae.

Commissioned by NHSE to prevent or reduce the frequency of bleeding episodes in people with haemophilia A who have factor VIII inhibitors in accordance with Clinical Commissioning Policy 170067/P via haemophilia comprehensive care centres only.

Generic product should be used where possible.

Commissioned by NHS England (for HIV in combination with other anti-retroviral drugs) as per BHIVA guidelines.

Liquid emulsion, benzalkonium chloride 0.5%, liquid paraffin 25%, isopropyl myristate 25%

Excipients include polysorbate 60

Self Care Medicine for primary care.

Pre-thickened feed for use in severe gastro-oesophageal reflux. 

Generally use as a second choice to 1.5kcal/ml sip feeds as not nutritionally complete. However these supplements do provide more calories per ml approx. 600kcal in 250ml so useful for those with very high calorie needs (when reconstituted with whole milk) e.g. CF Patients

NICE CG32 (Feb 2006) Nutrition support in adults www.nice.org.uk/page.aspx?o=cg032niceguideline

Should be prescribed only after nutrition screening has taken place using a validated tool e.g. MUST (Malnutrition Universal Screening Tool)

Adult sip feeds containing 1kcal/ml (Fresubin Original, Ensure, Fortimel, Clinutren ISO) should not be prescribed as they are less cost effective compared to 1.5kcal/ml sip feeds

NICE CG32 Nutrition support in adults

Should be prescribed only after nutrition screening has taken place using a validated tool e.g. MUST (Malnutrition Universal Screening Tool) 

Restrict use to those patients with bowel problems as slightly more expensive than 1.5kcal.ml sips without fibre.

NICE CG32 (Feb 2006) Nutrition support in adults www.nice.org.uk/page.aspx?o=cg032niceguideline

Should be prescribed only after nutrition screening has taken place using a validated tool e.g. MUST (Malnutrition Universal Screening Tool)

Adult sip feeds containing 1kcal/ml (Fresubin Original, Ensure, Fortimel, Clinutren ISO) should not be prescribed as they are less cost effective compared to 1.5kcal/ml sip feeds

Calories are based on a sachet made up with 200ml of full cream milk and contains approx 385 kcals.

If patient likes milky drinks, prescribe as a supplement to diet 1-2 servings/day.

Not suitable for patients with cow's milk intolerance or galactosaemia.

Not nutritionally complete.

If patient dislikes milk drinks, choose from the juice style supplements instead.

Tablets.
See shared care guideline for entacapone.

Used as an adjunct to levodopa therapy in patients who cannot be stabilised, particularly those with 'end-of-dose' fluctuations.

See local guidance on drug treatment of Parkinson's Disease and shared care guideline.

Cream, yellow soft paraffin 15%, liquid paraffin 10%, emulsifying wax 5%
Excipients include cetostearyl alcohol, chlorocresol

Ointment, emulsifying wax 30%, yellow soft paraffin 30%, liquid paraffin 40%
Excipients include cetostearyl alcohol

Not stocked at RBCH: use Hydromol ointment

Self Care Medicine - to be purchased when part of routine skin care in the absence of a moderate to severe skin condition.

Nasal drops 0.5% and 1%

Self Care Medicine for primary care.

When used as monotherapy or with metformin in patients with Type 2 Diabetes

NB: Not currently commissioned for use with insulin.

All products should be prescribed by brand. Biosimilar should be used where possible.

 Commissioned by CCG for:

• Rheumatoid arthritis in accordance with NICE TA 375 and local pathway.
• Ankylosing spondylitis in accordance with NICE TA383 and local pathway
• Plaque psoriasis in accordance with NICE TA103
• Psoriatic arthritis in accordance with NICE TA199 and local pathway

 Commissioned by NHS England for:

• Juvenile idiopathic arthritis in line with NICE TA373.
• Paediatric patients in line with adult NICE TAs.

  DCHFT renal consultants only.

Commissioned by NHS England in line with NICE TA448 for treating secondary hyperparathyroidism via specialist centres only.

Treatment must have prior approval on Blueteq^®.

Ethinylestradiol 20 mcg / norethisterone 1mg

Prescribe by brand

Loestrin 20®

Ethinylestradiol 30 micrograms/ Norethisterone acetate 1.5mg

Prescribe by brand

Loestrin 30®

Ethinylestradiol 30 micrograms/gestodene 75 micrograms

Prescribe by brand 

Femodene® tablets 

Aidulan® 30microgram/75microgram tablets

Katya® 30/75 tablets 

Millinette® 30microgram/75microgram tablets

Sofiperla® 75microgram/30microgram tablets

Ethinylestradiol 35 micrograms/Norgestimate 250 micrograms

Prescribe by brand

Cilique® 250microgram/35microgram tablets 

Lizinna® 250microgram/35microgram tablets

Cilest® - Now discontinued.

Lotion, urea 10%

Excipients include benzyl alcohol, isopropyl palmitate

Not RBCH
Not DCHFT
Not stocked PGH

Self Care Medicine for primary care.

RED, Initiation by lipid specialist – this can be by written or verbal approval to other secondary care consultant clinicians. A copy of any letters should be forwarded to the patient’s GP.

Commissioned by CCG in accordance with NICE TA 394 for primary non-familial hypercholesterolaemia or mixed dyslipidaemia and primary heterozygous familial hypercholesterolaemia.

Commissioned by NHS England via specialist centres only for homozygous familial hypercholesterolaemia.

Use with oral agents, in accordance with NICE NG28 recommendations for treatment of type 2 diabetes and local shared care guideline.

Also when used as adjunctive therapy to basal insulin with or without metformin and/or pioglitazone in adults

Give twice daily within 1 hour before 2 main meals (at least 6 hours apart)

: When used with oral hypoglycaemics in patients with Type 2 Diabetes

: When used with insulin in patients with Type 2 Diabetes

DCHFT: Consultant diabetologist only.