Government Out-Patients Formulary List

Transcription

1 Government Out-Patients Formulary List This formulary was compiled by the Directorate for Pharmaceutical Affairs Ministry of Health, the Elderly and Community Care March 2012

2 Contents How to use the formulary iii The Schedule V Chronic Conditions iv Dispensing vi 1. Gastro-Intestinal system 1 2. Cardiovascular system 5 3. Respiratory system Central nervous system Infections Endocrine system Obstetrics, gynaecology, and urinary-tract disorders Malignant disease and immunosuppression Nutrition and blood Musculoskeletal and joint disease Eye Ear, nose, and oropharynx Skin Anaesthesia Consumables 54 Appendixes and indices Appendix 1 Borderline substances 55 Index 58 ii

3 How to use the formulary Note: This formulary lists medicinal products that are available within the National Health Scheme for Out-Patients use. Medicinal products listed can be issued via a Schedule V Card (Yellow Card) once Schedule V entitlement is in place or to Pink Card holders if the respective item is Pink Card Positive. Certain medicinal products are protocol regulated and will be supplied only against the relevant approval in addition to the Schedule V Card. After hours, approval of protocol regulated drugs can be endorsed by the Resident Specialist on duty, provided that it is then endorsed by its respective consultant on the next day. Abbreviations A Acute AG Antimicrobial Guidelines ATC Anatomical Therapeutic Chemical Classification System B Both Acute and Chronic C Chronic HDO Hospital Dispensing Only HU Hospital Use MDHP Mater Dei Hospital Pharmacy MEU Medicines Entitlement Unit MP Medicinal Protocol N/A Not Applicable TBDF To be dispensed from U/L Unlicensed Prescriber Criteria: All Medical Practitioners, i.e. doctors working within the National Health Services and private doctors, can change the dose of treatment for the following conditions when an item is marked on the formulary as Medical Practitioners or Consultant. This includes also protocol-regulated items. (Medicines that require permit/approval) 1. Hypertension 2. Diabetes Mellitus 3. Chronic Heart Failure 4. Asthma 5. Chronic Obstructive Pulmonary Disease 6. Treatment for hypercholesterolaemia under the respective Schedule V conditions 7. Chronic Mood Disorders 8. Chronic Neurotic Disorders iii

4 The Schedule V Chronic Conditions The Fifth Schedule of the Social Security Act lists the diseases and conditions in respect of which free medicines are provided irrespective of financial position. These are as follows: 1. Malignant Diseases 2. Cardiovascular Diseases: (a) Chronic Heart Failure (b) Hypertension (c) Ischaemic Heart Disease (d) Cardiac Arrhythmias (e) Peripheral Vascular Disease (f) Cerebrovascular disease (g) Genetic Dyslipidaemia 3. Respiratory Diseases: (a) Chronic Respiratory Failure (b) Cystic Fibrosis (c) Chronic Obstructive Pulmonary Disease (d) Chronic Asthma 4. Digestive system diseases: (a) Gastro Oesophageal Reflux Disease (b) Gastric/Duodenal Ulcers (c) Inflammatory Bowel Disease (d) Coeliac Disease (e) Diverticular Disease requiring Stoma Care (f) Hirschprung s Disease (g) Imperforate Anus (h) Small Intestinal Failure 5. Liver diseases: (a) Chronic Liver Disease 6. Haematological Diseases: (a) Inherited Bleeding Disorders (b) Inherited Haemoglobinopathies 7. Nervous System Diseases: (a) Epilepsy (b) Parkinson s disease (c) Myasthenia Gravis (d) Multiple Sclerosis (e) Motor Neurone Disease (f) Trigeminal Neuralgia (g) Huntington s Chorea (h) Dementia (i) Schizophrenia (j) Psychosis (k) Chronic Mood Disorders (l) Chronic Neurotic Disorders (m) Addiction Disorders (n) Chronic Psychiatric Disorders starting in Childhood (o) Chronic Eating Disorders (p) Cerebral Palsy (q) Narcolepsy (r) Spinal Cord Pathologies (s) Congenital indifference to pain iv

5 8. Renal diseases: (a) Chronic Kidney Disease 9. Endocrine diseases: (a) Diabetes Mellitus (b) Addison s Disease (c) Precocious Puberty (d) Hypoparathyroidism (e) Hypopituitarism (f) Hypogonadism (g) Enzyme Disorders (h) Endometriosis and Adenomyosis (i) Pituitary Adenomas 10. Skin diseases: (a) Psoriasis (b) Chronic Immunobullous Disorders (c) Congenital Ichthyosis 11. Infectious Diseases: (a) HIV/AIDS and HIV Related Diseases (b) Hepatitis B & C (c) Tuberculosis (d) Hospital Acquired Infections (e) Leprosy (f) Polio and Post-Polio Syndrome (g) Chronic Osteomyelitis 12. Rheumatic Diseases: (a) Rheumatoid Arthritis (b) Paget s Disease (c) Lupus Erythematosus (d) Systemic Sclerosis (e) Dermatomyositis/Polymyositis (f) Polyarteritis Nodosa (g) Seronegative Arthritis (h) Crystal Deposition Disease (i) Polymyalgia Rheumatica 13. Metabolic Disorders: a) Inborn errors of Metabolism 14. Eye diseases: (a) Glaucoma (b) Vascular Disease of the Retina 15. Immunodeficiency: (a) Primary Immunodeficiency Disorder (b) Secondary Immunodeficiency Disorder 16. Chromosome Disorders: (a) Down Syndrome (b) Turner Syndrome (c) Prader-Willi Syndrome v

6 Dispensing When dispensing a formulary item, patient should present: Valid Schedule V card Prescription (white prescription [DH 46] and/or green prescription [DH 129] + Control card [DH680i]) Patient s ID card and ID card of person who comes to collect the medicines on the patient s behalf When dispensing a protocol regulated item, patient should present: Approval form Valid Schedule V card Prescription (white form [DH 46] and/or green form [DH 129] + Control card [DH680i]) Patient s ID card and ID card of person who comes to collect the medicines on the patient s behalf If an item is added to the Schedule V card in ink and endorsed by the Consultant, the dispenser should dispense the newly added item once, and instruct the patient to go to the Schedule V office for a new card to be issued. If the Schedule V card is expired, the dispenser should dispense the items once and instruct the patient to fix an appointment with the Consultant for the renewal. The schedule V endorsed request can than be left at MDHP or sent to the Schedule V office. If a Schedule V Card Application with the relevant prescriptions is presented, the dispenser should dispense the items once and instruct the patient to leave the application at MDHP or send it to the Schedule V office. Protocol Regulated Drugs The requests for these drugs should be sent to the MEU (Medicines Entitlement Unit) to be reviewed accordingly. The approval is given according to the individual protocols and approved for a stated duration (in months or years) depending on the specific item. If the approval is expired, the dispenser should dispense the item once and instruct the patient to fix an appointment with the Consultant for the renewal requests endorsement. The endorsed request should be left at MDHP or sent to the MEU. If a Schedule V card is valid and there is no more space to log in dispensing entries, patients should not be sent to the Schedule V office for a Continuation Sheet/Card. Instead, a Continuation Sheet/Card is attached to the Schedule V card, by the dispenser. The Continuation Sheet/Card is only valid if attached to the valid issued Schedule V card. Dispensers are to make sure that they have Continuation Sheets readily available. If a request for a protocol regulated drug with the relevant prescription is presented, the dispenser may dispense items for one month only if the item is according to protocol. vi

7 Genitourinary (GU) Clinic Entitlement A legal notice (LN 188/2009) was issued containing a list of medicines that can be dispensed by the consultant from the GU Clinic. The legal notice entitled Provision of Medicinal Products through the Genitourinary Clinic within the Government Health Services Rules states that: The medicinal products listed in the Schedule shall only be provided by the consultant to patients attending or who have been referred to the clinic. The consultant shall: a. Provide the medicinal products referred to in the Schedule, directly to patients attending the clinic, and he shall keep a record thereof; b. Dispense only those amounts which are needed for the period specified therein; c. Immediately notify the Authority of any amendment needed in the Schedule; d. Inform the Authority of the address of the clinic and of any changes in such an address; e. Be responsible for all duties and obligations relating to the provision of medicinal products to patients under the Act and any regulations or rules made thereunder, and for standards and conditions issued by the Authority from time to time in relation to dispensing; f. Keep such amount of medicinal products as per internal arrangements with the hospital pharmacy in order to ensure continuation of service at the clinic; g. Take all reasonable precautions to ensure appropriate storage and dispensing of medicinal products; h. Keep updated, written and agreed procedures with the hospital pharmacy supplying the medicinal products. List of medicinal products authorized for the purpose of these rules 1. Doxycycline 100mg bd for 7 days. (Occasionally for 14 days in epididymitis and rarely for 28 days in LGV and Latent Syphilis) 2. Erythromycin 250mg - two tablets daily for 7 days 3. Metronidazole 200mg tablets - 2 tablets daily for 7 days 4. Ceftriaxone 250mg IM injections and 1% lignocaine injection for dilution to be given as stat dose 5. Spectinomycin 2g IM stat 6. Benzathine Penicillin 1.2 million units IM injections and 1% lignocaine injection for dilution to be given as stat dose of 2.4 million units. 7. Clotrimazole 100mg pessaries 8. Podophyllotoxin 0.15% cream 9. Podophyllotoxin 0.5% topical solution 10. Aciclovir 200mg to be given as 400mg tds for 7 days for acute episodes 11. Prednisolone 5mg to be given as 20mg tds for 3 days 12. Amoxicillin 250mg to be given as 500mg tds for 5 days When dispensing one of the above mentioned drugs, a patient needs only to present a prescription from GU consultant; there is no need of a Schedule II card (Pink Card) or a Schedule V card. This applies for the 12 drugs mentioned in the Legal Notice only. vii

8 Other Information Medicines Entitlement Unit Address: St. Luke s Hospital, Guardamangia (ex Out-Patients Pharmacy) Tel: (Available from Monday to Friday from 8.30am to 12.00pm) Opening Hours: Monday, Wednesday, Friday 7.30am 2.30pm viii

9 ATC Code Active Ingredient Dosage Form and Strength Prescriber Criteria Protocol Pink Card 1. Gastro-intestinal system 1.1 Dyspepsia and gastro-oesophageal reflux disease Antacids and simeticone A02AC01 Calcium Carbonate Tablets 500mg Consultants A02AX Magnesium Hydroxide + Oral Liquid Medical Practitioners A Aluminium Hydroxide + Simeticone A02AA04 Magnesium Hydroxide Mixture Oral Liquid Medical Practitioners A Compound alginates and proprietary indigestion preparations A02AX Antacid Compound Preparation Tablets Medical Practitioners A 1.2 Antispasmodics and other drugs altering gut motility A03AB01 Atropine Sulphate Tablets 0.6mg Consultant Neurologists, Consultant Geriatricians, Consultant Paediatricians A03BB01 Hyoscine Butylbromide Injections 20mg Consultant Palliative Care HDO A03BB01 Hyoscine Butylbromide Tablets 10mg Medical Practitioners A A03AA04 Mebeverine Hydrochloride Tablets 135mg Medical Practitioners C A03AB05 Propantheline Bromide Tablets 15mg Medical Practitioners A 1.3 Antisecretory drugs and mucosal protectants H2-Receptor antagonists A02BA03 Ranitidine Syrup Consultant Geriatricians, Consultant Oncologists, Consultant Paediatricians, Consultant Gastroenterologists, Consultant Palliative Care A02BA02 Ranitidine Tablets 150mg Medical Practitioners B Chelates and complexes A07BB Bismuth Chelate Tablets 120mg Consultant Gastroenterologists, Consultant Surgeons A02BX02 Sucralfate Oral Liquid 1g/5mL Consultant Gastroenterologists, Consultant Paediatricians, MP 184 Consultant Geriatricians A02BX02 Sucralfate Tablets 1g Consultants C MP 13 MP Gastro-intestinal System 1

10 1.3.3 Prostaglandin analogues A02BB01 Misoprostol Tablets 200mcg Consultant Rheumatologists, Consultant Gastroenterologists, Consultant Obstetrics & Gynaecology, Consultant Cardiologists, Consultant Cardiac Surgeons Proton pump inhibitors A02BC01 Omeprazole Capsules 20mg Medical Practitioners B 1.4 Acute diarrhoea Antimotility drugs N02AA Codeine Phosphate Tablets 30mg Hospital Doctors A07DA032 Loperamide Capsules 2mg Medical Practitioners A 1.5 Chronic bowel disorders Aminosalicylates A07EC02 Mesalazine Enema 1g Consultant Gastroenterologists, Consultant Paediatricians, Consultant Surgeons A07EC02 Mesalazine Suppositories Consultant Gastroenterologists, Consultant Paediatricians, 500mg Consultant Surgeons A07EC02 Mesalazine Tablets 400mg Consultant Gastroenterologists, Consultant Paediatricians, Consultant Surgeons A07EC02 Mesalazine (Pentasa ) Slow Release Consultant Gastroenterologists, Consultant Paediatricians, Tablets 500mg Consultant Surgeons A07EC02 Sulfasalazine Oral Liquid Consultant Gastroenterologists, Consultant Paediatricians, 250mg/mL Consultant Surgeons MP 132 MP 125 MP 186 A07EC01 Sulfasalazine Suppositories 500mg Consultant Gastroenterologists MP 185 A07EC01 Sulfasalazine Tablets 500mg Consultant Gastroenterologists, Consultant Paediatricians, Consultant Surgeons, Consultant Rheumatologists Corticosteroids A07EA06 Budesonide Controlled Release Consultant Gastroenterologists, Consultant Surgeons MP 23 Capsules 3mg A07EA06 Budesonide Enema 2mg/100mL Consultant Gastroenterologists, Consultant Surgeons MP 24 A07EA02 Hydrocortisone Foam Enema 10% Consultant Gastroenterologists, Consultant Surgeons, Consultant Paediatricians A07EA01 Prednisolone Retention Enema Consultant Gastroenterologists, Consultant Surgeons, Consultant 20mg/100mL Paediatricians, Consultant Oncologists, Consultant Palliative Care C C 1. Gastro-intestinal System 2

11 1.5.3 Drugs affecting the immune response L04AX01 Azathioprine Tablets 50mg Hospital Doctors L04AD01 Ciclosporin (Cyclosporin) Capsules 100mg Consultants MP 46 L04AD01 Ciclosporin (Cyclosporin) Capsules 25mg Consultants MP 46 L04AD01 Ciclosporin (Cyclosporin) Oral Solution MP mg/mL Consultant Nephrologists, Consultant Dermatologists, Consultant Rheumatologists, Consultant Paediatricians, Consultant Haematologists, Consultant Cardiac Surgeons L01BB02 Mercaptopurine Tablets 50mg Consultants L04AX03 Methotrexate Tablets 2.5mg Consultants 1.6 Laxatives Bulk-forming laxatives A06AC01 Ispaghula Husk Powder Medical Practitioners B A06AC06 Methylcellulose Tablets 500mg Hospital Doctors Stimulant laxatives A06AB02 Bisacodyl Suppositories 10mg Medical Practitioners A A06AB02 Bisacodyl Tablets 5mg Medical Practitioners A A06AB53 Co-Danthramer Suspension 75/1000 Consultant Oncologists, Consultant Palliative Care MP 43 in 5mL A06AX01 Glycerol Adult Suppositories Medical Practitioners A 4g A06AX01 Glycerol Infant Suppositories 1g Medical Practitioners A A06AB06 Senna Tablets 7.5mg Medical Practitioners A Osmotic laxatives A06AD11 Lactulose Syrup 3.35g/5mL Consultants MP 109 A02AA04 Magnesium Hydroxide Mixture Oral Liquid Medical Practitioners A A06AG Phosphate Enema Medical Practitioners A 1.7 Drugs affecting intestinal secretions Drugs affecting biliary composition and flow A05AA02 Ursodeoxycholic Acid Capsules 150mg Consultant Gastroenterologists A05AA02 Ursodeoxycholic Acid Capsules 250mg Consultant Gastroenterologists Bile acid sequestrants C10AC01 Colestyramine Powder Medical Practitioners C 1. Gastro-intestinal System 3

12 1.7.3 Pancreatin A09AA02 Pancreatin Capsules (Creon Consultants 10,000U) A09AA02 Pancreatin Tablets Medical Practitioners C A09AA02 Pancreatin Tablets High Dose Medical Practitioners C 1. Gastro-intestinal System 4

13 ATC Code Active Ingredient Dosage Form and Strength Prescriber Criteria Protocol Pink Card 2. Cardiovascular system 2.1 Positive inotropic drugs Cardiac glycosides C01AA05 Digoxin Elixir 0.05mg/mL Consultants C C01AA05 Digoxin Tablets mg Medical Practitioners C C01AA05 Digoxin Tablets 0.25mg Medical Practitioners C 2.2 Diuretics C03AA01 C03AA01 Bendroflumethiazide (Bendrofluazide) Bendroflumethiazide (Bendrofluazide) Thiazides and related diuretics Tablets 2.5mg Medical Practitioners C Tablets 5mg Medical Practitioners C C03BA08 Metolazone Tartrate Tablets 5mg Consultant Physicians MP Loop diuretics C03CA02 Bumetanide Tablets 1mg Medical Practitioners C C03CA02 Bumetanide Tablets 5mg Medical Practitioners C C03CA01 Furosemide Syrup 1mg/mL Consultants C03CA01 Furosemide Tablets 40mg Medical Practitioners C Potassium-sparing diuretics and aldosterone antagonists C03DB01 Amiloride Hydrochloride Tablets 5mg Consultants C03DA01 Spironolactone Tablets 25mg Medical Practitioners C C03DA01 Spironolactone Tablets 100mg Consultants Potassium-sparing diuretics with other diuretics C03EA01 Amiloride + Hydrochlorothiazide Tablets 5mg + 50mg C03EB01 Co-amilofruse (Amiloride + Furosemide [Frusemide]) Tablets 5mg + 40mg Medical Practitioners C Consultant Cardiologists, Consultant Cardiac Surgeons MP Cardiovascular System 5

14 2.3 Anti-arrhythmic drugs C01BD01 Amiodarone HCl Tablets 200mg Consultants C01BA03 Disopyramide Tablets 100mg Consultants C C01BC04 Flecainide Tablets 100mg Consultants C01BB02 Mexiletine HCl Tablets 200mg Consultant Cardiologists C01BC03 Propafenone Tablets 150mg Consultant Physicians, Consultant Cardiologists MP 169 C01BA01 Quinidine Bisulphate Modified Release Consultants Tablets 250mg 2.4 Beta-adrenoceptor blocking drugs C07AB03 Atenolol Tablets 25mg Medical Practitioners C C07AB03 Atenolol Tablets 100mg Medical Practitioners C C07AG02 Carvedilol Tablets 6.25mg Consultants C07AG02 Carvedilol Tablets 25mg Consultants C07AG01 Labetalol Hydrochloride Tablets 100mg Hospital Doctors C C07AG01 Labetalol Hydrochloride Tablets 200mg Hospital Doctors C C07AB02 Metoprolol Tartrate Tablets 50mg Consultants C07AB02 Metoprolol Tartrate Tablets 100mg Consultants C07AA05 Propranolol Hydrochloride Oral Solution Consultant Paediatricians 1mg/mL C07AA05 Propranolol Hydrochloride Tablets 10mg Medical Practitioners C C07AA05 Propranolol Hydrochloride Tablets 40mg Medical Practitioners C C07AA07 Sotalol Tablets 80mg Consultants 2.5 Hypertension and heart failure Vasodilator antihypertensive drugs C02DB02 Hydralazine Tablets 25mg Medical Practitioners C C02DC01 Minoxidil Tablets 10mg Consultant Physicians, Consultant Cardiologists MP Centrally acting antihypertensive drugs C02AC01 Clonidine Hydrochloride Tablets 100mcg Consultants C C02AB Methyldopa Tablets 250mg Medical Practitioners C Alpha-adrenoceptor blocking drugs C02CA04 Doxazosin Tablets 1mg Consultants C02CA04 Doxazosin Tablets 2mg Consultants C (Consultant Urologist) C02CA04 Doxazosin Tablets 4mg Consultants 2. Cardiovascular System 6

15 C04AX02 Phenoxybenzamine Capsules 10mg Consultant Intensivists MP 238 C02CA01 Prazosin Hydrochloride Tablets 1mg Consultant Physicians, Consultant Cardiologists, Consultant MP 166 Cardiac Surgeons C02CA01 Prazosin Hydrochloride Tablets 500mcg Consultant Physicians, Consultant Cardiologists, Consultant Cardiac Surgeons Drugs affecting the renin-angiotensin system Angiotensin-converting enzyme inhibitors C09AA01 Captopril Tablets 12.5mg Medical Practitioners C C09AA01 Captopril Tablets 25mg Medical Practitioners C C09AA01 Captopril Tablets 50mg Medical Practitioners C C09AA02 Enalapril Tablets 5mg Medical Practitioners C C09AA02 Enalapril Tablets 20mg Medical Practitioners C C09AA03 Lisinopril Tablets 5mg Consultants C09AA03 Lisinopril Tablets 10mg Consultants C09AA04 Perindopril Tablets 4mg Consultants Angiotensin-II-receptor antagonists C09CA01 Losartan Potassium Tablets 50mg Consultant Physicians, Consultant Cardiologists, Consultant MP 9 Cardiac Surgeons C09CA03 Valsartan Tablets 80mg Consultant Physicians, Consultant Cardiologists, Consultant Cardiac Surgeons C09CA03 Valsartan Tablets 160mg Consultant Physicians, Consultant Cardiologists, Consultant Cardiac Surgeons C01DA02 Glyceryl Trinitrate Sublingual tablets 500mcg C01DA02 Glyceryl Trinitrate Transdermal Patches 5mg/24hrs C01DA02 Glyceryl Trinitrate Transdermal Patches 10mg/24hrs 2.6 Nitrates, calcium-channel blockers, and other antianginal drugs Nitrates MP 166 MP 9 MP 9 Medical Practitioners C Consultant Physicians, Consultant Cardiologists, Consultant Cardiac Surgeons Consultant Physicians, Consultant Cardiologists, Consultant Cardiac Surgeons C01DA08 Isosorbide Dinitrate Tablets 10mg Medical Practitioners C C01DA14 Isosorbide Mononitrate Tablets 20mg Consultant Physicians, Consultant Cardiologists, Consultant Cardiac Surgeons, Consultant Gastroenterologists 2. Cardiovascular System 7

16 C01DA14 Isosorbide Mononitrate Tablets SR 60mg Consultant Physicians, Consultant Cardiologists, Consultant Cardiac Surgeons Calcium-channel blockers C08CA01 Amlodipine Tablets 5mg Consultants C08CA01 Amlodipine Tablets 10mg Consultants C08DB01 Diltiazem Tablets 60mg Consultants C08CA05 Nifedipine Modified Release Consultants Tablets 10mg C08CA05 Nifedipine Slow Release Consultants Capsule/Tablets 20mg C08CA05 Nifedipine Tablets/Capsules Consultants 10mg C08CA06 Nimodipine Tablets 30mg Consultant Neurologists MP 146 C08DA01 Verapamil Slow Release Consultant Physicians, Consultant Cardiologists, Consultant MP 196 Tablets 240mg Cardiac Surgeons C08DA01 Verapamil Tablets 40mg Medical Practitioners C Other antianginal drugs C01DX16 Nicorandil Tablets 10mg Consultant Physicians, Consultant Cardiologists MP Peripheral vasodilators and related drugs C04AD03 Pentoxifylline (Oxypentifylline) Tablets 400mg Consultant Cardiologists, Consultant Cardiac Surgeons, Consultant Vascular Surgeons, Consultant Rheumatologists KAT inhibitors C01EB15 Trimetazidine Hydrochloride Tablets 20mg Consultant Physicians, Consultant Cardiologists, Consultant Cardiac Surgeons 2.7 Anticoagulants and protamine B01AB01 Heparin Calcium Prefilled Syringes 2500 IU/mL in 0.2mL B01AB01 Heparin Sodium in Sodium Chloride Injection 10Units/mL in 5mL B01AB05 Enoxaparin Sodium Vials for injection single dose 20mg Parenteral anticoagulants Consultants B Hospital Doctors TBDF MDHP only (TPN patients) Consultants MP Cardiovascular System 8

17 B01AB05 Enoxaparin Sodium Vials for injection single dose 40mg B01AB05 Enoxaparin Sodium Vials for injection single dose 60mg B01AB05 Enoxaparin Sodium Vials for injection single dose 80mg B01AB05 Enoxaparin Sodium Vials for injection single dose 100mg Consultants MP 204 Consultants MP 204 Consultants MP 204 Consultants MP Oral anticoagulants B01AA02 Phenindione Tablets 50mg Consultants B01AA03 Warfarin Tablets 1mg Hospital Doctors C B01AA03 Warfarin Tablets 3mg Hospital Doctors C B01AA03 Warfarin Tablets 5mg Hospital Doctors C 2.8 Antiplatelet drugs B01AC06 Aspirin Tablets 75mg Medical Practitioners C B01AC04 Clopidogrel Tablets 75mg Consultant Physicians MP 276 B01AC07 Dipyridamole Tablets 25mg Medical Practitioners C B01AC07 Dipyridamole Tablets 100mg Medical Practitioners C 2.9 Antifibrinolytic drugs and heamostatics B02BD02 Anti-Haemophilic Factor VIII Infusion 500IU Consultant Haematologists, Consultant Paediatricians, Consultant Infectious Diseases Physician B02BD02 Anti-Haemophilic Factor VIII Infusion 1000IU Consultant Haematologists, Consultant Paediatricians, Consultant Infectious Diseases Physician B02BD06 Anti-Heamophilic Factor VIII Injection IV 500IU Consultant Haematologists, Consultant Paediatricians, Consultant Intermediate Infectious Diseases Physicians B02BD03 Anti-Haemophilic Factor VIII Injection IV 500IU Consultant Haematologists, Consultant Paediatricians, Consultant inhibitor bypassing activity Infectious Diseases Physicians TBDF MDHP only TBDF MDHP only TBDF MDHP only TBDF MDHP only B02BD04 Anti-Haemophilic Factor IX Infusion 500IU Consultant Haematologists, Consultant Paediatricians, Consultant Infectious Diseases Physicians TBDF MDHP only B02BD08 Eptacog Alfa (Recombinant Factor VIIa) (stand-by) Vials Consultant Anaesthetists, Consultant Haematologists TBDF MDHP only B02BB01 Fibrinogen Concentrate (stand-by) Vials Consultants Haematologists TBDF MDHP only MP 212 B02BD07 Factor XIII Concentrate Vials Consultant Haematologists MP 211 B02AA02 Tranexamic Acid Tablets 500mg Consultants 2. Cardiovascular System 9

18 2.10 Lipid-regulating drugs C10AD06 Acipimox Capsules 250mg Consultant Physicians MP 1 C10AA05 Atorvastatin Tablets 10mg Consultants MP 12 C10AA05 Atorvastatin Tablets 20mg Consultants MP 12 C10AA05 Atorvastatin Tablets 40mg Consultants MP 12 C10AA05 Atorvastatin Tablets 80mg Consultants MP 12 C10AB02 Bezafibrate Tablets 400mg Medical Practitioners C10AC02 Colestipol Powder Medical Practitioners C10AC01 Colestyramine Powder Medical Practitioners C10AB05 Fenofibrate Non-micronised Medical Practitioners 300mg capsules, or Micronised 200mg capsules, or Tablets 145mg C10AB05 Fenofibrate Non-micronised Medical Practitioners 100mg capsules or Micronised 67mg Capsules C10AA04 Fluvastatin Capsules 40mg Consultants MP 71 C10AA04 Fluvastatin Prolonged Release Consultants MP 71 Tablets 80mg C10AA01 Simvastatin Tablets 10mg Medical Practitioners C10AA01 Simvastatin Tablets 20mg Medical Practitioners 2. Cardiovascular System 10

19 ATC Code Active Ingredient Dosage Form and Strength Prescriber Criteria Protocol Pink Card 3. Respiratory system 3.1 Bronchodilators H02AB06 Prednisolone Soluble Tablets 5mg Consultant Paediatricians H02AB06 Prednisolone Tablets 1mg Medical Practitioners B H02AB06 Prednisolone Tablets 5mg Medical Practitioners, GU Clinic Consultant B H02AB06 Prednisolone Tablets entericcoated Medical Practitioners B 5mg H02AB06 Prednisone Acetate Suppositories 30mg Consultant Paediatricians MP Adrenoceptor agonists Selective beta2 agonists R03AC12 Salmeterol Inhaler Consultant Respiratory Physicians, Consultant Paediatricians MP 270 R03AC12/ Long Acting Beta 2 -Agonist for Inhaler Consultant Respiratory Physicians, Consultant Paediatricians MP 271 R03AC13 patients over 12 years inhaler R03AC02 Salbutamol Inhaler 100mcg/puff Medical Practitioners B R03AC02 Salbutamol Respiratory Solution Medical Practitioners C 5mg/mL R03AC02 Salbutamol Syrup 2mg/5mL Medical Practitioners B R03AC02 Salbutamol Tablets 4mg Medical Practitioners B R03AC03 Terbutaline Dry Powder Inhaler 500mcg Consultant Respiratory Physicians, Consultant Paediatricians MP Antimuscarinic bronchodilators R03BB01 Ipratropium Inhaler 20mcg/dose Consultants R03BB01 Ipratropium Nebuliser Solution Consultants 250mcg/mL Theophylline R03DA04 Theophylline Tablets 250mg Hospital Doctors 3.2 Corticosteroids R03BA01 Beclometasone Dipropionate Inhaler 50mcg Medical Practitioners B R03BA01 Beclometasone Dipropionate Inhaler 250mcg Consultants 3. Respiratory System 11

20 R03BA02 Budesonide Breath-Actuated Consultant Respiratory Physicians, Consultant Paediatricians MP 27 Metered Dose Powder Inhaler 100mcg/Dose R03BA02 Budesonide Inhaler 50mcg/Dose Consultants MP 25 R03BA02 Budesonide Inhaler Consultants MP mcg/Dose R03BA02 Budesonide Nebuliser Solution Ampoules 0.25mg/mL R03BA02 Budesonide Nebuliser Solution Ampoules 0.5mg/mL Consultant Respiratory Physicians, Consultant Paediatricians, Consultant Oncologists Consultant Respiratory Physicians, Consultant Paediatricians, Consultant Oncologists R03BA05 Fluticasone Inhaler 50mcg Consultant Respiratory Physicians, Consultant Paediatricians MP 77 R03BA05 Fluticasone Inhaler 250mcg Consultant Respiratory Physicians, Consultant Paediatricians MP Cromoglicate and related therapy, leukotriene receptor antagonists, and phosphodiesterase type-4 inhibitors Leukotriene Receptor Antagonists R03DC03 Montelukast Chewable Tablets Consultant Respiratory Physicians, Consultant Paediatricians MP 295 5mg R03DC03 Montelukast Tablets 10mg Consultant Respiratory Physicians, Consultant Paediatricians MP 295 R06AD01 Alimemazine (Trimeprazine Tartrate) 3.4 Antihistamines, hyposensitisation, and allergic emergencies Antihistamines Syrup 30mg/5mL Hospital Doctors R06AX02 Cyproheptadine Hydrochloride Tablets 4mg Consultants A N05BB01 Hydroxyzine Hydrochloride Tablets 25mg Medical Practitioners B N06AD02 Promethazine Hydrochloride Syrup 5mg/5mL Medical Practitioners A N06AD02 Promethazine Hydrochloride Tablets 10mg Medical Practitioners B N06AD02 Promethazine Hydrochloride Tablets 25mg Medical Practitioners B Allergen Immunotherapy R03DX05 Omalizumab Injections 150mg Consultant Respiratory Physicians, Consultant Paediatricians MP Oxygen V03AN01 Medical Oxygen 1.5m³ Gas Medical Practitioners MP 28 MP Respiratory System 12

21 3.6 Mucolytics R05CB02 Bromhexine Syrup 8mg/10mL Medical Practitioners A R05CB02 Bromhexine Tablets 8mg Medical Practitioners A 3.7 Aromatic inhalations R01AX10 Benzoin Tincture Tincture 50mL Medical Practitioners A 3.8 Cough preparations R05DA04 Codeine Phosphate Suspension 15mg/5mL R06AA52 Diphenhydramine Citrate + Menthol Cough suppressants Medical Practitioners B Expectorant and demulcent cough preparations Syrup 125mL Medical Practitioners A 3. Respiratory System 13

22 ATC Code Active Ingredient Dosage Form and Strength Prescriber Criteria Protocol Pink Card 4. Central nervous system 4.1 Hypnotics and anxiolytics Hypnotics N05BA01 Diazepam Syrup 2mg/5mL Medical Practitioners B N05BA01 Diazepam Tablets 2mg Medical Practitioners B N05BA01 Diazepam Tablets 5mg Medical Practitioners B N05CD02 Nitrazepam Tablets 5mg Medical Practitioners B N06AD02 Promethazine Hydrochloride Syrup 5mg/5mL Medical Practitioners A N06AD02 Promethazine Hydrochloride Tablets 10mg Medical Practitioners B N06AD02 Promethazine Hydrochloride Tablets 25mg Medical Practitioners B N05CD07 Temazepam Tablets 10mg Consultants B Anxiolytics N05BA08 Bromazepam Tablets 1.5mg Medical Practitioners B N05BA08 Bromazepam Tablets 3mg Medical Practitioners B N05BA08 Bromazepam Tablets 6mg Medical Practitioners B N05BE01 Buspirone Hydrochloride Tablets 10mg Consultants N05BA01 Diazepam Rectal Tubes Medical Practitioners B 5mg/2.5mL N05BA01 Diazepam Rectal Tubes 10mg/2.5mL Medical Practitioners B N05BA01 Diazepam Syrup 2mg/5mL Medical Practitioners B N05BA01 Diazepam Tablets 2mg Medical Practitioners B N05BA01 Diazepam Tablets 5mg Medical Practitioners B N05BA06 Lorazepam Tablets 1mg Medical Practitioners B N05BA06 Lorazepam Tablets 2mg Medical Practitioners B 4.2 Drugs used in psychoses and related disorders Antipsychotic drugs N05AA01 Chlorpromazine Hydrochloride Tablets 25mg Medical Practitioners C N05AA01 Chlorpromazine Hydrochloride Tablets 100mg Medical Practitioners C 4. Central Nervous System 14

23 N05AH02 Clozapine Tablets 25mg Consultant Psychiatrists MP 42 N05AH02 Clozapine Tablets 100mg Consultant Psychiatrists MP 42 N05AF01 Flupentixol Dihydrochloride Tablets 0.5mg Consultant Psychiatrists N05AD01 Haloperidol Capsules 0.5mg Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists, Consultant Geriatricians N05AD01 Haloperidol Injections 5mg Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists N05AD01 Haloperidol Oral Solution 2mg/mL Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists, Consultant Geriatricians N05AD01 Haloperidol Tablets 1.5mg Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists, Consultant Geriatricians N05AD01 Haloperidol Tablets 5mg Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists, Consultant Geriatricians N05AA02 Levomepromazine Tablets 25mg Consultant Paediatricians, Consultant Oncologists, Consultant Palliative Care N05AH03 Olanzapine Coated Tablets Consultant Psychiatrists 10mg N05AH03 Olanzapine Coated Tablets 5mg Consultant Psychiatrists N05AG02 Pimozide Tablets 4mg Consultant Psychiatrists N05AB04 Prochlorperazine Tablets 5mg Medical Practitioners A N05AH04 Quetiapine Tablets 25mg Consultant Psychiatrists N05AH04 Quetiapine Tablets 100mg Consultant Psychiatrists N05AH04 Quetiapine Tablets 200mg Consultant Psychiatrists N05AX08 Risperidone Syrup 1mg/mL Consultant Psychiatrists MP 175 N05AX08 Risperidone Tablets 1mg Consultant Psychiatrists C N05AX08 Risperidone Tablets 2mg Consultant Psychiatrists C N05AL01 Sulpiride Capsules 50mg Consultant Psychiatrists N05AL01 Sulpiride Suspension Consultant Psychiatrists 5mg/5mL N05AL01 Sulpiride Tablets 200mg Consultant Psychiatrists N05AB06 Trifluoperazine Syrup 1mg/5mL Hospital Doctors N05AB06 Trifluoperazine Tablets 1mg Medical Practitioners C N05AB06 Trifluoperazine Tablets 5mg Medical Practitioners C N05AF05 Zuclopenthixol Acetate Oily injection 50mg Consultant Psychiatrists N05AF05 Zuclopenthixol Acetate Oily injection 100mg Consultant Psychiatrists N05AF05 Zuclopenthixol Dihydrochloride Tablets 2mg Consultant Psychiatrists N05AF05 Zuclopenthixol Dihydrochloride Tablets 10mg Consultant Psychiatrists 4. Central Nervous System 15 MP 287 C C C C

24 N05AF05 Zuclopenthixol Dihydrochloride Tablets 25mg Consultant Psychiatrists Antipsychotic depo injections N05AF01 Flupentixol Decanoate Injection 20mg/mL Consultant Psychiatrists N05AF01 Flupentixol Decanoate Injection 100mg/mL Consultant Psychiatrists N05AB02 Fluphenazine Decanoate Injection 25mg Consultant Psychiatrists N05AB02 Fluphenazine Decanoate Injection 100mg Consultant Psychiatrists N05AD01 Haloperidol Decanoate Injection 50mg Consultant Psychiatrists N05AD01 Haloperidol Decanoate Injection 100mg Consultant Psychiatrists N05AX08 Risperidone Depot Injection Consultant Psychiatrists MP mg N05AX08 Risperidone Depot Injection Consultant Psychiatrists MP mg N05AX08 Risperidone Depot Injection 50mg Consultant Psychiatrists MP 291 N05AF05 Zuclopenthixol Decanoate Injection 200mg Consultant Psychiatrists Antimanic drugs N05AN01 Lithium Carbonate Tablets 400mg Medical Practitioners C N05AN01 Lithium Citrate Syrup 520mg/5mL Consultant Psychiatrists MP Antidepressant drugs Tricyclic and related antidepressant drugs N06AA09 Amitriptyline (U/L) Syrup 10mg/5mL Consultant Psychiatrists, Consultant Paediatricians, Consultant Oncologists, Consultant Palliative Care N06AA09 Amitriptyline Tablets 10mg Medical Practitioners B N06AA09 Amitriptyline Tablets 25mg Medical Practitioners B N06AA04 Clomipramine Hydrochloride Tablets 10mg Medical Practitioners C N06AA05 Clomipramine Hydrochloride Tablets 25mg Medical Practitioners C N06AA02 Imipramine Hydrochloride Tablets 10mg Medical Practitioners C N06AA02 Imipramine Hydrochloride Tablets 25mg Medical Practitioners C N06AA21 Maprotiline Hydrochloride Tablets 25mg Hospital Doctors N06AX03 Mianserin Hydrochloride Tablets 10mg Medical Practitioners C N06AX03 Mianserin Hydrochloride Tablets 30mg Medical Practitioners C N06AA09 Nortriptyline Tablets 10mg Medical Practitioners C N06AA09 Nortriptyline Tablets 25mg Medical Practitioners C N06AA06 Trimipramine Tablets 10mg Medical Practitioners C N06AA06 Trimipramine Tablets 25mg Medical Practitioners C N06AA06 Trimipramine Tablets 50mg Medical Practitioners C 4. Central Nervous System 16

25 4.3.2 Monoamine-oxidase inhibitors N06AG02 Moclobemide Tablets 150mg Consultant Psychiatrists MP Selective serotonin re-uptake inhibitors N06AB03 Fluoxetine Tablets 20mg Consultant Psychiatrists C N06AB08 Fluvoxamine Maleate Tablets 100mg Consultant Psychiatrists N06AB05 Paroxetine Tablets 20mg Consultant Psychiatrists, Consultant Palliative Care C Other antidepressant drugs N05AF01 Flupentixol Dihydrochloride Tablets 0.5mg Consultant Psychiatrists N06AX16 Venlafaxine Modified Release Consultant Psychiatrists Capsules 75mg N06AX16 Venlafaxine Modified Release Capsules 150mg Consultant Psychiatrists 4.4 CNS stimulants and drugs used in attention deficit hyperactivity disorder N06BA02 Dexamphetamine Sulphate Tablets 5mg Consultants N06BA04 Methylphenidate Hydrochloride Tablets 10mg Consultant Psychiatrists C 4.5 Drugs used in nausea and vertigo A04AD12 Aprepitant Capsules 80mg Consultant Oncologists, Consultant Palliative Care MP 269 A04AD12 Aprepitant Capsules 125mg Consultant Oncologists, Consultant Palliative Care MP 269 R06AE03 Cyclizine Ampoules 50mg/mL Consultant Anaesthetists, Consultant Obstetricians and MP 267 Gynaecologists, Consultant Oncologists, Consultant Palliative Care R06AE03 Cyclizine Tablets 50mg Hospital Doctors A R06AA02 Dimenhydrinate Tablets 50mg Medical Practitioners A A03FA03 Domperidone Suppositories 30mg Consultants A A03FA03 Domperidone Suspension 1mg/mL Consultants MP 57 C A03FA03 Domperidone Tablets 10mg Consultants MP 56 C A03FA01 Metoclopramide Ampoules 10mg/mL Hospital Doctors, Consultant Oncologists and Consultant Palliative HU/HDO Care for outpatients use A03FA01 Metoclopramide Tablets 10mg Medical Practitioners A A04AA01 Ondansetron Syrup 4mg/5mL Consultant Paediatricians, Paediatric Surgeons, Consultant MP 153 Palliative Care, Consultant Oncologists A04AA01 Ondansetron Tablets 4mg Consultants MP 154 A04AA01 Ondansetron Tablets 8mg Consultants MP 154 N05AB04 Prochlorperazine Tablets 5mg Medical Practitioners A 4. Central Nervous System 17

26 4.6 Analgesics Non-opioid analgesics N02BA01 Aspirin Effervescent Tablets Medical Practitioners B 300mg N02BA01 Aspirin Tablets 300mg Medical Practitioners B N02BE01 Paracetamol Suppositories 100mg or 125mg Medical Practitioners A N02BE01 Paracetamol Suppositories 250mg N02BE01 Paracetamol Suppositories 500mg Medical Practitioners A Medical Practitioners A N02BE01 Paracetamol Syrup 120mg/5mL Medical Practitioners A N02BE01 Paracetamol Tablets 500mg Medical Practitioners B Opioid analgesics N02AA Codeine Phosphate Tablets 30mg Hospital Doctors N02AA08 Dihydrocodeine Tartrate Tablets 30mg Hospital Doctors N07AC52 Methadone HCl Tablets 5mg Designated Consultant as appointed by DGPHR MP 266 N02AA01 Morphine Sulphate Injection 10mg/mL Hospital Doctors N02AA01 Morphine Sulphate Injection 15mg/mL Hospital Doctors N02AA01 Morphine Sulphate Injection 20mg/mL Hospital Doctors N02AA01 Morphine Sulphate Injection 30mg/mL Hospital Doctors N02AA01 Morphine Sulphate Solution 10mg/5mL Hospital Doctors N02AA01 Morphine Sulphate/Hydrochloride Slow-Release Hospital Doctors Tablets 10mg N02AA01 Morphine Sulphate/Hydrochloride Slow-Release Tablets 30mg N02AA01 Morphine Sulphate/Hydrochloride Slow-Release Tablets 60mg Hospital Doctors Hospital Doctors N02AD01 Pentazocine Tablets 25mg Consultants N02AA01 Pethidine Hydrochloride Tablets 50mg Hospital Doctors N02AX02 Tramadol Capsules 50mg Consultant Physicians, Consultant Surgeons, Consultant Anaesthetists, Consultant Palliative Care, Consultants Oncologists, Pain Clinic Specialists Neuropathic pain N02AA09 Amitriptyline (U/L) Syrup 10mg/5mL Consultant Psychiatrists, Consultant Paediatricians, Consultant Oncologists, Consultant Palliative Care MP Central Nervous System 18

27 N02AA09 Amitriptyline (U/L) Tablets 10mg Medical Practitioners B N02AA09 Amitriptyline (U/L) Tablets 25mg Medical Practitioners B N06AA10 Nortriptyline (U/L) Tablets 10mg Medical Practitioners C N06AA10 Nortriptyline (U/L) Tablets 25mg Medical Practitioners C N03AX16 Pregabalin Capsules 75mg Consultant Geriatricians, Consultant Neurologists, Consultant MP 160 Psychiatrists N03AX16 Pregabalin Capsules 150mg Consultant Geriatricians, Consultant Neurologists, Consultant MP 160 Psychiatrists N03AX16 Pregabalin Capsules 300mg Consultant Geriatricians, Consultant Neurologists, Consultant Psychiatrists MP 160 N02CA52 Ergotamine Compound Tablets ergotamine 2mg + Cyclizine 50mg + Caffeine 100mg Antimigraine drugs Treatment of acute migraine Hospital Doctors Prophylaxis Treatment of acute migraine C02AC01 Clonidine Hydrochloride Tablets 100mcg Consultants C 4.7 Antiepileptic drugs Control of epilepsy S01EC01 Acetazolamide Tablets 250mg Consultants N03AF01 Carbamazepine Controlled Release Consultant Paediatricians, Consultant Neurologists, Consultant Tablets 200mg Psychiatrists, Consultant Geriatricians N03AF01 Carbamazepine Controlled Release Tablets 400mg Consultant Paediatricians, Consultant Neurologists, Consultant Psychiatrists, Consultant Geriatricians N03AF01 Carbamazepine Syrup 100mg/5mL Medical Practitioners C N03AF01 Carbamazepine Tablets 200mg Medical Practitioners C N05BA09 Clobazam Tablets 10mg Consultant Paediatricians N03AE01 Clonazepam Tablets 0.5mg Medical Practitioners B N03AE01 Clonazepam Tablets 2mg Medical Practitioners B N03AD01 Ethosuximide Syrup 250mg/5mL Consultants N03AD01 Ethosuximide Tablets 250mg Consultants N03AX12 Gabapentin Tablets 100mg Consultant Neurologists, Consultant Paediatricians MP 83 N03AX12 Gabapentin Tablets 300mg Consultant Neurologists, Consultant Paediatricians MP 83 N03AX09 Lamotrigine Dispersible Tablets 5mg Consultant Paediatricians, Consultant Neurologists, Consultant Psychiatrists 4. Central Nervous System 19

28 N03AX09 Lamotrigine Dispersible Tablets 25mg Consultant Paediatricians, Consultant Neurologists, Consultant Psychiatrists N03AX09 Lamotrigine Tablets 25mg Consultant Paediatricians, Consultant Neurologists, Consultant Psychiatrists N03AX09 Lamotrigine Tablets 50mg Consultant Paediatricians, Consultant Neurologists, Consultant Psychiatrists N03AX09 Lamotrigine Tablets 100mg Consultant Paediatricians, Consultant Neurologists, Consultant Psychiatrists N03AX14 Levetiracetam Syrup 100mg/mL Consultant Paediatricians, Consultant Neurologists MP 116 N03AX14 Levetiracetam Tablets 500mg Consultant Paediatricians, Consultant Neurologists MP 115 N03AX14 Levetiracetam Tablets 1000mg Consultant Paediatricians, Consultant Neurologists MP 115 N03AA02 Phenobarbital (Phenobarbitone) Mixture Hospital Doctors N03AA02 Phenobarbital (Phenobarbitone) Tablets 30mg Medical Practitioners B N03AB02 Phenytoin Sodium Capsules 25mg Consultants N03AB02 Phenytoin Sodium Capsules 50mg Consultants N03AB02 Phenytoin Sodium Capsules 100mg Consultants N03AB02 Phenytoin Sodium Capsules 300mg Consultants N03AB02 Phenytoin Sodium Syrup 30mg/5mL Consultants N03AX16 Pregabalin Capsules 75mg Consultant Neurologists, Consultant Psychiatrists, Consultant MP 160 Geriatricians N03AX16 Pregabalin Capsules 150mg Consultant Neurologists, Consultant Psychiatrists, Consultant MP 160 Geriatricians N03AX16 Pregabalin Capsules 300mg Consultant Neurologists, Consultant Psychiatrists, Consultant MP 160 Geriatricians N03AA03 Primidone Tablets 250mg Medical Practitioners C N03AF03 Rufinamide Tablets 200mg Consultant Neurologist, Consultant Paediatrician MP 293 N03AG01 Sodium Valproate Controlled Release Tablets 200mg Consultants N03AG01 Sodium Valproate Controlled Release Consultants Tablets 500mg N03AG01 Sodium Valproate Syrup 200mg/5mL Consultant Paediatricians, Consultant Neurologists, Consultant Geriatricians N03AX11 Topiramate Tablets 25mg Consultant Neurologists MP 191 N03AX11 Topiramate Tablets 50mg Consultant Neurologists MP 191 N03AX11 Topiramate Tablets 100mg Consultant Neurologists MP 191 N03AX11 Topiramate Tablets 200mg Consultant Neurologists MP 191 N03AG04 Vigabatrin Sachets 500mg Consultant Paediatricians, Consultant Neurologists MP 198 N03AG04 Vigabatrin Tablets 500mg Consultant Paediatricians, Consultant Neurologists MP Central Nervous System 20

29 N05BA01 Diazepam Rectal Tubes 5mg/2.5mL N05BA01 Diazepam Rectal Tubes 10mg/2.5mL Drugs used in status epilepticus Medical Practitioners B Medical Practitioners B 4.8 Drugs used in parkinsonism and related disorders Dopaminergic drugs used in parkinsonism N04BB01 Amantadine Tablets 100mg Consultants N04BC01 Bromocriptine Mesylate Tablets 2.5mg Consultants N04BA01 Levodopa Tablets 500mg Hospital Doctors N04BA02 Levodopa + Benserazide Dispersible Tablets Consultant Geriatricians, Consultant Neurologists MP 118 Hydrochloride 100mg + 25mg N04BA02 N04BA02 N04BA02 Levodopa + Benserazide Hydrochloride Levodopa + Benserazide Hydrochloride Levodopa + Benserazide Hydrochloride Tablets 50mg mg Tablets 100mg + 25mg Tablets 200mg + 50mg N04BA02 Levodopa + Carbidopa Tablets 100mg + 10mg N04BA02 Levodopa + Carbidopa Tablets 250mg + 25mg N04BA03 Levodopa + Carbidopa + Tablets 100mg + Entacapone 25mg + 200mg N04BC04 N04BC04 N04BC04 Non-Ergot Dopamine Receptor Agonists (Ropinirole) Non-Ergot Dopamine Receptor Agonists (Ropinirole) Non-Ergot Dopamine Receptor Agonists (Ropinirole) Medical Practitioners C Medical Practitioners C Medical Practitioners C Medical Practitioners C Medical Practitioners C Consultant Geriatricians, Consultant Neurologists MP 216 Tablets 250mcg Consultant Geriatricians, Consultant Neurologists MP 215 Tablets 1mg Consultant Geriatricians, Consultant Neurologists MP 215 Tablets 5mg Consultant Geriatricians, Consultant Neurologists MP 215 N04BD02 Rasagiline Tablets 1mg Consultant Neurologists, Consultant Geriatricians MP 268 N04BD01 Selegiline Tablets 5mg Medical Practitioners C Antimuscarinic drugs used in parkinsonism N04AC01 Benzatropine Mesylate Tablets 2mg Medical Practitioners C N04AB02 Orphenadrine Hydrochloride Tablets 50mg Hospital Doctors N04AA04 Procyclidine Injection IM/IV Consultant Geriatricians, Consultant Neurologists, Consultant 10mg/2mL Psychiatrists 4. Central Nervous System 21

30 N04AA04 Procyclidine Syrup 5mg/5mL Consultant Geriatricians, Consultant Neurologists, Consultant Psychiatrists N04AA04 Procyclidine Tablets 5mg Consultant Geriatricians, Consultant Neurologists, Consultant Psychiatrists N04AA01 Trihexyphenidyl Hydrochloride (Benzhexol Hydrochloride) MP 168 Tablets 2mg Medical Practitioners C Drugs used in tremor, chorea, tics and related disorders N05AD01 Haloperidol Capsules 0.5mg Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists, Consultant Geriatricians N05AD01 Haloperidol Injections 5mg Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists N05AD01 Haloperidol Oral Solution 2mg/mL Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists, Consultant Geriatricians N05AD01 Haloperidol Tablets 1.5mg Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists, Consultant Geriatricians N05AD01 Haloperidol Tablets 5mg Consultant Psychiatrists, Consultant Palliative Care, Consultant Oncologists, Consultant Geriatricians N07XX06 Tetrabenazine Tablets 25mg Consultants C 4.9 Drugs used in substance dependence N07BB01 Disulfiram Tablets 200mg Hospital Doctors C N07BB04 Naltrexone Hydrochloride Tablets 50mg Consultant Psychiatrists MP 142 C C C C 4. Central Nervous System 22

31 ATC Code Active Ingredient Dosage Form and Strength Prescriber Criteria Protocol Pink Card 5. Infections 5.1 Antibacterial drugs Penicillins J01CA04 Amoxicillin Capsules 250mg Medical Practitioners, GU Clinic Consultants A J01CA04 Amoxicillin Injection 250mg Medical Practitioners A J01CA04 Amoxicillin Injection 500mg Medical Practitioners A J01CA04 Amoxicillin Syrup 125mg/mL Medical Practitioners A J01CR02 Amoxicillin + Clavulanic Acid Syrup 156mg/5mg Medical Practitioners A J01CR02 Amoxicillin + Clavulanic Acid Tablets 250mg + Medical Practitioners A 125mg J01CE01 Benzylpenicillin Injection 600mg Medical Practitioners A J01CF05 Flucloxacillin Capsules 250mg Medical Practitioners A J01CF05 Flucloxacillin Injection 250mg Medical Practitioners A J01CF05 Flucloxacillin Syrup 125mg/5mL Medical Practitioners A J01CE01 Phenoxymethylpenicillin Solution Medical Practitioners C (penicillin V) 125mg/5mL J01CE02 Phenoxymethylpenicillin (penicillin V) Tablets 250mg Medical Practitioners C Cephalosporins J01DB01 Cefalexin Capsules 250mg Medical Practitioners A J01DB01 Cefalexin Syrup 125mg/5mL Medical Practitioners A J01DC02 Cefuroxime Axetil Suspension Medical Practitioners A 125mg/5mL J01DC02 Cefuroxime Axetil Tablets 250mg Medical Practitioners A Tetracyclines J01AA02 Doxycycline Capsules 100mg Consultants, GU Clinic Consultants J01AA07 Tetracycline Capsules 250mg Medical Practitioners A 5. Infections 23

32 J01GB03 Gentamicin Injection 80mg (to be inhaled in cystic fibrosis) Aminoglycosides Hospital Doctors TBDF MDHP only Macrolides J01FA09 Clarithromycin Syrup 125mg/5mL Consultant Paediatricians J01FA09 Clarithromycin Tablets 250mg Consultants A J01FA01 Erythromycin Syrup 125mg/5mL Medical Practitioners B J01FA01 Erythromycin Tablets 250mg Medical Practitioners, GU Clinic Consultants B Clindamycin J01FF01 Clindamycin Capsules 150mg Consultants A Some other antibacterials J01BA02 Chloramphenicol Capsules 250mg Consultants A J01XB01 Colistimethate Sodium (Colistin Consultant Paediatricians, Consultant Infectious Diseases Sulphomethate Sodium) Physicians, Consultant Respiratory Physicians Injection 1 MU (for inhalation in cystic fibrosis) MP 44 TBDF MDHP only J01XC01 Fusidate Sodium Tablets 250mg Consultants A J01XC01 Fusidic Acid Oral Suspension Consultants A 250mg/5mL A07AA09 Vancomycin Capsules 125mg Consultants MP 281 Initiation in Hospital J01EE01 Co-Trimoxazole Syrup Adult 480mg/5mL J01EE01 Co-Trimoxazole Syrup Paediatric 240mg/5mL J01EE01 Co-Trimoxazole Tablets 400mg + 80mg Sulphonamides and trimethoprim Medical Practitioners B Medical Practitioners B Medical Practitioners B J01EC02 Sulfadiazine Tablets 500mg Hospital Doctors J01EA01 Trimethoprim Tablets 100mg Medical Practitioners A Antituberculosis drugs J04AB01 Cycloserine Tablets 250mg Consultant Infectious Diseases Physicians, Paediatric Infectious Diseases Clinic Physicians, Consultant Respiratory Physicians, Chest Clinic Physicians 5. Infections 24

33 J04AK02 Ethambutol Tablets 100mg Consultant Infectious Diseases Physicians, Paediatric Infectious Diseases Clinic Physicians, Consultant Respiratory Physicians, Chest Clinic Physicians J04AK02 Ethambutol Tablets 400mg Consultant Infectious Diseases Physicians, Paediatric Infectious Diseases Clinic Physicians, Consultant Respiratory Physicians, Chest Clinic Physicians As per AG J04AD03 Ethionamide Tablets 250mg Consultant Infectious Diseases Physicians, Chest Clinic Physicians MP 255 J04AC01 Isoniazid Tablets 100mg Consultant Infectious Diseases Physicians, Paediatric Infectious Diseases Clinic Physicians, Consultant Respiratory Physicians, Chest Clinic Physicians J04AM02 Isoniazid + Rifampicin Tablets 100mg + 150mg J04AM02 Isoniazid + Rifampicin Tablets 150mg + 300mg Consultant Infectious Diseases Physicians, Paediatric Infectious Diseases Clinic Physicians, Consultant Respiratory Physicians, Chest Clinic Physicians Consultant Infectious Diseases Physicians, Paediatric Infectious Diseases Clinic Physicians, Consultant Respiratory Physicians, Chest Clinic Physicians J04AD01 Protionamide Tablets 250mg Consultant Infectious Diseases Physicians, Paediatric Infectious Diseases Clinic Physicians, Consultant Respiratory Physicians, Chest Clinic Physicians J04AK01 Pyrazinamide Tablets 500mg Consultant Infectious Diseases Physicians, Paediatric Infectious Diseases Clinic Physicians, Consultant Respiratory Physicians, Chest Clinic Physicians J04AB04 Rifabutin Capsules 150mg Consultant Infectious Diseases Physicians, Chest Clinic Physicians MP 259 J04AB02 Rifampicin Capsules 300mg Consultants MP 174 J04AB02 Rifampicin Syrup 100mg/5mL Consultants MP Antileprotic drugs J01BA01 Clofazimine Tablets 100mg Consultants J04BA02 Dapsone Tablets 50mg Consultants J04BA02 Dapsone Tablets 100mg Consultants L04AX02 Thalidomide (U/L) Tablets 100mg Consultant Rheumatologists, Consultant Dermatologists, Consultant Haematologists, Consultant Oncologists MP Infections 25