sign in sign up
<<
Home , Cabergoline, Ergometrine

Obstetrics and Gynaecology Specialist Formulary List

**Other indications for particular may be included on completion of further specialist lists**

For information on use of unlicensed or medicines used 'off-label' - click here

The following specialist medicines are approved for prescribing by or on the recommendation of a prescribing 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

(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 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 Suppression of following stillbirth

Ursodeoxycholic acid Pruritus of pregnancy due to intrahepatic

(unlicensed: off-label) Prednisolone tablets Hyperemesis gravidarum

Hydrocortisone injection

Labetalol tablets in pregnancy. 1st line (used in NICE CG107Hypertension in pregnancy

combination with if required). injection

Hydralazine injection 2nd line injection for hypertension in pregnancy or 1st

line when labetalol is contra-indicated 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 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 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) injection Postpartum haemorrhage (may be used by community midwives) Ergometrine with 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 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 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

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: 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 ( 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 (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