Approved for use in line with NICE TA610  

Tablet, Oral Solution

Tablet

Injection

to be initiated  and prescribed by commissioned, specialised services. continuation of prescribing needs to be under the advice of commissioned or specialised service

Acetycholine 1%, Mannitol 3% Solution

   Tablet, Suspension

   Injection & Infusion

Gel and cream

Tablet

 NHSE funded indication are usually Hospital Only

50mg/10ml Injection

Consultant Cardiologist only for diagnosis of Brugada syndrome

CAPSULE

Tablets 10mg, 70mg

(including 70 mg effervescent Tablets for PEG/NG tube patient administration)

Tablet, Tablet m/r

Subcutaneous Injection

tablets

Injection, Dual chamber

Intracavernosal injection 10 micrograms, 20 micrograms

- specialist initiation.

Urethral application 125 micrograms, 250 micrograms, 500 micrograms, 1mg

Injection

Tablet MR - Restricted for existing patients only, new patients to start on theophylline.

injection

Tablet

Oral Solution

Tablets

injection

1mg Tablet

Eye Drops

Tablet
- approved in line with NICE TA419 and NICE TA433

Use as per HYCCN Network

enema

Infusion

Restricted use for palliative care only

Capsule

Concentrate for solution for infusion 

Eye Drops 0.5%

Eye Drops 1%

Eye Ointment 1%

Minims 1%

Injection

Tablets 25mg, 50mg

Capsules, Suspension

syrup

tablets

capsules

Injection 

infusion

peadiatrics

Tablets

Infusion

50mg and 150mg tablets

Bimatoprost 300mcg/ml, Timolol 5mg/ml Eyr drops (UDVs for Preservative Sensitivity)

lispro 25% / Lispro Protamine 75%

KwikPen, 3mL

Vial Cartridge, Kwikpen

Tablets

First line use for all patients with systolic LV dysfunction

injection

capsule

Tablet

injection

Eye Drops 0.2%

Eye Drops 1%

Brinzolamide 10mg/ml & brimonidine 2mg/ml Eye Drops

Eye Drops 0.09%

Modified Release Capsules

easyhaler

Sublingual Tablets

To be commenced by specialist service only and prescribing must be in collaboration with the advice from substance misuse services.  

Nasal Spray

tablets

500 microgram tablets

Tablet, injection

Tablets

capsaicin cream

Syrup

Tablets

Modified Release tablets

Capsules, Liquid

Injection

Powder for infusion

Single Dose Units 0.5%, 1%

implant

Tablets

Chlorhexidine

Chlorhexidine Uro-Tainer 0.02%

Tablets

Injection

Injection

For pelvic inflammatory disease

unlicensed

5% Eye Drops

50mg Intra-cameral Injection

Capsule

Injection

Capsule, Injection

Microbiology Approval is required

capsule

   Tablet, Syrup
     

   Injection             

For the treatment of malaria. Should not be prescribed for malaria    prophylaxis on the NHS. Patients should obtain a supply on private prescription or purchase a supply "over the counter" as appropriate

Injection

Capsules,

Oral, Solution

 Injection

 NHSE funded indication are usually Hospital Only

Eye Drops 1% (As per NICE TA369)

Indication for painful bladder only

'Restricted by Indication'

 Tablet, Suspension

  Injections 'prescribed in hospital only'

Injection

Tablet

for Lower repsirtory tract infections 

Used for bacterial vaginosis

Tablet

tablets

Tablets

Cream 2% - please consult antibiotic formulary advice

500mg pessaries (stat treatment)

 Canestan "Pessary Combi" for Primary care use only

Tablets, Dispersible Tablets, Suspension

To be prescribed in accordance with local antimicrobial guidance and guidance from health protection agency

  Capsules

Tablet

(Carbidopa/Levodopa) Tablets, MR Tablets

Tablets

Tablets

tablets

Sachets

Injection
Microbiologist approval required in all cases

Nebule
"Restricted by Indication"

Use with caution in severe renal impairment as aluminium and magnesium may accumulate.

Suitable for patients with hepatic or cardiac failure, as it has low sodium content and is sugar free.

Transdermal patch
20micrograms, 50micrograms, 75micrograms & 100micrograms

Ethinylestradiol 35micrograms and Norethisterone 500 micrograms, 750 micrograms and 1000micrograms.

For the treatment of hereditary angioedema in the emergency care setting. 

ACBS preparation which can only be prescribed for disfiguring skin lesions (birthmarks, mutilating lesions, scars, vitilgo)  

Capsule

Tablets

Injection

Tablet, Injection

Tablets

Capsules

Injection

injection

capsules

tablet

Solution for infusion

Tablet

Powder for oral Suspension

Injection

Capsules

Limited clinical use in context of antibiotic. Sometimes indicated for endocrine indications such as SIADH. Hence warranting restrited use

60mg/ml Injection

Tablets 200 micrograms

 For nocturnal enuresis,

Any pituitary condition the status should be designated as amber- please refer to chapter 7 for enuresis indication

Sublingual tablets

Tablet

Eye Drops

Eye Ointment

 Tablets, Injection

 Diamorphine hydrochloride (Ayendi ) 720microgram/actuation Nasal Spray, CD

*Please see information regarding current shortage: Patient Information *Patient information – diamorphine *

Further information regarding Diamorphine Shortage (mainly applicable for Secondary Care prescribing)
Unfortunately Accord have advised that there has been a further delay to their resupply date for diamorphine 5mg and 10mg injection and they are now expecting stock to be available during the week commencing 10th September. Wockhardt’s position remains unchanged, so please can all hospitals continue with current management plans as per previous communications in email chain below until the middle of September. There have been no changes to the supply position for the alternatives, so please refer to below communication for information about this.
We will communicate further information about the recovery plan in early September.

Injection
emulsion injection 10mg/2ml

Diazepam is a high risk injectable medicine as identified by the NPSA patient safety alert 20

Oral solution, tablets

50 mg Tablet, oral solution (250mg/5mL)

Approved indications:

Insulinoma and tumour induced hypoglycaemia

Post gastric bypass hypoglycaemia causing syncope 

Suppositories
Injection

Not recommended as a first line NSAID of choice due to small cardiac risks with diclofenac

0.1% Single Dose Units

unlicensed

Tablets

Tablets

 Injection

 oral Liquid

Diltiazem MR (12hour) Tablets, Capsules. Prescribe by brand

Diltiazem XL (24 hour) Capsules. Prescribe by brand

Modified Release Capsule

unlicensed

0.37% Solution 20ml

4% Solution 200ml

Injection 15mg, 90mg vial. Hospital Only

to be initiated  and prescribed by commissioned, specialised services. continuation of prescribing needs to be under the advice of commissioned or specialised service

Injection

Tablet

Tablets

injection

Dorzolomide 2%, Timolol 0.5% Eye Drops

Tablets

Injection

Capsules

Dispersible Tablets

Injection

To be used in accordance with the Diabetes Pathway. Initiation of GLP 1 agonists analogues to be carried out by prescribers trained in insulin initiation.

concentrate for solution for infusion

Tablets

Tablet

To be used in Accordance with NICE TA 471

Tablet

Tablet

Tablets

capsule

Tablet

SECOND CHOICE

Second line aldosterone antagonist if spironolactone is not tolerated for NYHA class II heart failure

Second Line agent if Spironolactone is not tolerated for use within the licenced indication, of stable post MI patient with left ventricular dysfunction and clinical evidence of heart failure in line with NICE guidance.

500micrograms/ml Injection

Tablets

Tablets

solution for infusion

Microbiologist Approval required in all cases

Talets

Use in pregnancy or if there is a known intolerance to clarithromycin

Erythromycin ethyl succinate mixture

Tablets

Tablets

subcutaneous injection

tablet

unlicensed  - Ethambutol Liquid. Consultant Paediatrician Only (unlicenced & specials)

Not formulary within secondary care during inpatient stay, please encourage patients to use their own supply.

Can be prescribed for outpatient clinics for secondary care

Not formulary within secondary care during inpatient stay, please encourage patients to use their own supply.

Can be prescribed for outpatient clinics for secondary care

Not formulary within secondary care during inpatient stay, please encourage patients to use their own supply.

Can be prescribed for outpatient clinics for secondary care

68mg Implant (Nexplanon). Primary Care & Sexual Health Only

Tablet

Tablets

Tablets 25mg

To be used in accordance with associated NICE technical appraisal

Tablet

tablets

Injection

200mg Tablets - Requires Microbiologist authorisation 

Suitable for Primary care to prescribe provided there is authorisation from a microbiologist

Tablets

Tablet and Syrup

Injection

Injection, Infusion

Tablet, Capsule

Tablets

 if prescribed for postural hypotension

1% Minims

2% Minims

  20 Injections (Hospital Consultant Only)

Capsules

Depot Injection 

depot injection

children between 12-18 where sirdupla is not licenced

 Seretide 50 Evohaler * Paediatric use only

 Seretide Evohaler and Accuhaler.
Restricted to use in asthma not to be used as new initiation for COPD   

Turbohaler

• Long-acting beta-agonist
• Formoterol Easyhaler^® preferred as more cost effective

  3g Oral Sachets

Not be used first line and must be used in accordance with culture and sensitivity results.

For treatment resistant UTI licenced for women, doses change as per gender

  Injection ( Unlicensed )

 Injection.  IV doses of 40mg or 80mg can be slow bolused. Larger doses must be infused at a max rate of 4mg/min

Capsules

From April 2019 gabapentin will be reclassified as class C controlled substance. Prescriptions will need to be physically signed by doctors; electronic copies will not be accepted by pharmacists - the total quantity will need to be written on the prescription in both words and figures and pharmacists will need to dispense the drugs within 28 days of the prescription being written

Infusion

Tablets

Tablet

injection

Eye Drops 0.3%

Capsules 2.5mg

Tablet

Injection, Tablets , Drink ( e.g. lucozade drink) 

FreeStyle Libre® is a flash glucose monitoring (Flash GM) system which monitors glucose levels using interstitial fluid levels rather than capillary blood glucose from finger prick testing

All prescribing of freestyle libre should be carried out in line with the agreed prescribing statement below

https://www.northernlincolnshireapc.nhs.uk/wp-content/uploads/2019/08/Prescribing-Arrangements-for-Flash-Glucose-Monitoring-Final-2.pdf

50% Eye Drops unlicensed

BP Syrup, licensed

Available as S/L Tablet, Spray

 Injection

   Patches

Irrigation solution 1.5%

 Injection
Injection 3.6mg, 10.8mg.

3.6mg  Injection

Injection

Tablets

Consultant Initiated Only and Restricted Hospice Use

Subcutaneous Injection by Immunologist Only

Capsule
Tablet
Oral liquid

haloperidol solution for injection

Injection

Minims 2%

Foam Enema

Colifoam

Suspension 5mg/5ml
Paediatrician Initiated Only

tablet

Tablets,

Injection - only green for use in Palliative care only

0.3% Eye Drops

0.5% Eye Drops

1% Eye Drops

150mg Tablets

3mg Injection Post-menopausal Osteoporosis

Tablet, Suspension

For the treatment of hereditary angioedema in the emergency care setting. 

Injection. For reversal of dabigatran anticoagulation only. Not suitable for Anti Xa Agents

tablet

tablet

2.5mg Tablets

Capsules, MR Capsules

Vial, KwikPen, 3mL cartridge, 100unils/mL

unlicensed product

Named patient only

In light of adhering towards the integrated Diabetes pathway the AMBER status only applies if the Diabetologist has provided a written confirmation ( via email/ or letter etc) to a General Practitioner stating the appropriateness of initiating the prescribing of Tresiba. 

General Practitioner are therefore permitted to prescribe this medication provided that the suitability of initiating this product must be identified by a specialist/ diabetologist.

Cartridge, Prefilled pen (FlexPen, InnoLet)
Long-acting insulin analogues (LAIAs) have no advantages over human isophane insulin in effects on HbA1c levels. 

In light of adhering towards the integrated Diabetes pathway the AMBER status only applies if the Diabetologist has provided a written confirmation ( via email/ or letter etc) to a General Practitioner stating the appropriateness of initiating the prescribing of Toujeo. 

General Practitioner are therefore permitted to prescribe this medication provided that the suitability of initiating this product must be identified by a specialist/ diabetologist.

Vial, 3mL cartridge, solostar

Injection

Injection

Intra-uterine system

Concentrate for intravenous infusion

Tablets

Tablet, Injection
Elixir 50mg/5ml - Unlicensed

Vial, Cartridge, Prefilled pen (KwikPen)

Tablets

including Long acting, once daily preparation

Granules

Tablets

Specialist Initation only for two indications :

1) Angina

Cardiology specialist initiation only in line with NICE Clinical Guidance on stable angina for patients who remain symptomatic despite maximal doses of other anti-anginal medication. 

2) Heart Failure

In line with NICE TA 267.  Ivabradine is an option for treating people with chronic heart failure who meet the following criteria :

- with NYHA class II to IV stable chronic heart failure with systolic dysfunction and
- who are in sinus rhythm with a heart rate of 75 bpm or more and
- who are given ivabradine in combination with standard therapy including beta-blocker therapy, ACE inhibitors and aldosterone antagonists, or when beta-blocker therapy is contraindicated or not tolerated and
- with a left ventricular ejection fraction of 35% or less.

Shampoo

Tablets

 Injection

Liquid

Tablet

Capsules

Orodispersible tablets  restricted for use in patients with swallowing difficulties or who are on enteral tube feeding.

Latanoprost 50mcg, Timolol 5mg/ml

Tablet

Capsule

To be prescribed by brand

Tablet

3.75mg Injection

unlicensed

Unlicenced Tablet

Tablet

 Levofloxacin Infusion 500mg/100ml  restricted use only

Tablet

Injection

Tablets

Lidocaine hydrochloride 4%, Fluorescein Sodium 0.25% Minims

DPP-4 inhibitor approved for use in patients with severe renal or hepatic impairment

Tablets, Injection

Capsules

Tablet MR

Tablet MR

Injection

For use as an adjunct to existing oral hypoglycaemic and/or insulin therapy in type 2 diabetes mellitus (DM) where glycaemic control is inadequate

To be used in accordance with the Diabetes Pathway. Initiation of GLP 1 agonists analogues to be carried out by prescribers trained in insulin initiation

Tablet
Liquid

tablets

Tablet

To be used in accordance with NICE TA318

Capsules

Sachets

Hospital Only

Tablets
Suspension

Tablets

150 mg/ml PFS. Primary Care & Sexual Health Only

modified release tablet

Tablets

Tablet, orodispersible tablet and solution

tablet, suspension

Modified Release Tablets

Octasa is the first choice formulation for all newly diagnosed patients as it is more cost-effective than Asacol.

modified release granules, modified release tablets, suppositories, enema

Mezavant XL  ( Modified release tablets)  

Injection

Tablet, sachets, Oral Liquid

To be commenced by the specialist service only and prescribing must be in collaboration with the advice from the substance misuse services.

2.5mg tablets

Tablets

3ml +Inhaler + ac chamber

for use in Emergency Care Centres only

Tablets

MR Capsules

Equasym XL,

Medikinet XL

500mg injection
1g Vial

Methylprednisolone 100mg tablets, Rahabilitation services and Opthalmic surgery only

Tablet was discontinued March 2012.

For patients in whom bendroflumethiazide is not suitable, an unlicensed import may be available for use by secondary care

 Tablet, Suspension, Suppository

 Infusion

Intravaginal cream

Vaginal capsule

oromucosal solution

^{Consultant initiation only when fludrocortisone ineffective for orthostatic hypotension.}

Intravenous Infusion

Injection

Tablet m/r

Tablets

Injection, bladder instillation

Infusion

Tablets

Tablets

Injection

Tablets

No 1 Injection

No 2 Injection

Capsules

To be used in accordance with NICE TA345 and the constipation pathway

injection

injection

Intravenous Infusion

Tablets, Syrup

Specialist initiation only

0.1% Eye Drops

Tablet, Suspension, Tablet MR

Capsules

Modified Release Tablets to be prescribed by Brand.

Tablets and Injection

Tablet

tablets

Tablets

Tablets

Infusion

50 mcg/ml, 100 mcg/ml injection

50mg, 100mg Implants

Estraderm MX 25, 50, 75

Estriol Intra Vaginal Cream 0.01% Contains Arachis (peanut) Oil

Estriol Intra Vaginal Cream 0.1%

Infusion

Eye Drops 0.3%

depot Injection

Injection

Eye Drops 0.1%

Capsules

orodispersible tablets available for when the beads in the capsule are too large and lansoprazole orodispersible are not acceptable

Injection/ infusion

Tablet

Capsule and suspension

To be used with Public health Guidance

Injection

tablets

0.4% Minims

Patch

unlicensed

Tablets

injection

Intravenous Infusion

Injection

Tablets
Tablets forte
Capsule

Injection

Intravenous Infusion

Cautionary note: to ensure one checks timing of the previous paracetamol dose before administering the next dose.

Weight considerations ( e.g. >50kg)For patients weighing less than 50kg (use 15mg/kg qds)

Tablets,

Capsule

Not to be prescribed by Secondary Care

Tablets

Capsules

Not to be prescribed as co-codamol in secondary care

Injection, Enema. Hospital Only

Tablet

Injection

Injection

Injection

Capsule

Infusion

tablets

Tablets

 Injection

Capsules

Injection