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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.01.02  Expand sub section  Antimuscarinic bronchodilators
Tiotropium
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First Choice
Green

For COPD

  • Prescribe by brand.
  • Despite being different doses; Braltus® and Spiriva® Handihaler and Respimat are clinically equivalent and produce the same amount of active ingredient in the body. 10 micrograms of Braltus® is equivalent to 18 micrograms of Spiriva® Handihaler and 5 micrograms of Respimat.
  • Capsules for Spiriva® Handihaler and Braltus® should be used for their intended device only.
  • Spiriva® should be prescribed/endorsed with the type of device intended on the prescription (either HandiHaler or Respimat).
  • The Braltus Zonda is significantly cheaper than Spiriva HandiHaler and product switching from the Spiriva product to Braltus Zonda is encouraged.

For Asthma

  • Only the Respimat® device is licensed for asthma
 
Aclidinium (Eklira Genuair)
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Formulary
Green

DPI

 
   
Glycopyrronium (Seebri breezhaler)
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Formulary
Green
 
   
Ipratropium Bromide
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Formulary
Green

Short-acting antimuscarinic
Inhaler, Nebules
Should only be prescribed for those patients with COPD in whom salbutamol is not tolerated or ineffective. It should not be used in combination with salbutamol.
For those patients requiring regular antimuscarinuc therapy tiotropium is the prefered choice

 
   
Umeclidinium (Incruse Ellipta)
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Formulary
Green
 
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Green -Medicines suitable for routine use within primary care and Secondary care Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies  

Amber

Amber- Medicines suitable to be prescribed in primary care after specialist /Consultant recommendation or initiation. A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust Medicines and Therapeutic Committee and approved by the Area Prescribing Committee.   

Red

Red-Hospital initiation and continuation only  

Amber Shared Care Protocol

AMBER SHARE CARE PROTOCOL- Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised  

Blue

To be supplied from the appropriate commissioned provider.   

Green 2

GREEN 2- to be prescribed by primary care only   

Grey

GREY- NON FORMULARY (As agreed by Area Prescribing Committee)  

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