For initation by Renal team only.

ACBS Indications Dietary management of water-soluble vitamin deficiency in adults with renal failure on dialysis

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
  
  

Pre-filled syringe - various brands available. Injection technique is device specific. To ensure patients receive the auto-injector device that they have been trained to use, prescribers should normally prescribe by brand.

First line spacer option.

Commissioned by NHS England in line with NICE TA310.

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

NICE CG32 (Feb 2006) Nutrition support in adults

This has a smaller volume and more than 2kcals /ml these can very useful in those who struggle with a larger volume

Alu-Cap^® discontinued

Unlicensed products available

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 NHSE for treating Adult-onset Still's disease with moderate to high disease activity, or continued disease activity after disease that has responded inadequately to 2 or more conventional disease‑modifying antirheumatic drugs (DMARDs), in line with NICE TA685.

Commissioned by NHSE for treating systemic juvenile idiopathic arthritis in people 8 months and older with a body weight of 10 kg or more that has not responded to at least 1 conventional DMARD, in line with NICE TA685.

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. 

Alternative option for cow's milk protein allergy

Cream, emulsifying ointment 30%, (1)phenoxyethanol 1% in freshly boiled and cooled purified water

Excipients include cetostearyl alcohol

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.

Enema.

• Contains peanut oil. DO NOT give to patients with PEANUT ALLERGY.

Self Care Medicine for primary care.

Tablets, Orodispersible tablets.

Use in accordance with NICE CG178 recommendations for the use of atypical antipsychotic drugs for the treatment of schizophrenia and local shared care guidelines.

See guidance on the use of antipsychotics in conditions other than schizophrenia
 
Solution shouldn't be used routinely as is very expensive (30mg = ~£600 per month)

Option based on NICE guidance and licence.

For the maintenance of adult patients with schizophrenia who have responded to oral aripiprazole but who are non-compliant.

see guidelines for the use of aripiprazole long acting injections

"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"�

Indicated for the management of exuding partial to full thickness wounds, stage I -IV pressure sores, venous ulcers, second degree burns and donor sites. It is indicated for external use only and may be used in the management of infected wounds under medical supervision at the discretion of the physician.

Sterile dressing consisting of two layers:

• an absorbent polyurethane foam layer which provides for the absorption of wound exudate.


• an ionic silver alginate matrix which provides for broad anti-microbial effectiveness and helps prevent contamination from external bacteria.

Tablets, suppositories.

Dispersible tablets are considered 2nd Line 

Self Care Medicine for primary care.

Commissioned by CDF in line with CDF criteria and NICE TA492 recommendations at a dose of 1200mg every 3 weeks (Specialist Sevices Circular 2096 Dec 19). Other licensed dose schedules are not funded. 

Commissioned by NHSE in line with NICE TA520,TA525 and and TA584 recommendations. For NICE TA 520 and 525 the dose must be 1200mg every 3 weeks (Specialist Sevices Circular 2096 Dec 19). Other licensed dose schedules are not funded.  

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, as per NICE TA639.
   • Patients previously started for this indication via the MHRA Early Access to Medicines Scheme (EAMS) who do not meet the new criteria should continue to receive the drug from the manufacturer.

Use in combination with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer in adults with an ECOG score of 0 or 1, as per NICE TA638.
   • Patients previously started for this indication via the MHRA Early Access to Medicines Scheme (EAMS) who do not meet the new criteria should continue to receive the drug from the manufacturer.

Atezolizumab plus Bevacizumab is commissioned by NHSE as an option for treating advanced or unresectable hepatocellular carcinoma (HCC) in adults who have not had previous systemic treatment in line with NICE TA666, only if:
  •  they have Child-Pugh grade A liver impairment and an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

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. 

Cream, colloidal oatmeal in emollient basis
Excipients include benzyl alcohol, cetyl alcohol, isopropyl palmitate

RBCH: Dermatology only

Only to be used under ACBS specified conditions as follows:

Endogenous and exogenous eczema, xeroderma, ichthyosis and senile pruritus associated with dry skin.

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

Commissioned by CDF in line with CDF criteria and NICE TA559 at commissioned CAR-T treatment centres only.

Commissioned centres include:

• University College London Hospital NHS Foundation Trust


• King’s College Hospital NHS Foundation Trust


• University Hospitals Bristol NHS Trust

Capsaicin 0.075% cream
Specialist initiation

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

for Sexual Health indications in Primary Care - see Sexual Health Dorset Guidelines below. Liquid preparation is green for use in children who are allergic to penicillin.

 For patients with COPD and bronchiectasis, in line with local shared care guideline

For other indications.

Consultant microbiologist or specialist use only.

Cream, urea 5%, ceramide 0.1%

Excipients include cetostearyl alcohol, polysorbates, propylene glycol

Not RBCH

Self Care Medicine for primary care.

Size: 4mm/32g
Size: 5mm/31g

Pack Size : 90

Self Care Medicine for primary care.

For use within its licensed indication for COPD

Commissioned by NHS England in line with TA216 and NHSE clinical commissioning policies (see below).

NOT commissioned for the treatment of relapsed multiple myeloma from 3rd September 2020 in line with new NHSE commissioning statement SSC 2161.
 •   Existing patients registered with BlueTeq prior to this date may continue to receive Bendamustine for this indication providing the patient continues to meet the treatment criteria.

Commissioned by NHS England in accordance with NICE TA565 at specialist centres only.

 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.

Cream, betamethasone (as valerate) 0.1%, neomycin sulfate 0.5%
Potency: potent
Excipients may include cetostearyl alcohol, chlorocresol

Ointment, betamethasone (as valerate) 0.1%, neomycin sulfate 0.5%
Potency: potent

Only to be used on the advice of a specialist

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.

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, TA524 and TA577 recommendations.

Commissioned by NHSE in line with NICE TA641 in combination with Cyclophosphamide, Doxorubicin and Prednisone (CHP) for untreated systemic anaplastic large cell lymphoma in adults.

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

Commissioned by NHSE in line with NICE TA670 as an option for treating anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell lung cancer (NSCLC) that has not been previously treated with an ALK inhibitor in adults.
  •  This indication is funded by CDF until 27th April 2021

For use within its licensed indications for asthma and COPD

• MR Capsules - once daily administration.


• Prescribe by brand name.
  
  For patients with active Crohn's disease who are at high risk of corticosteroid side effects with, or intolerant of conventional steroids (e.g. prednisolone).

Inhalers.

200/6 metered dose inhaler, licensed for COPD only.

200/6 and 400/12 turbohalers are licensed for COPD and asthma.

100/6 turbohaler, licensed for asthma only.

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

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

For Substance misuse as per DMAG November 2020

Cabometyx^®:

• Commissioned by NHSE in accordance with NICE TA463 and TA542 for the treatment of previously treated advanced renal cell carcinoma and untreated locally advanced or metastatic renal cell carcinoma respectively.


• Patients initiated on the Named Patient Programme should remain on free of charge stock for the duration of their treatment.

Cometriq^®:

• Commissioned in accordance with NICE TA516 for the first line treatment of medullary thyroid cancer.

One gram of cutaneous foam contains 50 micrograms of calcipotriol (as monohydrate) and 0.5 mg of betamethasone (as dipropionate).

Not stocked at RBCH

Calcitonin can be used for the treatment of hypercalcaemia associated with malignancy

DCHFT:   Renal consultant only.

In accordance with the phosphate binders shared care guideline for the management of Hyperphosphataemia in patients with chronic kidney disease.

2nd line option at RBCH for patients intolerat of Adcal D3

Energy supplement.

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. 

Energy supplement.

Calogen and Calogen extra contain some vitamins & minerals 

To be used under direction of dietitian only.

Dilute before use in child under the age of 5.

Tablets

Calvive® 1000 (Formerly Sandocal^®1000) only at RBCH

Commissioned by NHS England as per Cryopyrin Associated Periodic Syndrome service specification.

Commissioned by NHSE via specialist centres for the treatment of periodic fever syndrome (all ages) under the NHSE policy.
NOTE: Does not apply to any hospitals in Dorset

Not routinely commissioned by NHS England for juvenile arthritis - see NICE TA302.

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

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

Commissioned by NHS England for use with Clobazam in Specialist Centres Only as per criteria laid out in NICE TA614 and TA615.

Restrict to where moderate to severe skin condition requires it (not for cradle cap)

Shampoo, coal tar 1%, coconut oil 1%, salicylic acid 0.5%

Self Care Medicine

Tablets, chewable tablets, modified release tablets, liquid, suppositories.
For trigeminal neuralgia.

Carbagen® IR tablets and PR tablets have been discontinued (Sept 2020).

Please see the SPS information here for further details.

PHFT - for prevention of post-partum haemorrhage following caesarean section.

Carfilzomib with dexamethasone is recommended as an option for treating multiple myeloma in adults who have had only 1 previous therapy in accordance with NICE TA657.

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).

For treatment of plaque psoriasis as per NICE TA 574

For use in genital areas

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

Emollient bath additive, light liquid paraffin 82.8%

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

Also used as part of oral hygiene protocols for ventilated patients in Critical Care to prevent VAPUnlicensed

Self Care Medicine for primary care.

Sedating option

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).

During the shortage of ranitidine, you can supply cimetidine, nizatidine or famotidine as a last resort

Ointment, suppositories.

Brands include: Scheriproct^®

As Second line choice only in Primary Care, based on sensitivities

All sizes are on the formulary

Permeable Non-Woven Synthetic Adhesive Tape BP 1988

Hypoallergenic and strictly conforms to Drug Tariff specifications

Clinipore is gentle on the skin, leaving minimal adhesive residue upon removal 

Available as 1.25cm x 5m / 2.5cm x 5m / 2.5cm x 10cm and 5cm x 5m

Commissioned by CDF for the treatment of relapsed/refractory acute lymphoblastic leukaemia in line with CDF criteria.

Self Care Medicine for primary care.

To be initiated by consultant psychiatrist only. For treatment-resistant schizophrenia.
Clozaril is also indicated in psychotic disorders occurring during the course of Parkinson's disease, in cases where standard treatment has failed.


24 hour helpline number for CPMS 08457 698269.

Use in accordance with NICE recommendations for the treatment and management of psychosis and schizophrenia in adults (CG178 which replaces CG82) and local shared care guideline.

(Amber in original pilot sites.)

Hospital only.

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

Tablets.

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

Prescribers should use a LICENSED brand (e.g.Fultium D3^®; Aviticol^®;Plenachol^®).

Many other 20,000unit preparations are available(e.g.Pro D3^®, Dekristol^®). These do not have a marketing authorisation as they are marketed as nutritional supplements.unlicensed

Not at DCHFT and RBCH.

Powder.

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

• If provided by primary care for Cystic Fibrosis prior to April 2013 as per shared care guidelines.


• For non-cystic fibrosis bronchiectasis as per shared care guidelines (Colomycin brand only).

For CF patients initiated after April 2013:

• Adult patients: specilaist centres only.


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

For use in Dupuytren's Contracture in line with the existing criteria for access to treatment within the policy for common hand conditions.

Xiapex® has now been discontinued 

Comfeel Plus Transparent is a thin and flexible hydrocolloid dressing.

Key benefits:

• Transparency for wound inspection


• Flexibilty to dress any part of the body

Commissioned by CDF in line with CDF criteria and NICE TA529 and NHS England in line with NICE TA406 and TA422.

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. 

In accordance with NICE TA595

Cream, hydrocortisone 1%, miconazole nitrate 2%
Potency: mild
Excipients include butylated hydroxyanisole, disodium edetate

Self Care Medicine for primary care - Hydrocortisone 1% / Miconazole 2% cream 15g pack

Cream, miconazole nitrate 2%
Excipients include butylated hydroxyanisole

Self Care Medicine for primary care.

RBCH Tube-fed /Swallowing difficulites who would otherwise require Sanatogen A-Z

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

 When used in Type 1 diabetes in combination with insulin

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

Restricted for use according to NHSE Commissioning requirements and BHIVA guidelines.

Commissioned by NHS England in line with NICE TA425 and TA426.

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

Fat-soluble vitamin supplements for use when recommended by specialist in patients with cystic fibrosis. Specialists to ensure preferred formulation and dose is clearly communicated to primary care prescribers

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.

Age restriction of under one year or patients with severe conditions

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 NHS England - use in accordance with agreed Trust Guidelines, for the treatment of anthracycline extravasation.

Commissioned by NHSE for preventing cardiotoxicity in children and young people (<25 years) receiving high-dose anthracyclines or related drugs for the treatment of cancer as per Commissioning Statement SSC 2137.

Not routinely commissioned by NHS England for anthracycline cardiotoxicity outside the above indications.

Injections.

See Primary care protocol for anxiety disorders.

Tablets, syrup.

Tablets, Elixir, (Injection - secondary care only)
Bioavailabilities are approximately: Injection 100%, Liquid 80%, Tablets 70%.

July 2019: Amber for new heart failure patients in accordance with NICE Guidance NG106

Extended Release Capsules/tablets for once daily dosing

Slozem^® products XL discontinued December 2019

• RBH + PHFT: use Viazem^® XL

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

Used for management of extravasation of cytotoxic chemotherapy.

Commissioned by NHSE in line with NICE TA538 at or under shared care with a neuro-oncology centre.

Cream, cetomacrogol 2.25%, cetostearyl alcohol 7.2%, liquid paraffin 6%, white soft paraffin 15%
Ointment, liquid paraffin 5%, white soft paraffin 95%,
Excipients include cetostearyl alcohol, chlorocresol

DCHFT: Ointment not stocked.

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

Capsule, Tablet MR (Injection - secondary care only).
Hospital initiation.

• DCHFT: Not routinely stocked.

Capsules, syrup, paediatric syrup.

• Alternative prescribing option.

Self Care Medicine for primary care.

Tablets, suppositories, suspension.

Domperidone should only be used for the relief of the symptoms of nausea and vomiting (not conditions such as heartburn, bloating or relief of stomach discomfort)

The recommended dose in adults and adolescents over 12 years and over 35kg is 10 mg up to 3 times daily (it is no longer licensed in children under 12 or patients under 35kg).

Domperidone should be used at the lowest effective dose for the shortest possible duration (max. treatment duration should not normally exceed 1 week).

Domperidone is contra-indicated for use in conditions where cardiac conduction is, or could be impaired, or where there is underlying cardiac disease, when administered concomitantly with drugs that prolong the QT interval or potent CYP3A4 inhibitors, and in severe hepatic impairment

Note This advice does not apply to unlicensed uses of domperidone (e.g palliative care)

RBCH: Policy states to use higher doses than usual: 200mg stat then 100mg TWICE daily

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

Application, aluminium chloride hexahydrate 20% in an alcoholic basis

Not stocked at RBCH

RBCH :  Consultant Anaesthetist only in Recovery areas for Intractable PONV.

 When used with oral anti-hyperglycaemics in patients with Type 2 Diabetes

 When used in combination with insulin in patients with Type 2 Diabetes

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.

Self Care Medicine for primary care.

Commissioned by the CCG for treating Adults with moderate to severe atopic dermatitis, in accordance with NICE TA534
- BlueTeq not required for this indication in Adults!

Commissioned by NHSE in specialist paediatric dermatology centres for the treatment of adolescent patients aged 12 upto 18 years of age with severe atopic dermatitis who have responded inadequately to at least one systemic therapy or where the available systemic therapies are not recommended or are not tolerated who meet criteria set out within NICE TA 534 for adults as per NHS England SSC 2082.

Available via EAMS in specialist paediatric dermatology centres for children 6 to 11 years of age with severe atopic dermatitis who are candidates for systemic therapy and where existing systemic therapies are not advisable.

• 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. 

Eflornithine 11.5% for facial hirsutism in women. Refer to local guideline.

Excipients include cetostearyl alcohol, hydroxybenzoates, stearyl alcohol.

Alternative option for cow’s milk protein allergy 

To be prescribed by specialist metabolic centres only in accordance with NICE HSTG 5 and NHS England Commissioning criteria. 

Approved specialist adult metabolic centres are:
„h Addenbrookes
„h University Hospital Birmingham
„h Salford Royal
„h UCLH
„h Royal Free Hospital

In accordance with NICE TA

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