1. Drugs acting on the Gastrointestinal System

1.1 Antacids and other drugs for dyspepsia

1.1.1 Aluminium- and magnesium- containing Aluminium hydroxide antacids Co-magaldrox (Mucogel®) Magnesium trisilicate

1.1.2 Antacid preparations containing simeticone Asilone® (for use in accordance with the Palliative Care Pain and Symptom Control Guidelines)

1.1.3 Other drugs for dyspepsia and gastro- Algicon® (second-line alginate) oesophageal disease Gaviscon Advance® liquid (first-line alginate) Gaviscon Infant® (Neonatal Unit only)

1.2 Antispasmodics and other drugs altering gut motility

Alverine (Gastroenterology only) Dicycloverine Domperidone Hyoscine-n-butyl bromide Mebeverine Metoclopramide Peppermint oil

1.3 Ulcer-healing drugs

1.3.1 H2-receptor antagonists Cimetidine Ranitidine

1.3.3 Chelates and complexes Sucralfate

1.3.5 Proton pump inhibitors - Omeprazole capsules (first line PPI - Losec MUPS are non-formulary) see Salford PPI Strategy and Guidelines Lansoprazole orodispersible tablet (FasTab®) (for patients unable to swallow tablets) Rabeprazole (Gastroenterologists and Gastroenterology Surgeons only)

1.4 Acute diarrhoea

1.4.1 Adsorbents & bulk-forming Kaolin mixture

1.4.2 Antimotility drugs Codeine phosphate Loperamide

1.5 Chronic bowel disorders

Colifoam® (hydrocortisone) Infliximab (in accordance with NICE guidance) - Follow restricted high cost drug procedure when prescribing infliximab Mesalazine Predenema® Predfoam® Predsol® Sulfasalazine Clipper® (Beclometasone dipropionate) (consultant gastroenterologist only) Budesonide Rectal Foam (consultant gastroenterologist only) Adalimumab (for Crohn’s disease)

1.6 Laxatives

1.6.1 Bulk forming laxatives Ispaghula husk (Fybogel®) Methylcellulose Sterculia (Normacol®)

1.6.2 Stimulant laxatives Bisacodyl Co-danthramer Co-danthrusate Docusate sodium Glycerol suppositories Senna Sodium picosulfate Neostigimine

1.6.3 Faecal softeners Arachis oil enema

1.6.4 Osmotic laxatives Lactulose (Gastroenterology only) Movicol® (do not use first line) Phosphate enema Micralax micro-enema®

1.6.5 Bowel cleansing solutions Fleet Phospho-soda® Klean-prep® Picolax®

1.7 Preparations for haemorrhoids

1.7.1 Soothing haemorrhoidal preps Anusol®

1.7.2 Compound preps with corticosteroids Anusol-HC® Xyloproct®

1.7.3 Rectal sclerosants Phenol

1.7.4 Management of anal fissures Dltiazem 2% cream (unlicensed - should not be used first line) Glyceryl trinitrate 0.4% (Rectogesic®) (for use in the treatment of anal fissure)

1.8 Stoma Care - contact Stoma Care Specialist for advice

Dansac® soft paste

1.9 Drugs affecting intestinal secretions

1.9.2 Bile acid sequestrants Colestyramine

1.9.4 Pancreatin Creon® Pancrease®