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Obstetrics & Gynaecology Specialist Formulary List

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Obstetrics & Gynaecology Specialist Formulary List Obstetrics and Gynaecology Specialist Formulary List **Other indications for particular drugs may be included on completion of further specialist lists** For information on use of unlicensed medicines or medicines used 'off-label' - click here The following specialist medicines are approved for prescribing by or on the recommendation of a prescribing obstetrics or gynaecology specialist: In the event of a broken link please forward details to [email protected] Please include the location and full title of the link MEDICINE SUMMARY OF RESTRICTED INDICATION CATEGORY PROTOCOL Oxybutynin tablets, patches Treatment of overactive bladder (OAB) in adults on the advice of Urology/Uro-gynaecology Spironolactone Hirsutism in postmenopausal women (unlicensed: off- label) Metformin Polycystic ovary syndrome (unlicensed: off-label) NICE Evidence summary: ESUOM6 Polycystic ovary syndrome: metformin in women not planning pregnancy (unlicensed/off-label medicines) Ulipristal acetate 5mg tablets Pre-operative treatment or intermittent treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age. Progesterone (Utrogestan® - micronised 2nd line for endometrial protection as part of HRT in Utrogestan® (micronised progesterone progesterone, 100mg oral capsules) women with an intact uterus taking oestrogen under protocol) Treatment Protocol direction of Tayside Menopause clinic Progesterone pessaries Prevention of recurrent pre-term birth (unlicensed: off- Protocol in development label) Cyproterone acetate Hirsutism in postmenopausal women (unlicensed: off- label) Finasteride Hirsutism in postmenopausal women (unlicensed: off- label) Clomifene Anovulatory infertility NICE CG156 Fertility: Assessment and treatment for people with fertility problems Goserelin (Zoladex® 3.6mg implant) Endometriosis, endometrial thinning prior to ablation or resection, uterine fibroids in conjunction with iron therapy prior to surgery Ovarian stromal hyperthecosis (unlicensed: off-label) Triptorelin (Decapeptyl® SR) 3mg or Alternative to goserelin for endometriosis 11.25mg injection Cabergoline Suppression of lactation following stillbirth Ursodeoxycholic acid Pruritus of pregnancy due to intrahepatic cholestasis (unlicensed: off-label) Prednisolone tablets Hyperemesis gravidarum Hydrocortisone injection Labetalol tablets Hypertension in pregnancy. 1st line (used in NICE CG107Hypertension in pregnancy combination with nifedipine if required). Labetalol injection Hydralazine injection 2nd line injection for hypertension in pregnancy or 1st line when labetalol is contra-indicated Methyldopa Pregnancy induced hypertension restricted to the Cardiovascular Risk and Obstetric clinics. 3rd line. Nifedipine MR Hypertension in pregnancy in combination with labetalol (unlicensed: off-label) Tranexamic Acid Injection Post partum haemorrhage Heavy menstrual bleeding Domperidone Augmentation of Lactation (unlicensed: off-label) NHS Tayside Guideline Domperidone for the augmentation of lactation and GP letter Betamethasone (as sodium phosphate) Preterm labour – to reduce the incidence of neonatal NICE - Preterm labour and birth in injection 4mg/mL 1st line respiratory adverse outcomes (unlicensed: off-label) development Dexamethasone (as sodium phosphate) injection 4mg/mL 2nd line Magnesium Sulfate injection Pre-eclampsia NICE CG107 Hypertension in Pregnancy Eclampsia NHS Tayside Guideline For Management of Severe Preeclampsia/ Eclampsia (for use in Prevention of adverse neurological outcomes in Ninewells hospital) neonates following pre-term birth (unlicensed: off- label) ® Dinoprostone pessaries (Propess ) Induction of labour (may be used by community midwives) Ergometrine injection Postpartum haemorrhage (may be used by community midwives) Ergometrine with oxytocin Active management of third stage of labour ® (Syntometrine ) injection (may be used by Prevention and treatment of postpartum haemorrhage community midwives) ® Oxytocin (Syntocinon ) injection Induction or enhancement of labour (may be used by Active management of third stage of labour community (unlicensed: off-label) midwives) Prevention and treatment of postpartum haemorrhage Carboprost Injection Severe postpartum haemorrhage unresponsive to ergometrine and oxytocin Nifedipine immediate release 10mg Inhibition of uncomplicated premature labour between capsules 24 and 33 weeks of gestation Terbutaline subcutaneous injection Hyperstimulation in labour (unlicensed: off-label) Methotrexate intramuscular injection Ectopic pregnancy (unlicensed: off-label) NHS Tayside Protocol for medical management of ectopic pregnancy methotrexate Mifepristone Medical termination of pregnancy NHS Tayside Protocol for medical management of non continuing pregnancy Medical management of miscarriage Misoprostol Induction of medical abortion (unlicensed: off-label) Medical management of miscarriage (unlicensed: off- label) Mifepristone 200mg tablet and For medical termination of developing intra-uterine NHS Tayside Protocol for medical misoprostol 0.2mg vaginal tablets pregnancy of up to 63 days of amenorrhoea. management of non continuing pregnancy combipack Imiquimod Vulval Intraepithelial Neoplasia (unlicensed: off-label) NHS Tayside Imiquimod letter to GP and PIL Tamoxifen Anovulatory infertility Letrozole Anovulatory infertility (unlicensed: off-label) Protocol in development Testosterone gel Under the direction of menopause specialists within Local Treatment Protocol: Testosterone in Sexual & Reproductive Health for selected post- menopausal women with low sexual desire menopausal women with low sexual dersire where HRT alone is not effective and after other causes have been excluded [off-label] in accordance with local treatment protocol. Assisted Conception Unit (ACU) Specialist Medicines MEDICINE SUMMARY OF RESTRICTED INDICATION CATEGORY PROTOCOL Choriogonadotrophin alfa (HcG) Infertility treatment (under specialist supervision – injection (Ovitrelle®) Assisted Conception Unit) Follitropin alfa pre-filled pen for Infertility treatment (under specialist supervision – Brand name must be stated on prescriptions subcutaneous injection (Bemfola®) Assisted Conception Unit). 1st line for follitropin alfa. Follitropin alfa pre-filled pen injection Infertility treatment (under specialist supervision – Brand name must be stated on prescriptions (Gonal-F®) Assisted Conception Unit). 2nd line for follitropin alfa. Menotrophin (human menopausal Infertility treatment (under specialist supervision – gonadotrophins) injection (Menopur®) Assisted Conception Unit) Goserelin (Zoladex® 3.6mg implant) Pituitary desensitisation before induction of ovulation by gonadotrophins for in vitro fertilisation (under specialist supervision) Buserelin 150 micrograms/dose nasal Infertility treatment (under specialist supervision – spray, injection (Suprecur®) Assisted Conception Unit) Cetrorelix (Cetrotide®) injection Infertility treatment (under specialist supervision – Assisted Conception Unit) Cabergoline Modify ovarian hyperstimulation during infertility treatment (unlicensed: off-label) Progesterone Vaginal Gel 8% Infertility treatment (under specialist supervision – (Crinone®) Assisted Conception Unit). 1st line Progesterone pessary (Cyclogest®) Infertility treatment (under specialist supervision – Assisted Conception Unit). 2nd line Progesterone solution for injection Infertility treatment (under specialist supervision – 25mg (Lubion®) Assisted Conception Unit). 3rd line Traffic light status information To be prescribed by Hospital Specialists Only. Can be prescribed in General Practice under the direction of a Specialist. Updated: 20th January 2021 .
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