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

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 respiratory oscillating positive clinician only. For airways expiratory pressure clearance in selected patients devices 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]. Date Drug and formulation Colour BNF Comments Action status section

19/6/19 Mepivacaine 3% Red 15.2 For specialist use only in Add injection [Scandonest Solent Sexual Health Service. Plain] 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 with solution 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 simvastatin 19/6/19 Hyaluronic acid gel Red 7.5 For localised use in the uterus Amend only, for prevention of adhesions. Use products registered as medical devices (i.e. CE marked) or medicines only, e.g. Hyalobarrier®; Hyaregen®; Materegen®. Date Drug and formulation Colour BNF Comments Action status section

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 Ocrelizumab 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 Date Drug and formulation Colour BNF Comments Action status section

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 ipilimumab. Available through Cancer Drugs Fund, only if conditions in the managed access agreement are followed. 22/5/19 Abemaciclib tabs Red 8.1.5 NICE TA579: for HR+, HER2- Amend advanced breast cancer (with fulvestrant after endocrine therapy). Available through Cancer Drugs Fund. 22/5/19 Brentuximab vedotin inj Red 8.1.5 NICE TA577: for CD-30+ Amend cutaneous T-cell lymphoma 22/5/19 Conestat alfa inj Red 3.4.3 For treatment of acute severe Add [Ruconest] 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 myotonia Add [Namuscla] 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-positive Add 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 Date Drug and formulation Colour BNF Comments Action status section

24/4/19 Daratumumab infusion Red 8.1.5 NICE TA573: for previously Amend treated multiple myeloma, with bortezomib and dexamethasone (Cancer Drugs Fund) 24/4/19 Certolizumab pegol Red 13.5.3 NICE TA574: for moderate to Amend severe plaque psoriasis

24/4/19 Tildrakizumab inj Red 13.5.3 NICE TA575: for moderate to Add [Ilumetri] 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 2018 Add – 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 binimetinib 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 Date Drug and formulation Colour BNF Comments Action status section

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 Commissioning Cobicistat/elvitegravir/e Policy F03/P/b mtricitabine/tenofovir 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 HRT Add (micronised) 100mg (Utrogestan®) capsules Date Drug and formulation Colour BNF Comments Action status section

27/2/19 Lidocaine medicated See 4.7.3 Restricted use. Amend plaster 5% comme Green for use in patients who nts 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. Restricted Add suspension 50mg in 5ml use - short term use for postoperative analgesia in children. Second line to ibuprofen and only when licensed options are not suitable.

30/1/19 Regorafenib tabs Red 8.1.5 TA555: for previously treated Amend [Stivarga] 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 Lenvatinib 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] Date Drug and formulation Colour BNF Comments Action status section

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 Adalimumab 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 Tofacitinib tabs Red 1.5.3 TA547: Previously treated Add moderately to severely active ulcerative colitis (adults) Date Drug and formulation Colour BNF Comments Action status section

21/12/18 Acetic acid spray [Ear Blue 12.1.1 Added for use in primary care Add Calm] for otitis externa 21/12/18 Dexamethasone/framyc Green 12.1.1 Changed from amber to green Amend etin/gramicidin ear (remains amber for ocular drops [Sofradex] use)

21/12/18 Dexamethasone/neomy Green 12.1.1 Changed from amber to green Amend cin/acetic acid spray [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 green Amend 4.8.1 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 policy ised for chronic Pseudomonas lung commis infection in cystic fibrosis sioning (adults) )

24/10/18 Bezafibrate MR tab Amber 2.12 Additional use off-label for Amend treatment of primary biliary cholangitis 24/10/18 Tocilizumab inj Red 10.1.3 Additional use for treatment Amend of toxicities associated with CAR-T cell therapy 24/10/18 Moviprep Red 1.6.5 First choice bowel prep Add Date Drug and formulation Colour BNF Comments Action status section

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

26/09/18 Tacrolimus 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 refractory Add classical Hodgkin lymphoma 26/09/18 Inotuzumab ozogamicin Red 8.1.5 TA541: Relapsed/refractory Add infusion B-cell acute lymphoblastic leukaemia

29/08/18 Aprepitant liquid Red 4.6 Prevention of N+V with highly Add 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 externa/media Add dexamethasone ear where aminoglycoside should drops [Cilodex] not be used. Licensed preparation. 29/08/18 Ulipristal acetate tablets Amber 6.7.2 Removed 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 Golimumab inj Red 1.5.3 Additional indication for use in Add Crohn’s disease. Date Drug and formulation Colour BNF Comments Action status section

29/08/18 Glycopyronnium Green 1.2 For severe sialorrhoea in Add bromide liquid children and adolescents with [Sialanar] chronic neurological disorders. 29/08/18 Trehalose/sodium Green 11.8.1 For the treatment of dry eyes, Add hyaluronate eye drops 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 UC Add [Cortiment] 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 line Amend 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 for Amend extended thromboprophylaxis 29/08/18 Pembrolizumab infusion Red 8.1.5 TA531: 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 Sorafenib 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 Dinutuximab beta Red 8.1.5 TA538: For neuroblastoma Add infusion 29/08/18 Emicizumab inj Red 8.1.5 Policy 170067/P: Prophylaxis Add 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. Date Drug and formulation Colour BNF Comments Action status section

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 green Amend 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 option Add tablets 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 Midostaurin 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 sclerosis Amend

18/07/18 Glatiramer acetate Red 8.2.4 TA 527: For multiple sclerosis Amend Date Drug and formulation Colour BNF Comments Action status section

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 criteria Add

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 locally, Add sodium caps but not for use in primary (Unlicensed) care. 25/04/18 Cabozantinib caps Red 8.1.5 TA 516: For medullary thyroid Amend cancer Date Drug and formulation Colour BNF Comments Action status section

25/04/18 Avelumab inj Red 8.1.5 TA 517: For metastatic Merkel Add cell carcinoma 25/04/18 Tocilizumab inj Red 10.1.3 TA 518: For giant cell ateritis Amend

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 Daclizumab 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 NICEpatients TA already507 – For on chronictreatment Add voxilaprevir tabs hepatitis C in adults

28/03/18 Pertuzumab inj Red 8.1.5 NICE TA 509 – In combination Add 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 Tivozanib 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 Ceritinib cap Red 8.1.5 TA500: For ALK positive non Amend small cell lung cancer Date Drug and formulation Colour BNF Comments Action status section

22.02.18 Glecaprevir with Red 5.3.3.2 TA499: For chronic hepatitis C Add pibrentasvir cap [Maviret] 22.02.18 Everolimus tab Red 8.1.5 TA498: with lenvatinib for Amend [Afinitor] advanced renal cell carcinoma 22.02.18 Lenvatinib cap [Kisplyx] Red 8.1.5 TA498: with everolimus for Add advanced renal cell carcinoma 22.02.18 Golimumab inj Red 10.1.3 TA497: 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 Pirfenidone 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 green Amend cap for migraine prophylaxis

(Remains amber for epilepsy – BNF section 4.8.1) Date Drug and formulation Colour BNF Comments Action status section

22.02.18 Dupilumab inj Red 13.5.3 Consultant dermatologist Add only. 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 line Add effervescent – once 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 or Add 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 head Amend and neck Date Drug and formulation Colour BNF Comments Action status section

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 sedation Add 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 and 29.11.17 Brimonidine/timolol eye Amber 11.6 consultantsDPC approved 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 TA48circular3/4 – 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 Aflibercept 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 Date Drug and formulation Colour BNF Comments Action status section

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 articular Add implantation 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 Reslizumab 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 Basiliximab 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 Dimethyl fumarate 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 treatment Add 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 Date Drug and formulation Colour BNF Comments Action status section

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 commissioning Add Lymphocyte criteria set by NHS England immunoglobulin 12.09.17 Cidofovir inf Red 5.3.2.1 For use as per commissioning Add criteria set by NHS England 12.09.17 Co-careldopa 20mg/ml Red 4.9.1 For use as per commissioning Add Gel cassette criteria set by NHS England

12.09.17 Deferasirox disp tab Red 9.1.3 For use as per commissioning Add criteria set by NHS England 12.09.17 Deferiprone tab Red 9.1.3 For use as per commissioning Add criteria set by NHS England 12.09.17 Everolimus (Votubia) Red 8.1.5 For use as per commissioning Add tab criteria set by NHS England 12.09.17 Icatibant inj Red 3.4.3 For use as per commissioning Add criteria set by NHS England 12.09.17 Plerixafor inj Red 9.1.7 For use as per commissioning Add 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 “Note: Amend um = this contains an antimicrobial. blue Not recommended for long- term use.” 08.09.17 Epaderm/Hydromol/Zer Epader 13.2.1 Amended Hydromol from blue Amend oderm ointment m/Hydr to green, added Zeroderm as omol = blue. green, Zerode rm = blue) Date Drug and formulation Colour BNF Comments Action status section

08.09.17 Aqueous cream Aqueou 13.2.1 Added ZeroAQS as blue. Amend /ZeroAQS cream s Amended further information crm=gr to indicate ZeroAQS as een, potential alternative (SLS- ZeroAQ free). 08.09.17 Doublebase/Isomol/Zer DoubleS = 13.2.1 Added Isomol and Zerodouble Amend odouble gel baseblue = 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 / 08.09.17 Tadalafil 10mg and ZerobaGreen 7.4.5 ‘Further information’ wording Amend 20mg tab se = has been amended to clarify blue once-daily dosing not recommended, and entry now specifies 10mg and 20mg strengths to reflect this 08.09.17 Morphine sulfate tab/MR Green 4.7.2 Suppository now unlicensed Amend (2.5mg and 5mg to be cap/liq/MR (licensed has been considered as non-formulary). sachet/inj/suppository discontinued, only available Added TA number 273. as special).

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 rectal Add enema foam in light 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 green Amend inj approved by DPC Date Drug and formulation Colour BNF Comments Action status section

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 Diphtheria,polio vaccine tetanus, and Green 14.4 As per routine immunisation Add haemoppertussis,hilus polio, influenzae schedule from Autumn 2017 typeHaemophilus 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-targeted therapy

30.08.17 Olaratumab 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 tolerate Add liquid. Not for ward stock 26.07.17 Albendazole tab Red 5.5 Add

26.07.17 Hydrocortisone, Amber 12.1.1 Product previously Add neomycin and polymyxin discontinued added back onto B ear drops [Otosporin] market Date Drug and formulation Colour BNF Comments Action status section

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 committee (Menveo) 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, etanercept 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 Ponatinib 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. Unlicensed Add in acetone 0.00001- ; as per BAD specials list, 6.0% w/v 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) cream Date Drug and formulation Colour BNF Comments Action status section

28.06.17 Propylene 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. Unlicensed Add in cetomacrogol cream ; as per BAD specials list, previously agreed at DPC 28.06.17 Glycopyrrolate 0.05% in Red 13.12 Dermatology only. Unlicensed Add aqueous solution ; 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 urology Add microgram/phentolamine clinic. mesilate 2mg Second line after alprostadil. intracavernosal inj [Invicorp] 28.06.17 Desmopressin tab Green/ 6.5.2 Noqdirna - Not recommended Amend (except Noqdirna)/nasal Amber by DPC. Safety concerns re: spray/intranasal use without specialist support. solution/inj

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 Secukinumab inj Red 10.1.3 TA 445 Amend Date Drug and formulation Colour BNF Comments Action status section

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 paediatric Add theatres Date Drug and formulation Colour BNF Comments Action status section

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 Panitumumab 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” as for inhalation 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. bu t may opt to start new patients on Braltus brand Any(lower other cost). use will be as non- formulary.[Note: both brands deliver 10micrograms tiotropium per 15.03.17 Adapalene gel/cream Green 13.6.2 Added cream formulation. Amend 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 Apremilast 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 formula).

Date Drug and formulation Colour BNF Comments Action status section

01.03.17 Hydroquinone 5%, Red 13.12 Unlicensed 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 Dasatinib, nilotinib 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 1broncst linehial preparation for Add granules patientshyperresponsiveness with distal disease. Second line treatment for pan-colitis

11.01.201 Tacrolimus MR cap Red/A 8.2.2 Red for renal transplant, Add 7 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) Date Drug and formulation Colour BNF Comments Action status section

14.12.201 Apremilast tab Red 13.5.3 NICE TA 419 Add 6 14.12.201 Dapagliflozin tab Green 6.1.2.3 NICE TA 418 Amend 6 14.12.201 Nivolumab inj Red 8.1.5 NICE TA 417 Amend 6 14.12.201 Ataluren granules Red 10.2 NICE HST (Highly Specialised Add 6 Technologies guidance) 3 14.12.201 Ciclesonide inhaler Amber 3.2 Specialist recommendation as Add 6 a steroid sparing agent at step 4/5 of the BTS guidelines

14.12.201 Lecicarbon A Amber 1.6 Specialist recommendation as Add 6 suppositories per chronic constipation guidelines 14.12.201 Pancrex V granules Amber 1.9.4 For use in patients who Add 6 require administration of pancreatin via enteral feeding tubes.

14.12.201 Sodium hyaluronate Green 11.8.1 Add 6 (Clinitas Multi) 0.4% eye drops

14.12.201 Stiripentol Amber 4.8.1 For use in paediatric patients Add 6 capsules/powder with severe myoclonic epilepsy

14.12.201 Alfacalcidol liq/caps Amber 9.6.4 Amend to amber/add caps Amend 6 14.12.201 Calcitriol caps Amber 9.6.4 Amend to amber Amend 6 14.12.201 Toujeo U300 (Insulin Amber 6.1.1.2 Specialist initiation Add 6 glargine) 300units/ml inj 14.12.201 Tresiba U200 (Insulin Amber 6.1.1.2 Specialist initiation Add 6 degludec) 200units/ml inj 14.12.201 Humalog U200 (Insulin Amber 6.1.1.1 Specialist initiation Add 6 lispro) 200units/ml

14.12.201 Emtricitabine/tenofovir Red 5.3.1 GUM and Child health Add 6 tab specialist only. As per local commissioning arrangements 14.12.201 Estradiol patches Green 6.4.1.1 Amend from blue to green. Amend 6 Remove branding Date Drug and formulation Colour BNF Comments Action status section

23.11.201 Azithromycin inj Red 5.1.5 Remove words second line Add 6 macrolide – follow guideline 23.11.201 Elbasvir-grazoprevir tab Red 5.3.3.2 NICE TA 413 Add 6 23.11.201 Certolizumab-pegol inj Red 10.1.3 NICE TA 415 Amend 6 23.11.201 Osimertinib tab Red 8.1.5 NICE TA 416 Add 6

26.10.201 Degarelix inj Amber 8.3.4.2 NICE TA404 Amend 6 Specialist initiation only for 26.10.201 Crizotinib cap Red 8.1.5 NICEselected TA406 patients in Add 6 accordance with NICE TA guidance. 26.10.201 Secukinumab inj Red 10.1.3 NICE TA407 Amend (add TA 6 (Removed previous restriction number) 26.10.201 Pegaspargase inj Red 8.1.5 NICEfor use TA408 only in emergency Amend (add TA 6 situations as a single dose) number) 26.10.201 Aflibercept inj Red 11.8.2 NICE TA409 Amend (add TA 6 number) 26.10.201 Talimogene Red 8.1.5 NICE TA410 Add 6 laherparepvec inj Specialist use only in 26.10.201 Radium-223 dichloride Red 8.1 NICEaccordance TA412 with special Amend (add TA 6 inj Aprecautions radiopharmaceutical for handling for and use number) anddisposal administration (refer to SPC only section by authorised6.6). persons. To be prepared in pharmacy 26.10.201 Sodium hyaluronate Red N/A Urologyat UHS. specialist use only at Add 6 1.6% and sodium 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) 11.10.201 Azelastine & fluticasone Green 12.2.1 Third line therapy for allergic Add 6 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 Date Drug and formulation Colour BNF Comments Action status section

11.10.201 Ulipristal acetate tab Amber 6.4.1.2 Specialist recommendation as Amend (added 6 [Esmya] an option for pre-operative new indication) treatment of uterine fibroids or for intermittent treatment of uterine fibroids where first line therapies are inappropriate

11.10.201 Midazolam inj Green 15.1.4.1 Green for use in palliative Add 6 care only (remains red for all other indications)

11.10.201 Amiodarone tab Amber 2.3.2 Amended to amber as Amend 6 requested by DPC (safety (changed from reasons) green to amber) 11.10.201 Calcium lactate and Amber 9.5.1.1 Specialist recommendation for Add 6 calcium gluconate oral paediatric patients only. liquid 0.51mmol/ml Licensed as a nutritional [Alliance Calcium supplement. 11.10.201 OmeprazoleSyrup] oral Amber Not Specialist(Prescribe recommendationby brand name in Add 6 solution listed onlyprimary for paediatriccare) patients (unlicensed product)

11.10.201 Ganciclovir 0.15% eye Green 11.3.3 Second line option when Add 6 gel aciclovir eye oint is unavailable 11.10.201 Ferric maltol cap Amber 9.1.1.1 Gastoenterology specialist Amend 6 [Feraccru] initiation only for patients with IBD unable to tolerate other oral iron preparations 11.10.201 Fosfomycin oral sachets Green 5.1.7 Prescribe in line with local Amend 6 [Monuril] guidance/in response to (changed to antimicrobial sensitivities green from amber)

28.09.201 Azithromycin 1.5% eye Red 11.3.1 Add 6 drops

28.09.201 Trifluridine-tipiracil tab Red 8.1.3 NICE TA 405 Add 6 28.09.201 Pemetrexed inj Red 8.1.3 NICE TA 402 Add 6 28.09.201 Bosutinib tab Red 8.1.5 NICE TA 401 Add 6 Date Drug and formulation Colour BNF Comments Action status section

28.09.201 Amphotericin Green 12.3.2 Discontinued Remove 6 suspension/lozenges 28.09.201 Hydrocortisone, Amber 12.1.1 Product discontinued May Remove 6 neomycin and 2014 polymyxin B ear drops [Otosporin]

28.09.201 Co-codamol 30/500 Green 4.7.1 For patients with swallowing Add 6 effervescent tabs difficulties/enteral feeding tubes 28.09.201 Carbocisteine oral Amber 3.7 Add 6 sachets 07.09.201 Midazolam inj Amber 15.1.4.1 Amber for use in palliative Add 6 care only

17.08.201 Ferric maltol cap Red 9.1.1.1 Gastroenterology only Add 6

17.08.201 Evolocumab inj Red 2.12 NICE TA 394 Add 6 17.08.201 Alirocumab inj Red 2.12 NICE TA 393 Add 6 17.08.201 Paliperidone palmitate Red 4.2.2 3 monthly preparation for Add 6 prolonged release patients already stabilised on suspension for injection the one monthly depot. [Trevicta]

17.08.201 Clobazam suspension Green 4.8.1 For paediatric patients or Add 6 [Tapclob] those with swallowing difficulties 17.08.201 Progesterone vaginal Red 6.4.1.2 For emergency supply to Add 6 capsules [Utrogestan] patients treated by the fertility unit only.

17.08.201 Progesterone 8% Red 6.4.1.2 Replaced by capsules above Remove 6 vaginal gel

17.08.201 Nivolumab infusion Red 8.1.5 NICE TA 400 Add 6

17.08.201 Trametinib tab Red 8.1.5 NICE TA 396 Add 6 17.08.201 Ceritinib cap Red 8.1.5 NICE TA 395 Add 6 17.08.201 Belimumab infusion Red 10.1.3 NICE TA 397 Add 6 17.08.201 Transvasin cream Red 13 For use in the respiratory Add 6 centre, prior to capillary blood gas sampling Date Drug and formulation Colour BNF Comments Action status section

17.08.201 Cetraben cream Green 13.2.1 Add 6

17.08.201 Calcipotriol and Green 13.5.2 Add 6 betamethasone cutaneous foam [Enstilar]

17.08.201 Adalimumab inj Red 13.5.3 NICE TA 392 Add 6

17.08.201 Tacrolimus inj Red 8.2.2 For patients already receiving Add 6 therapy who become nil by 17.08.201 Macitentan tab Red 2.5.1 Formouth patients managed under a Add 6 shared care agreement with the Royal Brompton hospital only

19.07.201 Phenothrin 0.5% liquid Blue 13.10.4 Discontinued Remove 6 [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 patients 22.6.2016 Methotrexate tab/inj Amber 10.1.3 & Specialist(e.g. inadequate initiation seizure (unless GP Amend (NB Once weekly) 13.5.3 indicatescontrol or a where preference other to initiateantiepileptic therapy) drugs. are Seecontraindicated, DPC Shared notCare tolerated Guideline.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 Date Drug and formulation Colour BNF Comments Action status section

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 choose Amend 8.3.4.2 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- diaminopyridin e 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 committee Added Advance x 1 (List for paediatric patients at UHS 2) 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 agreement Added, with TA tablets currently from CCGs for 1 month’s number listed supply to be initiated in secondary care and then continued in primary care. Date Drug and formulation Colour BNF Comments Action status section

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, liposomal doxorubicin TA91/222. added TA hydrochloride, number and paclitaxel, trabectedin removed TA and gemcitabine number

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 Ruxolitinib 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, Remove TA132 added TA (TA385 replaces TA132) number and removed TA number

23.3.2016 Nivolumab inj [Opdivo] Red 8.2.4 TA384 Added, with TA number Date Drug and formulation Colour BNF Comments Action status section

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

23.3.2016 Golimumab inj Red 1.5.3 & Added brand name. Amended, [Simponi] 10.1.3 TA383. added TA number 23.3.2016 Certolizumab pegol inj Red 10.1.4 Added brand name. Amended, [Cimzia] TA383. added TA number 23.3.2016 Etanercept inj [Enbrel] Red 10.1.3 & Added brand name to Amended, 13.5.3 formulary entry to avoid any added TA confusion as biosimilar now number and also available. removed TA TA383. number Remove TA143. (TA383 replaces TA143) 23.3.2016 Adalimumab inj Red 1.5.3, Added brand name. Amended, [Humira] 10.1.3 & TA383. added TA 13.5.3 Remove TA143. number and (TA383 replaces TA143) removed TA 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) Date Drug and formulation Colour BNF Comments Action status section

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, preferred IV PPI for adult added TA 17.2.2016 Certolizumab inj Red 10.1.3 patients]TA375 Amended,number 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 Abatacept inj Red 10.1.3 TA375 Amended, added TA number Date Drug and formulation Colour BNF Comments Action status section

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, [Remicade]; Infliximab added TA biosimilar inj [Inflectra, number Remsima] 17.2.2016 Enzalutamide cap Red 8.3.4.2 TA377 Amended, added TA number 17.2.2016 Nintedanib 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 only Added 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 Erlotinib tab Red 8.1.5 TA374 Amended, added TA number Date Drug and formulation Colour BNF Comments Action status section

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 to Amended green

30.12.201 Dasabuvir tab Red 5.3.3.2 NICE TA365 Amended, 16.12.2015 Ciclosporin eye drops Amber 11.8.1 NICESpecialist TA369 use only Amended,added TA 5 Specialist addednumber NICE TA initiation/recommendation number. 16.12.201 Dulaglutide inj Green 6.1.2.3 Removed wording “Not a first Amended only Changed colour 5 line option, but may be from red to considered for patients with amber. compliance problems or

needle phobia, or for patients

with kidney impairment (see prescribing information and local guidelines)“

16.12.201 Empagliflozin tab Green 6.1.2.3 AddedAs recommended wording “First by Diabetesline Amended 5 SGLTSub Committee-2 inhibitor of for DPC patients – witrestrictionsh established removed as now cardiovascularpriced more competitively disease” versus other GLP-1 agonists. As recommended by Diabetes Sub Committee of DPC – recently published evidence to support positive outcomes in this patient group.

16.12.201 Denosumab inj Green 6.6.2 NICE TA204 Amended 5 Now green for prevention of Changed colour fractures in patients with from amber to osteoporosis. green

Remains red for cancer- related indications Date Drug and formulation Colour BNF Comments Action status section

16.12.201 Brinzolamide and Amber 11.6 Added 5 brimonidine eye drops [Simbrinza] 16.12.201 Daclatasvir tab Red 5.3.3.2 NICE TA364 Amended, 5 Specialist use only added TA number 16.12.201 Sofosbuvir and Red 5.3.3.2 NICE TA363 Amended, 5 ledipasvir tab [Harvoni] Specialist use only added TA number 16.12.201 Ombitasvir and Red 5.3.3.2 NICE TA365 Amended, 5 paritaprevir and Specialist use only added TA ritonavir tab [Viekiraz] number 16.12.201 Pembrolizumab inj Red 8.2.4 NICE TA366 Amended, 5 Oncology only added new TA number

16.12.201 Idelalisib tab Red 8.1.5 NICE TA359 Added 5 Oncology only

16.12.201 Tolvaptan tab Red 6.5.2 NICE TA358 Added 5 Specialist use only

18.11.201 Efavirenz tab/cap/liq Red 5.3.1 Liquid deleted as discontinued Amended 18.11.2015 Ingenol gel [Picato] Amber 13.8.1 N.B.by manufacturers. both strengths Added 5 (150mcg/gRemoved text and “The 500mcg/g) oral aresolution approved. is an alternative to tablets in patients with 18.11.201 Granisetron patch Red 4.6 nasogastricSpecialist use tubes only or as children” per Added 5 [Sancuso] licensed indications. 18.11.201 Erythromycin 2% and Green 13.6.1 (Isotrexin gel) Added 5 0.05% gel 18.11.201 Clindamycin 1% and Green 13.6.1 (Treclin gel) Added 5 tretinoin 0.025% gel 18.11.201 Magnesium aspartate Green 9.5.1.3 Licensed magnesium Added 5 dihydrate powder for supplement. oral solution Consider in preference to unlicensed preparations.

09.11.201 Phytomenadione cap Amber 9.6.6 Removed wording ‘unlicensed’ Amended 5 [Neokay] as now licensed as a POM.

02.11.201 Aclidinium DPI [Eklira Green 3.1.2 Added brand name Amended 5 Genuair]

02.11.201 Salbutamol MDI/breath- Green 3.1.1.1 Added Easyhaler as an option Amended 5 actuated MDI/DPI (e.g. as included in new COPD Accuhaler/Easyhaler)/ne Guidelines. b/inj Date Drug and formulation Colour BNF Comments Action status section

02.11.201 Formoterol MDI [Atimos Green 3.1.1.1 Added Turbohaler as an Amended 5 Modulite]/Formoterol option as included in new DPI (e.g. COPD Guidelines. Easyhaler/Turbohaler)

02.11.201 Umeclidinium DPI Green 3.1.2 Included as an option in new Added 5 [Incruse Ellipta] COPD Guidelines.

02.11.201 Indacaterol inhalation Green 3.1.1.1 Included as an option in new Added 5 powder caps [Onbrez COPD Guidelines. Breezhaler]

02.11.201 Aclidinium and Green 3.1.4 Included as an option in new Added 5 formoterol DPI [Duaklir COPD Guidelines. Genuair] 02.11.201 Umeclidinium and Green 3.1.4 Included as an option in new Added 5 vilanterol DPI [Anoro COPD Guidelines. Ellipta] 02.11.201 Glycopyrronium and Green 3.1.4 Included as an option in new Added 5 indacaterol powder caps COPD Guidelines. [Ultibro Breezhaler]

02.11.201 Budesonide and Green 3.2 Added Duoresp Spiromax as Amended 5 formoterol DPI an option as included in new [Symbicort Turbohaler, COPD Guidelines. Duoresp Spiromax]

02.11.201 Olodaterol solution for Green 3.1.1.1 Included as an option in new Added 5 inhalation [Striverdi COPD Guidelines. Respimat]

02.11.201 Tiotropium and Green 3.1.4 Included as an option in new Added 5 olodaterol solution for COPD Guidelines. inhalation [Spiolto Respimat]

02.11.201 Pembrolizumab inj Red 8.2.4 NICE TA357 Added, with TA 5 Oncology only number

07.10.201 Sodium chloride 0.18% N/A 9.2.2 Not available Removed 5 and glucose 10% 500ml bags 07.10.201 Paediatric renal Amber Unlicens Discontinued by Removed 5 vitamins tab ed manufacturers

07.10.201 Hetastarch and N/A 9.2.2 Discontinued by Removed 5 Pentastarch (various manufacturers strengths) Date Drug and formulation Colour BNF Comments Action status section

07.10.201 Dinoprostone pessary Red 7.1.1 ‘Off label’ use at UHS for Added 5 [Propess] outpatient induction of labour (as per guideline/procedure)

07.10.201 Glatiramer acetate Red 8.2.4 Added wording ‘Specialist use Amended 5 20mg/ml, 40mg/ml inj only for multiple sclerosis’ (added strengths as both now approved) 07.10.201 Peginterferon beta-1a Red 8.4.2 Specialist use only for Added 5 inj multiple sclerosis (commissioned by NHS England)

07.10.201 Vedolizumab inj Red 1.5.3 NICE TA352 Amended, 5 Removed phrase ‘For added new TA ulcerative colitis’ (now also number recommended by NICE for Crohns Disease)

07.10.201 Edoxaban tab Green 2.8.2 NICE TA354/355 Added, with TA 5 numbers

07.10.201 Lidocaine plaster Red 15.2 ‘Off label’ use at UHS for Added 5 management of traumatic rib 07.10.201 Isotretinoin gel Green 13.6.1 Replacementfractures (refer for to tretinoin protocol) gel. Added 5 [Isotrex]

07.10.201 Tretinoin gel [Retin A] Green 13.6.1 Discontinued by Removed 5 manufacturers

07.10.201 Ciclosporin eye Red Amended wording to reflect Amended 5 drops/eye ointment that only the eye ointment is unlicensed (eye drops now 07.10.201 Clindamycin cap/liq/inj Green 5.1.6 licensed)Caps and Liquid were Amended. 5 (Cap/li previously red. Discussed with Changed colour q) DPC Chair and Microbiology - from red to Red agreed suitable for green green (inj) status. Note: Liquid is unlicensed.

Remains red for pneumocystis pneumonia (section 5.4.8) 07.10.201 Abasaglar (insulin Green 6.1.1.2 Some dose adjustment may Added 5 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) Date Drug and formulation Colour BNF Comments Action status section

09.09.201 Midodrine tab Green 6.1.5 Removed word “unlicensed” Amended 5 as a licensed preparation is now available (Bramox). Removed wording “for postural hypotension”. Prescribers should use SPC for guidance.

02.09.201 Nalmefene tab Amber 4.10.1 NICE TA325 Added, with TA 5 Only in conjunction with number continuous psychosocial support.

02.09.201 Sodium hyaluronate Green 11.8.1 e.g. Hylo-Tear, Hylo-Forte Amended. 5 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.

02.09.201 Carmellose sodium Green 11.8.1 Included in Dry Eye Amended. 5 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. 02.09.201 Polyvinyl alcohol 1.4% Green 11.8.1 e.g. SnoTears, Liquifilm Tears Amended. 5 eye drops and unit dose (Brand name not specified in Changed colour eye drops main entry to allow from amber to (preservative-free) organisations to choose green preferred option) Included in Dry Eye Guidelines for Primary Care (pending) GP can initiate if required.

02.09.201 Carbomer 0.2% Green 11.8.1 e.g. Clinitas Gel Amended. 5 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. Date Drug and formulation Colour BNF Comments Action status section

02.09.201 Hypromellose 0.3% Green 11.8.1 Included in Dry Eye Amended. 5 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.

02.09.201 Tears Naturale eye Amber 11.8.1 No longer required. Removed 5 drops Not included in Dry Eye Guidelines for Primary Care (pending)

02.09.201 VitA-POS (retinol Green 11.8.1 Included in Dry Eye Added 5 palmitate, liquid Guidelines for Primary Care paraffin, wool fat, white (pending) soft paraffin) eye Preservative-free formulation. ointment 02.09.201 Propylene glycol & Green 11.8.1 Included in Dry Eye Added 5 polyethylene glycol unit Guidelines for Primary Care dose eye drops (pending) (preservative-free) Preservative-free alternative [Systane] to Systane Balance.

02.09.201 Propylene glycol eye Green 11.8.1 Included in Dry Eye Added 5 drops [Systane Balance] Guidelines for Primary Care (pending) 02.09.201 Dexamethasone Red 11.4.1 NICE TA349 Amended, 5 intravitreal implant added TA number 02.09.201 Aflibercept intravitreal Red 11.8.2 NICE TA367. Amended, 5 inj Removed wording “Also for added TA treatment of diabetic macular number oedema” as not needed now that approved by NICE.

02.09.201 Rifaximin tab Red 5.1.7 Specialist use only as per UHS Added 5 [Targaxan] guideline ‘Off-label’ use, third line antibiotic treatment for small bowel (short intestine) bacterial overgrowth

02.09.201 Hexaminolevulinate Red 7.4.4 UHS: Urology specialist use Added 5 intravesical instillation only in selected patients (e.g. high risk of multiple or flat tumours) 02.09.201 Secukinumab inj Red 13.5.3 NICE TA350 Added, with TA 5 number Date Drug and formulation Colour BNF Comments Action status section

02.09.201 Naloxegol tab Amber 1.6 NICE TA345 Added, with TA 5 number 02.09.201 Nintedanib cap Red 8.1.5 Specialist use only. Added, with TA 5 NICE TA347. number 02.09.201 Meningococcal Group B Green 14.4 Added 5 Vaccine 02.09.201 Nortriptyline tab Green 4.7.3 ‘Off-label’ use. Added 5 A second-line choice at step 2 of neuropathic pain ladder.

02.09.201 Nortriptyline tab Green 4.3.1 Not(Relatively a first linehigh option cost in Amended 5 primary care therefore Changed colour (Discussedamitriptyline at remains UHS Drugs first from red to Committeeline) and Chair’s Action green taken for DPC. No need for specialist-only (red) status, although relatively high cost in primary care therefore amitriptyline remains first line)

02.09.201 Ferrous sulfate tab Green 9.1.1.1 Second line oral iron Added 5 preparation

(re-added to formulary as this preparation appears to continue to be widely used in primary and secondary care) 02.09.201 Ferrous fumarate tab Green 9.1.1.1 Added phrase “First line oral Amended 5 iron preparation”

02.09.201 Aqueous cream Green 13.2.1 Removed phrase “first line” as Amended 5 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. Date Drug and formulation Colour BNF Comments Action status section

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 Date Drug and formulation Colour BNF Comments Action status section

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 [Targaxan] NICE TA337. number and 29.06.15 Omalizumab inj Red 3.4.2 NICEShared TA339 care guidance Addedbrand name.TA available (although needs numberChanged colour updating). from red to amber. 29.06..15 Ustekinumab inj Red 13.5.3 NICE(Note: TA340 remains non-formulary Added TA for other indications) number 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 for Added 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 Date Drug and formulation Colour BNF Comments Action status section

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, or 24.06.15 Carmellose sodium eye Amber 11.8.1 Removedfor patients brand with namekidney 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 Amber for prevention of number, added atherothrombotic events after wording 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 Date Drug and formulation Colour BNF Comments Action status section

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 inj Also for treatment of diabetic number and macular oedema additional 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 manufacturer Removed pessary 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 manufacturer Removed

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 Date Drug and formulation Colour BNF Comments Action status section

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 accordance Changed from tabs/lithium citrate with shared care guidelines green to amber liquid

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 for Added TA the treatment and secondary number prevention of deep vein thrombosis and/or pulmonary embolism

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

28.01.15 Provide Xtra Following formulary review of Removed feeds and nutritional supplements 28.01.15 Maxijul Super Soluble Following formulary review of Removed feeds and nutritional supplements 28.01.15 Elemental 028 Powder Following formulary review of Removed feeds and nutritional supplements Date Drug and formulation Colour BNF Comments Action status section

28.01.15 Duocal Super Soluble Following formulary review of Removed feeds and nutritional supplements 28.01.15 Suplena Following formulary review of Removed feeds and nutritional supplements 28.01.15 Seravit Paediatric Following formulary review of Removed Powder feeds and nutritional supplements

28.01.15 Prosure Following formulary review of Removed feeds and nutritional supplements

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

28.01.15 Vital 1.5 Section Following formulary review of Added 2 of oral feeds and nutritional nutrition supplements section 28.01.15 Peptamen HN Section Following formulary review of Added 2 of oral feeds and nutritional nutrition supplements section 28.01.15 Liquigen Section Following formulary review of Added 2 of oral feeds and nutritional nutrition supplements section 28.01.15 Ketocal powder Section Following formulary review of Added 2 of oral feeds and nutritional nutrition supplements section 28.01.15 Fortisip Compact Protein Section Following formulary review of Added 2 of oral feeds and nutritional nutrition supplements section 28.01.15 Fortisip Compact Fibre Section Following formulary review of Added 2 of oral feeds and nutritional nutrition supplements section Date Drug and formulation Colour BNF Comments Action status section

28.01.15 Fortini Creamy Section Following formulary review of Added 2 of oral feeds and nutritional nutrition supplements section 28.01.15 Fortimel Regular Section Following formulary review of Added 2 of oral feeds and nutritional nutrition supplements section 28.01.15 Paediasure Peptide Section Following formulary review of Added 1 of oral feeds and nutritional nutrition supplements section 28.01.15 Fresubin Thickened Section Following formulary review of Added Stage 2 1 of oral feeds and nutritional nutrition supplements section 28.01.15 Fortini Smoothie Section Following formulary review of Added 1 of oral feeds and nutritional nutrition supplements section 28.01.15 Estradiol implants Discontinued by manufacturer Removed

28.01.15 Clinitest reagent tabs Discontinued by manufacturer Removed

07.01.15 Erythropoiesis- Red 9.1.3 According to NICE TA323 Changed TA 07.01.15(Decembe Imatinibstimulating tablets agents Red 8.1.5 According to NICE TA326 Adnumberded TA (December (epoetin and number rmeeting) darbepoetin) meeting) 07.01.15 Dabrafenib capsules Red 8.1.5 According to NICE TA321 Added (Decembe r 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

Date Drug and formulation Colour BNF Comments Action status section

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 20.10.14 Lenalidomidecapsules capsules Red 8.2.4 According to NICE TA322 Added

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

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

29.9.14 Adrenaline Discontinued by manufacturer Removed (epinephrine) inhaler [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 used is Note (Augustmeeting) forsecond stimulation-line of lactation, meeting) following a restriction to its licensed indications. Local recommendation is 10mg three times a day for 7 to 10 days, then stop. Contra- indicated in patients with known cardiac problems Date Drug and formulation Colour BNF Comments Action status section

1.9.14 Generic sildenafil when Green 7.4.5 For men post-prostatectomy Note (August required meeting)

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 scanning meeting)

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

1.9.14 Brimonidine gel Green 13.6.3 For patients with rosacea who Added (August have failed to respond to, or meeting) are intolerant of, other options, or have psychological distress due to persistent redness. Cautious 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 Date Drug and formulation Colour BNF Comments Action status section

1.9.14 Canagliflozin tablets Green 6.1.2.3 According to TA315 Added (August meeting)

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 manufacturer Removed 21.7.14 Trifluoperazinesuppositories MR Discontinued by manufacturer Removed capsule

21.7.14 Artesunate IV Red No For severe or complicated P. Added mono- falciparum malaria graph in 21.7.14 Artemether and Red BNF5.4.1 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 Date Drug and formulation Colour BNF Comments Action status section

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 with Changed colour tablets/liquid severe behavioural insomnia from red to amber

30.6.14 Afatinib 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 Alemtuzumab 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, is 30.6.14 Didronel PMO nowDiscontinued only available by manufacturer as a Removed named patient drug

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

30.6.14 Forceval Junior Soluble Green 9.6.7 Replace formulation Changed from Foreceval Junior capsules 30.6.14 Butrans patches Green 4.7.2 Included in previously agreed toChanged Junior from primary care guideline Solubleamber to green Date Drug and formulation Colour BNF Comments Action status section

30.6.14 Transtec patches Green 4.7.2 Included in previously agreed Changed from primary care guideline amber to green

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 declined (May formulary entry for nocturnal 300mg tablets or contra-indicated (up to 120 meeting) leg camps are now hours after intercourse) available for this indication 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 severe Added (May vilanterol (Relvar COPD.Flutica sone 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 micropropionategrams twice once dailydaily andis the approximately184 micrograms equivalent once a day to 250dose micrograms to propionate fluticasone 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 recommendatio meeting) of neurological adverse ns effects. See MHRA Drug Safety Update August 2013 Date Drug and formulation Colour BNF Comments Action status section

2.6.14 Domperidone No longer indicated as a Note new (May tab/susp/suppos motility stimulant due to risk recommendatio meeting) of serious cardiac side effects. ns 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 macular oedema (central number 28.4.14 Rituximab infusion Red 8.2.3 Accordingretinal vein to occlusion) NICE TA308 for Added TA anti-neutrophil cytoplasmic number antibody-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 now Amended 24.2.14 Fluocinoloneinfusion (generic) acetonide Red 11.4.1 Accordingavailable and to NICE can be TA301 used for Added implant diabeticwhen clinicians macular choose oedema to prescribe off-label for patients with osteoporosis Date Drug and formulation Colour BNF Comments Action status section

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 Teriflunomide 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 associ redated to amber. with Amended Modic type 1 changes On advice of microbiology for first episode of severe C. diff 16.12.13 Magnesium oxide Amber 9.5.1.3 onChange concomitant from red antibiotic to amber or Amended capsules 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 cognitive impairment Date Drug and formulation Colour BNF Comments Action status section

16.12.13 Ribavirin tablets Red 5.3.3 According 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 commissioned Amended 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.westhampshirecc g.nhs.uk/medicines/healthcar e-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 patients Amended macular degeneration BNF with ‘category 4’ AMD who formulation (Viteyes 2 Formula have advanced disease in one capsules) eye only (advanced lesions or visual acuity <20/32). ‘Viteyes 2 Formula’ is the preferred product as it is the least expensive and contains the correct combination of vitamins and zinc. Unlike previous AMD vitamins it can be given to previous 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. Date Drug and formulation Colour BNF Comments Action status section

30.9.13 Buccal midazolam Red 4.8.2 Off-label use prior to Added (Buccolam) endoscopy for a specific group indication of adults and children over 10 years who do not tolerate IV cannulation (e.g. those with learning difficulties).

IV midazolam continues to be the first line option for the majority of patients

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 number. Changed from amber to green Date Drug and formulation Colour BNF Comments Action status section

2.9.13 Ceftaroline inj Red 5.1.2 Only for specialist use on the Added advice of microbiology

2.9.13 Eltrombopag tab Red 9.1.4 According to NICE TA293 Added

2.9.13 Eptotermin alfa Red Not in Replacement for Inductos for Amended (Opgenra) for BNF spinal surgery. Osigraft 2.9.13 Dapagliflozinimplantation tab Amber 6.1.2.3 Accordingremains the to formularyNICE TA288 choice Added 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 malignant Added (August (Gliolan) powder for oral BNF tissue during surgery for meeting) solution 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 MHRA by manufacturer 29.7.2013 Pripsen sachets Discontinued by manufacturer Removed

29.7.2013 Calcium carbonate Green 9.5.1.1 While Calcium Sandoz liquid is Added effervescent tablets 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 Date Drug and formulation Colour BNF Comments Action status section

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 when 24.6.2013 Aflibercept inj Red 11.8.2 Forconcurrent wet age antibiotics-related macular cannot Add degenerationbe stopped; and according for second to NICEepisodes TA294 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 (rheumatoid arthritis) TA number

Date Drug and formulation Colour BNF Comments Action status section

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 these to greenpatients as toGPs a specialistdon’t refer these patients to a specialist 29.4.13 Apixaban tab Green 2.8.2 NICE TA275 for prevention of Added 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 of Added renal impairment

29.4.13 Tobramycin dry powder Red 5.1.4 NICE TA276 Added inhaler Date Drug and formulation Colour BNF Comments Action status section

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 gonadotrophin inj ‘Menopur’ 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 on Added inhaler which device the patient can use and cost 25.2.13 Glycopyrronium inhaler Green 3.1.2 Base prescribing decisions on Added which device the patient can use and cost

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

Date Drug and formulation Colour BNF Comments Action status section

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 Vemurafenib 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 maintenance Updated 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 Forhyperhidro renal protectionsis 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] Date Drug and formulation Colour BNF Comments Action status section

21.1.13 Methylthioninium Red Not in Blue Marker is to be used Added 12.12.12 chlorideDimeticone 1% lotion inj Green BNF13.10.4 duringDue to surgery.supply problems with Updated (methylene(Hedrin) blue) [Blue Methylthioniniummalathion aqueous chloride liquid, Marker] 5mg/mldimeticone (methylene lotion (Hedrin) blue) has [Proveblue]been changed to frombe used blue for to patientsgreen with methaemoglobinaemia

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/pr from Epipen to Jext (thisimary device-care/ has a longer shelf life)Register 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 Date Drug and formulation Colour BNF Comments Action status section

17.9.12 Taurolidine IV Red Not in Used as a line lock in patients Added 17.9.12 Naltrexone tablets Amber 4.10the BNF Foron long alcohol-term addiction TPN or IV fluids Previously used at Southern, now also at 17.9.12 Sodium hyaluronate eye Amber 11.8.1 For patients with a proven UHSAdded 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 Date Drug and formulation Colour BNF Comments Action status section

17.9.12 Dabigatran capsules Amber 2.8.1 Possible treatment to prevent Added 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 risk Removed of cancer

17.9.12 Buccal midazolam pre- Amber 4.8.2 To replace unlicensed Added filled syringes midazolam for children with a 17.9.12 Prucalopride tablets Amber 1.6.7 Changedseizure disorder from 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 Thalidomide 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 from 17.9.12 Bortezomib injection Red 8.1.5 hospitalNICE TA228 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 the 6 local patients receiving 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 Date Drug and formulation Colour BNF Comments Action status section

18.6.12 Telaprevir tablets Red 5.3.3.2 According to NICE TA252 Added

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 imatinib 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 selected Added inhaler patients e.g active patients, stable patients (superseded 18.6.12 Bee venom Red 3.4.2 Accordingby NICE TA276) to NICE TA246 Added (Pharmalgen)

18.6.12 Fingolimod capsules Red 8.2.4 Only according to NICE TA254 Added

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 current low priorities guidance, i.e. flatten their fingers or palm on 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 Date Drug and formulation Colour BNF Comments Action status section

18.6.12 Rituximab injection Red 10.1.3 According to agreed guidance for Added adults with systemic lupus erythematosus

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 patients Updated theon other licensed options indications to Omnitrope for or brandedGenotropin and generic 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 heavy tablets 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 Changed ed) to ‘green’ to promote use in UHS for adults with chronic constipation or faecal impaction Date Drug and formulation Colour BNF Comments Action status section

27.2.12 Estradiol vaginal tablet Green 7.2.1 Changed 10 micrograms from blue to green 27.2.12 Quetiapine MR tab 4.2.1 Use immediate-release tablets Removed 27.2.12 Goserelin, leuprorelin, Amber 6.7.2 The 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 Interferon alfa 2a eye Red Not in For specialist use only Added drops BNF 27.2.12 Sterile talc kit 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, juvenile, Added 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 Date Drug and formulation Colour BNF Comments Action status section

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 FORMULA FORM- Pharmacy. RY 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 Date Drug and formulation Colour BNF Comments Action status section

(Oxynorm) capsules inline with Trust’s Medicines Policy 19.07.11 Golimumab injection Red 10.1.3 NICE TA220 Added 19.07.11 Romiplostim 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 Remo ve 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 Pazopanib 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 arthritis Added - drugs for treatment after failure Date Drug and formulation Colour BNF Comments Action status section

of a TNF inhibitor 18.04.11 Sirolimus 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 treatment 21.03.11 Dovobet Gel Green 13.5.2 Topicalof mycobacterium Treatment abcessusof scalp Amended psoriasis.respiratory Topical infection treatment in cystic of mildfibrosis to 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 15-17 For 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 patients Amended carbohydrate drink® 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 require 21.02.11 Melatonin tablet/capsule Amber 4.1.1 Cost effective first line choice is Amendment preservative free prostaglandin Biomelatonin tabs, followed by eye drops, e.g. for patients with Melatonin Life extension caps and corneal grafts 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 problem 21.02.11 Liraglutide injection Amber 6.1.2.3 According to NICE TA203 For Date Drug and formulation Colour BNF Comments Action status section

Information 21.02.11 Gefitinib tablet Red 8.1.5 According to NICE TA192 21.02.11 Trastuzumab injection Red 8.1.5 Gastric cancer according to NICE For 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 of information 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 removed Added (Nexplanon®) 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 patients Amended carbohydrate drink® 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) Date Drug and formulation Colour BNF Comments Action status section

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 diabetes Added 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 only. Added 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 Date Drug and formulation Colour BNF Comments Action status section

injection rheumatoid arthritis if already tried methotrexate and another DMARD, according to NICE: http://guidance.nice.org.uk/TA186 26.04.10 Trabectedin injection Red 8.1.5 Soft tissue sarcoma according to Added NICE: http://guidance.nice.org.uk/TA185 26.04.10 Ferrous fumarate tablet Green 9.1.1.1 Currently PCT use only, change to Amended 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

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