BNF 9: Blood and Nutrition

Transcription

1 FORMULARY CHOICE RESTRICTED 1 Blood and Blood-Forming Organs 1.1 Anaemias Epoetins Epoetinalfa pre-filled (Eprex ) 1,000unit 2,000unit 3,000unit 4,000unit 5,000unit 6,000unit 8,000unit 10,000unit 20,000unit 30,000unit 40,000unit Methoxy polyethylene glycol-epoetin beta prefilled (Mircera ) 30microg 50microg 75microg 100microg 120microg 150microg 200microg 250microg 360microg 1.2 Anaemias, Iron Deficiency Iron, Injectable Ferric Carboxymaltose (Ferrinject ) 1000mg/20ml Specialist use Page 1 of 10 Restricted to the treatment of anaemias associated with chronic renal failure. A small amount of specialist prescribing to treat symptomatic anaemia in adults receiving cancer chemotherapy NICE TA323 Specialist use Restricted to the treatment of anaemias associated with chronic renal failure. Specialist use in accordance with agreed Trust guidance and specific prescribing proformas.

2 100mg/2ml 500mg/10ml Iron Dextran 100mg/2ml (Cosmofer ) Iron Sucrose 100mg/5ml (Venofer ) Iron, Oral Ferrous Sulfate 200mg tablet 325mg m/r tablet Ferrous Fumarate 210mg tablet 322mg tablet 140mg/5ml syrup Ferrous Gluconate 300mg tablet Sodium Feredetate 190mg/5ml elixir Ferrous Fumarate 305mg / folic acid 350microg tablet Ferrous Fumarate 322mg / folic acid 350microg tablet 1.3 Anaemias, Megaloblastic Folates Folic acid 400microg tablet 5mg tablet 2.5mg/5ml syrup Folic acid 15mg/ml Vitamin B Group Hydroxocobalamin 1mg/ml 1.5 Iron Overload Iron Chelators Page 2 of 10 Specialist use in accordance with agreed Trust guidance and specific prescribing proformas. Specialist use in accordance with agreed Trust guidance and specific prescribing proformas. Specialist use; usually within the Critical Care setting.

3 Desferrioxamine 500mg powder for 2g powder for 1.6 Neutropenia Specialist and Emergency Use Only to treat iron overload. Granulocyte-Colony Stimulating Factors Filgrastim 30millionunits (300microg)/ml Specialist use in the treatment of neutropenia; taking account of Trust Guidelines for the use of Colony Stimulating factors for Oncology and Haematology Patients. Lenograstim 13.4million-units powder for 33.6million-units powder for Pegfilgrastim 6mg/0.6ml Specialist use in the treatment of neutropenia; taking account of Trust Guidelines for the use of Colony Stimulating factors for Oncology and Haematology Patients. Specialist use in the treatment of neutropenia; taking account of Trust Guidelines for the use of Colony Stimulating factors for Oncology and Haematology Patients. 1.8 Platelet Disorders Cyclic AMP Phosphodiesterase III Inhibitors Anagrelide 500microg capsule Very specialist use for the treatment of essential thrombocythaemia. Thrombopoietin Receptor Agonists Eltrombopag 25mg tablet 50mg tablet Romiplostim 250 microgam 2 Fluid and Electrolyte Imbalances Bicarbonate Sodium bicarbonate 500mg capsule Sodium bicarbonate 1.4% 500ml Consultant Haematologist initiation only. Very specialist use in accordance with NICE TA293, noting NICE TA382 Very specialist use in accordance with NICE TA221 Page 3 of 10

4 4.2% 500ml 8.4% 200ml 4.2% 10ml 8.4% 10ml 8.4% 50ml prefilled Oral Rehydration Salts Dioralyte sachet Potassium 0.6% sodium chloride, 0.32% sodium lactate, 0.04% potassium chloride and 0.027% calcium chloride, 1000ml (Hartmann s Solution) Potassium chloride 20mmol in 5% glucose 1000ml 40mmol in 5% glucose 1000ml Potassium chloride in 0.9% sodium chloride 20mmol 500ml 20mmol 1000ml 40mmol 1000ml Potassium chloride in 0.45% sodium chloride and 5% glucose 20mmol 500ml 10mmol 500ml Potassium chloride in 0.18% sodium chloride and 4% glucose 20mmol 500ml Page 4 of 10

5 10mmol 500ml Potassium chloride 0.15% (10mmol) in glucose 10% - 500mls Potassium Chloride 15% Concentrate 10ml ampoule Sodium Sodium chloride 600mg tablet 0.9% sodium chloride 50ml 100ml 250ml 500ml 1000ml 5ml 10ml 20ml 0.18% sodium chloride and 4% glucose 500ml 1000ml 0.9% sodium chloride and 5% glucose 500ml 0.45% sodium chloride and 5% glucose 500ml Sugars Glucose 5% 250ml 5% 500ml 10% 500ml 20% 500ml 20% 20ml Very limited and strictly controlled usage Only to be utilised in accordance with the Trust s Potassium Chloride Concentrate Injection Protocol and associated Controlled Drug procedures t commonly used Page 5 of 10

6 50% 500ml 50% 50ml 2.1 Calcium Imbalance Hypercalcaemia and Hypercalciurua Calcimimetic Agents Cinacalcet 30mg tablet Specialist use only - in accordance with agreed Shared Care Guideline when treating Primary Hyperparathyroidism. Etelcalcetide 2.5 mg solution for 5 mg 10 mg solution for Hypocalcaemia Calcium Calcium carbonate 1.25g eff. tablet Calcium carbonate 1.25g tablet Calcium compound 1000mg tablet Calcium Gluconate 10% Calcium Chloride 10% 2.2 Low Blood Volume Plasma Products Human Albumin 4.5% 100ml solution 4.5% 500ml solution 20% 100ml solution 20% 500ml solution Consultation initiation only in renal patients, in accordance with NICE guidance NICE TA117 Specialist use only in accordance with NICE TA448 Page 6 of 10

7 Plasma Substitutes Dextran 40 in 5% glucose 500ml 70 in 5% glucose 500ml 70 in 0.9% sodium chloride 500ml Gelatin (Gelaspan ) 500ml 2.3 Magnesium Imbalance Hypomagnesaemia Magnesium Magnesium Glycerophosphate 4mmol tablet 4mmol/5ml solution Magnesium Sulfate 50% 2ml 10ml 2.4 Phosphate Imbalance Hyperphosphataemia Calcium Calcium Acetate 1g tablet Phosphate Binders Calcium Carbonate 1.25g tablet (Calcichew ) Sevelamer 800mg tablet (Renvela ) 2.4g sachet (Renvela ) Lanthanum (Fosrenol ) 500mg tablet 750mg tablet 1000mg tablet Hypophosphataemia Page 7 of 10 Unlicensed products, but relatively widely used to treat hypomagnesaemia Specialist prescribing under the control of the Trust s Renal Team Specialist prescribing under the control of the Trust s Renal Team Specialist prescribing under the control of the Trust s Renal Team Specialist prescribing under the control of the Trust s Renal Team

8 Phosphates Phosphate compound 1.936g dispersible tablet Phosphate 500ml Polyfusor 2.5 Potassium Imbalance Hyperkalaemia Cation Exchange Resins Calcium Resonium powder Resonium A Limited use within renal patients. Hypokalaemia Potassium Potassium chloride 1mmol/ml syrup Potassium bicarbonate / potassium chloride 12mmol tablet 6 Vitamin Deficiency Multivitamins Vitamin Compound tablet Vitamin A, B and C drop (Abidec and Dalivit ) Forceval capsule Junior capsule Renavit tablet Specialist prescribing under the control of the Trust s Renal Team Aquadeks liquid Specialist prescribing - for cystic fibrosis patients only Vitamin B Group Pyridoxine 10mg tablet 50mg tablet Thiamine 100mg tablet Vitamin B Compound Strong tablet Pabrinex high potency intravenous Page 8 of 10

9 intramuscular Vitamin C Ascorbic Acid 50mg tablet 500mg tablet Vitamin D and Analogues Alfacalcidol 250nanog capsule 1microg capsule 2microg/ml oral drop 2microg/ml Calcitriol 250nanog capsule Colecalciferol 20,000 unit capsule (Pro D3l ) Calcium and ergocaliferol tablet Calcium Carbonate 1.5g / Colecalciferol 10microg tablet (Adcal D3 ) Calcium Carbonate 1.5g / Colecalciferol 10 microg eff. tablet (Adcal D3 Dissolve ) Calcium Carbonate 2.5g / Colecalciferol 22 microg tablet (theical- D3 ) Vitamin E Vitamin E 500mg/5ml suspension Vitamin K Menadiol phosphate 10mg tablet Phytomenadione 10mg tablet Phytomenadione 10mg/ml (Konakion MM) Phytomenadione Page 9 of 10 Unlicensed but only currently available oral vitamin D Only for patients unable to tolerate and be concordant with Adcal D3 tablets.

10 2mg/0.2ml (Konakion MM paediatric) Page 10 of 10