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SOUTHAMPTON JOINT FORMULARY

CUMULATIVE UPDATE

This document is a cumulative list summarising changes to the Southampton Joint Formulary. To check the current status of a medicine please refer to www.southamptonformulary.nhs.uk

Date Drug and formulation Colour BNF Comments Action status section

16/03/21 / Red 8.1.5 From 10/02/2021 NHS England and Add Improvement will commission the subcutaneous injection new combined pertuzumab and [Phesgo] trastuzumab subcutaneous injection, brand name PHESGO®, for all existing pertuzumab and trastuzumab indications as an alternative to IV pertuzumab and trastuzumab (NICE TA424, NICE TA509, NICE TA569) 16/03/21 injection Black 8.1.5 Funding from the Cancer Drugs Fund Remove [Keytruva] for 1st line use in urothelial cancer has been ceased from 17th Feb 2021 following publication of NICE terminated guidance (NICE TA674)- NICE TA522 has been replaced. 16/03/21 Pembrolizumab injection Red 8.1.5 NICE TA683: Pembrolizumab with Amend [Keytruva] pemetrexed and platinum is recommended as an option for untreated, metastatic, non-squamous non-small-cell lung cancer (NSCLC) in adults whose tumours have no epidermal growth factor receptor (EGFR)‑ positive or anaplastic kinase (ALK)‑positive mutations 16/03/21 Erenumab prefilled Red 4.7.4.2 NICE TA682: Erenumab for Add 140mg injection preventing migraine [Amiovig®] only if:  they have 4 or more migraine days a month  at least 3 preventive drug treatments have failed  the 140 mg dose of erenumab is used and  the company provides it according to the commercial arrangement. (both chronic and episodic) 16/03/21 [Revlimid] Red 8.2.4 NICE TA680 Lenalidomide is Amend capsules recommended as maintenance treatment after an autologous stem cell transplant for newly diagnosed multiple myeloma in adults, only if:  the dosage schedule is 10 mg per day on days 1 to 21 of a 28‑day cycle and  the company provides lenalidomide according to the commercial arrangement. 16/03/21 tablets Red 13.5.3 NICE TA681:Baricitinib is Amend [Olumiant®] recommended as an option for treating moderate to severe atopic dermatitis in adults, only if:  the disease has not responded to at least 1 systemic immunosuppressant, such as , , and mycophenolate mofetil, or these are not suitable, and  the company provides it according to the commercial arrangement. 16/03/21 Filgotinib tablets Red 10.1.3 NICE TA676:Filgotinib, with Add [Jyseleca®] methotrexate, is recommended as an option for treating active in adults whose disease has responded inadequately to intensive therapy with 2 or more conventional disease-modifying antirheumatic drugs (DMARDs), only if:  disease is moderate or severe (a disease activity score [DAS28] of 3.2 or more) and

 the company provides filgotinib according to the commercial arrangement.

16/03/21 Niraparib capsules Red 8.1.5 NICE TA673: Niraparib for Amend [Zejula] maintenance treatment of advanced ovarian, fallopian tube and peritoneal cancer after response to first-line platinum-based chemotherapy

Use within cancer drug fund 16/03/21 Brolucizumab [Beovu] Red 11.8.2 NICE TA672: Brolucizumab is Add prefilled injection recommended as an option for treating wet age-related macular degeneration in adults, only if, in the eye to be treated: •the best-corrected visual acuity is between 6/12 and 6/96 •there is no permanent structural damage to the central fovea •the lesion size is less than or equal to 12 disc areas in greatest linear dimension and •there is recent presumed disease progression (for example, blood vessel growth, as shown by fluorescein angiography, or recent visual acuity changes).

It is recommended only if the company provides brolucizumab according to the commercial arrangement. 16/03/21 [Nucala] Red 3.4.2 NICE TA431 updated and replaced Add injection/pre-filled by NICE TA671 (Mepolizumab for syringes treating severe eosinophilic asthma) 16/03/21 injection Black 3.4.2 NICE TA678 Omalizumab for treating NFD [Xolair®] chronic rhinosinusitis with nasal polyps (terminated appraisal)

The company has confirmed that it does not intend to make a submission for the appraisal because the technology will not be launched in the UK for treating this indication. 16/03/21 Vernakalant infusion Black 2.3.2 NICE TA675: Vernakalant for the NFD [Brinavess®] rapid conversion of recent onset atrial fibrillation to sinus rhythm (terminated appraisal)

The company has confirmed that it does not intend to make a submission because it considers there is insufficient evidence. 16/03/21 Desmopressin Amber 6.5.2 Urologist recommendation only. Amend oral lyophilisate tabs (I) Initiated by UHS, along with initial [Noqdirna] sodium monitoring. Then can be continued by primary care. SCG not required as per DPC discussion Feb 2021

16/03/21 Subcutaneous Red 10.1.3 Alternative route to IV. For use in Add prefilled syringes/pens 1.5.3 rheumatology and gastroenterology [Remsima®] indications. Funding approved

16/02/21 Estradiol/ Green 6.4.1.1 HRT option for women with intact Add Dydrogesterone. uterus [Femoston/ Femoston Conti tablet]

16/02/21 Droperidol injection Red 4.6 Prevention and treatment of PONV in Add paediatrics (second-line to ondansetron and dexamethasone. Restricted to anaesthetist use only. Guideline in development 16/02/21 Nefopam tablets Red 4.7.1 Analgesic for post-operative acute Add pain when other analgesics (paracetamol, NSAIDS and opioids) are found to be ineffective, not tolerated or contraindicated. Pain team recommendation only. Not for use in chronic pain 16/02/21 Semaglutide solution for Red 6.1.2.3 Type 2 diabetes mellitus in children Amend injection [Ozempic] ≥10y, not adequately controlled with diet, exercise, and metformin alone (or where metformin is contraindicated or not tolerated).

Severe obesity in children ≥10y with comorbidities, where a) Weight management is not adequately controlled with diet, exercise, and metformin (or where metformin is contraindicated or not tolerated), or

b) Exceptional circumstances prevent adherence to the above measures (e.g., severely autism, severe learning disabilities, immobility). 16/02/21 Phenol Swabs Red 13.11.5 Used for the treatment/ ablation of Add in-growing toe nails.

16/02/21 Nortriptyline Black 4.3.1 For treatment of post-stroke Remain tablets/capsules depression in updated Southern NFD Health guidelines.

Currently not supported for this indication in DPC area – remains NFD 16/02/21 Dapagliflozin tablets Amber 6.1.2.3 NICE TA679: Dapagliflozin for Amend (I) treatment of heart failure with reduced ejection fraction in patients with OR without diabetes

GPs may prescribe following specialist recommendation/SCG (not yet completed)

16/02/21 Semaglutide tabs Green 6.1.2.3 Second line to injectable GLP1-RAs Add [Rybelsus] for management of T2DM

GPs should seek specialist advice if seeking to switch patients from injectable to oral.

16/02/21 Hypertonic glucose 50% NFD 6.1.4 For use in prolotherapy. Add as injection NFD Individual patients may be considered via IFR application. 16/02/21 tablet Red 8.1.5 NICE TA670: Brigatinib for Amend [Alunbrig®] anaplastic lymphoma kinase (ALK)- positive advanced non-small-cell lung cancer that has not been previously treated with an ALK inhibitor (may be offered as an alternative to or ) 16/02/21 capsules Red 8.1.5 NICE Amend [Braftovi®] TA668: Encorafenib plus f or previously treated BRAF V600E mutation-positive metastatic colorectal cancer in adults who have had previous systemic treatment 16/02/21 infusion Red 8.1.5 NICE Amend [Tecentriq®] TA666: Atezolizumab (Tecentriq) with (Avastin or licensed biosimilar products) for treating advanced or unresectable hepatocellular carcinoma in adults who have not had previous systemic treatment, only if:

 they have Child-Pugh grade A liver impairment and an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

16/02/21 Caplacizumab infusion/ Red 9.1 NICE TA667: Caplacizumab with Add subcutaneous injection plasma exchange and [Calblivi®] is recommended, within its marketing authorisation, as an option for treating an acute episode of acquired thrombotic thrombocytopenic purpura (aTTP) in adults, and in young people aged 12 years and over who weigh at least 40 kg.

16/02/21 tablet Red 8.1.5 NICE Amend [Venclyxto®] TA663: Venetoclax plus obinutuzum ab is recommended as an option for untreated chronic lymphocytic leukaemia (CLL) in adults, only if:

 there is a 17p deletion or TP53 mutation, or  there is no 17p deletion or TP53 mutation, and fludarabine plus cyclophosphamide and (FCR), or bendamustine plus rituximab (BR), is unsuitable

Note: venetoclax plus is recommended for use within the Cancer Drugs Fund as an option for untreated CLL in adults, only if:

 there is no 17p deletion or TP53 mutation, and FCR or BR is suitable, and conditions for managed access agreement are followed. 16/02/21 Liraglutide Red 6.1.2.3 NICE TA664: Liraglutide (Saxenda) Amend subcutaneous injection for managing overweight and [only Saxenda®] obesity alongside a reduced-calorie diet and increased physical activity in adults only if (all criteria must be met):

 BMI of at least 35kg/m2  have non-diabetic hyperglycaemia  high risk of cardiovascular disease  prescribed in secondary care by a specialist multidisciplinary tier 3 weight management service

16/02/21 tablets Red 10.1.3 NICE TA665: Upadacitinib, with [Rinvoq®] methotrexate, is recommended as an option for treating active rheumatoid arthritis in adults whose disease has responded inadequately to intensive therapy with a combination of conventional disease- modifying anti-rheumatic drugs (DMARDs), only if:  disease is severe (a disease activity score [DAS28] of more than 5.1)

16/02/21 Trifluridine– Black 8.1.3 NICE TA669: Trifluridine–tipiracil for Add as tipiracil tablet [Lonsurf®] treating metastatic gastric cancer or NFD gastro-oesophageal junction adenocarcinoma after 2 or more therapies

(does not meet NICE's criterion to be considered a life-extending treatment at the end of life and not recommended for use with Cancer Drug Fund)

16/02/21 Vonicog alfa Red 9.1 NHS England has approved clinical Add [Veyvondi®] commissioning policy for the use of Vonicog alfa, within its licensed indication for the treatment and prevention of bleeding in adults with von Willebrand disease, when: desmopressin treatment alone is ineffective or not indicated for the following; • Treatment of hemorrhage and surgical bleeding, • Prevention of surgical bleeding.

16/02/21 Berotralstat tablets Red 3.4.3 Berotralstat is indicated for routine prevention of recurrent attacks of hereditary angioedema (HAE) in adult and adolescent patients aged 12 years and older (MHRA EAMS) [unlicensed] 26/02/21 Morphine MR granules Remov 4.7.2 Discontinued product 2021 remove sachets ed

1/12/20 Baricitinib tablets Black 10.1.3 Moderate - severe atopic dermatitis Add as [Olumiant] which has not responded NFD to dupilumab, or in those who qualify for, but are unsuitable for, dupilumab.

MEC/DPC: not supported other than in exceptional circumstances (use IFR process for eligible patients) 1/12/20 Aymes Actasolve Sect. 2 25 Dairy free/ vegan supplement Add Smoothie of enteral feeds 1/12/20 Complan Shake Sect.1 25 First line (UHS) powdered nutritional Add supplement of (replace Meritene shake) enteral feeds 1/12/20 Prosource TF Plant Sect.2 25 Protein energy malnutrition and /or Add of on a fluid restricted diet e.g. ICU, enteral wounds, pressure sores, burns, renal feeds disease, oncology, liver disease, bariatrics and the elderly malnourished. Patients who are vegetarian / vegan or avoid bovine products for cultural / religious reasons

1/12/20 Nutrison Peptisorb Sect.2 25 Dietary management of disease Add HEHP of related malnutrition in patients with enteral malabsorption and/or mal-digestion. feeds 1/12/20 Nutrison Sect. 2 25 Dietary management of disease Add Protien Plus Energy of related malnutrition in patients with enteral increased protein requirements +/- feeds fluid restriction. 1/12/20 Cyanocobalamin 1mg Green 9.1.2 Licensed preparation now available. Amend tablets [Orobalin]

1/12/20 Urea 10% cream Amber 13.2.1 Calmurid cream now discontinued. Amend (R) New formulation available ‘Udrate’ – added as an example preparation.

1/12/20 Tramadol ONCE daily Green 4.7.2 Clarification to state ONCE daily Amend preparations (XL) preparation (XL) are non–formulary (Tradorec XL®, Zamadol® 24hr, and Zydol XL®) Immediate and modified release preparations (BD) are formulary approved. 1/12/2020 Nifedipine (immediate Green 2.6.2 Use in the treatment of autonomic Amend release) capsules dysreflexia is considered ‘off label’ use.

1/12/20 Remdesivir Red 5.3 Updated to reflect the more Amend [Veklury] infusion positive position on remdesivir supply into the UK – revised interim clinical commissioning policy (Nov 2020). 1/12/20 Darolutamide Red 8.3.4.2 NICE TA660: Darolutamide with Add [Nubeqa] tablets androgen deprivation therapy for treating hormone-relapsed non- metastatic prostate cancer 1/12/20 Pembrolizumab injection Red 8.1.5 NICE TA661: Pembrolizumab for Amend [Keytruda] untreated metastatic or unresectable recurrent head and neck squamous cell carcinoma 1/12/20 Red 8.2.4 NICE TA656: Siponimod for treating Add [Mayzent] tablets secondary progressive multiple sclerosis 1/12/20 Carfilzomib injection Red 8.1.5 NICE TA657: Carfilzomib for Amend [Kyprolis] previously treated multiple myeloma 1/12/20 infusion Red 8.1.5 NICE TA658: Isatuximab with Add [Sarclisa] and dexamethasone for treating relapsed and refractory multiple myeloma. (CDF)

1/12/20 Galcanezumab Red 4.7.4.2 NICE TA659: Add pre-filled injection Galcanezumab for preventing [Emgality] migraine (episodic or chronic) in adults.

1/12/20 infusion Black 8.1.5 NICE TA662: Durvalumab in Amend to [Imfinzi] combination for untreated extensive- highlight stage small-cell lung cancer. NFD for Terminated appraisal as company this withdrew evidence submission indication

10/11/2020 Esomeprazole sachets Amber 1.3.5 Restricted to child health Add (R) only

For children >1 year and >10kg with feeding tubes.

10/11/2020 Meropenem- Red 5.1.2.2 Restricted to microbiology Add vaborbactam infusion approval only [Vaborem]

10/11/2020 Delafloxacin Red 5.1.12 Restricted to microbiology Add infusion/tablets approval only [Quofenix] (Not to be used as first-line treatment option) 10/11/2020 Cefiderocol infusion Red 5.1.2.1 Restricted to microbiology Add [Fetcroja] approval only

10/11/2020 Bath and Shower Black 13.2.1.1 All bath and shower Remove Emollients emollients have been (now listed as removed from the formulary NFD) Eg: in accordance with NHS Dermalo Bath England guidance on items additive that should not routinely be Emulsiderm Emollient prescribed in primary care. Bath additive Hydromol Bath and Soap avoidance and ‘Leave- Shower Emollient on’ emollient moisturisers Oilatum/Zerolatum can still be used for treating Emollient Bath eczema. These emollients additive can also be used as a soap substitute.

10/11/2020 Monofer injection Red 9.1.1.2 Name change from iron Amend isomaltoside to ferric derisomaltose to align the nomenclature globally(INN)

10/11/2020 Diamorphine nasal - 4.7.2 Product now discontinued Remove Spray [Ayendi]

10/11/2020 alfa 2a (eye - 11.8.2 Product now discontinued Remove drops) (unlicensed special) 10/11/2020 Estradiol transdermal Black 6.4.1.1 For hormonal replacement Remains NFD therapy. MEC and DPC do not support use. Other spray formulary options are considered more suitable for [Lenzetto] use 10/11/2020 mesylate Red 8.1.5 NICE TA654: Osimertinib for Amend tablets untreated EGFR mutation- [Tagrisso] positive non-small-cell lung cancer. It is recommended only if the company provides osimertinib according to the commercial arrangement [PAS available].

NICE TA653: Osimertinib for treating EGFR T790M mutation-positive advanced non-small-cell lung cancer (locally advanced or metabolic) when: · Disease progression seen after first-line treatment with an EGFR tyrosine kinase inhibitor and · the company provides according to the commercial arrangement

{Replaces NICEs TA621 and TA 416} 10/11/2020 infusion Red 8.1.5 NICE TA655: Nivolumab for Amend advanced squamous non- [Opdivo] small-cell lung cancer after chemotherapy 10/11/2020 Letermovir infusion Red 5.3.2.2 Licensed infusion now Add available. [Prevymis] NICE TA591: Letermovir for preventing cytomegalovirus disease after a stem cell transplant 10/11/2020 Alpelisib tablets Black 8.1.5 NICE TA652: Alpelisib with fulvestrant for treating Add as NFD [Piqray] hormone-receptor positive, HER2-negative, PIK3CA- positive advanced breast cancer (terminated appraisal). Not supported as evidence submission not provided by drug company.

06/10/2020 Mesalazine prolonged Amber 01.05.01 For those already Add release granules established on Pentasa [Pentasa PR sachets] branded granules in the management of mild- moderate ulcerative colitis, to prevent de-stabilising if switched to Salofalk during admission.

Salofalk brand to remain first-line preference for new patients. 06/10/2020 Risdiplam powder for Red 10.02 For the treatment of type 1 Add oral solution and type 2 Spinal Muscular Atrophy (SMA) in patients 2 months and older who are not suitable for authorised treatments.

Specialist use only.

Available via MHRA EAMS application for eligible patients.

06/10/2020 Red 08.01.05 NICE TA649: Polatuzumab Add [Polivy] injection vedotin (Polivy) with rituximab and bendamustine for treating relapsed or refractory diffuse large B- cell lymphoma in adults who cannot have a haematopoietic stem cell transplant.

06/10/2020 Naldemedine tablets Green 01.06.06 NICE TA651: for treating Add opioid-induced constipation in adults who have had laxative treatment. 06/10/2020 Pembrolizumab injection Black 08.01.05 NICE TA650: Pembrolizumab Add (Non- with for untreated formulary) advanced renal cell carcinoma is not supported as long-term benefit is uncertain and even despite this not deemed cost effective at current price. 6/10/2020 Dupilumab injection Black 03.04.02 NICE TA648: for treating Add (Non- chronic rhinosinusitis with formulary) nasal polyps. Terminated appraisal.

8/9/2020 Infliximab biosimilar Black 10.1.3 For subcutaneous injection. Add (Non- pre-filled syringe/pen Non-formulary for all formulary) [Remsima] indications while awaiting commissioning decision. 8/9/2020 tablets Black 8.1.5 NICE TA646: with Add (Non- [Daurismo] chemotherapy for untreated formulary) AML. Terminated appraisal. 8/9/2020 injection Red/ 9.1.3 Amended entry to red for Amend [Soliris] Black atypical haemolytic uraemic syndrome (NICE HST1) and black for relapsing neuromyelitis optica (NICE TA647). 8/9/2020 Treosulfan injection Red 8.1.1 NICE TA640: Treosulfan with Add [Trecondi] fludarabine for malignant disease before allogenic stem cell transplant. (N.B. treosulfan will remain non-formulary for palliative treatment of advanced epithelial ovarian cancer and for use prior to alloHSCT in patients with non-malignant disease) 8/9/2020 capsules Red 8.1.5 NICE TA643: Entrectinib for Add [Rozlytrek] treating ROS1-positive advanced non-small cell lung cancer NICE TA644: Entrectinib for treating NTRK fusion- positive solid tumours 8/9/2020 tablets Red 8.1.5 NICE TA642: Gilteritinib for Add [Xospata] treating relapsed or refractory acute myeloid leukaemia 8/9/2020 Red 8.1.5 NICE TA641: Brentuximab Amend injection vedotin in combination for untreated systemic anaplastic large cell lymphoma 8/9/2020 injection Red 8.1.5 NICE TA645: Avelumab with Amend [Bavencio] axitinib for untreated advanced renal cell carcinoma 8/9/2020 Vitamin B compound Green 9.6.2 Added ‘Restricted Use’ tag Amend strong tablets and link to RMOC Position Statement on oral vitamin B supplementation, and statement to use vitamin B compound strong in preference to vitamin B compound tablets.

[Note: UHS may prescribe vitamin B compound strong tablets for patients with Wernicke-Korsakoff syndrome - in this case all supplies (total 1 month) will be made by the hospital] 8/9/2020 Turoctocog alfa pegol Red 2.11 To be made available via Add injection [Esperoct] Homecare at UHS. Specialist use only (haematology). NHS England commissioned. 8/9/2020 Rurioctocog alfa pegol Red 2.11 To be made available via Add injection [Adynovi] Homecare at UHS. Specialist use only (haematology). NHS England commissioned. 8/9/2020 Melatonin oral solution Amber 4.1.1 Use supported by DPC in Add 5mg in 5ml [Colonis updated Shared Care Pharma] Guidelines. For use only when tablets are not suitable. N.B. alcohol has now been removed from formulation. Propylene glycol and sorbitol levels should be considered before prescribing for children. Tablets (crushed) or liquid specials may be preferred in younger infants or with high doses. 8/9/2020 Melatonin Pharma Nord Amber 4.1.1 Amendment of brand name Amend 3mg tablets (previously Bio-Melatonin tablets) and removed unlicensed tag (now licensed for short-term treatment of jet lag in adults). Supported as a treatment option for off label use in children with sleep disorders (see DPC Shared Care guidelines). Prescribe by brand name.

Note: Melatonin 3mg tablets (Colonis Pharma) are non- formulary. 8/9/2020 Elexacaftor/tezacaftor/ Red 3.7 Restricted to use in patients Add ivacaftor tablets as per NHS England [Kaftrio] commissioning policy statement 8/9/2020 Hydrocortisone sodium Amber 11.4.1 Added as an alternative Add phosphate preservative- option to prednisolone free single use eye preservative-free eye drops. drops [Softacort]

2/9/2020 Dupilumab Red 13.5.3 Approved for FOC supply via Amend subcutaneous injection MHRA EAMS for specialist [Dupixent] use only for children aged 6 to 11 years with severe atopic dermatitis (off label). Patients must be registered on Blueteq. 1/9/2020 Emtricitabine/rilpivirine/ Red 5.3.1 Specialist use only. Add tenofovir disoproxil Commissioned by NHS fumarate tablets England. [Eviplera] 25/8/2020 Clonidine transdermal - 2.5.2 Non-formulary. Unlicensed Add (non- patch preparation – in occasional formulary status) use at UHS – specialist use only – not suitable for primary care. Awaiting full formulary review. 25/8/2020 Fluphenazine decanoate Amber 4.2.2 Discontinued by Remove depot injection manufacturers and all stock [Modecate] expired 04/08/2020 Ceftolozane / Red 5.1.2.1 Restricted to ‘microbiology Amend tazobactam injection recommendation only’ for [Zerbaxa®] use in serious Gram- negative infection (hospital- acquired pneumonia including ventilator- associated pneumonia, intra-abdominal infection, urinary tract infection) due to multi-drug resistant organisms

04/08/2020 Danazol capsules Red 6.4.3 For long-term prophylaxis of Amend [Unlicensed import] hereditary angioedema.

Switched from AMBER to RED as UK licensed preparation was discontinued. 04/08/2020 Adapalene/benzoyl Green 13.6.1 Addition of 0.3% gel for Amend peroxide gel [Epiduo®]- moderate to severe papulopustular acne

04/08/2020 injection Red 1.5.3 NICE TA663: for treating Amend [Stelara®] moderately to severely active ulcerative colitis in adults when conventional therapy or a biological agent cannot be tolerated, or the disease has responded inadequately or lost response to treatment 04/08/20 Avatrombopag tablets Red 9.1.4 NICE TA626: Avatrombopag Add [Doptelet®] for treating in people with chronic liver disease needing a planned invasive procedure

Oral therapy.

Not yet available in UK. Expected date of availability November 2020 04/08/2020 Atezolizumab Red 8.1.5 NICE TA639: Atezolizumab Amend [Tecentriq®] with nab-paclitaxel is recommended for treating triple-negative, unresectable, locally advanced or metastatic breast cancer in adults whose tumours express PD-L1 at a level of 1% or more and who have not had previous chemotherapy for metastatic disease.

NICE TA638: Atezolizumab with carboplatin and etoposide is recommended as an option for untreated extensive-stage small-cell lung cancer in adults

04/08/20 Nedocromil eye drops Green 11.4.2 Discontinued. Remove [Rapitil®] Formulary alternatives include: sodium cromoglicate, olopatadine, lodoxamide, antazoline with xylometazoline

16/6/2020 Calcium carbonate and Green 9.5.1.1 Brand name change from Amend calcium lactate Sandocal® 1000 to Calvive® gluconate effervescent 1000 tablets [Calvive 1000] 16/6/2020 Red 8.1.5 NICE TA632: Trastuzumab Amend injection emtansine for adjuvant treatment of HER2-positive early breast cancer.

16/6/2020 Fremanezumab injection Red 4.7.4.2 NICE TA631: Add [Ajovy] Fremanezumab injection for preventing migraine. Criteria:  the migraine is chronic, that is, 15 or more headache days a month for more than 3 months with at least 8 of those having features of migraine  at least 3 preventive drug treatments have failed and  the company provides it according to the commercial arrangement. Stop if the migraine frequency does not reduce by at least 30% after 12 weeks of treatment.

Not recommended for preventing episodic migraine. 16/6/2020 oral Red 8.1.5 NICE TA630: Larotrectinib Add solution [Vitrakvi] for NTRK fusion-positive solid tumours

For use within Cancer Drugs Fund 16/6/2020 tabs Red 8.1.5 NICE TA628: Lorlatinib for Add [Lorviqua] previously treated ALK- positive advanced Non-small cell lung cancer (adults). 16/6/2020 Obinutuzumab inj Red 8.2.3 NICE TA629: Obinutuzumab Amend with bendamustine for treating follicular lymphoma after rituximab. 16/6/2020 Prasterone pessary Black 7.2.1 DPC Jun 2020: Not Add as NFD [Intrarosa] supported for the treatment of vulvar and vaginal atrophy in postmenopausal women - recommendation to remain non-formulary as no clear advantages over current treatment and potentially less safe (MEC evaluation) 16/6//20 pre-filled Red 1.5.3 New formulation for Amend syringe or pen for injection subcutaneous [Entyvio] administration. Supported by District Prescribing Committee (Chair’s Action June 2020). 16/6/20 Tinzaparin Red 2.8.1 Specialist use in paediatric Add 10,000unit/1ml patients ONLY multi use vial for injection Indication: Prophylaxis and treatment of [unlicensed use in thromboembolic disorders in children] long term/Homecare paediatric patients with no necessity to remain in hospital.

Not for use in adults (enoxaparin is LMWH of choice at UHS in adults).

Where possible use alternative CIVAS enoxaparin syringes in neonates due to benzyl alcohol content. LMWH use in children (UHS only) 16/6/2020 Dolutegravir-rilpivirine Red 5.3.1 For specialist use only. Add For the treatment of HIV-1 in adult

NHSE Clinical Commissioning Policy Ref 200210P

16/6/2020 Dolutegravir / Red 5.3.1 For specialist use only. Add lamivudine For the treatment of Human Immunodeficiency Virus (HIV-1) infected adults and adolescents over 12 years of age

NHSE Clinical Commissioning Policy Ref 200301P 16/6/2020 Benzathine Red 5.1.1.1 Specialist use by sexual Add benzylpenicillin injection health clinics ONLY (Benzathine penicillin G) Indication: Deep IM injection for syphilis as recommended in BASHH guidelines

Now licensed prep available 16/6/2020 Dequalinium chloride Red 7.2.2 Specialist use by sexual Add vaginal 10mg tablets health clinics only. For bacterial vaginosis when other treatments have failed 16/6/2020 Catephen (Camellia Red 13.7 Specialist use by sexual Add sinensis extract) 10% health clinics only when ointment other treatments have failed

For the treatment of external genital and perianal warts in immunocompetent patients aged >18 yrs. (recommended by BASHH)

Camellia sinensis extract is a green tea leaf extract 16/6/2020 Boric acid 600mg Red 7.2.2 Specialist use by sexual Add vaginal pessaries health clinics only. [unlicensed] For the treatment of chronic/recurrent vaginal candidiasis for which other treatments (incl. azoles, clotrimazole and nystatin) have failed.

16/6/2020 Temozolomide capsules Red 8.1.5 Specialist use only. Amend For treatment of newly diagnosed anaplastic astrocytoma without 1p/19q codeletion following surgery and radiotherapy (adults)

NHSE Clinical Commissioning Policy Ref 200203P 16/6/2020 Dexrazoxane inj Red 8.1 Specialist use only. Add [Cardioxane] For prevention of cardiotoxicity in children and young people < 25 years receiving high dose anthracyclines.

NHSE Clinical Commissioning Policy Ref 200204P

*Note: Savene brand (anthracycline extravasation) will remain as NFD 16/6/2020 Remdesivir injection Red 5.3 For treatment of COVID-19 Add [unlicensed] (patients hospitalised with suspected or laboratory- confirmed SARS-CoV-2 infection who meet the clinical criteria)

 EAMS alert  Remdesivir treatment and supply (UHS only)  NICE ES27 16/6/2020 Simple eye ointment Green 11.8.1 Discussed with primary care Remove (yellow soft paraffin, and ophthalmologists April liquid paraffin, wool fat) 2019. Due to high cost, all agreed this could be removed from formulary. 11/6/2020 Triamcinolone acetonide Red 11.4.1 For specialist ophthalmology Add ophthalmic suspension use only. for intravitreal Medical device. administration Approved for opacification of [Intracinol] the vitreous humour in eye surgery and treatment and prevention of macular oedema in inflammatory eye conditions (off-label). Supported by UHS Drugs Committee (May 2020) as a safer alternative to off-label use of Kenalog injection. 9/6/2020 Potassium Green 13.11.6 Added caution: Amend permanganate tablet to “Should be dispensed in prepare topical solution original container (i.e. as whole pack) only”

Added links to London Northwick Park Safety Bulletin (here) and UKMi Q&A on evidence for use of potassium permanganate (here)

12/5/2020 Cyanocobalamin Green 9.1.2 Restricted: for use only Add tablets/capsules 1,000 when patients are unable to micrograms (1mg) receive hydroxocobalamin injections (e.g. during COVID-19). Available only as nutritional supplement (refer to BNF for prescribing options). Self Care Medicine: Patients should be recommended to self purchase unless they meet the exception criteria outlined in the NHS England Guidance on conditions for which over the counter items should not routinely be prescribed in primary care (section 4.1.2 Vitamins and Minerals) 12/5/2020 Cyanocobalamin tablets Green 9.1.2 Restricted: for use only Add 50 micrograms when patients are unable to receive hydroxocobalamin injections (e.g. during COVID-19). Self Care Medicine: Not usually suitable for prescribing on the NHS. Patients should be recommended to self purchase unless they meet the exception criteria outlined in the NHS England Guidance on conditions for which over the counter items should not routinely be prescribed in primary care (section 4.1.2 Vitamins and Minerals) 12/5/2020 Omeprazole oral Amber 1.3.5 Available as licensed Amend solution 20mg in 5ml preparation (Rosemont), suitable for enteral tube administration. Powder should be reconstituted by pharmacist prior to dispensing to the patient (see product SPC). 12/5/2020 Alprostadil Green 7.4.5 Note added: Viridal Duo Amend intracavernosal injection brand preferred for initiation [Caverject, Viridal Duo] at UHS Approved by DPC due to ongoing supply problems with Caverject brand. 12/5/2020 Cimetidine tablets; oral Green 1.3.1 Temporary amendment to Amend solution include use as an alternative H2-antagonist while ranitidine not available (note: a PPI is generally preferred). Also remains available for palliative care use. 12/5/2020 Nizatidine capsules Green 1.3.1 Temporary addition for use Add as an alternative H2- antagonist while ranitidine not available (note: a PPI is generally preferred). 12/5/2020 Famotidine tablets Green 1.3.1 Temporary addition for use Add as an alternative H2- antagonist while ranitidine not available (note: a PPI is generally preferred).

28/4/2020 Hylo Night eye ointment Green 11.8.1 Name change for VitA-POS. Amend

17/4/2020 Aripiprazole 7.5mg/ml Red 4.2.1 Restricted to specialist use Add injection only by Southern Health in (intramuscular) [Abilify] accordance with rapid tranquilisation guidelines. 15/4/2020 Lenalidomide capsules Red 8.2.4 NICE TA627: Lenalidomide Amend [Revlimid] with rituximab for previously treated follicular lymphoma 15/4/2020 Edoxaban tablets Green 2.8.2 Now flagged up as 1st choice Amend [Lixiana] DOAC locally for stroke prevention in patients with non-valvular AF, with link to DPC Decision Aid.

11/3/2020 Peginterferon beta-1a Red 8.2.4 NICE TA624: Peginterferon Amend [Plegridy] beta-1a for treating relapsing-remitting multiple sclerosis 11/3/2020 Patiromer sorbitex Red/ 9.2.1.1 NICE TA623: Patiromer for Add calcium sachets Amber treating hyperkalaemia. [Veltassa] Red for acute use Amber for chronic use 11/3/2020 Dapoxetine tablets Amber 7.4.6 Restricted use. Add [Priligy] Supported by DPC Feb 2014 for use when recommended by a specialist for select patients who have failed or are not considered suitable for other treatment options. Note: for patients with concomitant depression/anxiety, 'off label' use of SSRIs would be preferred. 11/3/2020 Glibenclamide tablets Amber 6.1.2 Discontinued. Remove 11/3/2020 Darifenacin modified- Green 7.4.2 Removed status as second Amend release tablets choice. Solifenacin now preferred. 11/3/2020 Solifenacin tablets Green 7.4.2 Removed restriction to use Amend more cost effective alternatives when possible. Due to patent loss this is now one of the most cost effective options for treatment of urinary incontinence. Amended status to second choice (after oxybutynin and tolterodine). 11/3/2020 Ingenol mebutate gel Green 13.8.1 Discontinued by Remove [Picato] manufacturers following European Medicines Agency safety review. 11/3/2020 Fluorouracil 5% cream Green 13.8.1 Amended from amber to Amend [Efudix] green. Preferred treatment for actinic keratoses. 11/3/2020 Stiripentol Amber 4.8.1 Dravet syndrome added as Amend capsule/sachet approved indication. [Diacomit] Shared care guidelines supported by DPC Feb 2020. 11/3/2020 Cannabis extract Red 10.2.2 Restricted use. Add oromucosal spray Use is supported only [Sativex] for spasticity in patients with multiple sclerosis in accordance with NICE guidelines NG144. Must be initiated and supervised by a physician with specialist expertise in treating spasticity due to multiple sclerosis. For secondary care prescribing only until shared care guidelines have been developed and approved. 11/3/2020 Alimemazine Red/ 3.4.1 Removed from formulary in Remove tablets/liquid amber accordance with DPC recommendations (Feb 2020). High costs, poor evidence of efficacy, safety concerns. Alternative formulary options available. 11/3/2020 Testosterone 20mg/g Amber 6.4.2 Preferred brand of Add transdermal gel testosterone gel (better [Testavan] safety profile, lower cost). 11/3/2020 Modafinil tablets Amber 4.4 Restricted use. Add For treatment of excessive sleepiness associated with narcolepsy only. Prescribing to be initiated by sleep specialist/neurologist. Not supported for other (off label) indications. 10/3/2020 Norethisterone 350 Green 7.3.2.1 Micronor brand discontinued Remove/ Amend microgram tablets – removed from formulary. [Noriday] Noriday brand amended from blue to green.

3/2/2020 Medroxyprogesterone Green 7.3.2.2 Sayana Press brand added Amend acetate [Depo- as an alternative option Provera/Sayana Press] (useful for women who wish to self-administer – see primary care guidance here). 3/2/2020 Clonidine 50 Red 2.5.2 Restricted– only for short- Add micrograms in 5ml oral term, off label use in solution sedation/opioid withdrawal in high care paediatrics in accordance with UHS protocol; oral solution for use only when tablet formulation not suitable 3/2/2020 Olaparib Red 8.1.5 Olaparib for maintenance Amend capsules/tablets treatment of relapsed platinum-sensitive ovarian, fallopian tube or primary peritoneal cancer in adults with a BRCA1 or BRCA2 mutation. For use within the Cancer Drugs Fund. Replaces NICE TA381. Note: only the ‘tablets’ formulation are covered by this TA and TA598 (capsules are due to be discontinued) 3/2/2020 Lusutrombopag tablets Red 9.1.4 NICE TA617: Add [Mulpleo] Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure. 3/2/2020 capsules Red 10.2 NICE TA616: Cladribine for Amend [Mavenclad] treating relapsing–remitting multiple sclerosis. Replaces NICE TA493 3/2/2020 Cannabidiol 100mg per Red 4.8.1 Registered specialist only. Add ml oral solution NICE TAs614 and 615: [Epidyolex] Cannabidiol with clobazam for treating seizures associated with Lennox– Gastaut syndrome and Dravet syndrome 3/2/2020 capsules Red 8.1.5 NICE TA619: Palbociclib with Amend [Ibrance] fulvestrant for treating HR- positive, HER2-negative, advanced breast cancer. For use within the Cancer Drugs Fund. Blueteq registration required. 3/2/2020 Cycloserine capsules Red 5.1.9 Specialist microbiology/TB Add service recommendation only. (For use in accordance with WHO Guidelines for multi drug-resistant tuberculosis). 3/2/2020 Clofazimine capsules Red 5.1.9 Unlicensed. Add Specialist microbiology/TB service recommendation only. (For use in accordance with WHO Guidelines for multi drug-resistant tuberculosis). 3/2/2020 Diltiazem prolonged- Blue 2.6.2 Cost effective alternative Add release capsules brand for use in primary [Zemtard XL] care. 3/2/2020 Diltiazem prolonged- Green 2.6.2 Amended from blue to Amend release capsules green. [Viazem XL] This will now be the brand of choice at UHS. 3/2/2020 Diltiazem prolonged- Green 2.6.2 Discontinued by Remove release capsules manufacturers [Slozem] 3/2/2020 Zanamivir inj [Dectova] Red 5.3.4 For treatment of complicated Add and potentially life- threatening influenza A or B virus infection in accordance with official guidance. 3/2/2020 Fluticasone/umeclidiniu Green 3.2 Amended from amber to Amend m/vilanterol DPI green. [Trelegy Ellipta]

3/2/2020 Beclometasone/formote Green 3.2 Amended from amber to Amend rol/glycopyrronium MDI green. [Trimbow] 3/2/2020 Buprenorphine oral Amber 4.10.3 Not initiated in UHS. Add lyophilisate tablets Note: this brand is not [Espranor] interchangeable with other buprenorphine products.

18/12/19 Histidine, tryptophan, Red 9.2.2.1 Restricted – for specialist Add ketoglutarate perfusion cardiac surgery use only. Off solution [Custodiol] label use for administration into renal arteries as renal protection during open thoracoabdominal aortic aneurysm repair surgery. Solution is classed as a medical device – CE marked. 18/12/19 Rucaparib tablets Red 8.1.5 NICE TA611: Rucaparib for Add [Rubraca] maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer 18/12/19 tablets Red 8.1.5 NICE TA612: Neratinib for Add [Nerlynx] extended adjuvant treatment of hormone receptor-positive, HER2- positive early stage breast cancer after adjuvant trastuzumab 18/12/19 Sodium zirconium Red 9.2.1.1 NICE TA599: for treating Add cyclosilicate powder for hyperkalaemia oral suspension [Lokelma] 18/12/19 Cyclizine Green 4.6 RAG status updated. Amend tablet/injection Red Remains as green for oral, intramuscular or subcutaneous administration. Changed to red for intravenous administration. Due to safety concerns, intravenous use of cyclizine at UHS is restricted to short- term (i.e. single dose) only.

18/12/19 Oxetacaine & antacid Amber 12.3.1 Reclassified from ‘red’ to Amend oral suspension ‘amber’ as per DPC recommendations Dec 2019. Unlicensed product included in Drug Tariff specials list. For use in cancer care for oral mucositis and oesophageal lesions causing painful swallowing (see monograph here).

18/12/19 tablets Red 8.1.5 Tablets introduced in various Amend [Imbruvica] strengths to replace capsules formulation (discontinued) 18/12/19 Cefazolin injection Red 5.1.2.1 For MSSA bacteraemia in Add patients with mild penicillin allergy who are not suitable for treatment with flucloxacillin. SPC and PIL available on MHRA website. 18/12/19 Fluticasone propionate Amber 12.2.1 For chronic rhinosinusitis Add nasal drops [Flixonase with nasal polyps as second Nasule Drops] line option if control with glucocorticoid nasal sprays is insufficient. DPC recommend indication and intended duration of use should be communicated to primary care. 18/12/19 Melatonin modified Amber 4.1.1 Slenyto formulation added Amend release tablets as an option in accordance [Circadin/Slenyto] with DPC recommendations Aug 2019.

Restricted use - CAMHS initiation/supervision only for use in children with sleep disorders in accordance with DPC Shared Care guidance (currently under review). Tablets may be crushed but this will result in loss of modified-release properties. Note: use of Circadin in this setting will be off label, but is established practice. Current patients established on this formulation may continue.

21/11/19 Safinamide tablets Amber 4.9.1 Status amended to Amber Amend [Xadago] as per Shared Care Guidelines for Parkinson’s. Black triangle status removed. 21/11/19 Guanfacine Prolonged Amber 4.4 Added to formulary as per Add release tablets [Intuniv] CAMHS Shared Care guidelines for ADHD. 21/11/19 Insulin degludec 100 Green 6.1.1.2 Switched from amber to Amend units per ml injection green as per DPC Jun 19. [Tresiba]

21/11/19 Lumacaftor and Red 3.7 Added as per NHS England Add ivacaftor access agreement. Negative Tablets/granules NICE TA398 removed for [Orkambi] clarity. 21/11/19 Tezacaftor and ivacaftor Red 3.7 Added as per NHS England Add [Symkevi] access agreement for CF patients. 21/11/19 Ivacaftor tablets Red 3.7 Added as per NHS England Amend [Kalydeco] access agreement for CF patients. 21/11/19 Tranexamic acid 5% Red 2.11 Unlicensed special added for Add mouthwash use in post oral surgery bleeding. 21/11/19 Isavuconazole capsules Red 5.2.1 Added to formulary as Add or injection [Cresemba] already in use and commissioned by NHSE. 21/11/19 Rivaroxaban tablets Green 2.8.2 NICEIncluded TA607 on :Bluteq. Rivaroxaban Amend [Xarelto] for preventing atherothrombotic events in people with coronary or peripheral artery disease 21/11/19 Pentosan polyfusate Red 7.4.3 NICE TA610: Pentosan Amend sodium capsules polysulfate sodium for treating bladder pain syndrome. 21/11/19 Lanadelumab 300mg Red 3.4.3 NICE TA606: Lanadelumab Add subcutaneous injection for preventing recurrent attacks of hereditary angioedema. 21/11/19 Levonorgestrel IUS Amber 7.3.2.3 Second entry for use in Add [Kyleena] obstetrics off-label for heavy menstrual bleeding where Mirena/Levosert devices are too large

21/11/19 Lubiprostone capsules NA 1.6.7 Removed from formulary as Remove [Amitiza] has been discontinued in UK 21/11/19 Pembrolizumab injection Red 8.1.5 NICE TA477 removed and Amend replaced by TA600.

23/10/19 Pembrolizumab inj Red 8.1.5 NICE TA600: for untreated Amend metastatic squamous non small-cell lung cancer (with carboplatin and paclitaxel). For use within the Cancer Drugs Fund. 23/10/19 Botulinum neurotoxin Red 1.2 NICE TA605: Xeomin Amend type A [Xeomin] (botulinum neurotoxin type A) for treating chronic sialorrhoea.

23/10/19 Bictegravir/emtricitabin Red 5.3.1 Treatment for HIV-1 in Add e/enofovir/alafenamide adults in line with criteria tablets [Biktarvy] stipulated in NHS England Clinical Commissioning Policy (170131P). Specialist use only. 23/10/19 Pitolisant tablets Red 4.1 For specialist sleep clinic use Add [Wakix] in patients aged ≥18 years, only when conventional stimulants have failed/not tolerated, and sodium oxybate is not suitable/not tolerated.

23/10/19 Flecainide oral solution Amber 2.3.2 Unlicensed special. Add 25mg in 5ml For use in children unable to swallow tablets.

23/10/19 Heparin Sodium Flush Amber 2.8.1 Restricted use in primary Amend 50 units in 5ml care. GPs to prescribe only for children for administration by specialist paediatric community nurses.

28/08/19 Bedaquiline tablets Red 5.1.9 For multidrug-resistant and Add [Sirturo] extensively drug-resistant tuberculosis in line with criteria stipulated in NHS England Clinical Commissioning Policy (170132P). Specialist use only. All patients must be registered on Blueteq. 28/08/19 Delamanid tablets Red 5.1.9 For multidrug-resistant and Add [Deltyba] extensively drug-resistant tuberculosis in line with criteria stipulated in NHS England Clinical Commissioning Policy (170132P). Specialist use only. All patients must be registered on Blueteq. 28/08/19 DEKAs/DEKAs Plus Amber 9.6.7 Vitamin and mineral Add vitamins supplements for use when liquid/capsules/chewabl recommended by a e tabs/softgels specialist in patients with cystic fibrosis For further info see website (link) 28/08/19 Paravit-CF vitamins Amber 9.6.7 Fat-soluble vitamin Add liquid/capsules supplements for use when recommended by specialist in patients with cystic fibrosis. For further info see website (link) 28/08/19 Clobetasone, Green 13.4 For short-term use only in Add oxytetracycline, nystatin accordance with product cream [Trimovate] licence. Not usually a first- line treatment. Note: remains non-formulary for off label use in chronic wound management 28/08/19 Nusinersen injection Red 10.2 NICE TA588: for treating Amend [Spinraza] spinal muscular atrophy

28/08/19 injection Red 8.1.5 NICE TA589: for treating Amend acute lymphoblastic leukaemia in remission with minimal residual disease activity 28/08/19 Fluocinolone acetonide Red 11.4.1 NICE TA590: for treating Amend intravitreal implant recurrent non-infectious [Iluvien] uveitis 28/08/19 Letermovir tablets Red 5.3.2.2 NICE TA591: for preventing Add [Prevymis] cytomegalovirus disease after a stem cell transplant.

28/08/19 injection Red 8.2.4 NICE TA592: for treating Add [Libtayo] metastatic or locally advanced cutaneous squamous cell carcinoma. 28/08/19 tablets Red 8.1.5 NICE TA593: for treating Amend [Kisqali] hormone receptor-positive, HER2-negative, advanced breast cancer. 28/08/19 tablets Red 8.1.5 NICE TA595: for untreated Add [Vizimpro] EGFR mutation-positive non- small-cell lung cancer.

17/7/19 Triamcinolone with Green 13.04 Removed from formulary as Remove chlortetracycline discontinued Feb 2017. ointment (Aurecort) 17/7/19 Lenalidomide capsules Red 8.2.4 TA586: Lenalidomide plus Add (Revlimid) dexamethasone for multiple myeloma after 1 treatment with bortezomib TA587: Lenalidomide plus dexamethasone for previously untreated multiple myeloma

19/6/19 PARI O-PEP; Aerobika; Amber 3.12 For initiation by specialist Add Acapella Choice physiotherapist or oscillating positive respiratory clinician only. expiratory pressure For airways clearance in devices selected patients with chronic sputum-producing lung disease, e.g. cystic fibrosis, bronchiectasis, COPD. All follow up and monitoring of patients, and routine replacement of devices to be carried out in secondary care. Primary care prescribing on FP10 only when required for urgent supply of additional/replacement device (Drug Tariff listed approved appliances). PARI O-PEP 1st choice, Aerobika 2nd, Acapella 3rd. [Note: all other OPEP devices (e.g. Flutter, RC- Cornet, LungFlute) non- formulary – for use in exceptional circumstances only]. 19/6/19 Mepivacaine 3% Red 15.2 For specialist use only in Add injection [Scandonest Solent Sexual Health Plain] Service. For selected patients as intra-cervical block to facilitate insertion of intra- uterine contraception (off- label use) in accordance with FSRH guidance. 19/6/19 Epimax Paraffin-free Green 13.2.1 Restricted - for use only in Add ointment patients intolerant to paraffin-containing products. Note: MHRA safety warnings re: fire risks also apply to paraffin-free emollients.

19/6/19 Diclofenac sodium 75mg Red 15.1.4.2 Restricted to paediatric Amend in 3ml inj theatresNote: MHRA only, safety or forwarnings adults re: if fireketorolac risks also injection apply to not paraffin - available. Referfree emollients. to product information or Medusa IV guide for instructions on administration. Must be diluted and buffered prior to administration by IV infusion. Not suitable for IV bolus. Use in children is off label. 19/6/19 Glycopyrronium - 1.2 May be continued in existing Remove 320micrograms/ml oral patients. solution [Sialanar] 1mg/5ml oral solution preferred for new patients.

19/6/19 Glycopyrronium Amber 1.2 For severe sialorrhoea in Add Bromide 1mg/5ml oral children and adolescents solution with chronic neurological disorders.

19/6/19 Rosuvastatin tabs Green 2.12 Reserved for use in patients Add requiring high intensity statin unable to tolerate/unsuitable for atorvastatin or high dose 19/6/19 Hyaluronic acid gel Red 7.5 Forsimvastatin localised use in the Amend uterus only, for prevention of adhesions. Use products registered as medical devices (i.e. CE marked) or medicines only, e.g. Hyalobarrier®; Hyaregen®; Materegen®. 19/6/19 Tafamidis caps Red 2.14 Specialist use only. NHS Add [Vyndaqel] England specialised commissioning for treatment of transthyretin amyloid cardiomyopathy in adults in Trusts providing specialised amyloidosis services. Available via MHRA EAMS application for eligible patients. Not routinely stocked at UHS. If required, liaise with lead divisional pharmacist.

19/6/19 Trientine caps/tabs Red 9.8.1 Specialist use only. For Add treatment of Wilson's disease in accordance with NHS England Clinical Commissioning Policy. Not routinely stocked at UHS. If required please liaise with divisional lead pharmacist. [N.B. Available as trientine dihydrochloride 300mg capsules and trientine tetrahydrochloride (Cuprior) 150mg tablets. NHS England confirm that both formulations will be commissioned] 19/6/19 Durvalumab inj Red 8.1.5 NICE TA578: for locally Add [Imfinzi] advanced unresecatble non- small-cell lung cancer after platinum-based chemoradiation 19/6/19 inj Red 8.2.4 NICE TA585: for treating Amend [Ocrevus] primary progressive multiple scerosis 19/6/19 Atezolizumab infusion Red 8.1.5 NICE TA584: for treating Amend metastatic non-squamous non-small-cell lung cancer (in combination)

19/6/19 Ertugliflozin tabs Green 6.1.2.3 NICE TA583: with metformin Amend and a DPP-4 inhibitor for treating type 2 diabetes 19/6/19 Inotersen inj [Tegsedi] Red 9.8.1 NICE HST9: for treating Add hereditary transthyretin amyloidosis 13/6/19 Burosumab inj Red 9.8.1 NICE HST8: for treating X- Add [Crysvita] linked hypophosphataemia in children and young people. UHS is a specialist centre.

22/5/19 Nivolumab inj Red 8.1.5 NICE TA581: for untreated Amend advanced renal cell carcinoma, with . Available through Cancer Drugs Fund, only if conditions in the managed access agreement are followed. 22/5/19 tabs Red 8.1.5 NICE TA579: for HR+, Amend HER2- advanced breast cancer (with fulvestrant after endocrine therapy). Available through Cancer 22/5/19 Brentuximab vedotin inj Red 8.1.5 NICEDrugs TA577 Fund.: for CD-30+ Amend cutaneous T-cell lymphoma 22/5/19 Conestat alfa inj Red 3.4.3 For treatment of acute Add [Ruconest] severe attacks in hereditary angioedema due to C1 inhibitor deficiency/dysfunction in accordance with NHS England Specialised Clinical Commissioning policy only (Ref NHSCB/B09/P/b). 22/5/19 Mexiletine caps Red 10.2.2 For the treatment of Add [Namuscla] myotonia in patients with non-dystrophic myotonic disorders. Specialised commissioning. Remains amber for cardiology patients (unlicensed) – section 2.3.2

24/4/19 Pertuzumab inj Red 8.1.5 NICE TA569: for adjuvant Amend treatment of HER 2-positive early stage breast cancer 24/4/19 Brigatinib tabs Red 8.1.5 NICE TA571: for ALK- Add positive advanced non-small cell lung cancer after crizotinib 24/4/19 Ertugliflozin tabs Green 6.1.2.3 NICE TA572: for type 2 Add diabetes, as monotherapy or with metformin 24/4/19 infusion Red 8.1.5 NICE TA573: for previously Amend treated multiple myeloma, with bortezomib and dexamethasone (Cancer Drugs Fund) 24/4/19 Red 13.5.3 NICE TA574: for moderate Amend to severe plaque psoriasis

24/4/19 Tildrakizumab inj Red 13.5.3 NICE TA575: for moderate Add [Ilumetri] to severe plaque psoriasis 24/4/19 Ciclosporin eye drops Amber 11.4.2 Ophthalmologist initiation Add [Verkazia] only. Prescribe by brand name (different licensed indication to Ikervis brand).

24/4/19 Lixisenatide inj 6.1.2.3 No longer recommended by Remove UHS diabetes team for new patients. May be continued in established patients. 24/4/19 Semaglutide inj Green 6.1.2.3 Add [Ozempic]

25/3/19 Safinamide tabs Red 4.9.1 Supported by DPC June Add 2018 – awaiting shared care guidance. Added to formulary as ‘red’ in interim. Restricted use for late-stage Parkinson’s Disease and motor fluctuations where treatment with rasagiline/selegiline and entacapone has failed/not tolerated.

20/3/19 Ulipristal tabs [Esmya] Red 6.7.2 Amended from amber to red Amend in view of MHRA safety update Aug 2018 20/3/19 Abemaciclib tabs Red 8.1.5 NICETA563: for previously Add [Verzenios] untreated, HR-positive, HER2-negative, locally advanced or metastatic breast cancer 20/3/19 Encorafenib caps Red 8.1.5 NICE TA562: with Add [Braftovi] for unresectable or metastatic BRAF V600 mutation-positive melanoma

20/3/19 Venetoclax tabs Red 8.1.5 NICE TA561: with rituximab Amend for previously treated CLL 20/3/19 Benralizumab inj Red 3.4.2 NICE TA565: for severe Add [Fasenra] eosinophilic asthma 20/3/19 Latanoprost with timolol Amber 11.6 Added ‘unit dose eye drops’ Amend eye drops/unit dose eye (Fixapost) as preservative- drops free option for combination prostaglandin analogue/beta-blocker (more cost effective than tafluprost/timolol or bimatoprost/timolol). Use restricted to patients allergic/intolerant of preservatives or high risk of developing allergy since generic (preservative- containing) latanoprost/timolol remain significantly lower cost. 20/3/19 Cobicistat tablets Red 5.3.1 Specialist only, in line with Add (Tybost); NHSE Clinical Cobicistat/elvitegravir/e Commissioning Policy mtricitabine/tenofovir F03/P/b disoproxil fumarate tablets (Stribild); Cobicistat/darunavir/em tricitabine/tenofovir alafenamide fumarate tablets (Symtuza)

27/2/19 Grass pollen allergen Red 3.4.2 Specialist allergy clinics only Add extract (Grazax®) inj

27/2/19 Lais® 1,000 AU Red 3.4.2 Unlicensed (available by Add sublingual tablets import). Specialist allergy clinics only, for use when licensed alternatives are not suitable

27/2/19 Progesterone Green 6.4.1.2 For oral administration as Add (micronised) HRT 100mg (Utrogestan®) capsules 27/2/19 Lidocaine medicated See 4.7.3 Restricted use. Amend plaster 5% comme Green for use in patients nts who have been treated in line with NICE CG173: Neuropathic pain, but are still experiencing pain associated with previous herpes zoster infection (post-herpetic neuralgia) (licensed indication). Amber for chronic neuropathic pain/focal neuralgia ['off label' use] in exceptional circumstances only (e.g. other treatment options have failed or cannot be used due to co- morbidities) in a co- operation arrangement with chronic pain or cancer care/palliative care specialist teams as per DPC Chronic Pain Prescribing Guidelines or Wessex Palliative Care Guidelines. Red for use in rib fracture pain (section 15.02).

27/2/19 Diclofenac oral Red 10.1.1 Unlicensed special. Add suspension 50mg in 5ml Restricted use - short term use for postoperative analgesia in children. Second line to ibuprofen and only when licensed options are not suitable.

30/1/19 tabs Red 8.1.5 TA555: for previously Amend [Stivarga] treated advanced hepatocellular carcinoma 30/1/19 Nivolumab infusion Red 8.1.5 TA558: for adjuvant Amend [Opdivo] treatment of completely resected melanoma with lymph node involvement or metastatic disease

30/1/19 caps Red 8.1.5 TA551: for untreated Amend [Lenvima] advanced hepatocellular carcinoma

30/1/19 Liposomal daunorubicin- Red 8.1.5 TA552: for untreated acute Add cytarabine myeloid leukaemia infusion[Vyxeos]

30/1/19 Pembrolizumab inj Red 8.1.5 TA553: for adjuvant Amend [Keytruda] treatment of resected melanoma with high risk of recurrence (available through Cancer Drugs Fund)

TA557: for untreated, metastatic, non-squamous non-small-cell lung cancer, with pemetrexed and platinum chemotherapy (available through Cancer Drugs Fund)

30/1/19 Hydrocortisone granules Amber 6.3.1 Restricted for use only when Add in capsules for opening standard tablets are not [Alkindi] suitable or practical, e.g. infants/young children on doses <5mg. UHS will only routinely stock lower strengths, i.e. 0.5mg, 1mg and 2mg. Patients on doses ≥5mg should be switched to standard tablets, which can be divided using a tablet cutter. Unlicensed in patients <18 years. Discuss options for adult patients unable to swallow tablets with pharmacist.

30/1/19 Clobetasone butyrate 13.4 No longer supported by DPC Remove 0.05% with 11.12.18. oxytetracycline 3% and nystatin cream [Trimovate] 30/1/19 biosimilar Red 1.5.3; Biosimilars now available at Add injections [Imraldi, 10.1.3; UHS for use in all indications Amgevita] 11.4; (except paediatric uveitis). 13.5.3 3/1/19 Bumetanide Green 2.2.2 Removed injection Amend tablet/liquid/injection formulation as product discontinued (not ordered at UHS since 2012)

21/12/18 tabs Red 1.5.3 TA547: Previously treated Add moderately to severely active ulcerative colitis 21/12/18 Acetic acid spray [Ear Blue 12.1.1 Added(adults) for use in primary Add Calm] care for otitis externa 21/12/18 Dexamethasone/framyc Green 12.1.1 Changed from amber to Amend etin/gramicidin ear green drops [Sofradex] (remains amber for ocular use) 21/12/18 Dexamethasone/neomy Green 12.1.1 Changed from amber to Amend cin/acetic acid spray green [Otomize] 21/12/18 Empagliflozin Green 6.1.2.3 Remove statement “first line Amend SGLT-2 inhibitor for patients with established cardiovascular disease”. Trial data now supports CV safety and possible benefits for all 3 licensed drugs in this class 21/12/18 Ranolazine prolonged- Amber 2.6.3 Specialist recommendation Add release tabs [Ranexa] only. Third-line option for stable angina where other anti-anginals are contraindicated/not tolerated/ due to hypotensive and/or bradycardic effects and revascularisation options not available 21/12/18 Pregabalin caps Green 4.7.3; Changed from amber to Amend 4.8.1 green for neuropathic pain and anxiety (remains amber for epilepsy)

21/12/18 Gemtuzumab Red 8.1.5 TA545: Acute myeloid Add ozogamicin infusion leukaemia (CD-33 positive, untreated)

21/12/18 Levofloxacin nebuliser Red 5.1.2 For use according to NHS Add solution [Quinsair] (special England commissioning ised policy for chronic commis Pseudomonas lung infection sioning in cystic fibrosis (adults) )

24/10/18 Bezafibrate MR tab Amber 2.12 Additional use off-label for Amend treatment of primary biliary cholangitis 24/10/18 inj Red 10.1.3 Additional use for treatment Amend of toxicities associated with CAR- therapy 24/10/18 Moviprep Red 1.6.5 First choice bowel prep Add

24/10/18 tab Red 8.1.5 TA 542: Advanced renal cell Amend carcinoma 24/10/18 Tofacitinib tab Red 10.1.3 TA 543: Active psoriatic Amend arthritis

24/10/18 Red 8.1.5 TA 544: Adjuvant in BRAF Amend cap/ tab V600 +ve melanoma

26/09/18 granules Red/A 8.2.2 Formulation added for use in Add mber paediatrics. Red for transplant indications, amber for all other indications 26/09/18 Lutetium (177Lu) Red 8.1.5 TA539: Unresectable Add oxodoteotride infusion metastatic neuroendocrine tumours 26/09/18 Pembrolizumab infusion Red 8.2.4 TA540: Relapsed or Add refractory classical Hodgkin 26/09/18 Red 8.1.5 TA541:lymphoma Relapsed/refractory Add infusion B-cell acute lymphoblastic leukaemia

29/08/18 Aprepitant liquid Red 4.6 Prevention of N+V with Add highly and moderately emetogenic chemotherapy in children 6months-12 years. 29/08/18 Rifampicin/isoniazid/ Red 5.1.9 To be used in place of Add pyrazinamide/ethambut separate constituents. 50 ol tablets patients to initiate therapy [Rimstar/Voractiv] but not all will continue on quadruple therapy. 29/08/18 Ciprofloxacin and Red 12.1 For acute otitis Add dexamethasone ear externa/media where drops [Cilodex] aminoglycoside should not be used. Licensed 29/08/18 Ulipristal acetate tablets Amber 6.7.2 Removedpreparation. due to safety Add [Esmya] concerns. Added in line with MHRA restrictions. 29/08/18 Levonorgestrel IUS Green 7.3.2.3 Alternative IUS. Add [Levosert/Kyleena]

29/08/18 Levonorgestrel IUS 7.3.2.3 Replaced by Kyleena Remove [Jaydess]

29/08/18 inj Red 1.5.3 Additional indication for use Add in Crohn’s disease. 29/08/18 Glycopyronnium Green 1.2 For severe sialorrhoea in Add bromide liquid children and adolescents [Sialanar] with chronic neurological disorders. 29/08/18 Trehalose/sodium Green 11.8.1 For the treatment of dry Add hyaluronate eye drops eyes, in line with guidelines. [Thealoz-duo] 29/08/18 Riluzole liquid Amber 4.9.3 For patients who have Add difficulty crushing tablets 29/08/18 Budesonide MR tablets Amber 1.5.2 Specifically formulated for Add [Cortiment] UC 29/08/18 Piracetam tablets Amber 4.8.1 In line with NICE guidance. Add 29/08/18 Stiripentol capsules Amber 4.8.1 To add for use in adults in Amend line with NICE guidance. 29/08/18 Prednisolone rectal Amber 1.5.2 For use in paediatrics only Add foam 29/08/18 Oxycodone injection Amber 4.7.2 Amber for use in palliative Amend care 29/08/18 Fluticasone/Umeclidiniu Green 3.2 Triple combination DPI for Add m/Vilanterol inhaler COPD [Trelegy] 29/08/18 Enoxaparin injection Amber 2.8.1 Change from red to amber Amend for extended 29/08/18 Pembrolizumab infusion Red 8.1.5 TA531:thromboprophylaxis PD-L1+ve NSCLC Add

29/08/18 Ocrelizumab infusion Red 8.2.4 TA533:Relapsing-remitting Add MS 29/08/18 Dupilumab injection Red 13.5.3 TA534: Moderate to severe Add atopic dermatitis 29/08/18 Levatinib capsules & Red 8.1.5 TA535: Thyroid cancer Add tablets 29/08/18 Alectinib capsules Red 8.1.5 TA536: ALK +ve NSCLC Add

29/08/18 Ixekizumab injection Red 13.5.3 TA537: Psoriatic arthritis Add

29/08/18 beta Red 8.1.5 TA538: For neuroblastoma Add infusion 29/08/18 Emicizumab inj Red 8.1.5 Policy 170067/P: Add Prophylaxis in people with congenital haemophilia A with factor VIII inhibitors. 29/08/18 Idebenone capsules Red 11.8.1 For DMD as part of EAMS. Add

18/07/18 Fentanyl nasal spray Amber 4.7.2 For use in palliative care, Add [Pecfent] endorsed by DPC. Prescribe by brand. 18/07/18 Fentanyl sublingual Amber 4.7.2 For use in palliative care, Add tablets [Abstral] endorsed by DPC. Prescribe by brand. 18/07/18 Celecoxib capsules Green 10.1.1 Endorsed by DPC. Add

18/07/18 Parecoxib injection Red 10.1.1 For use in palliative care by Add CSCI as per palliative care formulary. Endorsed by DPC. 18/07/18 Ondansetron tablets Green 4.6 Change from amber to Amend green endorsed by DPC.

18/07/18 Intranasal diamorphine Red 4.7.2 For severe acute pain in Add paediatric patients in ED.

18/07/18 Ticagrelor orodispersible TBC 2.9 As per NICE TA236. An Add tablets option for patients unable to swallow clopidogrel. 18/07/18 Epimax ointment Green 13.2.1 Cheaper preparation to Add replace Epaderm ointment.

18/07/18 Lacosamide injection Red 4.8.1 For NBM patients. Add

18/07/18 Guselkumab inj Red 13.5.3 TA 521: For plaque psoriasis Add

18/07/18 Pembrolizumab inj Red 8.1.5 TA 522: For metastatic Amend urothelial carcinoma when cisplatin unsuitable 18/07/18 capsules Red 8.1.5 TA 523: For FLT-3 +ve Add myeloid leukaemia

18/07/18 Brentuximab vedotin inj Red 8.1.5 TA 524: For CD-30 +ve Amend Hodgkin lymphoma 18/07/18 Atezolizumab infusion Red 8.1.5 TA 525: For metastatic Amend urothelial carcinoma after platinum chemotherapy 18/07/18 Arsenic trioxide infusion Red 8.1.5 TA 526: For promyelocytic Add leukaemia

18/07/18 Beta-interferon injection Red 8.2.4 TA 527: For multiple Amend sclerosis

18/07/18 Glatiramer acetate Red 8.2.4 TA 527: For multiple Amend sclerosis

18/07/18 Niraparib capsules Red 8.1.5 TA 528: For fallopian tube Add and peritoneal cancer

18/07/18 Crizotinib capsules Red 8.1.5 TA 529: For NSCLC Amend

18/07/18 Nivolumab infusion Red 8.1.5 TA 530: For metastatic Amend urothelial cancer

25.06.18 Pegvisomant inj Red 6.8.1 As per commissioning Add criteria

25.06.18 Sildenafil liquid Red 2.5.1 For pulmonary hypertension Add in line with specialised commissioning criteria 25.06.18 Eculizumab inj Red 9.1.3 NICE HST1 Add

25.06.18 Zafirlukast tabs Amber 3.3.2 Discontinued by Remove manufacturers

29/05/18 Flunarizine tab/caps Non- 4.7.4.2 Not evaluated by DPC. Add (as non- formula Unlicensed in the UK. Not formulary) ry recommended for prescribing locally. 23/05/18 Timolol 0.1% unit dose Amber 11.6 Cheaper alternative Add eye gel preservative-free preparation for glaucoma 23/05/18 Pembrolizumab inf Red 8.1.5 TA 519: For locally advanced Add or metastatic urothelial carcinoma 23/05/18 Atezolizumab inf Red 8.1.5 TA 520: For locally advanced Add or metastatic non-small-cell lung cancer

25/04/18 Mydriasert (tropicamide Red 6.7.2 For pre-operative mydriasis. Add and phenylephrine ophthalmic insert) 25/04/18 Pentosan Polysulfate Red 7.4.3 Recommended for use Add sodium caps locally, but not for use in (Unlicensed) primary care. 25/04/18 Cabozantinib caps Red 8.1.5 TA 516: For medullary Amend thyroid cancer 25/04/18 Avelumab inj Red 8.1.5 TA 517: For metastatic Add Merkel cell carcinoma 25/04/18 Tocilizumab inj Red 10.1.3 TA 518: For giant cell Amend ateritis 25/04/18 Levofloxacin tab Red 5.1.2 In line with trust guidelines Add and for prophylaxis in newly diagnosed myeloma patients

28/03/18 Ulipristal tab - 6.7.2 Removed due to safety Remove warnings 28/03/18 inj - 8.2.2 Removed due to safety Remove warnings 28/03/18 Acetylcysteine Amber 3.7 Added in place of unlicensed Add effervescent tab formulation, for existing IPF 28/03/18 Sofosbuvir-velpatasvir- Red 5.3.3.2 NpatientsICE TA already507 – For on chronic Add voxilaprevir tabs hepatitistreatment C in adults

28/03/18 Pertuzumab inj Red 8.1.5 NICE TA 509 – In Add combination with trastuzumab and doxetaxel for breast cancer 28/03/18 Daratumumab inj Red 8.1.5 NICE TA 510 – For relapsed Add or refractory multiple myeloma 28/03/18 Brodalumab inj Red 13.5.3 NICE TA 511 – Moderate to Add severe plaque psoriasis

28/03/18 cap Red 8.1.5 NICE TA 512 – Advanced Add renal cell carcinoma 28/03/18 Obinutuzumab inj Red 8.2.3 NICE TA 513 – Advanced Add follicular lymphoma

26.02.18 Ivermectin tablets Red 13.10.4 Restricted use - on Add microbiology advice only 26.02.18 High sodium powders Red 9.2.1.2 Nutrition team only Add (“St. Mark’s solution”) (For scabies - unlicensed) (Added to formulary again following notice from manufacturers to discontinue Glucodrate sachets) 22.02.18 Ibrutinib cap Red 8.1.5 TA502: For Amend relapsed/refractory mantle cell lymphoma 22.02.18 cap Red 8.1.5 TA500: For ALK positive non Amend small cell lung cancer 22.02.18 Glecaprevir with Red 5.3.3.2 TA499: For chronic hepatitis Add pibrentasvir cap C [Maviret] 22.02.18 tab Red 8.1.5 TA498: with lenvatinib for Amend [Afinitor] advanced renal cell 22.02.18 Lenvatinib cap [Kisplyx] Red 8.1.5 TA498:carcinoma with everolimus for Add advanced renal cell 22.02.18 Golimumab inj Red 10.1.3 TA497:carcinoma For non-radiographic Amend axial spondyloarthritis 22.02.18 Ixazomib cap Red 8.1.5 TA505: For Add relapsed/refractory multiple myeloma 22.02.18 cap Red 3.11 TA504: For idiopathic Amend pulmonary fibrosis (replaces TA282) 22.02.18 Viteyes 2 Formula Amber 9.6.7 Removed from formulary as Remove caps/softgels recommended by DPC Feb 2018. No new patients and GPs/ophthalmologists to deprescribe in current patients. Patients wishing to continue may purchase OTC. 22.02.18 Plasma-Lyte 148; N/A 9.2.2.1 Restricted - for use in Add Plasma-Lyte 148 with Southampton Children’s Glucose 5% w/v Hospital as alternative to intravenous infusion compound sodium lactate (Hartmann’s) and as standard fluid of choice.

22.02.18 Humulin I (isophane Green 6.1.1.2 Not a brand of choice at UHS Add insulin) inj but several patients admitted on it therefore added to formulary.

22.02.18 Infliximab biosimilar inj Red 1.5.3 For use in gastroenterology Add [Flixabi] patients at UHS.

Prescribe by brand name.

22.02.18 Topiramate tab/sprinkle Green 4.7.4.2 Change from amber to Amend cap green for migraine prophylaxis

22.02.18 Dupilumab inj Red 13.5.3 (RemainsConsultant amber dermatologist for epilepsy Add –only. BNF section 4.8.1) For eligible adult patients with moderate to severe atopic dermatitis poorly controlled with topical agents and intolerant of or unsuitable for systemic immunosupressants. 22.02.18 Alendronic acid Green 6.6.2 Restricted use. Not a first Add effervescent – once line option. weekly tab For use only in patients unable to swallow conventional bisphosphonate tablets, and unwilling/unsuitable for treatment with parenteral options.

(See DPC Update Feb 2018)

13.12.17 Mercaptamine eye drops Red 9.8.1 As per NHSE specialist Add 17.01.18 Atezolizumab inj Red 8.1.5 TA492:commission For untreatedcriteria locally Add advanced or metastatic urothelial carcinoma in adults 17.01.18 Cladribine tab Red 8.2.4 TA493: For relapsing- Amend remitting MS 17.01.18 Palbociclib cap Red 8.1.5 TA495:For locally advanced Add or metastatic breast cancer 17.01.18 Ribociclib tab Red 8.1.5 TA496: For locally advanced Add or metastatic breast cancer 17.01.18 Miconazole vaginal Green 7.2.2 Discontinued Remove capsule 17.01.18 Miconazole vaginal Green 7.2.2 To replace capsules Add cream 17.01.18 Aprotinin infusion Red 2.11 Restricted to use by Cardio- Add thoracic anaesthetist only

13.12.17 Mercaptamine eye drops Red 9.8.1 As per NHSE specialist Add commission criteria

13.12.17 Mercaptamine tablets Red 9.8.1 As per NHSE specialist Add commission criteria 13.12.17 Regorafenib tab Red 8.1.5 TA488 – For GI stromal Add tumours 13.12.17 Nivolumab inj Red 8.1.5 TA 490 – For SCC of the Amend head and neck 13.12.17 Ibrutinib cap Red 8.1.5 TA 491 – For Waldenstrom’s Amend macroglobulinaemia 13.12.17 Thiotepa inj Red 8.1.5 For treatment of CNS diffuse Add large B cell lymphoma 13.12.17 Colesevelam tablets Amber 2.12 Second line to colestyramine Add for bile acid malabsorption 13.12.17 Eslicarbazepine tab Amber 4.8.1 Third line to carbamazepine Add and oxcarbazepine 13.12.17 Beclometasone, Amber 3.2 Add formoterol and glycopyrronium inhaler [Trimbow] 13.12.17 Insulin degludec and Amber 6.1.2.3 Change from red to amber Amend liraglutide injection [Xultophy] 13.12.17 Omega 3 capsule Red 2.12 Removed

29.11.17 Dexmedetomidine inj Red 15.1.4.4 Restricted for use for Add sedation to NeuroICU consultant only 29.11.17 Renestart powder 9.4 Replace Kindergen powder Add

29.11.17 Ketamine 100mg/ml IM Red 2.11 Unlicensed product. Use Add injection restricted to senior ED/anaesthetic registrars 29.11.17 Brimonidine/timolol eye Amber 11.6 andDPC consultantsapproved 10/10/2017 Add drops

29.11.17 Brinzolamide/timolol eye Amber 11.6 DPC approved 10/10/2017 Add drops 29.11.17 Bimatoprost/timolol eye Amber 11.6 DPC approved 10/10/2017 Add drops 29.11.17 Cladribine tab Red 8.1.3 For use in MS in line with Add specialised commissioning 29.11.17 Nivolumab inj Red 8.1.5 TA483/4circular – For previously Add treated squamous and non- squamous NSCLC

29.11.17 Sarilumab inj Red 10.1.3 TA 485 – For moderate to Add severe rheumatoid arthritis 29.11.17 intravitreal Red 11.8.2 TA 486 – For choroidal Add injection neovascularisation in adults 29.11.17 Venetoclax tab Red 8.1.5 TA 487 – For chronic Add lymphocytic leukaemia

01.11.17 Roflumilast tab Amber 3.3.2 As per DPC 10/2017 Amend

01.11.17 Enoxaparin inj Various 2.8.1 Note added to prescribe by Amend brand name as biosimilar Inhixa now available and in use 01.11.17 Glycopyrrolate 0.05% in Amber Amend aqueous solution

01.11.17 Opicapone caps Amber As per DPC 10/2017 Add 01.11.17 Optho-Lique eye drops Green 11.8.1 Add

01.11.17 Ropinirole MR tab Amber 4.9.1 Add

01.11.17 Ceftazidime/ Avibactam Red 5.1.2.1 Add inj 01.11.17 Autologus chondrocyte Red TA 477 – For treating Add implantation articular cartilage defects of the knee 01.11.17 Brentuximab inj Red 8.1.5 TA 478 – For relapsed or Amend refractory systemic anaplastic large cell lymphoma in adults 01.11.17 inj Red 3.4.2 TA 479 – For severe Add eosinophillic asthma inadequately controlled in adults 01.11.17 Tofacitinib tab Red 10.1.3 TA 480 – For moderate to Add severe rheumatoid arthritis 01.11.17 inj, Red 8.2 TA 481/2 – Amend tacrolimus, Immunosuppressive therapy mycophenolate mofetil for kidney transplant in adults/children

01.11.17 Nusinersen inj Red SCC 1777 Add

11.10.17 Neomycin eye oint Green 11.3.1 Removed from formulary as Remove formulation discontinued

27.09.17 tab Red 8.2.4 TA 475 Amend

27.09.17 Eluxadoline tab Amber 1.2 TA 471 Add

27.09.17 Oralvac compact Red 3.4.2 Specialist allergy clinic only. Add oromucosal solution Second line therapy if Pollinex not suitable 27.09.17 Pseudoephedrine tab Red 3.10 For the emergency Add treatment of priapism 27.09.17 Sorafenib tab Red 8.1.5 TA 474 Add 27.09.17 Paclitaxel albumin inj Red 8.1.5 TA 476 Add 27.09.17 Cetuximab inj Red 8.1.5 TA 473 Amend 27.09.17 Obinutuzumab inj Red 8.2.3 TA 472 Amend

12.09.17 Ambrisentan tab Red 2.5.1 Only for patients already Add commenced on therapy by commissioned centre for pulmonary hypertension 12.09.17 Bosentan tab Red 2.5.1 Only for patients already Add commenced on therapy by commissioned centre for pulmonary hypertension 12.09.17 Anti-human T- Red For use as per Add Lymphocyte commissioning criteria set immunoglobulin by NHS England 12.09.17 Cidofovir inf Red 5.3.2.1 For use as per Add commissioning criteria set 12.09.17 Co-careldopa 20mg/ml Red 4.9.1 Forby NHS use asEngland per Add Gel cassette commissioning criteria set by NHS England 12.09.17 Deferasirox disp tab Red 9.1.3 For use as per Add commissioning criteria set by NHS England 12.09.17 Deferiprone tab Red 9.1.3 For use as per Add commissioning criteria set 12.09.17 Everolimus (Votubia) Red 8.1.5 Forby NHS use asEngland per Add tab commissioning criteria set by NHS England 12.09.17 Icatibant inj Red 3.4.3 For use as per Add commissioning criteria set by NHS England 12.09.17 Plerixafor inj Red 9.1.7 For use as per Add commissioning criteria set by NHS England 12.09.17 Sodium oxybate liq Red 4.1.1 For use in children as per Add commissioning criteria set by NHS England 08.09.17 Oilatum/Zerolatum Oilatu 13.2.1.1 Added Zerolatum as blue. Amend fragrance free bath m = additive green, 08.09.17 Dermol 500 lotion ZerolatGreen 13.2.1 Additional information Amend um = “Note: this contains an blue antimicrobial. Not recommended for long-term use.” 08.09.17 Epaderm/Hydromol/Zer Epader 13.2.1 Amended Hydromol from Amend oderm ointment m/Hydr blue to green, added omol = Zeroderm as blue. green, Zerode rm = 08.09.17 Aqueous cream Aqueoublue) 13.2.1 Added ZeroAQS as blue. Amend /ZeroAQS cream s Amended further crm=gr information to indicate een, ZeroAQS as potential ZeroAQ alternative (SLS-free). 08.09.17 Doublebase/Isomol/Zer DoubleS = 13.2.1 Added Isomol and Amend odouble gel baseblue = Zerodouble as blue. green, Isomol/ Zeroba 08.09.17 Diprobase/Epimax/Zero Diprobse = 13.2.1 Added Epimax and Zerobase Amend base cream/ointment aseblue = as blue. green, Epimax / Zeroba se = blue 08.09.17 Tadalafil 10mg and Green 7.4.5 ‘Further information’ Amend 20mg tab wording has been amended to clarify once-daily dosing not recommended, and entry now specifies 10mg and 20mg strengths to 08.09.17 Morphine sulfate tab/MR Green 4.7.2 Suppository now unlicensed Amend reflect this (2.5mg and 5mg cap/liq/MR (licensed has been to be considered as non- sachet/inj/suppository discontinued, only available formulary). as special). Added TA number 273.

31.08.17 Magnesium Amber 9.5.1.3 Added brand name – new, Amend glycerophosphate 2mmol licensed formulation (caps cap/4 mmol chewable remain unlicensed) tab [Neomag]

31.08.17 Liraglutide inj Green 6.1.2.3 Amended wording around Amend maximum doses, as NICE no longer specifies. Removed TA203 as this has been updated and replaced by NG28.

30.08.17 Budesonide rectal foam Amber 1.5.2 Replacing prednisolone Add enema rectal foam in of price increase 30.08.17 Prednisolone rectal foam Amber 1.5.2 Replaced by budesonide Remove enema 30.08.17 Buspirone tab Amber 4.1.2 Change from red to amber Amend approved by DPC 30.08.17 Retigabine tab Amber 4.8.1 Product discontinued Remove

30.08.17 Levemir (insulin detemir) Green 6.1.1.2 Change from amber to Amend inj green approved by DPC 30.08.17 Insulin Aspart [Fiasp] inj Amber 6.1.1.1 Recommended by DPC. For Add specialist recommendation. 30.08.17 Glucodrate powder Amber 9.2.1.2 Replacing St Mark’s solution. Add Approved by DPC 30.08.17 High sodium powders Red 9.2.1.2 Replaced by Glucodrate Remove (“St Mark’s Solution”)

30.08.17 Ketocal liquid N/A 9.4 Replacing ketocal powder Add

30.08.17 Anamix feeds N/A 9.4 Add

30.08.17 Diphtheria, tetanus, 5 Green 14.4 Replaced by hexavalent Remove component acellular vaccine on routine schedule pertussis, inactivated 30.08.17 polioDiphtheria, vaccine tetanus, and Green 14.4 As per routine immunisation Add haemoppertussis,hilus polio, influenzae schedule from Autumn 2017 Haemophilustype b vaccine influenzae type b (Hib) and hepatitis B [Infanrix hexa] 30.08.17 Cabozantinib tab Red 8.1.5 TA 463 – For advanced renal Add cell carcinoma in adults after VEGF-

30.08.17 inj Red 8.1.5 TA 465 – For use within the Add CDF as an option for soft tissue sarcoma 30.08.17 Baricitinib tab Red 10.1.3 TA 466 – An option for Add moderate to severe RA

26.07.17 Lucozade Red 6.1.6 No longer suitable for oral Remove glucose tolerance test due to reduced glucose content 26.07.17 Strontium ranelate Green 6.6.2 Discontinued. Remove granules 26.07.17 Donepezil orodispersible Green 4.11 For patients with swallowing Add tabs difficulties 26.07.17 Oxycodone capsules Green 4.7.2 For patients unable to Add tolerate liquid. Not for ward 26.07.17 Albendazole tab Red 5.5 stock Add

26.07.17 Hydrocortisone, Amber 12.1.1 Product previously Add neomycin and polymyxin discontinued added back B ear drops [Otosporin] onto market

26.07.17 Meningococcal Group A, Green 14.4 Added as per splenectomy Add C, W135 and Y guidelines previously conjugate vaccine approved by drugs (Menveo) committee June 2015 26.07.17 Vancomycin inj/cap Red/a 5.1.7 Injection only to be used Amend mber orally where capsules are unable to be given

26.07.17 Adalimumab, Red 13.5.3 TA 455 Amend and ustekinumab inj

26.07.17 Ustekinumab inj Red 1.5.3 TA 456 Amend

26.07.17 Pembrolizumab inj Red 8.1.5 TA 447 Amend 26.07.17 Etelcalcetide inj Red 9.5.1.2 TA 448 Add

26.07.17 Everolimus tab and Red 8.1.5 TA 449 Amend sunitib cap 26.07.17 Blinatumomab inj Red 8.1.5 TA 450 Add

26.07.17 tab Red 8.1.5 TA 451 Add

26.07.17 Carfilzomib inj Red 8.1.5 TA 457 Add 26.07.17 Trastuzumab emtansine Red 8.1.5 TA 458 Add inj 26.07.17 Collagenase clostridium Red 10.3.1 TA 459 Amend histolyticum [Xiapex] 26.07.17 Adalimumab Red 10.1.3/ TA 460 Amend inj/Dexamethasone 11.4.1 implant 26.07.17 Roflumilast tab Red 3.3.2 TA 461 Add

28.06.17 Diphenylcyclopropenone Red 13.12 Dermatology only. Add in acetone 0.00001- Unlicensed ; as per BAD 6.0% w/v specials list, previously agreed at DPC 28.06.17 Salicyclic acid in Amber 13.12 Unlicensed ; as per BAD Add emulsifying ointment specials list, previously 2%,5%,10%, 20% agreed at DPC

28.06.17 Dithranol in Lassar’s Red 13.5.2 Unlicensed ; as per BAD Add paste 0.1% - 15% w/w specials list, previously agreed at DPC 28.06.17 Salicyclic acid 5%/ Amber 13.4 Unlicensed ; as per BAD Add propylene glycol 47.5% specials list, previously in clobetasol propionate agreed at DPC 0.05% (Dermovate) 28.06.17 Propylenecream glycol 20% Amber 13.2.2 Unlicensed ; as per BAD Add w/w in aqueous cream specials list, previously agreed at DPC

28.06.17 Glycopyrrolate 2% w/w Red 13.12 Dermatology only. Add in cetomacrogol cream Unlicensed ; as per BAD specials list, previously agreed at DPC 28.06.17 Glycopyrrolate 0.05% in Red 13.12 Dermatology only. Add aqueous solution Unlicensed ; as per BAD specials list, previously agreed at DPC 28.06.17 Reflectant (Dundee) Amber 13.8.1 Unlicensed ; as per BAD Add sunscreens - coffee, specials list, previously coral pink, beige agreed at DPC 28.06.17 Eosin solution 2% Red 13.12 Unlicensed ; as per BAD Add specials list, previously agreed at DPC 28.06.17 Ibandronic acid tab Amber 6.6.2 Specialist initiation under Amend shared care agreement ‘off- label’ for patients assessed as being at increased risk of recurrence of breast cancer.

28.06.17 Aviptadil 25 Amber 7.4.5 Specialist initiation in Add microgram/phentolamin urology clinic. e mesilate 2mg Second line after alprostadil. intracavernosal inj [Invicorp] 28.06.17 Desmopressin tab Green/ 6.5.2 Noqdirna - Not Amend (except Noqdirna)/nasal Amber recommended by DPC. spray/intranasal Safety concerns re: use solution/inj without specialist support.

28.06.17 Fortini compact N/A 9.4 Add multifibre

28.06.17 Neocate Junior N/A 9.4 Add

28.06.17 Similac Alimentum N/A 9.4 Formula milk for CMPA. On Add infant guidelines, cheaper alternative to Nutramigen 1 and 2. 28.06.17 Nutramigen 1 and 2 N/A 9.4 Replaced by Similac Remove Alimentum 28.06.17 Isotretinoin gel None 13.6.1 Discontinued Remove 28.06.17 Certolizumab pegol inj Red 10.1.3 TA 445 Amend

28.06.17 inj Red 10.1.3 TA 445 Amend 28.06.17 Brentuximab inj Red 8.1.5 TA 446 Add

28.06.17 Levosimendan inj Red 2.1 Specialist use only Add

28.06.17 Obeticholic acid tab Amber 1.9.1 NICE TA 443 Add

24.05.17 Dexamethasone soluble Green 6.3.2 Add tabs 24.05.17 Quattro solution Red 11.9 Contact lens solutions Remove removed from formulary. No longer sourced through pharmacy and not to be prescribed by GPs 24.05.17 Opti-free express Red 11.9 24.05.17 Miraflow Red 11.9 Add 24.05.17 Amiclair protein remover Red 11.9 24.05.17 Saline spray Red 11.9 24.05.17 Boston advance Red 11.9 24.05.17 Netupitant/Palonosetron Red 4.6 24.05.17 Cocaine[Akynzeo] 5% capsules nasal spray Red 15.2 Add

24.05.17 Fondaparinux inj Red 2.8.1 New indication for superficial Amend thrombophlebitis 24.05.17 Dalbavancin inj Red 5.1.7 Restricted to microbiology Add recommendation 24.05.17 Triamcinolone/gramicidin Red 12.1.1 For ENT use. Unlicensed Add /neomycin/nystatin [Triadcortyl] ointment

24.05.17 Daclizumab inj Red 8.2.4 NICE TA 441 Add

24.05.17 Ixekizumab inj Red 13.5.3 NICE TA 442 Add

19.04.17 Adapalene 0.1%, Green 13.6.1 For treatment of acne Add benzoyl peroxide 2.5% vulgaris. Positive gel [Epiduo] recommendation by DPC.

19.04.17 Pilocarpine eye gel Amber 11.6 Discontinued 2012. Not used Remove since then as alternative eye drops are available 19.04.17 Dexmedetomidine inj Red 15.1.4.4 Additional use in paediatric Amend laryngotracheobronchoscopy 19.04.17 Diclofenac inj Red 15.1.4.2 Restricted to use in Add paediatric theatres 19.04.17 Humulin R insulin 500 Red 6.1.1 Unlicensed. All prescribing Add units/ml and monitoring to be carried out by specialists 19.04.17 Cetuximab inj Red 8.1.5 TA 439 Amend 19.04.17 inj Red 8.1.5 TA 439 Add

30.03.17 Benzoyl peroxide 4% Green 13.6.1 Now discontinued Remove and cream [Brevoxyl] replace with item below

30.03.17 Benzoyl peroxide gel Green 13.6.1 To replace Brevoxyl (see Add above) 21.03.17 Tiotropium inhalation Green 3.1.2 Amended wording to include Amend powder caps/solution “Prescribe by brand name” for inhalation as new brand now available (Braltus®) which delivers tiotropium via a different device. 21.03.17 Minocycline tabs Amber 5.1.3 & Removed from Formulary. Remove 13.6.2 SafetyPrescribers concerns are advised mean no to longermaintain recommended patients on currentfor use inbrand, acne. but may opt to start new patients on Braltus Anybrand other (lower use cost). will be as non[Note:-formulary. both brands deliver 10micrograms tiotropium 15.03.17 Adapalene gel/cream Green 13.6.2 Added cream formulation. Amend per inhalation] Useful for patients with dry, sensitive skin and same cost as gel.

14.03.17 Viteyes 2 Formula Amber 9.6.7 & Amended wording to clarify Amend caps/softgels or OTC 11.8.2 restrictions on use, as follows: “Restricted use – Specialist (secondary care ophthalmologist) recommendation only, for patients who have advanced AMD (category 4) in one eye only. Patients who do not meet criteria may opt to purchase OTC.”

01.03.17 tab Red 13.5.3 NICE TA 433 Add Added softgels as new formulation option (slightly 01.03.17 Everolimus tab Red 8.1.5 NICE TA 432 Add cheaper than caps and same 01.03.17 Hydroquinone 5%, Red 13.12 Unlicensedformula). Add hydrocortisone 1%, tretinoin [Pigmanorm] cream

01.03.17 Tafluprost/ Timolol Amber 11.6 Add [Taptiqom] preservative free eye drops

01.03.17 Rasagiline tablets Amber 4.9.1 Add

01.03.17 Ivermectin cream Green 13.6.3 First line option for the Add treatment of Papulopustular rosacea

31.01.17 Ticagrelor tab Green 2.9 NICE TA 420 Amend

31.01.17 Everolimus tab Red 8.1.5 NICE TA 421 Add 31.01.17 Crizotinib cap Red 8.1.5 NICE TA 422 Amend 31.01.17 Eribulin inj Red 8.1.5 NICE TA 423 Add 31.01.17 Pertuzumab inf Red 8.1.5 NICE TA 424 Add 31.01.17 , and Red 8.1.5 NICE TA 425/426 Amend 31.01.17 Pomalidomideimatinib cap Red 8.1.5 NICE TA 427 Add

31.01.17 Pembrolizumab inf Red 8.1.5 NICE TA 428 Amend

31.01.17 Ibrutinib cap Red 8.1.5 NICE TA 429 Add

31.01.17 Sofosbuvir/velpatasvir Red 5.3.3.2 NICE TA 430 Add 31.01.17 Mepolizumabtabs inj Red 3.4.2 NICE TA 431 Add

31.01.17 Mannitol inhalation Red 3.7 For diagnostic testing for Add 31.01.17 Mesalazinepowder [Osmohale] [Salofalk] Amber 1.5.1 1bronchialst line preparation for Add granules patientshyperresponsiveness with distal disease. Second line treatment for pan-colitis

11.01.2017 Tacrolimus MR cap Red/A 8.2.2 Red for renal transplant, Add mber amber for all other indications. For continuation in established patients only.

Added to Formulary in line with other local organisations (e.g. West Hants CCG, Portsmouth, Dorset)

14.12.2016 Apremilast tab Red 13.5.3 NICE TA 419 Add

14.12.2016 Dapagliflozin tab Green 6.1.2.3 NICE TA 418 Amend

14.12.2016 Nivolumab inj Red 8.1.5 NICE TA 417 Amend

14.12.2016 Ataluren granules Red 10.2 NICE HST (Highly Add Specialised Technologies guidance) 3 14.12.2016 Ciclesonide inhaler Amber 3.2 Specialist recommendation Add as a steroid sparing agent at step 4/5 of the BTS guidelines 14.12.2016 Lecicarbon A Amber 1.6 Specialist recommendation Add suppositories as per chronic constipation guidelines 14.12.2016 Pancrex V granules Amber 1.9.4 For use in patients who Add require administration of pancreatin via enteral feeding tubes.

14.12.2016 Sodium hyaluronate Green 11.8.1 Add (Clinitas Multi) 0.4% eye drops

14.12.2016 Stiripentol Amber 4.8.1 For use in paediatric Add capsules/powder patients with severe myoclonic epilepsy

14.12.2016 Alfacalcidol liq/caps Amber 9.6.4 Amend to amber/add caps Amend

14.12.2016 Calcitriol caps Amber 9.6.4 Amend to amber Amend

14.12.2016 Toujeo U300 (Insulin Amber 6.1.1.2 Specialist initiation Add glargine) 300units/ml inj 14.12.2016 Tresiba U200 (Insulin Amber 6.1.1.2 Specialist initiation Add degludec) 200units/ml inj 14.12.2016 Humalog U200 (Insulin Amber 6.1.1.1 Specialist initiation Add lispro) 200units/ml

14.12.2016 Emtricitabine/tenofovir Red 5.3.1 GUM and Child health Add tab specialist only. As per local commissioning arrangements 14.12.2016 Estradiol patches Green 6.4.1.1 Amend from blue to green. Amend Remove branding

23.11.2016 Azithromycin inj Red 5.1.5 Remove words second line Add – follow guideline 23.11.2016 Elbasvir-grazoprevir tab Red 5.3.3.2 NICE TA 413 Add

23.11.2016 Certolizumab-pegol inj Red 10.1.3 NICE TA 415 Amend

23.11.2016 Osimertinib tab Red 8.1.5 NICE TA 416 Add

26.10.2016 Degarelix inj Amber 8.3.4.2 NICE TA404 Amend Specialist initiation only for selected patients in accordance with NICE TA guidance.

(Removed previous restriction for use only in emergency situations as a single dose) 26.10.2016 Crizotinib cap Red 8.1.5 NICE TA406 Add

26.10.2016 Secukinumab inj Red 10.1.3 NICE TA407 Amend (add TA number) 26.10.2016 Pegaspargase inj Red 8.1.5 NICE TA408 Amend (add TA number) 26.10.2016 Aflibercept inj Red 11.8.2 NICE TA409 Amend (add TA number) 26.10.2016 Talimogene Red 8.1.5 NICE TA410 Add laherparepvec inj Specialist use only in 26.10.2016 Radium-223 dichloride Red 8.1 NICEaccordance TA412 with special Amend (add TA inj Aprecautions radiopharmaceutical for handling for and number) usedisposal and administration(refer to SPC only bysection authorised 6.6). persons. To be prepared in pharmacy 26.10.2016 Sodium hyaluronate Red N/A Urologyat UHS. specialist use only Add 1.6% and sodium at UHS for patients with chondroitin sulphate 2% insufficient response or intravesical instillation intolerant to other therapies, [iAluRil] including Hyacyst (refer to UHS Painful Bladder Syndrome Protocol) 11.10.2016 Azelastine & fluticasone Green 12.2.1 Third line therapy for allergic Add propionate nasal spray rhinitis where response to [Dymista] treatment with other therapies, including a combination of oral antihistamines and intranasal corticosteroids, was inadequate or not tolerated 11.10.2016 Ulipristal acetate tab Amber 6.4.1.2 Specialist recommendation Amend (added [Esmya] as an option for pre- new indication) operative treatment of uterine fibroids or for intermittent treatment of uterine fibroids where first line therapies are inappropriate

11.10.2016 Midazolam inj Green 15.1.4.1 Green for use in palliative Add care only (remains red for all other indications)

11.10.2016 Amiodarone tab Amber 2.3.2 Amended to amber as Amend (changed requested by DPC (safety from green to reasons) amber)

11.10.2016 Calcium lactate and Amber 9.5.1.1 Specialist recommendation Add calcium gluconate oral for paediatric patients only. liquid 0.51mmol/ml Licensed as a nutritional [Alliance Calcium supplement. 11.10.2016 OmeprazoleSyrup] oral Amber Not Specialist(Prescribe recommendationby brand name in Add solution listed onlyprimary for paediatriccare) patients (unlicensed product) 11.10.2016 Ganciclovir 0.15% eye Green 11.3.3 Second line option when Add gel aciclovir eye oint is unavailable 11.10.2016 Ferric maltol cap Amber 9.1.1.1 Gastoenterology specialist Amend [Feraccru] initiation only for patients with IBD unable to tolerate other oral iron preparations 11.10.2016 Fosfomycin oral sachets Green 5.1.7 Prescribe in line with local Amend (changed [Monuril] guidance/in response to to green from antimicrobial sensitivities amber)

28.09.2016 Azithromycin 1.5% eye Red 11.3.1 Add drops

28.09.2016 Trifluridine-tipiracil tab Red 8.1.3 NICE TA 405 Add

28.09.2016 Pemetrexed inj Red 8.1.3 NICE TA 402 Add

28.09.2016 tab Red 8.1.5 NICE TA 401 Add

28.09.2016 Amphotericin Green 12.3.2 Discontinued Remove suspension/lozenges 28.09.2016 Hydrocortisone, Amber 12.1.1 Product discontinued May Remove neomycin and 2014 polymyxin B ear drops [Otosporin]

28.09.2016 Co-codamol 30/500 Green 4.7.1 For patients with swallowing Add effervescent tabs difficulties/enteral feeding tubes 28.09.2016 Carbocisteine oral Amber 3.7 Add sachets 07.09.2016 Midazolam inj Amber 15.1.4.1 Amber for use in palliative Add care only

17.08.2016 Ferric maltol cap Red 9.1.1.1 Gastroenterology only Add

17.08.2016 Evolocumab inj Red 2.12 NICE TA 394 Add

17.08.2016 Alirocumab inj Red 2.12 NICE TA 393 Add

17.08.2016 Paliperidone palmitate Red 4.2.2 3 monthly preparation for Add prolonged release patients already stabilised suspension for injection on the one monthly depot. [Trevicta] 17.08.2016 Clobazam suspension Green 4.8.1 For paediatric patients or Add [Tapclob] those with swallowing difficulties 17.08.2016 Progesterone vaginal Red 6.4.1.2 For emergency supply to Add capsules [Utrogestan] patients treated by the fertility unit only.

17.08.2016 Progesterone 8% Red 6.4.1.2 Replaced by capsules above Remove vaginal gel

17.08.2016 Nivolumab infusion Red 8.1.5 NICE TA 400 Add

17.08.2016 Trametinib tab Red 8.1.5 NICE TA 396 Add

17.08.2016 Ceritinib cap Red 8.1.5 NICE TA 395 Add

17.08.2016 infusion Red 10.1.3 NICE TA 397 Add

17.08.2016 Transvasin cream Red 13 For use in the respiratory Add centre, prior to capillary 17.08.2016 Cetraben cream Green 13.2.1 blood gas sampling Add

17.08.2016 Calcipotriol and Green 13.5.2 Add betamethasone cutaneous foam [Enstilar]

17.08.2016 Adalimumab inj Red 13.5.3 NICE TA 392 Add

17.08.2016 Tacrolimus inj Red 8.2.2 For patients already Add receiving therapy who 17.08.2016 Macitentan tab Red 2.5.1 Forbecome patients nil by managed mouth under Add a shared care agreement with the Royal Brompton hospital only

19.07.2016 Phenothrin 0.5% liquid Blue 13.10.4 Discontinued Remove [Full Marks] (Now re-formulated using alternative active ingredient)

22.6.2016 Fostair 100/6 DPI Green 3.2 Add

22.6.2016 Brivaracetam tab/liq/inj Amber Not For specialist initiation. Use Add listed restricted to selected 22.6.2016 Methotrexate tab/inj Amber 10.1.3 & Specialistpatients (e.g. initiation inadequate (unless Amend (NB Once weekly) 13.5.3 GPseizure indicates control a preferenceor where to initiateother antiepileptic therapy). drugs are Seecontraindicated, DPC Shared notCare Guideline.tolerated or inappropriate). 22.6.2016 Cisatracurium inj Red 15.1.5 Add

22.6.2016 Atracurium inj Red 15.1.5 Remove

22.6.2016 Cabazitaxel inj Red 8.1.5 NICE TA391 Add

22.6.2016 Canagliflozin, Green 6.1.2.3 NICE TA390 Amend dapagliflozin and empagliflozin tablets

22.6.2016 Adrenaline Green 3.4.3 Remove the words “for self- Amend (epinephrine) administration” autoinjector [Jext 150 microgram or 300 microgram; EpiPen 0.3mg or Jr 0.15mg; Emerade 150 microgram, 300 microgram or 500 microgram]

22.6.2016 Axitinib tablets Red 8.1.5 NICE TA333 Add

22.6.2016 5-aminolevulinic acid Red Not Use supported by DPC Add hydrochloride (Ameluz) listed 11.6.2013 gel 22.6.2016 Mirabegron MR tab Green 7.4.2 NICE TA 290 – Listed as Amend green and amber on current formulary, status should be green 22.6.2016 Leuprorelin 3.75mg inj Amber 6.7.2 & Organisations can now Amend 8.3.4.2 choose which brand to prescribe. Remove current branding

18.5.2016 3,4-diaminopyridine tab Red 10.2.1 Amifampridine base is a Amended, synonym for this medicine. amifampridine base added to 3,4- diaminopyridine

18.5.2016 Prosource TF liquid N/A Appendi Approved by Drugs Added 45ml sachet (Nutrinovo) x 1 (List Committee for UHS patients 2) receiving enteral feed who are not meeting protein requirements with standard enteral feeds. 18.5.2016 Peptamen Junior N/A Appendi Approved by drugs Added Advance x 1 (List committee for paediatric 2) patients at UHS receiving enteral feed who are not meeting energy requirements within the volume allowance of a 1kcal enteral feed 18.5.2016 Sacubitril-valsartan Amber Not NICE TA388. Local Added, with TA tablets currently agreement from CCGs for 1 number listed month’s supply to be initiated in secondary care and then continued in primary care. 18.5.2016 Abiraterone tablets Red 8.3.4.2 NICE TA387 Amended, added TA number

18.5.2016 Topotecan, pegylated Red 8.1 NICE TA389, replaces Amended, added liposomal doxorubicin TA91/222. TA number and hydrochloride, removed TA paclitaxel, trabectedin number and gemcitabine

18.5.2016 Edrophonium inj Red 10.2.1 Discontinued. Removed Unlicensed product last used 25.11.14.

18.5.2016 Diclofenac inj 37.5 Green 15.1.4.2 Discontinued. Removed mg/ml

20.4.16 tab Red 8.2.4 TA386 Added, with TA number 20.4.16 Etanercept biosimilar inj Red 10.1.3 & Specify brand Added [Benepali] 13.5.3

Biosimilar. Recently approved for use at UHS. 20.4.16 Beclometasone and Green 3.2 For asthma only Added formoterol MDI [Fostair 200/6]

20.4.2016 Nortriptyline tab Green 4.3.1 & Reviewed by MEC and DPC. Removed 4.7.3 No longer recommended in NICE Guidance or local guidance for neuropathic pain. High cost versus other options. Use alternative agents according to indication.

23.3.2016 Ezetimibe tab Green 2.12 TA385 Amended, added Remove TA132 TA number and (TA385 replaces TA132) removed TA number

23.3.2016 Nivolumab inj [Opdivo] Red 8.2.4 TA384 Added, with TA number 23.3.2016 Infliximab inj Red 1.5.3, TA383. Amended, added [Remicade]; Infliximab 10.1.3 & Remove TA143. TA number biosimilar inj [Inflectra, 13.5.3 (TA383 replaces TA143) Remsima]

23.3.2016 Golimumab inj Red 1.5.3 & Added brand name. Amended, added [Simponi] 10.1.3 TA383. TA number

23.3.2016 Certolizumab pegol inj Red 10.1.4 Added brand name. Amended, added [Cimzia] TA383. TA number

23.3.2016 Etanercept inj [Enbrel] Red 10.1.3 & Added brand name to Amended, added 13.5.3 formulary entry to avoid any TA number and confusion as biosimilar now removed TA also available. number TA383. Remove TA143. (TA383 replaces TA143) 23.3.2016 Adalimumab inj Red 1.5.3, Added brand name. Amended, added [Humira] 10.1.3 & TA383. TA number and 13.5.3 Remove TA143. removed TA (TA383 replaces TA143) number

23.3.2016 Radium-223 dichloride Red 8.1 Specialist use only. TA376. Added, with TA injection number 23.3.2016 Stanozolol tab Red 6.7.2 Specialist immunology use Added only.

For long-term prophylaxis of hereditary angioedema attacks [Unlicensed drug and off-label indication]. Second-line option. Only for patients unable to tolerate danazol (note: long-term supply problems mean unlikely to be able to obtain stocks of this drug)

23.3.2016 Oxandrolone tab Red 6.7.2 Specialist immunology use Amended only.

For long-term prophylaxis of hereditary angioedema attacks [Unlicensed drug and off-label indication]. Third-line option. Only if stanozolol not available (long-term supply problem).

23.3.2016 Iron (III) isomaltoside Red 9.1.1.2 First-line IV iron preparation Added 1000 injection at UHS. [Monofer] Ferinject remains on formulary for patients not suitable for Monofer (e.g. <18 years)

14.3.2016 Tadalafil tab Green 7.4.5 Added wording “Not Amended recommended locally for treatment of benign prostatic hyperplasia.”

14.3.2016 Pixantrone injection Red 8.1.2 TA306 Added, with TA number Was due to be added April 2014, but not actioned.

14.3.2016 Aripiprazole prolonged- Red 4.2.2 For use in secondary Added release injection [Abilify psychiatric care. Maintena] Was due to be added April 2014, but not actioned.

17.2.2016 Esomeprazole inj Red 1.3.5 In UHS: Child Health only Added

17.2.2016 Golimumab inj Red 10.1.3 [PTA375antoprazole remains as Amended, added preferred IV PPI for adult TA number 17.2.2016 Certolizumab inj Red 10.1.3 patients]TA375 Amended, added TA number

17.2.2016 Etanercept inj Red 10.1.3 TA375 Amended, added TA number

17.2.2016 Adalimumab inj Red 10.1.3 TA375 Amended, added TA number

17.2.2016 inj Red 10.1.3 TA375 Amended, added TA number

17.2.2016 Tocilizumab inj Red 10.1.3 TA375 Amended, added TA number

17.2.2016 Infliximab inj Red 10.1.3 TA375 Amended, added [Remicade]; Infliximab TA number biosimilar inj [Inflectra, Remsima] 17.2.2016 Enzalutamide cap Red 8.3.4.2 TA377 Amended, added TA number

17.2.2016 cap Red 8.1.5 TA379 Amended, added TA number

17.2.2016 Olaparib cap Red 8.1.5 TA381 Added, with TA number 17.2.2016 Bortezomib inj Red 8.1.5 TA380 Amended, added TA number

17.2.2016 Panobinostat tab Red 8.1.5 TA380 Added, with TA number 17.2.2016 Vortioxetine tab Amber 4.3.4 TA367 Added, with TA number 17.2.2016 Idarucizumab inj Red 2.8.3 When rapid reversal of Added [Praxbind] dabigatran is required for emergency surgery/urgent procedures or in life- threatening or uncontrolled bleeding. On Consultant Haematologist advice only (refer to UHS guideline).

17.2.2016 Degarelix 120mg inj Red 8.3.4.2 Consultant urologist use Added only as a SINGLE DOSE (240mg) in patients with naive prostate cancer who present with emergencies such as:  Spinal cord compression.  Severe uraemia due to malignant ureteric obstruction.  Impending long bone pathological fracture.

Not for long-term treatment. 20.1.2016 tab Red 8.1.5 TA374 Amended, added TA number

20.1.2016 Bortezomib inj Red 8.1.5 TA370 Amended, added TA number

20.1.2016 Abatacept inj Red 10.1.3 TA373 Amended, added TA number

20.1.2016 Adalimumab inj Red 10.1.3 TA373 Amended, added TA number

20.1.2016 Etanercept inj Red 10.1.3 TA373 Amended, added TA number

20.1.2016 Tocilizumab inj Red 10.1.3 TA373 Amended, added TA number

20.1.2016 Ingenol gel [Picato] Green 13.8.1 Status change from amber Amended to green

30.12.2015 Dasabuvir tab Red 5.3.3.2 NICE TA365 Amended, added Specialist use only TA number 16.12.2015 Ciclosporin eye drops Amber 11.8.1 NICE TA369 Amended, added Specialist NICE TA number. initiation/recommendation Changed colour 16.12.2015 Dulaglutide inj Green 6.1.2.3 Removed wording “Not a Amended only from red to first line option, but may be amber. considered for patients with

compliance problems or

needle phobia, or for patients with kidney impairment (see prescribing information and local guidelines)“ 16.12.2015 Empagliflozin tab Green 6.1.2.3 Added wording “First line Amended SGLTAs recommended-2 inhibitor for by patients withDiabetes established Sub Committee of cardiovascularDPC – restrictions disease” removed as now priced more Ascompetitively recommended versus by other DiabetesGLP-1 agonists. Sub Committee of DPC – recently published evidence to support positive outcomes in this patient group. 16.12.2015 inj Green 6.6.2 NICE TA204 Amended Now green for prevention of Changed colour fractures in patients with from amber to osteoporosis. green

Remains red for cancer- related indications 16.12.2015 Brinzolamide and Amber 11.6 Added brimonidine eye drops [Simbrinza] 16.12.2015 Daclatasvir tab Red 5.3.3.2 NICE TA364 Amended, added Specialist use only TA number

16.12.2015 Sofosbuvir and Red 5.3.3.2 NICE TA363 Amended, added ledipasvir tab [Harvoni] Specialist use only TA number

16.12.2015 Ombitasvir and Red 5.3.3.2 NICE TA365 Amended, added paritaprevir and Specialist use only TA number ritonavir tab [Viekiraz] 16.12.2015 Pembrolizumab inj Red 8.2.4 NICE TA366 Amended, added Oncology only new TA number

16.12.2015 Idelalisib tab Red 8.1.5 NICE TA359 Added Oncology only

16.12.2015 Tolvaptan tab Red 6.5.2 NICE TA358 Added Specialist use only

18.11.2015 Efavirenz tab/cap/liq Red 5.3.1 Liquid deleted as Amended 18.11.2015 Ingenol gel [Picato] Amber 13.8.1 N.B.discontinued both strengths by Added (150mcg/gmanufacturers. and 500mcg/g) areRemoved approved. text “The oral solution is an alternative to tablets in patients with nasogastric tubes or children” 18.11.2015 Granisetron patch Red 4.6 Specialist use only as per Added [Sancuso] licensed indications. 18.11.2015 Erythromycin 2% and Green 13.6.1 (Isotrexin gel) Added 0.05% gel 18.11.2015 Clindamycin 1% and Green 13.6.1 (Treclin gel) Added tretinoin 0.025% gel 18.11.2015 Magnesium aspartate Green 9.5.1.3 Licensed magnesium Added dihydrate powder for supplement. oral solution Consider in preference to unlicensed preparations.

09.11.2015 Phytomenadione cap Amber 9.6.6 Removed wording Amended [Neokay] ‘unlicensed’ as now licensed as a POM. 02.11.2015 Aclidinium DPI [Eklira Green 3.1.2 Added brand name Amended Genuair]

02.11.2015 Salbutamol MDI/breath- Green 3.1.1.1 Added Easyhaler as an Amended actuated MDI/DPI (e.g. option as included in new Accuhaler/Easyhaler)/ne COPD Guidelines. b/inj

02.11.2015 Formoterol MDI [Atimos Green 3.1.1.1 Added Turbohaler as an Amended Modulite]/Formoterol option as included in new DPI (e.g. COPD Guidelines. Easyhaler/Turbohaler)

02.11.2015 Umeclidinium DPI Green 3.1.2 Included as an option in new Added [Incruse Ellipta] COPD Guidelines.

02.11.2015 Indacaterol inhalation Green 3.1.1.1 Included as an option in new Added powder caps [Onbrez COPD Guidelines. Breezhaler]

02.11.2015 Aclidinium and Green 3.1.4 Included as an option in new Added formoterol DPI [Duaklir COPD Guidelines. Genuair] 02.11.2015 Umeclidinium and Green 3.1.4 Included as an option in new Added vilanterol DPI [Anoro COPD Guidelines. Ellipta] 02.11.2015 Glycopyrronium and Green 3.1.4 Included as an option in new Added indacaterol powder caps COPD Guidelines. [Ultibro Breezhaler]

02.11.2015 Budesonide and Green 3.2 Added Duoresp Spiromax as Amended formoterol DPI an option as included in new [Symbicort Turbohaler, COPD Guidelines. Duoresp Spiromax]

02.11.2015 Olodaterol solution for Green 3.1.1.1 Included as an option in new Added inhalation [Striverdi COPD Guidelines. Respimat] 02.11.2015 Tiotropium and Green 3.1.4 Included as an option in new Added olodaterol solution for COPD Guidelines. inhalation [Spiolto Respimat]

02.11.2015 Pembrolizumab inj Red 8.2.4 NICE TA357 Added, with TA Oncology only number

07.10.2015 Sodium chloride 0.18% N/A 9.2.2 Not available Removed and glucose 10% 500ml bags 07.10.2015 Paediatric renal Amber Unlicens Discontinued by Removed vitamins tab ed manufacturers

07.10.2015 Hetastarch and N/A 9.2.2 Discontinued by Removed Pentastarch (various manufacturers strengths)

07.10.2015 Dinoprostone pessary Red 7.1.1 ‘Off label’ use at UHS for Added [Propess] outpatient induction of labour (as per guideline/procedure) 07.10.2015 Glatiramer acetate Red 8.2.4 Added wording ‘Specialist Amended 20mg/ml, 40mg/ml inj use only for multiple sclerosis’ (added strengths as both 07.10.2015 Peginterferon beta-1a Red 8.4.2 nowSpecialist approved) use only for Added inj multiple sclerosis (commissioned by NHS England)

07.10.2015 Vedolizumab inj Red 1.5.3 NICE TA352 Amended, added Removed phrase ‘For new TA number ulcerative colitis’ (now also recommended by NICE for Crohns Disease)

07.10.2015 Edoxaban tab Green 2.8.2 NICE TA354/355 Added, with TA numbers

07.10.2015 Lidocaine plaster Red 15.2 ‘Off label’ use at UHS for Added management of traumatic 07.10.2015 Isotretinoin gel Green 13.6.1 Replacementrib fractures (referfor tret toinoin Added [Isotrex] gelprotocol) .

07.10.2015 Tretinoin gel [Retin A] Green 13.6.1 Discontinued by Removed manufacturers

07.10.2015 Ciclosporin eye Red Amended wording to reflect Amended drops/eye ointment that only the eye ointment is unlicensed (eye drops now licensed) 07.10.2015 Clindamycin cap/liq/inj Green 5.1.6 Caps and Liquid were Amended. (Cap/li previously red. Discussed Changed colour q) with DPC Chair and from red to green Red Microbiology - agreed (inj) suitable for green status. Note: Liquid is unlicensed.

Remains red for pneumocystis pneumonia 07.10.2015 Abasaglar (insulin Green 6.1.1.2 Some(section dose 5.4.8) adjustment may Added glargine 100 Units/ml be needed if switching from biosimilar) inj other brands of insulin glargine (e.g. Lantus)

(First choice brand of insulin glargine for new patients)

09.09.2015 Midodrine tab Green 6.1.5 Removed word “unlicensed” Amended as a licensed preparation is now available (Bramox). Removed wording “for postural hypotension”. Prescribers should use SPC for guidance.

02.09.2015 Nalmefene tab Amber 4.10.1 NICE TA325 Added, with TA Only in conjunction with number continuous psychosocial support.

02.09.2015 Sodium hyaluronate Green 11.8.1 e.g. Hylo-Tear, Hylo-Forte Amended. 0.1% and 0.2% eye (Brand name not specified in Changed colour drops (preservative- main entry to allow from amber to free) organisations to choose green preferred option) Included in Dry Eye Guidelines for Primary Care (pending) GP can initiate if required.

02.09.2015 Carmellose sodium Green 11.8.1 Included in Dry Eye Amended. 0.5% and 1% eye drops Guidelines for Primary Care Changed colour (preservative-free) (pending) from amber to GP can initiate if required. green Removed brand name ‘Celluvisc’ as several other brands now available. 02.09.2015 Polyvinyl alcohol 1.4% Green 11.8.1 e.g. SnoTears, Liquifilm Amended. eye drops and unit dose Tears Changed colour eye drops (Brand name not specified in from amber to (preservative-free) main entry to allow green organisations to choose preferred option) Included in Dry Eye Guidelines for Primary Care (pending) GP can initiate if required. 02.09.2015 Carbomer 0.2% Green 11.8.1 e.g. Clinitas Gel Amended. ophthalmic gel (Brand name not specified in Changed colour main entry to allow from amber to organisations to choose green preferred option) Included in Dry Eye Guidelines for Primary Care (pending) GP can initiate if required.

02.09.2015 Hypromellose 0.3% Green 11.8.1 Included in Dry Eye Amended. preservative-free eye Guidelines for Primary Care Changed colour drops (pending) from amber to GP can initiate if required. green Removed ‘Unlicensed’ as now available as a licensed medical device.

02.09.2015 Tears Naturale eye Amber 11.8.1 No longer required. Removed drops Not included in Dry Eye Guidelines for Primary Care (pending)

02.09.2015 VitA-POS (retinol Green 11.8.1 Included in Dry Eye Added palmitate, liquid Guidelines for Primary Care paraffin, wool fat, white (pending) soft paraffin) eye Preservative-free ointment formulation. 02.09.2015 Propylene glycol & Green 11.8.1 Included in Dry Eye Added polyethylene glycol unit Guidelines for Primary Care dose eye drops (pending) (preservative-free) Preservative-free alternative [Systane] to Systane Balance.

02.09.2015 Propylene glycol eye Green 11.8.1 Included in Dry Eye Added drops [Systane Balance] Guidelines for Primary Care (pending) 02.09.2015 Dexamethasone Red 11.4.1 NICE TA349 Amended, added intravitreal implant TA number

02.09.2015 Aflibercept intravitreal Red 11.8.2 NICE TA367. Amended, added inj Removed wording “Also for TA number treatment of diabetic macular oedema” as not needed now that approved by NICE.

02.09.2015 Rifaximin tab Red 5.1.7 Specialist use only as per Added [Targaxan] UHS guideline ‘Off-label’ use, third line antibiotic treatment for small bowel (short intestine) bacterial overgrowth

02.09.2015 Hexaminolevulinate Red 7.4.4 UHS: Urology specialist use Added intravesical instillation only in selected patients (e.g. high risk of multiple or flat tumours) 02.09.2015 Secukinumab inj Red 13.5.3 NICE TA350 Added, with TA number

02.09.2015 Naloxegol tab Amber 1.6 NICE TA345 Added, with TA number 02.09.2015 Nintedanib cap Red 8.1.5 Specialist use only. Added, with TA NICE TA347. number 02.09.2015 Meningococcal Group B Green 14.4 Added Vaccine 02.09.2015 Nortriptyline tab Green 4.7.3 ‘Off-label’ use. Added A second-line choice at step 2 of neuropathic pain ladder.

02.09.2015 Nortriptyline tab Green 4.3.1 Not(Relatively a first linehigh option cost in Amended primary care therefore Changed colour (Discussedamitriptyline at remains UHS Drugs first from red to green Committeeline) and Chair’s Action taken for DPC. No need for specialist-only (red) status, although relatively high cost in primary care therefore amitriptyline remains first line) 02.09.2015 Ferrous sulfate tab Green 9.1.1.1 Second line oral iron Added preparation

(re-added to formulary as this preparation appears to continue to be widely used in primary and secondary care) 02.09.2015 Ferrous fumarate tab Green 9.1.1.1 Added phrase “First line oral Amended iron preparation”

02.09.2015 Aqueous cream Green 13.2.1 Removed phrase “first line” Amended as Dermatology specialists no longer recommend

30.07.15 Co-beneldopa Amber 4.9.1 Added Amended (levodopa/benserazide) “levodopa/benserazide” for cap/disp tab/MR cap clarity. [Madopar] 30.07.15 Co-careldopa Amber 4.9.1 Moved brand name Amended (levodopa/carbidopa) “[Sinemet]” from main entry tab/MR tab to further info section, as other brands and generic versions now available. Added “levodopa/carbidopa” for clarity.

30.07.15 Co-careldopa Amber 4.9.1 Moved brand name Amended (levodopa/carbidopa) “[Stalevo]” from main entry with entacapone tab to further info section as other brands now available. Added “levodopa/carbidopa” for clarity.

23.07.15 Colecalciferol (vitamin Green 9.6.4 Added “vitamin D3” for Amended D3) cap/tab/liq clarification. Added tablet and liquid formulations. Added further information: “Products that are UK licensed medicines should be prescribed and supplied wherever possible.”

23.07.15 Carmellose sodium Green 11.8.1 Amended wording from “If Amended 0.5% eye drops patient is allergic to [Optive] commonly used preservatives” to “Contains a gentle preservative so may be an option if patient is allergic to commonly-used preservatives”

23.07.15 Humalog (insulin lispro) Amber 6.1.1.2 Added strength (100 Amended 100units/ml inj Units/ml) as new, high strength formulation now also available (has same brand name)

23.07.15 Tresiba (insulin Amber 6.1.1.2 Added strength (100 Amended degludec) 100units/ml Units/ml) as new, high inj strength formulation now also available (has same brand name) 10.07.15 Lantus (insulin glargine Green 6.1.1.2 Added strength (100 Amended 100 Units /ml) inj Units/ml) as new, high strength formulation now also available (has different brand name)

29.06.15 Sofosbuvir and Red 5.3.3.2 Specialist use only. Added ledipasvir tab For patients with cirrhosis meeting NHS England criteria for treatment of chronic Hepatitis C

29.06.15 Ombitasvir and Red 5.3.3.2 Specialist use only. Added paritaprevir and For patients with cirrhosis ritonavir tab meeting NHS England criteria for treatment of chronic Hepatitis C 29.06.15 Dasabuvir tab Red 5.3.3.2 Specialist use only. Added For patients with cirrhosis meeting NHS England criteria for treatment of chronic Hepatitis C 29.06.15 Daclatasvir tab Red 5.3.3.2 Specialist use only. Added For patients with cirrhosis meeting NHS England criteria for treatment of chronic Hepatitis C 29.06.15 Sofosbuvir tab Red 5.3.3.2 Specialist use only. Added, with TA NICE TA330 number

29.06.15 Tegafur and uracil cap Red 8.1.3 Discontinued by Removed manufacturers (2013) 29.06.15 Obinutuzumab inj Red 8.2.3 NICE TA343 Added, with TA number 29.06.15 Rifaximin tab Amber 5.1.7 For hepatic encephalopathy. Added TA number [Targaxan] NICE TA337. and brand name. 29.06.15 Omalizumab inj Red 3.4.2 NICEShared TA339 care guidance AddedChanged TA colour number available (although needs from red to updating). amber.

29.06..15 Ustekinumab inj Red 13.5.3 NICE(Note: TA340 remains non- Added TA number formulary for other indications) 29.06.15 Apixaban tab Green 2.8.2 NICE TA341 Added TA number, and colour for indication (treatment and secondary prevention of DVT/PE)

29.06.15 Darifenacin tab Green 7.4.2 First or second line option Added for urinary incontinence. Represents a more cost effective alternative to solifenacin (recommended in NICE CG171)

29.06.15 Cetraben ointment Green 13.2.1 Added

29.06.15 Vedolizumab inj Red 1.5.3 For ulcerative colitis. Added, with TA Specialist use only. number NICE TA342 29.06.15 Exenatide long-acting Green 6.1.2.3 Amended colour from amber Amended inj to green

29.06.15 Lixisenatide inj Green 6.1.2.3 Amended colour from amber Amended to green and removed 29.06.15 Dulaglutide inj Green 6.1.2.3 Notdirection a first to-line consider option, as but first - Added mayline for be newconsidered patients for patients with compliance problems or needle phobia, 24.06.15 Carmellose sodium eye Amber 11.8.1 Removedor for patients brand with name kidney Amended drops (preservative- impairment (see prescribing free) [Celluvisc] information and local guidelines).

04.06.15 Fortisip Bottle 200ml N/A 9.4 Moved from section 2 to Amended section 1 of UHS feeds and nutritional supplements formulary

03.06.15 Amsacrine inj Red 8.1.5 Product discontinued Removed 03.06.15 Ciclosporin eye Red Unlicens Eye ointment for use if eye Amended drops/eye ointment ed drops unavailable

03.06.15 Magnesium sulfate 20% Red Unlicens For use within maternity Added (10g in 50ml) inj ed.9.3.1 services at the Princess Anne Hospital, Southampton.

29.04.15 Rivaroxaban Amber 2.8.2 NICE TA335. Added TA number, Amber for prevention of added wording atherothrombotic events after ACS

29.04.15 Etoricoxib tab Amber 10.1.1 Removed wording (‘For bariatric surgery only’), amended colour

29.04.15 Simeprevir cap Red 5.3.3.2 Specialist use only. Amended NICE TA331 wording, added TA number

29.04.15 Golimumab inj Red 1.5.3 Specialist use only. Added BNF NICE TA329 section, wording and TA number

29.04.15 Infliximab inj Red 1.5.3 Specify brand. Added wording, NICE TA329 added TA number 29.04.15 Adalimumab inj Red 1.5.3 NICE TA329 Added TA number

29.04.15 Cinacalcet tab Red 9.5.1.2 Specialist use only. Added with TA NICE TA117 number

29.04.15 Aflibercept intravitreal Red 11.8.2 NICE TA305 Added TA number inj Also for treatment of and additional diabetic macular oedema indication

29.04.15 Empagliflozin tab Green 6.1.2.3 NICE TA336 Added with TA number

29.04.15 Levonorgestrel intra- Blue 7.3.2.3 Second-line option to Mirena Added uterine system [Jaydess]

25.03.15 Miconazole 100mg Green 7.2.2 Discontinued by Removed pessary manufacturer 25.03.15 Ethinylestradiol Blue 7.3.1 Gedarel 30/150 replaces Amended 30microgram and Marvelon desogestrel 150microgram [Gedarel 30/150]

25.03.15 Ethinylestradiol Blue 7.3.1 Gedarel 20/150 replaces Amended 20microgram and Mercilon desogestrel 150microgram [Gedarel 20/150] 25.03.15 Calcium-Sandoz liquid Green 9.5.1.1 Discontinued by Removed manufacturer 25.03.15 GlucoRx blood glucose Blue 6.1.6 Replaced by GlucoRx Nexus Removed test strips and Wavesense Jazz/Jazz Duo blood glucose test strips 25.03.15 GlucoRx Nexus blood Blue 6.1.6 Replaces GlucoRx blood Added glucose test strips glucose test strips

25.03.15 Wavesense Blue 6.1.6 Replaces GlucoRx blood Added Jazz/Wavesense Jazz glucose test strips Duo blood glucose test strips 25.03.15 Tapentadol oral solution Amber 4.7.2 Specialist recommendation Added only for breakthrough pain for patients taking tapentadol MR tabs

25.02.15 Simeprevir caps Red 5.3.3.2 Specialist use only. For Added patients meeting NHS England eligibility criteria for treatment of Genotype 1 chronic Hepatitis C. 25.02.15 HyQvia (normal human Red 14.5.1 Adult immunology only. New Added immunoglobulin and second-line subcutaneous hyaluronidase) immunoglobulin.

25.02.15 Abacavir with Red 5.3.1 Specialist use only Added lamivudine and dolutegravir [Triumeq] tabs

25.02.15 Dolutegravir tabs Red 5.3.1 Specialist use only Added

25.02.15 Lithium carbonate MR Amber 4.2.3 Only to be used in Changed from tabs/lithium citrate accordance with shared care green to amber liquid guidelines

25.02.15 Liraglutide with insulin Red 6.1.2.3 Specialist use only Added degludec 25.02.15 Saxagliptin tabs Green 6.1.2 Replaced by alogliptin Removed

25.02.15 Alogliptin tabs Green 6.1.2 To replace saxagliptin Added

25.02.15 Dabigatran tabs Green 2.8.2 According to NICE TA 327 Added TA number for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism

28.01.15 Vitapro Powder Following formulary review Removed of feeds and nutritional supplements

28.01.15 Provide Xtra Following formulary review Removed of feeds and nutritional supplements 28.01.15 Maxijul Super Soluble Following formulary review Removed of feeds and nutritional supplements 28.01.15 Elemental 028 Powder Following formulary review Removed of feeds and nutritional supplements 28.01.15 Duocal Super Soluble Following formulary review Removed of feeds and nutritional supplements 28.01.15 Suplena Following formulary review Removed of feeds and nutritional supplements 28.01.15 Seravit Paediatric Following formulary review Removed Powder of feeds and nutritional supplements 28.01.15 Prosure Following formulary review Removed of feeds and nutritional supplements

28.01.15 Nepro Following formulary review Removed of feeds and nutritional supplements 28.01.15 Fortini Multifibre Following formulary review Removed of feeds and nutritional supplements

28.01.15 Vital 1.5 Section Following formulary review Added 2 of oral of feeds and nutritional nutrition supplements section 28.01.15 Peptamen HN Section Following formulary review Added 2 of oral of feeds and nutritional nutrition supplements section 28.01.15 Liquigen Section Following formulary review Added 2 of oral of feeds and nutritional nutrition supplements section 28.01.15 Ketocal powder Section Following formulary review Added 2 of oral of feeds and nutritional nutrition supplements section 28.01.15 Fortisip Compact Protein Section Following formulary review Added 2 of oral of feeds and nutritional nutrition supplements section 28.01.15 Fortisip Compact Fibre Section Following formulary review Added 2 of oral of feeds and nutritional nutrition supplements section 28.01.15 Fortini Creamy Section Following formulary review Added 2 of oral of feeds and nutritional nutrition supplements section 28.01.15 Fortimel Regular Section Following formulary review Added 2 of oral of feeds and nutritional nutrition supplements section 28.01.15 Paediasure Peptide Section Following formulary review Added 1 of oral of feeds and nutritional nutrition supplements section 28.01.15 Fresubin Thickened Section Following formulary review Added Stage 2 1 of oral of feeds and nutritional nutrition supplements section 28.01.15 Fortini Smoothie Section Following formulary review Added 1 of oral of feeds and nutritional nutrition supplements section 28.01.15 Estradiol implants Discontinued by Removed manufacturer

28.01.15 Clinitest reagent tabs Discontinued by Removed manufacturer

07.01.15 Erythropoiesis- Red 9.1.3 According to NICE TA323 Changed TA 07.01.15(December Imatinibstimulating tablets agents Red 8.1.5 According to NICE TA326 Adnumberded TA number (Decembermeeting) (epoetin and meeting) darbepoetin)

07.01.15 Dabrafenib capsules Red 8.1.5 According to NICE TA321 Added (December meeting)

26.11.14 Dihydrocodeine MR Green 4.7.2 Changed from blue to green Changed 26.11.14 Tramadoltablets MR Green 4.7.2 Changed from blue to green Changed

26.11.14 Co-amilofruse tablets Green 2.2.4 Changed from blue to green Changed

26.11.14 Osvaren tablets Green 9.5.2.2 Changed from blue to green Changed

26.11.14 Co-codamol 30/500 Green 4.7.1 Changed from blue to green Changed tablets

26.11.14 Ibuprofen gel Green 10.3.2 Changed from blue to green Changed

26.11.14 Metformin sachets Discontinued by Removed manufacturer. Some wards now have strong tablet crushers to crush the tablets

20.10.14 Dimethyl fumarate Red 8.2.4 According to NICE TA320 Added capsules 20.10.14 Lenalidomide capsules Red 8.2.4 According to NICE TA322 Added

20.10.14 Carbamazepine Discontinued by Removed chewable tablets manufacturer (Tegretol Chewtabs)

29.9.14 Buprenorphine patches Prescribe by brand name Note 29.9.14 Budesonide MDI Discontinued by Removed manufacturer

29.9.14 Adrenaline Discontinued by Removed (epinephrine) inhaler manufacturer [Primatene Mist]

1.9.14 Micafungin infusion Red 5.2.4 Micafungin is first-line Changed 1.9.14(August Domperidone Green Domperidoneechinocandin, cancaspofungin still be is Note (Augustmeeting) usedsecond for-line stimulation of meeting) lactation, following a restriction to its licensed 1.9.14 Generic sildenafil when Green 7.4.5 For men post-prostatectomy Note indications. Local (August required recommendation is 10mg meeting) three times a day for 7 to 10 days, then stop. Contra- indicated in patients with known cardiac problems

1.9.14 Sildenafil tablets Amber Not in Off-label use as an option in Added (August BNF for patients with Raynaud’s meeting) this phenomenon 1.9.14 Choice of NRT patch Green 4.10.2indicatio Change from NiQuitin CQ to Changed (August n Nicorette Invisi patches meeting)

1.9.14 Minoxidil tablets Now 2.5.1 Change from red to amber Changed (August amber meeting) 1.9.14 Regadenoson injection Red Not in For use during radionuclide Added (August BNF myocardial perfusion meeting) scanning

1.9.14 Dabigatran capsules Now 2.8.2 VTE prophylaxis (hips and Changed (August red knees) change from amber meeting) to red 1.9.14 Co-amoxiclav Discontinued by Removed (August dispersible tablets manufacturer meeting)

1.9.14 Quinupristin with Discontinued by Removed (August dalfopristin injection manufacturer meeting) 1.9.14 Sodium fusidate Discontinued by Removed (August injection manufacturer meeting) 1.9.14 Brimonidine gel Green 13.6.3 For patients with rosacea Added (August who have failed to respond meeting) to, or are intolerant of, other options, or have 1.9.14 Canagliflozin tablets Green 6.1.2.3 psychologicalAccording to TA315 distress due to Added (August persistent redness. Cautious meeting) use is advised until more data are available around long-term safety and potential loss of effect with longer-term use. Some patients have noted a worsening of their rosacea after application

1.9.14 Prasugrel tablets Amber 2.9 According to NICE TA317 Changed TA (August number meeting) 1.9.14 Lubiprostone capsules Amber 1.6.7 According to NICE TA318 Added (August meeting) 1.9.14 Ipilimumab infusion Red 8.1.5 According to NICE TA319 Added (August meeting) 1.9.14 Enzalutamide capsules Red 8.3.4.2 According to NICE TA316 Added (August meeting)

1.9.14 Acetylcysteine tablets Amber 3.7 Remove ‘effervescent’ from Removed (August formulary entry meeting)

21.7.14 Prochlorperazine Discontinued by Removed 21.7.14 Trifluoperazinesuppositories MR Discontinuedmanufacturer by Removed capsule manufacturer

21.7.14 Artesunate IV Red No For severe or complicated P. Added mono- falciparum malaria graph in BNF 21.7.14 Artemether and Red 5.4.1 For acute uncomplicated P. Added lumefantrine tablets falciparum malaria or as oral [Riamet] step-down treatment following IV artesunate 21.7.14 Emerade pre-filled pen Green 3.4.3 Supply problems with other Added brands of adrenaline for self- administration

21.7.14 Minims Word ‘Minims’ has been Amended replaced by ‘unit dose eye drops’ to allow purchasing of different brands

30.6.14 Dexmedetomidine Red 15.1.4.4 Off-label use for awake Added 30.6.14 Evrainfusion patch Blue 7.3.1 Thirdcraniotomy.-line option Added Patients to be informed of off-label status and lack of comparative evidence and that they can choose to have an alternative

30.6.14 Zoely tablets Blue 7.3.1 Third-line option. Consultant Added use only in Solent. 30.6.14 Alimemazine Amber 3.4.1 Off-label use for children Changed colour tablets/liquid with severe behavioural from red to amber insomnia

30.6.14 tablets Red 8.1.5 According to NICE TA310 Added

30.6.14 Bortezomib injection Red 8.1.5 According to NICE TA311 Added TA number

30.6.14 infusion Red Not yet According to NICE TA312 Added in BNF 30.6.14 Alemtuzumab infusion Red 8.2.3 The old formulation of Added ‘named alemtuzumab, used for bone patient’ marrow transplant patients, 30.6.14 Didronel PMO isDiscontinued now only available by as a Removed namedmanufacturer patient drug

30.6.14 Glyceryl trinitrate buccal Discontinued by Removed tablets manufacturer 30.6.14 Liothyronine sodium Amber 6.2.1 Shared care guideline not Changed from red tablets required to amber

30.6.14 Forceval Junior Soluble Green 9.6.7 Replace formulation Changed from Foreceval Junior capsules to Junior Soluble 30.6.14 Butrans patches Green 4.7.2 Included in previously Changed from agreed primary care amber to green guideline

30.6.14 Transtec patches Green 4.7.2 Included in previously Changed from agreed primary care amber to green guideline 30.6.14 Dapagliflozin tablets Green 6.1.2.3 To be used in line with NICE Changed colour TA288 from amber to green 30.6.14 Latanoprost Amber 11.6 For patients who are Added preservative-free eye intolerant of preservatives drops (Monopost)

2.6.14 ellaOne tablet Green 7.3.5 Wider use supported e.g Amended (May women with high BMI or 2.6.14 Quinine sulphate tablet Green 10.2.2 ‘300mg’ removed from Both 200 and meeting) intrauterine device is (May formulary entry for 300mg tablets are declined or contra-indicated meeting) nocturnal leg camps now available for (up to 120 hours after this indication intercourse) 2.6.14 Fluticasone furoate plus Green 3.2 Option for patients who Added (May vilanterol (Relvar cannot use other inhaler meeting) Ellipta) dry powder devices. inhaler for asthma 2.6.14 Fluticasone furoate plus Green 3.2 OptionNote: in moderate to Added (May vilanterol (Relvar severeFluticasone COPD. furoate is more meeting) Ellipta) dry powder potent than the propionate inhaler for COPD Notesalt. :Fluticasone furoate 92 Fluticasonemicrograms furoateonce daily is more is approximately equivalent to potent than the propionate salt.250 microgramsFluticasone furoatefluticasone 92 microgramspropionate twice once dailydaily andis approximatelythe 184 micrograms equivalent once toa 250day dosemicrograms to propio fluticasonenate 500 propionatemicrograms twice twice daily a day

2.6.14 Metoclopramide No longer indicated as a Note new (May tab/liq/inj motility stimulant due to risk recommendations meeting) of neurological adverse effects. See MHRA Drug Safety Update August 2013 2.6.14 Domperidone No longer indicated as a Note new (May tab/susp/suppos motility stimulant due to risk recommendations meeting) of serious cardiac side effects. See MHRA Drug Safety Update May 2014

28.4.14 Aripiprazole IM depot Red 4.2.2 For use in secondary Added 28.4.14 Pixantroneinjection injection Red 8.1.2 Accordingpsychiatric to care. NICE Criteria TA306 for for Added nonuse -areHodgkin’s being developed lymphoma

28.4.14 Aflibercept injection Red 11.8.2 According to NICE TA305 for Added TA number macular oedema (central 28.4.14 Rituximab infusion Red 8.2.3 Accordingretinal vein to occlusion) NICE TA308 for Added TA number anti-neutrophil cytoplasmic -associated vasculitis 28.4.14 Azathioprine suspension Amber 8.2.1/ Added 10.1.3

28.4.14 Forceval Soluble Green 9.6.7 For adult patients with poor Added effervescent tablets swallowing, who are nil by mouth or who require medicine administration through an enteral feeding tube. Product can be used orally or through a gastric or jejunal enteral feeding tube. May be suitable for patients who are at risk of refeeding syndrome, with poor wound healing or who need treatment for vitamin and mineral deficiencies and cannot use oral tablets.

Sanatogen A-Z Complete tablets remain on the formulary for all other situations for adult patients

24.2.14 Zoledronic acid 5mg Red 6.6.2 Generic zoledronic acid is Amended 24.2.14 Fluocinoloneinfusion (generic) acetonide Red 11.4.1 Accordingnow available to NICE and canTA301 be for Added implant diabeticused when macular clinicians oedema choose to prescribe off-label for patients with osteoporosis

24.2.14 Hyacyst (sodium Red Not in To be assessed and findings Added hyaluronate) bladder BNF reported back to DPC instillation (device) 24.2.14 Perampanel tablets Amber 4.8.1 Treatment initiated and Added patients stabilised by neurology specialists 24.2.14 Vesomni (tamsulosin Green Not yet For moderate to severe Added plus solifenacin) MR in BNF storage and voiding tablets symptoms associated with benign prostatic hyperplasia 24.2.14 tablets Red Not yet inNICE men TA303 who arefor adultsnot with Added in BNF adequatelyactive relapsing responding-remitting to treatmentmultiple sclerosis with monotherapy

20.1.14 Bretylium injection 2.3.2 No longer used Removed 20.1.14 Zoledronic acid 4mg Red 6.6.2 In cancer care, IV zoledronic Amended injection acid will replace pamidronate and oral clodronate

16.12.13 Amoxicillin capsules Red 5.1.1.3 For patients with chronic low Amended 16.12.13 Fidaxomicin tablets Amber 5.1.7 Changeback pain from associated red to amber. with Amended Modic type 1 changes On advice of microbiology for first episode of severe C. 16.12.13 Magnesium oxide Amber 9.5.1.3 diffChange on concomitant from red to amber Amended capsules antibiotic or second episode

16.12.13 Magnesium Amber 9.5.1.3 Change from red to amber Amended glycerophosphate capsules/tablets 16.12.13 Apomorphine injection Red for 4.9.1 Existing patients need co- Amended new ordinated transfer to patient secondary care s 16.12.13 Linaclotide capsules Amber 1.6.7 According to local algorithm Added

16.12.13 Immediate release Green 7.4.2 Not suitable for frail older Added wording oxybutynin tablets women or patients with 16.12.13 Ribavirin tablets Red 5.3.3 Accordingcognitive impairment to NICE Amended TA300 (hepatitis C, children and young people)

16.12.13 Peginterferon alfa Red 5.3.3 According to NICE Amended injection TA300 (hepatitis C, children and young people)

16.12.13 Ranibizumab intravitreal Red 11.8.2 According to NICE TA298 Amended injection (choroidal neovascularisation [pathological myopia]) 16.12.13 Ocriplasmin intravitreal Red 11.8.2 According to NICE TA297 Added injection (vitreomacular traction)

25.11.13 Botulinum toxin Red 4.9.3 List of routinely Amended commissioned indications has been updated (see end of document)

28.10.13 Lisdexamfetamine Amber 4.4 For licensed indication Added 28.10.13 Mercaptopurinecapsules tablets Change 8.1.3 Shared care guideline on Changed colour from azathiorpine/mercaptopurine red to is available from amber http://www.westhampshirec cg.nhs.uk/medicines/healthc are-professionals

30.9.13 Dibotermin alfa Now replaced by Opgenra Removed 30.9.13 Vitamins(Inductos) for age related Amber Not in Prescribed locally for Amended macular degeneration BNF patients with ‘category 4’ formulation (Viteyes 2 Formula AMD who have advanced 30.9.13 Buccal midazolam Red 4.8.2 Off-label use prior to Added indication capsules) disease in one eye only (Buccolam) endoscopy for a specific (advanced lesions or visual group of adults and children acuity <20/32). ‘Viteyes 2 over 10 years who do not F ormula’ is the preferred tolerate IV cannulation (e.g. product as it is the least those with learning expensive and contains the difficulties). correct combination of IVvitamins midazolam and zinc. continue Unlikes to beprevious the first AMD line vitamins option for it thecan majoritybe given ofto patientsprevious or current smokers as it no longer contains beta- carotene. In patients with AMD categories 1 to 3 there is no convincing evidence to support prescribing currently, but patients may opt to purchase these OTC.

Prescribing of Viteyes 2 is normally initiated on secondary care advice. Patients should be reviewed regularly and ‘treatment’ discontinued if found to be of no benefit

30.9.13 Testosterone gel Amber 6.4.2 Only for proven Added (Testogel/Tostran) hypogonadism with marked clinical symptoms of testosterone deficiency

30.9.13 Infatrini Peptisorb Section Added (200ml) 3 of oral nutrition section 30.9.13 Paediasure Plus Juce Section Added (200ml, apple and very 3 of oral berry) nutrition section

2.9.13 Mirabegron tab Green 7.4.2 According to NICE TA290 Added NICE TA 2.9.13 Ceftaroline inj Red 5.1.2 Only for specialist use on Addednumber. Changed the advice of microbiology from amber to green

2.9.13 tab Red 9.1.4 According to NICE TA293 Added

2.9.13 Eptotermin alfa Red Not in Replacement for Inductos Amended (Opgenra) for BNF for spinal surgery. Osigraft 2.9.13 Dapagliflozinimplantation tab Amber 6.1.2.3 Accordingremains the to formularyNICE TA288 Added choice for tibial surgery

2.9.13 Aripiprazole tab Amber 4.2.1 According to TA292 (bipolar Updated disorder in children)

2.9.13 Rivaroxaban tab Green 2.8.2 According to NICE TA287 Updated (pulmonary embolism and recurrent venous 2.9.13 5-aminolevulinic acid Red Not in Forthromboembolism) visualisation of Added (August (Gliolan) powder for BNF malignant tissue during meeting) oral solution surgery for malignant glioma

29.7.2013 Ketoconazole tab 5.2.2 No longer recommended for Note 29.7.2013 Norethisterone tablets Blue 7.3.2.1 Anfungal alternative infections. to Femulen, Add (Noriday) whichSee press has releasebeen discontinued from byMHRA manufacturer 29.7.2013 Pripsen sachets Discontinued by Removed manufacturer

29.7.2013 Calcium carbonate Green 9.5.1.1 While Calcium Sandoz liquid Added effervescent tablets is unavailable (Cacit) 29.7.2013 Colistimethate powder Red 5.1.7 According to NICE TA276 Added for inhalation (Colobreathe) 29.7.2013 Hydroxyethyl starch Licence has been suspended Removed (Voluven) because large RCTs have reported an increased risk of renal dysfunction and mortality in critically ill or septic patients who received hydroxyethyl starch compared with crystalloids. See Drug Safety Update

24.6.2013 Tramadol MR Blue 4.7.2 Add to blue 24.6.2013 Dihydrocodeine MR Blue(FP10 4.7.2 Addcategory to blue for (FP10use categoryprimary care for useonly) primary care only) 24.6.2013 Slow Sodium Amber 9.2.1.2 Change from red to amber

24.6.2013 Captopril liquid Amber 2.5.5 Change from red to amber 24.6.2013 Fidaxomicin tabs Red 5.1.7 Limited to patients with first Add episode of severe C diff 24.6.2013 Aflibercept inj Red 11.8.2 Forwhen wet concurrent age-related antibiotics macular Add degenerationcannot be stopped; according and tofor NICEsecond TA294 episodes of C diff. On advice of microbiology

24.6.2013 Paliperidone long-acting Red 4.2.2 For prescribing by Solent Change inj specialists (previously Southern Health only) 24.6.2013 Teriparatide inj Red 6.6.1 For treatment of atypical Change subtrochanteric fractures

24.6.2013 Omalizumab inj Red 3.4.2 According to NICE TA278 Update NICE TA number 24.6.2013 Ranibizumab injection Red 11.8.2 According to NICE TA283 Add NICE TA (macular oedema) number

24.6.2013 Pirfenidone caps Red 3.11 According to NICE TA282 Added

24.6.2013 Abatacept inj Red 10.1.3 According to NICE TA280 Update NICE TA (rheumatoid arthritis) number

20.5.13 Adcal chewable tab Green 9.5.1.1 Will replace Calcichew Changed 20.5.13 Adcal D3 effervescent Green 9.6.4 Will replace Calfovit sachets Changed tab 20.5.13 Adcal D3 chewable tab Green 9.6.4 Will replace Calcichew D3 Changed Forte

20.5.13 Adcal D3 caplets Green 9.6.4 Reserved for patients who Added cannot tolerate chewable or effervescent 20.5.13 Oxazepam tab Amber 4.10.1 For use according to the Added emergency department policy on alcohol misuse 20.5.13 Femulen 7.3.2.1 Has been discontinued Removed

29.4.13 Dabigatran cap Green 2.8.2 Previously amber for Changed 29.4.13 Rivaroxaban tab Green 2.8.2 Previouslyprevention amberof stroke for in Changed preventionpatients with of AF.stroke Changed in to patientsgreen as withGPs AF.don’t Changed refer to greenthese patientsas GPs don’t to a specialistrefer these patients to a specialist 29.4.13 Apixaban tab Green 2.8.2 NICE TA275 for prevention Added of stroke and systemic embolism in patients with non-valvular atrial fibrillation

29.4.13 Ranibizumab inj Red 11.8.2 NICE TA274 for diabetic Added macular oedema

29.4.13 Mirabegron tab Amber 7.4.2 Wording superseded by Added publication of NICE TA 29.4.13 Lixisenatide inj Amber 6.1.2.3 Consider as first-line GLP- Added receptor agonist for new patients instead of exenatide 29.4.13 Insulin degludec Amber 6.1.1.2 Initiated and stabilised by a Added (Tresiba) specialist for difficult to manage patients with type 1 29.4.13 Linagliptin tab Green 6.1.2.3 Fordiabetes patients with any stage Added of renal impairment 29.4.13 Tobramycin dry powder Red 5.1.4 NICE TA276 Added inhaler

29.4.13 Sevelamer carbonate Amber 9.5.2.2 When calcium-containing Added sachets products are not tolerated

29.4.13 Cerelle tab Green 7.3.2.1 Branded generic version of Added Cerazette

29.4.13 Octasa MR tab Amber 1.5.1 New name for Mesren Changed

29.4.13 Halothane Red 15.1.2 Has been discontinued Remove

25.2.13 Testosterone patch Blue 6.4.2 Had been discontinued, but Re-instated 25.2.13 Progesterone 8% Red 6.4.1.2 now available from a new Added vaginal gel supplier

25.2.13 Human menopausal Red 6.5.1 Added ‘Menopur’ gonadotrophin inj 25.2.13 Follitropin(Menopur) alfa inj Red 6.5.1 Added

25.2.13 Choriogonadotropin alfa Red 6.5.1 Added inj

25.2.13 Cetrorelix inj Red 6.7.2 Added

25.2.13 Buserelin inj Red 6.7.2 Added

25.2.13 Fluticasone and Green 3.1.1.1 Added formoterol inhaler 25.2.13 Ivacaftor(Flutiform) tab Red 3.7 Routinely commissioned for Added patients age 6 and over with cystic fibrosis and G551D mutation 25.2.13 Naltrexone tab Amber 4.10.1 For maintenance of Updated with (Adepend) abstinence in alcohol trade name dependence

25.2.13 Aclidinium bromide Green 3.1.2 Base prescribing decisions Added inhaler on which device the patient can use and cost 25.2.13 Glycopyrronium inhaler Green 3.1.2 Base prescribing decisions Added on which device the patient can use and cost

25.2.13 Voractiv tab Red 5.1.9 As complete courses of Added Voractiv. drugs for TB are managed 5.1.9 amended by the hospital, all drugs in section 5.1.9 of the formulary will become ‘red’

25.2.13 Argatroban inj Red 2.8.1 An option for patients in Added critical care areas with heparin-induced thrombocytopenia (HIT)

25.2.13 Eplerenone tab Amber 2.2.3 To reduce the risk of Amended cardiovascular mortality and morbidity in selected patients with chronic heart failure 25.2.13 Ipilimumab infusion Red 8.1.5 According to NICE TA268 Added

25.2.13 tab Red 8.1.5 According to NICE TA269 Added

25.2.13 Mannitol caps for Red 3.7 According to NICE TA266 Added inhalation

21.1.13 Ivabradine tab Amber 2.6.3 According to NICE TA267 Updated 21.1.13 Methylthioninium Red Not in Blue Marker is to be used Added chloride 1% inj BNF during surgery. 21.1.13 Budesonide(methylene blue)cap [Blue Amber 1.5.2 ForMethylthioninium ileo-caecal disease chloride Added brand [Budenofalk]Marker] 5mg/ml (methylene blue) [Proveblue] to be used for patients with methaemoglobinaemia

21.1.13 Darunavir liquid Red 5.3.1 GUM and Child Health Added specialists only 21.1.13 Naltrexone tab Amber 4.10.1 Now licensed for Updated maintenance of abstinence in alcohol dependence 21.1.13 Aluminium roll-on Green 13.12 Added [Andhydrol Forte]

21.1.13 Propantheline bromide Green 6.1.5 Previously in section 1.2 of Updated tab formulary. Now in 6.1.5 too, for use in patients with 21.1.13 Lysine/arginine 2.5% Red Not in Forhyperhidrosis renal protection during IV Added infusion BNF radionuclide DOTATATE therapy

21.1.13 Carbomer 980 Amber 11.8.1 To be used instead of Updated (polyacrylic acid) eye Geltears drops [Clinitas Gel]

21.1.13 Methylthioninium Red Not in Blue Marker is to be used Added chloride 1% inj BNF during surgery. (methylene blue) [Blue Methylthioninium chloride Marker] 5mg/ml (methylene blue) [Proveblue] to be used for patients with methaemoglobinaemia

12.12.12 Dimeticone lotion Green 13.10.4 Due to supply problems with Updated (Hedrin) malathion aqueous liquid, dimeticone lotion (Hedrin) has been changed from blue to green

12.11.12 Glatiramer injection Red 8.2.4 As part of the Department of Added Health’s risk sharing scheme for patients with multiple sclerosis

15.10.12 Alteplase injection Red 2.10.2 Update to NICE guidance for Change TA 15.10.12 Rilpivirine tablets Red 5.3.1 acute ischaemic stroke. Now numberAdded TA264

15.10.12 Prucalopride tablets Amber 1.6.7 According to shared care Updated 15.10.12 Jext auto-injector Green 3.4.3 Specialistguideline -(availableled managed from Added transferwww.hampshire.nhs.uk/ from Epipen to Jext (thisprimary device-care/ has a longer shelfRegister life) with NHS Hampshire for a password)

15.10.12 Iloprost infusion Red Unlicens For severe Raynaud’s Updated ed phenomenon secondary to systemic sclerosis, according to flowchart

15.10.12 Zostavax vaccine Red 14.4 Specialist prescribed in Added

secondary care for small

number of patients with severe, intractable, recurrent herpes zoster 15.10.12 Alphosyl HC cream 13.5.2 Discontinued Remove from

formulary

20.9.12 Varenicline tablets Green 4.10 Changed to green

17.9.12 Taurolidine IV Red Not in Used as a line lock in Added 17.9.12 Naltrexone tablets Amber 4.10the BNF Forpatie alcoholnts on addictionlong-term TPN Previously used at or IV fluids Southern, now also at UHS 17.9.12 Sodium hyaluronate eye Amber 11.8.1 For patients with a proven Added drops (Hylo-Tear & allergy to preservatives Hylo-Forte)

17.9.12 Travoprost eye drops Amber 11.6 For patients with a proven Added allergy to benzalkonium chloride

17.9.12 Loteprednol eye drops Amber 11.4.1 Added

17.9.12 Ulipristal 5mg tablets Amber 6.4.1.2 An option for the pre- Added operative treatment of uterine fibroids. Consultant recommendation (no shared care guideline required) 17.9.12 Fluorouracil plus Green 13.8.1 For actinic keratosis. Can be Added salicylic acid cutaneous used in primary care. Efudix solution (Actikerall) remains the first-line topical treatment (awaiting update of Map of Medicine) 17.9.12 Ivabradine tablets Green 2.6.3 (wording removed - Added superseded by NICE guidance) 17.9.12 Betnovate N cream and Green 13.4 Dermovate NN has been Added ointment discontinued 17.9.12 Rivaroxaban tablets Green 2.8.2 NICE TA261 -an option for Added treating DVT and long-term secondary prevention

17.9.12 Botulinum toxin type A Red 4.9.3 Option for chronic migraine Added according to NICE TA260 17.9.12 Abiraterone tablets Red 8.3.4 An option for metastatic Added prostate cancer after testosterone reduction 17.9.12 Erlotinib tablets Red 8.1.5 therapyPossible andfirst -docetaxelline option in Added accordinglocally advanced to NICE or TA259 metastatic non-small-cell EGFR-TK mutation positive lung cancer according to NICE TA258 17.9.12 Dabigatran capsules Amber 2.8.1 Possible treatment to Added prevent stroke and systemic embolism in people with atrial fibrillation according to NICE TA249

17.9.12 Calcitonin nasal spray 6.6 Being discontinued due to Removed risk of cancer

17.9.12 Buccal midazolam pre- Amber 4.8.2 To replace unlicensed Added filled syringes midazolam for children with 17.9.12 Prucalopride tablets Amber 1.6.7 Changeda seizure fromdisorder red to amber Changed 17.9.12 Ticagrelor tablets Green 2.9 NICE TA236 Changed colour

17.9.12 Rituximab infusion Red 8.2.3 NICE TA226 Added 17.9.12 Bivalirudin injection Red 2.8.1 NICE TA230 Added 17.9.12 capsules Red 8.2.4 NICE TA228 Added

17.9.12 Phenobarbital elixir Red 4.8.1 Unlicensed special order Added preparations are available, with and without alcohol as an excipient. Specialist only prescribing and supplied 17.9.12 Bortezomib injection Red 8.1.5 fromNICE hospitalTA228 pharmacies Added

17.9.12 Apixaban tablets Red 2.8.2 NICE TA245 Added

17.9.12 Nilotinib capsules Red 8.1.5 NICE TA241 Added

18.6.12 Indapamide tablets and Green 2.2.1 Added 18.6.12 Calcitoninprolonged -nasalrelease spray Red 6.6 (wording removed – product Added tablets now discontinued)

18.6.12 Omalizumab injection Red 3.4.2 Although ‘red’ locally it was Added

agreed that in order to reduce day case attendances 18.6.12 Telaprevir tablets Red 5.3.3.2 Accordingthe 6 local topatients NICE TA252 receiving Added this medication may be considered for SC administration in primary care as an interim measure, prior to teaching self- administration to these patients, by GP agreement. Prescribing responsibility will be retained by the specialists long term, with future consideration of a homecare supply service once patients are happy to self-administer

18.6.12 Boceprevir capsules Red 5.3.3.2 According to NICE TA253 Added

18.6.12 Nilotinib capsules Red 8.1.5 According to NICE guidance Added (TA251) as an option for first line treatment of chronic myeloid leukaemia 18.6.12 Standard dose Red 8.1.5 According to NICE TA251 as Added an option for first line treatment of chronic myeloid leukaemia

18.6.12 Tocilizumab injection Red 10.1.3 According to NICE guidance Updated TA247 for rheumatoid arthritis

18.6.12 Tobramycin dry powder Red 5.1.4 For specialist use for Added inhaler selected patients e.g active patients, stable patients 18.6.12 Bee venom Red 3.4.2 Accordi(supersededng to byNICE NICE TA246 Added (Pharmalgen) TA276)

18.6.12 capsules Red 8.2.4 Only according to NICE Added TA254

18.6.12 Proveblue injection Red 15.2 Licensed version of Added methylthioninium chloride 18.6.12 Collagenase injection Red 10.3.1 Only for use in a very specific Added (Xiapex) cohort of patients, in line with 18.6.12 Rituximab injection Red 10.1.3 Accordingcurrent low to priorities agreed guidance guidance, Added fori.e. adultsflatten with their systemic fingers or lupus palm erythematosuson a table; and there is functional impairment. One cord, 2 joints up to 90% flexion. Only to be administered by hand surgeons trained in its use. Restricted to cases where it is likely that only a single injection of Xiapex will be required for treatment of the contracture

18.6.12 Exenatide long-acting Amber 6.1.2.3 NICE TA248 Added injection

18.6.12 Growth hormone Red 6.5.1 First line choices are Omnitrope Updated and Genotropin. Consider 18.6.12 Pioglitazone tablets Green 6.1.2.3 Prescribeswitching generically.existing adult Although Updated thepatients licensed on other indications options for to brandedOmnitrope and or generic Genotropin versions are different, due solely to patent protection issues, generic pioglitazone has demonstrated bioequivalence with the branded version 18.6.12 Estradiol valerate plus Red 7.3.1 Specialist recommendation only Added dienogest (Qlaira) on an exceptional basis for tablets heavy menstrual bleeding 18.6.12 Tapentadol prolonged- Amber 4.7.2 Third or fourth line niche use, Added release tablets following specialist recommendation only 18.6.12 Paliperidone long-acting Red 4.2.2 Specialist prescribing only at Added injection Southern Health 18.6.12 Fluticasone furoate Green 12.2.1 Second or third line for patients Added nasal spray who need a different device

2.5.12 Rivaroxaban tablets Red 2.8.2 Off-label use for patients with Added 2.5.12 Prilocaine 2% injection Red 15.2 fractured neck of femur or who Added have a plaster cast and who fulfil the assessment criteria

26.3.12 Midodrine tablets Green 6.1.5 Missed off formulary previously Added 26.3.12 Laxido Green (unlicens1.6.4 Previously ‘blue’ but now Changed 27.2.12 Estradiol vaginal tablet Green ed)7.2.1 changed to ‘green’ to promote Changed from 10 micrograms use in UHS for adults with blue to green 27.2.12 Quetiapine MR tab 4.2.1 Usechronic immediate constipation-release or faecaltablets Removed 27.2.12 Goserelin, leuprorelin, Amber 6.7.2 Theimpaction least costly gonadorelin Changed triptorelin and analogue over the course of 8.3.4.2 treatment and for the organisation administering it should be used for its licensed indications 27.2.12 Simeticone oral Red 1.1.1 For use during endoscopy Added suspension 27.2.12 Easyhaler Formoterol Green 3.1.1.1 Added 27.2.12 Nevirapine MR tablets Red 5.3.1 Added 27.2.12 Rotigotine patches Amber 4.9.1 Initiated/recommended by Changed specialists: as a replacement for oral dopamine agonists in patients with inadequate control of nocturnal/early morning symptoms; in patients with inadequate compliance of complex regimens (cognitive problems, unable to swallow oral medication, motor problems) and as sole treatment in emergency situations when patients are unable to swallow oral drugs 27.2.12 Exenatide long-acting Amber 6.1.2.3 (wording removed - superseded Added injection by NICE guidance) 27.2.12 2a eye Red Not in For specialist use only Added drops BNF 27.2.12 Sterile talc Red Not in For specialist use only Added BNF 27.2.12 Rituximab injection Red 8.2.3 NICE TA243 – follicular Added lymphoma 27.2.12 Tocilizumb injection Red 10.1.3 NICE TA238 - systemic, Added juvenile, idiopathic arthritis 21.2.12 Dabigatran capsule Amber 2.8.2 Changed to 110mg and 150mg amber

23.1.12 Dabigatran capsule Red 2.8.2 (wording removed - superseded Added 110mg and 150mg by NICE guidance) 23.1.12 PelvicToner device Blue As part of pelvic floor training Added

23.1.12 Levonorgestrel tablet 30 Blue 7.3.2.1 For existing patients Added microgram 23.1.12 Ticagrelor tablet Blue 2.9 NICE TA236 Added 23.1.12 Mifamurtide injection Red 8.2.4 NICE TA235 Added 23.1.12 Estradiol vaginal tablet Blue 7.2.1 Added 10 micrograms 23.1.12 Nicorette Icy White Green 4.10.2 As part of smoking cessation Added Gum 4mg and 2mg programme

23.1.12 Nicorette Quickmist Green 4.10.2 As part of smoking cessation Added 23.1.12 mouthsprayNicorette Inhalator Green 4.10.2 programmeAs part of smoking cessation Added programme 23.1.12 Capsaicin patch 8% Red 10.3.2 Only for patients with post- Added herpetic neuralgia who have inadequate pain relief with other options 3.1.12 5% sodium chloride Green 9.2.2 Added infusion (Polyfusor) 12.12.11 Aminophylline MR tablet Green 3.1.3 For existing patients Added 12.12.11 Ferric carboxymaltose Red 9.1.1.2 Added inj 12.12.11 Levobupivacaine inj Red 15.2 Until 31 March 2012, additional Added 0.125% (200ml bags) indication of peripheral nerve infusion via peripheral nerve block catheter

14.11.11 Dexamethasone Red 11.4.1 NICE TA229 Added 14.11.11 Golimumab injection Red 10.1.3 NICE TA233 Added intravitreal implant 14.11.11 Moxifloxacin tablet Amber 5.1.12 Already on the formulary for Amended restricted use. Formulary entry to be amended to add use according to guideline (adult ENT)

17.10.11 TriRegol tablet Blue 7.3.1 To replace Logynon Added 17.10.11 Rigevidon tablet Blue 7.3.1 To replace Ovranette Added 17.10.11 Millinette 30/75 tablet Blue 7.3.1 To replace Femodene Added

12.09.11 Ciclosporin eye drops Red 11.8.1 A special Added 12.09.11 Golimumab injection Red 10.1.3 NICE TA225 Added

12.09.11 Retigabine tablets Amber 4.8.1 NICE TA232 Added

12.09.11 Botulinum A toxin Red 4.9.3 Restricted use. Specify which Added injection (Xeomin brand of botulinum is required brand) and indication 19.07.11 Oxycodone (Oxynorm) NOT Oxycodone (Oxynorm) capsule NOT ON capsule ON will no longer be stocked in FORMULARY FORM- Pharmacy. ULARY Any patients prescribed Oxycodone (Oxynorm) capsule will be changed to Oxycodone (Oxynorm) liquid (green) in accordance with the formulary. Patients may continue to bring their supply of Oxycodone (Oxynorm) capsules inline with Trust’s Medicines Policy 19.07.11 Golimumab injection Red 10.1.3 NICE TA220 Added 19.07.11 Red 9.1.4 NICE TA221 Added injection 19.07.11 Naftidrofuryl capsule Green 2.6.4 NICE TA223 Added

19.07.11 Denosumab injection Amber 6.6.2 NICE TA204 Added

19.07.11 Naltrexone tablet Amber 4.10.1 Maintaining abstinence after Amended alcohol withdrawal in patients with alcohol dependence. (Unlicensed indication). To be recommended by the alcohol detox service 19.07.11 Tamoxifen liquid Amber 8.3.4.1 Reserved for patients unable to Amended swallow tablets

13.06.11 Raltegravir tablet Red 5.3.1 Prescribing should be carried out be local HIV specialists only 13.06.11 Maraviroc tablet Red 5.3.1 Prescribing should be carried out be local HIV specialists only 13.06.11 GlucoRx test strips Blue 6.1.6 13.06.11 Osvaren tablet Blue 9.5.2.2 Hyperphosphataemia of chronic 13.06.11 Evicel sealant Red 2.11 Specialistrenal failure use in only. patients Remove Amended statementundergoing “for dialysis pancreatic and liver surgery only” 09.05.11 Fondaparinux injection Red 2.8.1 As an adjunct to thrombolysis Amended with tenecteplase in STEMI patients 09.05.11 Darunavir 400mg tablet Red 5.3.1 Indicated for treatment Amended experienced adults

18.04.11 Azacitidine injection Red 8.1.3 NICE TA218 - myelodysplastic Added syndromes 18.04.11 Saxagliptin tablet Green 6.1.2.3 Another option for Type 2 Added Diabetes. Can be used in patients with moderate to severe renal impairment 21.03.11 Gedarel tablet Blue 7.3.1 Alternative to Mercilon and Added. Marvelon whilst in short supply Amended June 2011 to correct colour = blue 18.04.11 tablet Red 8.1.5 According to NICE TA215 Added 18.04.11 Bendamustine injection Red 8.1.1 NICE TA216 – lymphocytic Added leukaemia 18.04.11 Abatacept infusion Red 10.1.3 NICE TA195. Rheumatoid Added arthritis - drugs for treatment after failure of a TNF inhibitor 18.04.11 tablet Amber 8.2.2 Prevention of rejection in post Amended liver transplant patients 18.04.11 Rosiglitazone tablet Green 6.1.2 Withdrawn from the UK Market Removed November 2010 21.03.11 Cefoxitin injection Red 5.1.2.1 Not licensed. Added Microbiology approved 21.03.11 Dovobet Gel Green 13.5.2 Topicaltreatment Treatment of mycobacterium of scalp Amended psoriasis.abcessus respiratoryTopical trea infectiontment of in mildcystic to fibrosis moderate “non scalp” plaque psoriasis. Dermatology only. Dovobet ointment already on formulary 21.03.11 Efavirenz solution Red 5.3.1 HIV infection. Alternative to Amended tablets in patients with NG tubes or paediatric patients. Tab and caps already on formulary 21.03.11 Liraglutide injection Green 6.1.2.3 {previously amber} Amended 21.03.11 Exenatide injection Green 6.1.2.3 {previously amber} Amended 21.03.11 Venlafaxine tablet Green 4.3.4 Only high dose is amber Amended {previously all doses amber} 21.03.11 Fluorouracil cream Amber 13.8.1 Previously red Amended

21.03.11 Aripiprazole tablet Amber 4.2.1 NICE TA213 Prescribing in 15- For 17 year old: schizophrenia information 21.03.11 Prucalopride tablet Red 1.6 NICE TA211 For (Resolor®) information 21.03.11 Nutricia Pre-op Red 9.4 Carbohydrate loading of Amended carbohydrate drink® patients prior to surgery on enhanced recovery programme

21.02.11 Nifedipine MR Green 2.6.2 Added 21.02.11 Coractentablet/capsule capsule Green 2.6.2 Removed

21.02.11 Denosumab injection Red 6.6.2 According to NICE TA204 Added

21.02.11 Tafluprost eye drops Amber 11.6 Specialist use and Added recommendation. Reserved for patients who 21.02.11 Melatonin tablet/capsule Amber 4.1.1 Cost effective first line choice is Amendment require preservative free Biomelatonin tabs, followed by prostaglandin eye drops, e.g. Melatonin Life extension caps for patients with corneal grafts and Melatonin Biotec caps

21.02.11 Peristeen Anal Irrigation Green 1.6.5 Reserved for patients with Added systems neurogenic bowel dysfunction e.g. after spinal cord injury when other treatments have failed, or when incontinence is a 21.02.11 Liraglutide injection Amber 6.1.2.3 Accordingproblem to NICE TA203 For Information 21.02.11 tablet Red 8.1.5 According to NICE TA192 21.02.11 Trastuzumab injection Red 8.1.5 Gastric cancer according to For NICE TA208 Information

13.12.10 Colecalciferol capsule Green 9.6.4 Added 13.12.10 Botulinum Toxin Indications agreed for NHS For Indications Hampshire only. See Last page information of cumulative update

05.11.10 Fortisip bottle 200ml Section 9.4 Remove: Neutral Amended 3 Add: Strawberry, vanilla and Dietitia banana n Keep: chocolate request 16.11.10 Tocilizumab injection Red 10.1.3 NICE TA Added

18.10.10 Pollinex Quattro® Red 3.4.2 Reserved for Specialist allergy Added injection clinic’s use only 18.10.10 Rosiglitazone tablet Green 6.1.2.3 MHRA alert. Removed from UK Removed market 21.10.10 18.10.10 Etonogestrel implant Blue 7.3.2.2 Only to be inserted and Added (Nexplanon®) removed by trained professionals 18.10.10 Etonogestrel implant Blue 7.3.2.2 No longer available Removed (Implanon®)

18.10.10 Calcium phosphate Green 9.6.4 Alternative to calcium and Added sachet (Calfovit D3®) vitamin D3 forte for patients unable to swallow tablets 18.10.10 Dronedarone tablet Amber 2.3.2 According to NICE TA197 Added

18.10.10 Fondaparinux injection Red 2.8.1 For NSTEMI (NICE CG94) Amended 18.10.10 Nutricia Pre-op Red 9.4 Carbohydrate loading of Amended carbohydrate drink® patients prior to elective primary total hip replacement on enhanced recovery programme 18.10.10 Polyacrylic acid eye Amber 11.8.1 Remove brand name Amended drops {Geltears®} 13.09.10 3,4- diaminopyridine Red 10.2.1 For Lambert Eaton Myasthenic Remains on tablet Syndrome formulary 13.09.10 Nebusal® (7% sodium Green 3.7 Recommended by specialist for Added chloride solution for cystic fibrosis. nebulisation) Prescribe by brand

13.09.10 Carmellose sodium Green 11.8.1 Less expensive than single use Added 0.5% eye drops carmellose drops (Celluvisc®) (Optive®) when allergy to commonly used preservatives is problematic 13.09.10 Prucalopride tablet Red 1.6 (wording removed - superseded Added (Resolor®) by NICE TA211) 13.09.10 Abidec® drops Green 9.6.7 Used by neonatal unit as an Added alternative to Dalivit drops 13.09.10 Insuman Comb25® Green 6.1.1.2 Alternative to Mixtard 30® Added (with ClickStar pen) 13.09.10 Vinorelbine capsule Red 8.1.4 Reserved for patients with poor Added venous access as part of a second or third line 13.09.10 Human Mixtard 30® Green 6.1.1.2 Discontinuedchemotherapy December regimen. 2010In all Removed vial and 3ml cartridge other circumstances, and for exceptional cases, an Individual 18.07.10 NuvaRing® Blue 7.3.1 3Fundingrd or 4th Request line option may be Added contraceptive device appropriate 18.07.10 Insulatard InnoLet® Green 6.1.1.2 Treatment of gestational Added diabetes and type 2 diabetes in pregnancy 18.07.10 Darunavir 400mg tablet Red 5.3.1 In combination with ritonavir for Added antiretroviral naïve patients 18.07.10 Beractant Red 3.5.2 Added (Survanta®) suspension 18.07.10 Sugammadex injection Red 15.1.7 Consultant Anaesthetist use Added only. To be used in line with “Protocol for use of sugammadex” 14.06.10 Methylprednisolone Green 6.3.2 Treatment of relapse in multiple Added tablet sclerosis (previously methylprednisolone sodium succinate powder for injection was administered orally) 14.06.10 Ritonavir tablet Red 5.3.1 Added

14.06.10 Ritonavir capsule Red 5.3.1 Removed

14.06.10 Prochlorperazine buccal Green 4.6 As an alternative to injectable Amended tablet antiemetics 14.06.10 Apraclonidine Red 11.8.2 Laser surgery Added 1% single use eye drop units

26.04.10 Remifentanil injection Red 15.1.4.3 Patient controlled analgesia for Amended labour (previously theatres only) 26.04.10 Stalevo® tablet Amber 4.9.1 Parkinson’s disease Added

26.04.10 Levofloxacin 0.5% eye Red 11.3.1 Following corneal graft surgery. Added drops Complete course to be provided on discharge 26.04.10 Levofloxacin 0.5% unit Red 11.3.1 Following corneal graft surgery if Added dose eye drops instillation is greater than 6 times daily. Complete course to be provided on discharge from hospital 26.04.10 Certolizumab pegol Red 10.1.3 Option in severe active Added injection rheumatoid arthritis if already tried methotrexate and another DMARD, according to NICE: http://guidance.nice.org.uk/TA18 6 26.04.10 Trabectedin injection Red 8.1.5 Soft tissue sarcoma according to Added NICE: http://guidance.nice.org.uk/TA18 5 26.04.10 Ferrous fumarate tablet Green 9.1.1.1 Currently PCT use only, change Amended to green 26.04.10 Ferrous sulphate Green 9.1.1.1 Replaced by ferrous fumarate Removed 26.04.10 Triclofos liquid Red 4.1.1 Discontinued Removed 26.04.10 Amphotericin lozenges Green 12.3.2 Discontinued Removed End of list

Basingstoke, Winchester & Southampton District Prescribing Committee Portsmouth Area Prescribing Committee Botulinum Toxin Indications Routinely Commissioned Licensed: Dysport Botox Xeomin NeuroBloc Blepharospasm √ √ √ Cervical dystonias √ √ √ √ Focal spasticity √ (arm & foot) √ (foot & post stroke wrist/hand) √ (post stroke arm) Hemifacial spasm √ √ Hyperhidrosis (severe) √ Migraine prophylaxis √ Neurogenic detrusor over- √ activity Incontinence due to subcervical √ spinal cord injury or multiple sclerosis Unlicensed: Ophalmology Induction of ptosis to treat corneal exposure problems or facial palsy Treatment of early onset squint EMG guided intra ocular inj for diagnostic purposes such as checking for binocular potential prior to squint surgery EMG guided intra ocular inj for therapeutic purposes such as inj into medial rectus & transpose vertical recti for cases of complete VI nerve palsy Synkinetic facial movements Treatment of crocodile tears

Surgery Anal Fissure

Neurology Paravertebral & shoulder muscle spasm Pyriformis syndrome Foot dystonia in Parkinsons Disease Face & neck tics Axial dystonia

ENT Frey’s Syndrome Laryngeal & tongue dystonia Cricopharyngeal spasm Vocal Cord Granuloma Severe drooling/hypersalivation Masseteric hypertrophy & associated facial pain Spasm of reconstructed pharynx after laryngectomy Spastic dysphonia Focal dystonia & muscle spasm of head and neck

Gastro Oesphageal spasm Achalasia (oesophageal motility disorder) Sphincter of Oddi dysfunction

Approved by Basingstoke, Southampton & Winchester DPC and Portsmouth APC 2013

(9.13)