GINETTE TABS ORATANE 10MG MEDITRIM 480MG AUSTELL CETIRIZINE 10MG

Transcription

1 SCRIPTPHARM RISK MANAGEMENT CHRONIC MEDICINE FORMULARY NEDGROUP SAVINGS PLAN CHRONIC CONDITIONS ACNE (Cystic Nodular ONLY) Acne L70.1 Acne 21 beige tabs: Cyproterone acetate 2mg; ethinylestradiol 0.035mg 7 placebo tabs 21 beige tabs: Cyproterone acetate 2mg; ethinylestradiol 0.035mg 7 placebo tabs GINETTE TABS ORATANE 10MG Acne Isotretinoin 20mg ORATANE 20MG Sulphonamides and combinations Trimethoprim 80mg; sulphamethoxazole 400mg MEDITRIM 480MG Tetracyclines Doxycycline HCl 100mg CYCLIDOX 100MG Tetracyclines Minocycline 100mg CYCLIMYCIN 100MG Tetracyclines Minocycline 50mg CYCLIMYCIN 50MG Tetracyclines Oxytetracycline HCl 250mg OXY 250MG ALLERGIC RHINITIS (With Asthma / <12 years old) Anti-Histamines Cetirizine dihydrochloride 10mg tab AUSTELL CETIRIZINE 10MG

2 J30 Anti-Histamines Cetirizine 1mg/ml syrup CETIRIZINE-HEXAL 1MG/1ML Anti-Histamines Loratadine 10mg tab SIMAYLA LORATADINE 10MG Anti-Histamines Loratadine 5mg/5ml LORAHIST SYRUP Glucocorticosteroids Beclomethasone dipropionate 50ug Aqueous CLENIL AQUEOUS NASAL SPRAY Glucocorticosteroids Fluticasone 50mcg FLONASE ALZHEIMER'S DISEASE Alzheimer's disease Donepezil HCl 10mg ARIKNOW 10MG DONECEPT 10MG G30 Alzheimer's disease Donepezil HCl 5mg ARIKNOW 5MG DONECEPT 5MG Alzheimer's disease Galantamine 8mg REMINYL CR 8MG Alzheimer's disease Galantamine 16mg REMINYL CR 16MG Alzheimer's disease Galantamine 24mg REMINYL CR 24MG Alzheimer's disease Rivastigamine 1.5mg EXELON 1.5 MG CAPS Alzheimer's disease Rivastigamine 3.0mg EXELON 3.0 MG CAPS

3 Alzheimer's disease Rivastigamine 4.5mg EXELON 4.5 MG CAPS Alzheimer's disease Rivastigamine 6.0mg EXELON 6.0 MG CAPS ANXIETY Others Buspirone HCl 10mg PASRIN 10MG TAB F41 SSRI Fluoxetine 20mg DEPROZAN 20MG SSRI Citalopram 20mg ARROW CITALOPRAM TALOMIL 20MG SSRI Paroxetine 20mg SERRAPRESS 20MG XET 20MG Beta-blockers Propranolol 40mg INDOBLOK 40MG TAB ATTENTION DEFICIT DISORDER (ADHD) Others Methylphenidate HCl 10mg RITALIN 10MG TABS METHYLPHENIDATE Only for patients under HCL- DOUGLAS 18 years of age F90 Others Methylphenidate HCl 20mg RITALIN LA 20MG CAPS Others Methylphenidate HCl 18mg CONCERTA 18MG Others Methylphenidate HCl 27mg CONCERTA 27MG

4 Others Methylphenidate HCl 36mg CONCERTA 36MG Others Methylphenidate HCl 54mg CONCERTA 54MG DEPRESSION, MAJOR F33 Mono-Amine Oxidase Mono-Amine Oxidase Selective serotonin reuptake Selective serotonin reuptake Selective serotonin reuptake Selective serotonin reuptake Selective serotonin reuptake Selective serotonin reuptake Selective serotonin reuptake Serotonin and Noradrenaline re-uptake Serotonin and Noradrenaline re-uptake Serotonin and Noradrenaline re-uptake Moclobemide 150mg Moclobemide 300mg Citalopram hydrobromide 20mg CLORIX 150MG TAB CLORIX 300MG TAB ARROW CITALOPRAM TALOMIL 20MG Fluoxetine HCI 20mg cap DEPROZAN 20MG ZYDUS-FLUOXETINE 20MG Paroxetine 20mg SERRAPRESS 20MG XET 20MG Escitalopram 10mg ZITOLEX 10MG ACCORD ESCITALOPRAM 10MG Escitalopram 20mg ZITOLEX 20MG ACCORD ESCITALOPRAM 20MG Sertraline 50mg DYNA-SERTRALINE 50MG SERDEP 50MG TAB Sertraline 100mg DYNA-SERTRALINE 100MG SERDEP100MG TAB Venlafaxine HCL 37.5mg Venlafaxine HCL 37.5mg ODIVEN 37.5MG TABS VENLOR XR 37.5MG Venlafaxine HCL 75mg VENLOR XR 75MG VENLAFAXINE UNICORN XR 75mg

5 Serotonin and Noradrenaline re-uptake Venlafaxine HCL 150mg VENLOR XR 150MG VENLAFAXINE UNICORN XR 150mg Tricyclics Amitriptyline HCI 25mg TREPILINE 25MG TAB Tricyclics Clomipramine HCI 10mg EQUINORM 10MG Tricyclics Clomipramine HCI 25mg CLOMIDEP 25MG Tricyclics Dothiepin HCI 25mg THADEN 25MG CAPS Tricyclics Dothiepin HCI 75mg THADEN 75MG CAPS Tricyclics Imipramine HCI 10mg ETHIPRAMINE 10MG TAB Tricyclics Imipramine HCI 25mg ETHIPRAMINE 25MG TAB Anti-epileptics Lamotrigine 25mg DYNA-LAMOTRIGINE 25MG Anti-epileptics Lamotrigine 50mg DYNA-LAMOTRIGINE 50MG LAMIDUS 50MG Anti-epileptics Lamotrigine 100mg DYNA-LAMOTRIGINE 100MG LAMIDUS 100MG Anti-epileptics Lamotrigine 200mg DYNA-LAMOTRIGINE 200MG LAMIDUS 200MG Other Mirtazapine 15mg MIRADEP 15MG MYLAN-MIRTAZAPINE 15MG Other Mirtazapine 30mg MIRADEP 30MG MYLAN-MIRTAZAPINE 30MG Anti-psychotics Risperidone 1mg RISNIA 1MG ZOXADON 1MG Anti-psychotics Risperidone 2mg RISNIA 2MG ZOXADON 2MG Other Agomelatine 25mg VALDOXANE 25MG TAB ECZEMA Emoliients and Lotion Aqueous Cream 400g EPI-MAX JUNIOR L20.9 Emoliients and Lotion Aqueous Cream 500g Epizone A L30.9 Emoliients and Lotion Emulsifying ointment 500g UNG EMULSIFICANS

6 Emoliients and Lotion Emulsifying ointment 500g EPIZONE E Cortico-steroids Hydrocortisone 25g DILUCORT CREAM DILUCORT OINTMENT Cortico-steroids Hydrocortisone 1g/100g MYLOCORT 1GM/100GM CREAM MYLOCORT 1GM/100GM OINT Cortico-steroids Betamethasone 1mg/g TOPIVATE 1MG/GM CREAM BETNOVATE 1MG/GM OINTMENT LENOVATE 0.1% Cortico-steroids Betamethasone 0.1% LENOVATE 0.1% OINT CREAM Cortico-steroids Methylprednisolone 1mg/g ADVANTAN CREAM ADVANTAN OINTMENT Cortico-steroids Methylprednisolone 1mg/g ADVANTAN FATTY OINT Anti-Histamines Chlorpheniramine 2mg/5ml SYR ALLERGEX 2MG/5ML SYR Anti-Histamines Chlorpheniramine 4mg ALLERGEX 4mg tablet ALLERHIST 4MG CAP Anti-Histamines Chlorpheniramine 4mg RHINETON 4MG TABS Fungicide Selenium 25mg/ml SELSUN SHAMPOO 2.5% Topical Cortico-steroids Fluocinolone 0.25mg/g SYNALAR GEL 0.25MG/G Cortico-steroids Betamethason 1mg/g BETNOVATE SCALP GASTRO- Histamine-2 receptor OESOPHAGEAL REFLUX antagonists DISEASE Histamine-2 receptor K21 antagonists Histamine-2 receptor antagonists Histamine-2 receptor antagonists Cimetidine 200mg Cimetidine 400mg Ranitidine HCI 150mg Ranitidine HCI 300mg CIMLOK 200MG CIMLOK 400MG AUSTAC 150MG AUSTAC 300MG Proton pump Lansoprazole 15mg LANCAP 15MG Proton pump Lansoprazole 30mg LANCAP 30MG

7 Proton pump Omeprazole 20mg NOZER 20MG Proton pump Omeprazole 10mg OMEZ 10MG Proton pump Pantoprazole 20mg PANTOCID 20MG Proton pump Pantoprazole 40mg PANTOCID 40MG GOUT Anti-gout Colchicine 0.5mg LENNON-COLCHICINE 0.5MG M10.99 Anti-gout Allopurinol PURICOS 300MG TABS Anti-gout Allopurinol PURICOS 100MG TABS INSOMNIA Others Zolpidem 10mg ZOLNOXS G47.0 Others Zopiclone 7.5mg ZOPIVANE 7.5MG TAB MIGRAINE(Prophylaxis ONLY) Anti-Migraine agents Clonidine HCl 0.025mg MENOGRAINE 0.025MG G43 Beta-receptor blockers Propranolol HCl 10mg INDOBLOK 10MG Beta-receptor blockers Propranolol HCl 40mg INDOBLOK 40MG Tricyclics Amitriptyline HCI 25mg TREPILINE 25MG TAB Tricyclics Imipramine HCI 10mg ETHIPRAMINE 10MG TAB Tricyclics Imipramine HCI 25mg ETHIPRAMINE 25MG TAB OSTEOARTHRITIS Analgesic and Antipyretics Paracetamol 500mg tab NAPAMOL 500MG TAB M15 Non selective COX Diclofenac sod. 100mg PANAMOR SR 100MG TAB Non selective COX Diclofenac sod 25mg Non selective COX Diclofenac sod 50mg tab MERCK-DICLOFENAC 25MG MERCK-DICLOFENAC 50MG

8 Non selective COX Ibuprofen 200mg Non selective COX Ibuprofen 400mg Non selective COX Ibuprofen 600mg Non selective COX Naproxen 250mg Non selective COX Naproxen 500mg RANFEN 200MG RANFEN 400MG SANDOZ IBUPROFEN 600MG TAB NAPFLAM 250MG NAPFLAM 500MG Non selective COX Indomethacin 25mg ARTHREXIN 25MG ARROW MELOXICAM Selective COX2 Meloxicam 15mg FLEXOCAM 15MG MG ARROW MELOXICAM Selective COX2 Meloxicam 7.5mg FLEXOCAM 7.5MG MG Specific COX2 - COXIB Etoricoxib 60mg ARCOXIA 60MG TAB OSTEOPOROSIS Biphosphonates Alendronate 10mg OSTEOBON 10MG TAB M81 Biphosphonates Alendronate 70mg OSTEOBON 70MG TAB Biphosphonates Alendronate 70mg FEMAX 70MG TAB Biphosphonates Ibandronic acid 150mg tab BONIVA 150MG TAB Vitamin D2 Ergocalciferol iu CALCIFEROL Calcium Selective oestrogen receptor modulators Calcium carbonate 1250mg; Vitamin D3 400iu Raloxifene HCl 60mg B-CAL-D TAB EVISTA 60MG Dual action bone agents Strontium ranelate PROTOS 2g/sachet

9 PSORIASIS L40 Cortico-steroids Cortico-steroids Cortico-steroids Calcipotriol 50mcg, betamethasone dipropiante 0,5mg/g Calcipotriol 50mcg, betamethasone dipropiante 0,5mg/g Betamethasone [as dipropionate] 0;5mg; salicylic acid 20mg/g DOVOBET OINTMENT XAMIOL GEL DIPROSALIC LOTION Cortico-steroids Betamethasone [as dipropionate] 0;5mg; salicylic acid 30mg/g DIPROSALIC OINT Cortico-steroids Betamethasone as valerate BETNOVATE SCALP LOTION Dermatologicals Calcipotriol DOVONEX SCALP Dermatologicals Coal tar POLYTAR Dermatologicals Coal tar TRITAR SHAMPOO Dermatologicals Tazarotene 0.05% ZORAK 0.05% GEL Dermatologicals Tazarotene 0.1% ZORAK 0.1% GEL

10 Dermatologist prescription ONLY Motivation, including history of therapy & patient's weight, required. Dermalologist prescription ONLY. Motivation, including history of therapy & patient's weight, required. Dermalologist prescription ONLY. Dermatologist prescription ONLY Dermatologist prescription ONLY. Maximum 30 per month. Dermatologist prescription ONLY. Maximum 60 per month. Dermatologist prescription ONLY. Maximum 60 per month. Dermatologist prescription ONLY. Maximum 60 per month. Clinical motivation required if prescribed together with Nasal Corticosteroid Spray

11 Clinical motivation required if prescribed together with Nasal Corticosteroid Spray Clinical motivation required if prescribed together with Nasal Corticosteroid Spray Clinical motivation required if prescribed together with Nasal Corticosteroid Spray Clinical motivation required if prescribed together with antihistamine tablets Clinical motivation required if prescribed together with antihistamine tablets Results of Mini-mental State Examination and Neurologist prescription required Results of Mini-mental State Examination and Neurologist prescription required Results of Mini-mental State Examination and Neurologist prescription required Results of Mini-mental State Examination and Neurologist prescription required Results of Mini-mental State Examination and Neurologist prescription required Results of Mini-mental State Examination and Neurologist prescription required Results of Mini-mental State Examination and Neurologist prescription required

12 Results of Mini-mental State Examination and Neurologist prescription required Results of Mini-mental State Examination and Neurologist prescription required (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered Paediatrician/Neurologist/ prescription. Paediatrician/Neurologist/ prescription. Motivation, including history of therapy, required. Paediatrician/Neurologist/ prescription Motivation, including history of therapy, required. Paediatrician/Neurologist/ prescription.

13 Motivation, including history of therapy, required. Paediatrician/Neurologist/ prescription. Motivation, including history of therapy, required. Paediatrician/Neurologist/ prescription. 1st Line Agent. 1st Line Agent. 1st Line Agent. 2nd Line Agent. Therapy must be initiated by a 2nd Line Agent. Therapy must be initiated by a

14 Psych motivation required Psych motivation required Psych motivation required Psych motivation required Limited to 400 gram per month Limited to 500 gram per month Limited to 500 gram per month

15 Limited to 500g per month Limited to 30g per month Limited to 30g per month Limited to 100ml per month Limited to 30g per month Limited to 30ml per month Gastroscopy results required - include Gastroscopy results required - include Gastroscopy results required - include Gastroscopy results required - include Gastroscopy results required - include Gastroscopy results required - include

16 Gastroscopy results required - include Gastroscopy results required - include Gastroscopy results required - include Gastroscopy results required - include Only if associated with Diabetes or Hypertension Only if associated with Diabetes or Hypertension Only if associated with Diabetes or Hypertension (If linked to Psychiatric PMB Condition ONLY) (If linked to Psychiatric PMB Condition ONLY)

17 Motivation indicating the risk factors considered for their use of conventional anti-inflammatory therapy Bone densitometry and risk factors required Bone densitometry and risk factors required Bone densitometry and risk factors required Bone densitometry and risk factors required Only in proven osteoporosis Bone densitometry and risk factors required Bone densitometry and risk factors required

18 Initial Specialist prescription required. Limited to 30g per month Initial Specialist prescription required. Limited to 30g per month Initial Specialist prescription required Initial Specialist prescription required Initial Specialist prescription required Initial Specialist prescription required Initial Specialist prescription required Initial Specialist prescription required Initial Specialist prescription required Initial Specialist prescription required