North West London Integrated Formulary PUBLISHED VERSION (v20 23.2.2016) The Integrated Formulary (IF) is a list of medicines for adult patients and is for use in North West London. The IF is intended to cover: prescriptions written in primary care; prescriptions or recommendations by hospital doctors in respect of outpatients or patients leaving hospital after an admission. The IF should be taken fully into account by prescribers when exercising their clinical judgement. However, it does not override the individual responsibility of prescribers to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer and informed by the summary of product characteristics of any medicines they are considering. Medicines recommended by NICE technology appraisal guidance (TAG) are regarded as included in the IF from the date the TAG is published, unless: the medicine will only be prescribed for hospital inpatients or it is deemed to be a medicine that should only be prescribed by a hospital specialist (in which case it will be added to the NWL red list of medicines that a hospital doctor should not ask a GP to prescribe). People currently receiving a medicine that is not included in the IF should have the option to continue until they and their clinicians consider it appropriate to stop. initiation A number of medicines in the IF are marked specialist initiation. These words should be interpreted as an attempt to reduce the risk of harm and taken into account by prescribers when exercising their clinical judgement. Appropriate action in response to a specialist initiation annotation may lie anywhere in a spectrum between: 1. The medicine should be prescribed by a relevant specialist for at least x months with monitoring of effectiveness and toxicity, until treatment is stable at which point the patient s GP can be asked whether s/he will take over prescribing, and 2. It is reasonable for a GP to write the first prescription after a telephone conversation with a relevant specialist clinician. Different GPs might reasonably take different decisions regarding whether or when to prescribe, depending on their knowledge and experience. Legal responsibility for prescribing lies with the doctor who signs the prescription. The specialist initiation annotations say nothing about who is or is not a relevant specialist in respect of a medicine. It will be reasonable for some of these medicines to be initiated by prescribers from more than one speciality. BNF chapter BNF section BNF sub-section 1.1 Dyspepsia and gastro-oesophageal reflux disease 1.1.1 Antacids and simeticone Drug name (shading indicates that the drug appears in more than one section) Co-magaldrox (prescribe Mucogel) Formulations co-magaldrox 195/220 suspension DRAFT Order of preference Initiate by specialist only? Comments Low sodium. Mucogel costs less than Maalox. 1.1 Dyspepsia and gastro-oesophageal reflux disease 1.1.1 Antacids and simeticone Asilone dried aluminium hydroxide 420 mg, simeticone 135 mg, light magnesium oxide 70 mg/5 ml Contains simeticone. 1.1 Dyspepsia and gastro-oesophageal reflux disease 1.1 Dyspepsia and gastro-oesophageal reflux disease 1.1 Dyspepsia and gastro-oesophageal reflux disease 1.1.1 Antacids and simeticone Magnesium trisilicate mixture 1.1.2 Compound alginates Peptac oral suspension, 5% each of magnesium trisilicate, light magnesium carbonate, and sodium bicarbonate in a suitable vehicle with a peppermint flavour suspension (peppermint or aniseed) 1.1.2 Compound alginates Gaviscon Infant oral powder; Tends to be laxative. Contains approx 6mmol sodium/10ml Contains alginate. Contains 6.2mmol sodium in 10ml. Contains alginate and 0.92mmol sodium /dose.
1.2 Antispasmodics and other altering gastric motility 1.2 Antispasmodics and other altering gastric motility 1.2 Antispasmodics and other altering gastric motility 1.3 Anti-secretory and mucosal protectants 1.2 1.2 1.2 1.3.1 H2- receptor antagonists Mebeverine hydrochloride Peppermint oil (prescribe Mintec) Hyoscine butylbromide Ranitidine tablets 135 mg e/c capsules 0.2ml tablets 10mg; injection 20mg in 1ml tablets 150mg, 300mg; effervescent tablets 150mg; oral solution 75mg in 5ml Mintec capsules cost less than MR Colpermin capsules Effervescent tablets cost much more than plain tablets. 1.3 Anti-secretory and mucosal protectants 1.3.3 Chelates and complexes Sucralfate tablets 1g; suspension 1g in 5ml tablets 20mg, 40mg 1.3 Anti-secretory and mucosal protectants 1.3.5 Proton pump inhibitors Esomeprazole See comments column 1.3 Anti-secretory and mucosal protectants 1.3.5 Proton pump inhibitors Omeprazole capsules 10mg, 20mg; dispersible tablets, film-coated, 10mg, 20mg Capsules cost much less than dispersible tablets 1.3 Anti-secretory and mucosal protectants 1.3 Anti-secretory and mucosal protectants 1.3 Anti-secretory and mucosal protectants 1.3.5 Proton pump inhibitors Pantoprazole 1.3.5 Proton pump inhibitors Lansoprazole 1.4 Acute diarrhoea 1.4.2 Loperamide 1.4 Acute diarrhoea 1.4.2 Co-phenotrope 1.5 Chronic bowel 1.5.1 Aminosalicylates Mesalazine tablets 20mg, 40mg orodispersible tablet, 15mg, 30mg (Fastab ); capsules 15mg, 30mg Test for Helicobacter pylori diabact UBT capsules 2mg; syrup 1mg in 5ml tablets 2.5/0.025 e/c tablets 400mg (Asacol MR, Octasa - see comments), 800mg (Asacol MR and Octasa ); MR tablets 500mg (Pentasa ); MR tablets 1.2g (Mezavant XL - see comments) gastro-resistant prolonged release granules 500mg, 1g (Salofalk ); retention enema 1g in 100ml; enema 2g in 59ml; foam enema 1g/application; suppositories 250mg, 500mg, 1g Capsules cost much less than orodispersible tablets Arrangements for H. pylori testing differ in different parts of NWL There is no evidence to show that any one oral preparation of mesalazine is more effective than another; however, the delivery characteristics of oral mesalazine may vary. If it is necessary to switch a patient to a different brand of mesalazine, the patient should be advised to report any changes in symptoms Octasa is the lowest cost brand and should be prescribed instead of other brands for new patients, and for patients who require a change to their drug regimen. Discretion should be applied in switching patients to Octasa who have mild and/or stable UC. Mezavant XL should only be considered for select patients experiencing difficultly with a high pill burden (i.e. >2.4g/daily), since it has a convenient once-daily dosing advantage. Since Mezavant XL is almost twice the cost of Octasa, at the point of maintenance dose prescribing (i.e. 2.4g/daily), Octasa should be substituted. 1.5 Chronic bowel 1.5.1 Aminosalicylates Sulfasalazine (Sulphasalazine) tablets 500mg; e/c tablets 500mg; suspension 250mg in 5ml; suppositories 500mg 1.5 Chronic bowel 1.5.1 Aminosalicylates Olsalazine 1.5 Chronic bowel 1.5.1 Aminosalicylates Balsalazide capsules 250mg capsules 750 mg
1.5 Chronic bowel 1.5.2 Corticosteroids Prednisolone retention enema, short tube, 20mg in 100ml (as sodium phosphate); foam enema, 20mg per metered application (as sodium metasulphobenzoate); suppositories 5mg (as sodium phosphate) 1.5 Chronic bowel 1.5.2 Corticosteroids Hydrocortisone acetate 1.5 Chronic bowel 1.5.2 Corticosteroids Budesonide foam, in aerosol pack, 10% as acetate (Colifoam ) e/c MR capsules 3mg 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.1 Bulk-forming laxatives Ispaghula husk granules 3.5g/sachet (orange flavoured or plain) 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.2 Stimulant laxatives Senna tablets total sennosides 7.5mg; syrup total sennosides 7.5mg in 5ml 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.2 Stimulant laxatives Glycerol (glycerin) suppositories, 1g (infant), 2g (child), 4g (adult); 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.2 Stimulant laxatives Docusate sodium capsules 100mg; oral solution 12.5mg in 5ml, 50mg in 5ml 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.2 Stimulant laxatives Co-danthramer suspension 25/200 (dantron 25 mg, poloxamer 188 200 mg) in 5ml; strong suspension 75/1000 (dantron 75 mg, poloxamer 188 1 g) in 5ml Only licensed for constipation in terminally ill patients. 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.2 Stimulant laxatives Bisacodyl e/c tablets 5mg; suppositories 10mg; paediatric suppositories 5mg 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.4 Osmotic laxatives Lactulose 1.6.4 Osmotic laxatives Macrogol compound oral powder solution Laxido Orange oral powder sachets; Laxido paediatric plain powder sachets; Movicol-Half powder sachets; Movicol Paediatric Plain powder sachets Laxido Orange costs less than Movicol 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.4 Osmotic laxatives Phosphates enema BP Formula B 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.4 Osmotic laxatives 1.6.7 Other used in constipation Micralax Microenema Prucalopride enema tablets 1mg, 2mg For use in line with NICE's guidance. 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.7 Other used in constipation 1.6.7 Other used in constipation Naloxegol Lubiprostone tablets 12.5mg, 25mg capsules 24 microgram For use in line with NICE's guidance. For use in line with NICE's guidance.
1.6 Laxatives - see BNF for comments on the role of laxatives 1.6.7 Other used in constipation 1.7 Local for anal and rectal 1.7.1 Soothing haemorrhoidal prepaarations 1.7.2 Compound 1.7 Local for anal and rectal haemorrhoidal with corticosteroids Linaclotide Anusol Xyloproct capsules 290 microgram Anusol Suppositories, Ointment, Cream Ointment (water-miscible), aluminium acetate 3.5%, hydrocortisone acetate 0.275%, lidocaine 5%, zinc oxide 18% Can be purchased over the counter. First choice if corticosteroid required 1.7.2 Compound 1.7 Local for anal and rectal haemorrhoidal with corticosteroids Scheriproct Suppositories, cinchocaine (dibucaine) hydrochloride 1mg, prednisolone hexanoate 1.3mg Ointment, cinchocaine (dibucaine) hydrochloride 0.5%, prednisolone hexanoate 0.19%. Second choice if corticosteroid containing suppositories required 1.7.2 Compound 1.7 Local for anal and rectal haemorrhoidal with corticosteroids Proctofoam HC Foam in aerosol pack, hydrocortisone acetate 1%, pramocaine hydrochloride 1%. 1.7 Local for anal and rectal 1.7.4 Management of anal fissures 1.7 Local for anal and rectal 1.7.4 Management of anal fissures 1.9 Drugs affecting intestinal secretions 1.9.1 Diltiazem Glyceryl trinitrate Ursodeoxycholic acid 1.9 Drugs affecting intestinal secretions 1.9.4 Creon rectal cream 2% (unlicensed) rectal ointment 0.4% (Rectogesic ) tablets 150mg; capsules 250mg Creon 10 000 Capsules,e/c granules of pancreatin (pork), providing: protease 600 units, lipase 10 000 units, amylase 8000 units; 25 000 capsules For treatment of anal fissure. Generally not suitable for repeat prescribing For treatment of anal fissure. Generally not suitable for repeat prescribing 2. Cardiovascular system 2.1 Positive inotropic 2.1.1 Digoxin tablets 62.5mcg, 125mcg, 250mcg; elixir 50mcg in 1ml; 2. Cardiovascular system 2.2 Diuretics 2.2.1 Thiazides and related diuretics Indapamide tablets 2.5mg; MR tablets 1.5mg 2. Cardiovascular system 2.2 Diuretics 2.2.1 Thiazides and related diuretics Chlortalidone tablets 50mg tablets 2.5mg, 5mg 2. Cardiovascular system 2.2 Diuretics 2.2.1 Thiazides and related diuretics Bendroflumethiazide 2. Cardiovascular system 2.2 Diuretics 2.2.2 Loop diuretics Furosemide tablets 20mg, 40mg, 500mg; oral solution 20mg in 5ml, 40mg in 5ml, 50mg in 5ml; 2. Cardiovascular system 2.2 Diuretics 2.2.2 Loop diuretics Bumetanide tablets 1mg, 5mg; Liquid 1mg in 5ml. 2. Cardiovascular system 2.2 Diuretics 2.2.2 Loop diuretics Torasemide 2.2.3 Potassium-sparing 2. Cardiovascular system 2.2 Diuretics diuretics and aldosterone Eplerenone antagonists tablets tablets 25mg, 50mg See comments column Costs much more than spironolactone.
2. Cardiovascular system 2.2 Diuretics 2.2.3 Potassium-sparing diuretics and aldosterone antagonists Spironolactone tablets 25mg, 100mg; 50 mg 2. Cardiovascular system 2.2 Diuretics 2.2.3 Potassium-sparing diuretics and aldosterone antagonists Amiloride 2. Cardiovascular system 2.2 Diuretics 2.2.4 Potassium-sparing diur Co-amilozide tablets 5mg; oral solution 5mg in 5ml tablets 2.5/25 (amiloride hydrochloride 2.5 mg, hydrochlorothiazide 25 mg), 5/50 (amiloride hydrochloride 5 mg, hydrochlorothiazide 50 mg) 2. Cardiovascular system 2.2 Diuretics 2.2.4 Potassium-sparing diur Co-amilofruse tablets 2.5/20 (amiloride hydrochloride 2.5 mg, furosemide 20 mg), 5/40 (amiloride hydrochloride 5 mg, furosemide 40 mg) 2. Cardiovascular system 2.3 Anti-arrhythmic 2.3.2 Propafenone 2. Cardiovascular system 2.3 Anti-arrhythmic 2.3.2 Flecainide 2. Cardiovascular system 2.3 Anti-arrhythmic 2.3.2 Disopyramide 2. Cardiovascular system 2.3 Anti-arrhythmic 2.3.2 Amiodarone 2. Cardiovascular system 2.4 Beta-adrenoceptor blocking 2.4 Sotalol tablets 150mg, 300mg tablets 50mg, 100mg; capsules 100mg, 150mg; tablets 100mg, 200mg; tablets 40mg, 80mg, 160mg, 200mg 2. Cardiovascular system 2.4 Beta-adrenoceptor blocking 2.4 Nebivolol tablets 5mg 2. Cardiovascular system 2.4 Beta-adrenoceptor blocking 2.4 Labetalol 2. Cardiovascular system 2.4 Beta-adrenoceptor blocking 2.4 Bisoprolol 2. Cardiovascular system 2.4 Beta-adrenoceptor blocking 2.4 Carvedilol tablets 50mg, 100mg, 200mg, 400mg tablets 1.25mg, 2.5mg, 3.75mg, 5mg, 7.5mg, 10mg tablets 3.125mg, 6.25mg, 12.5mg, 25mg 2. Cardiovascular system 2.4 Beta-adrenoceptor blocking 2.4 Propranolol tablets 10mg, 40mg, 80mg,160mg; MR capsules 80mg, 160mg; oral solution (Syprol brand) 5mg in 5ml, 10mg in 5ml, 50mg in 5ml If prescribing propranolol oral liquid, we suggest prescribing the Syprol brand to avoid high cost 'special' being dispensed. 2. Cardiovascular system 2.4 Beta-adrenoceptor blocking 2.4 Metoprolol tablets 50mg, 100mg; 2. Cardiovascular system 2.4 Beta-adrenoceptor blocking 2.4 Atenolol 2. Cardiovascular system 2.5 Hypertension and heart failure 2. Cardiovascular system 2.5 Hypertension and heart failure 2. Cardiovascular system 2.5 Hypertension and heart failure 2. Cardiovascular system 2.5 Hypertension and heart failure 2.5.1 Vasodilator antihypertensive 2.5.1 Vasodilator antihypertensive 2.5.2 Centrally acting antihypertensive 2.5.2 Centrally acting antihypertensive Hydralazine Minoxidil Moxonidine Methyldopa tablets 25mg, 50mg, 100mg; syrup 25mg in 5ml; tablets 25mg, 50mg; tablets 2.5mg, 5mg, 10mg tablets 200mcg, 300mcg, 400mcg tablets 125mg, 250mg, 500mg
2. Cardiovascular system 2.5 Hypertension and heart failure 2. Cardiovascular system 2.5 Hypertension and heart failure 2.5.4 Alpha-adrenoceptor blocking 2.5.4 Alpha-adrenoceptor blocking Phenoxybenzamine Doxazosin capsules 10mg tablets 1mg, 2mg, 4mg 2. Cardiovascular system 2.5 Hypertension and heart failure 2.5.5.1 Angiotensinconverting enzyme inhibitors Ramipril capsules or tablets 1.25mg, 2,5mg, 5mg, 10mg 2. Cardiovascular system 2.5 Hypertension and heart failure 2.5.5.1 Angiotensinconverting enzyme inhibitors Lisinopril tablets 2.5mg, 5mg, 10mg, 20mg 2. Cardiovascular system 2.5 Hypertension and heart failure 2. Cardiovascular system 2.5 Hypertension and heart failure 2. Cardiovascular system 2.5 Hypertension and heart failure 2. Cardiovascular system 2.5 Hypertension and heart failure 2.5.5.1 Angiotensinconverting enzyme inhibitors Perindopril erbumine tablets 2mg, 4mg, 8mg 2.5.5.1 Angiotensinconverting enzyme inhibitors 2.5.5.1 Angiotensinconverting enzyme inhibitors 2.5.5.2 Angiotensin-II receptor antagonists Enalapril Captopril Losartan tablets 2.5mg, 5mg, 10mg, 20mg tablets 12.5mg, 25mg, 50mg tablets 25mg, 50mg, 100mg, 12.5 mg 2. Cardiovascular system 2.5 Hypertension and heart failure 2.5.5.2 Angiotensin-II receptor antagonists Valsartan capsules 40mg, 80mg, 160mg 2. Cardiovascular system 2.5 Hypertension and heart failure 2. Cardiovascular system 2.5 Hypertension and heart failure 2.5.5.2 Angiotensin-II receptor antagonists 2.5.5.2 Angiotensin-II receptor antagonists Irbesartan Candesartan 2. Cardiovascular system 2.5 Hypertension and heart failure 2.5.5.3 Renin inhibitors Aliskiren 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.1 Nitrates Isosorbide mononitrate tablets 75mg, 150mg, 300mg tablets 2mg, 4mg, 8mg, 16mg, 32mg tablets 150mg, 300mg tablets 10mg, 20mg; MR capsules 25mg, 50mg; MR tablets 25mg, 40mg, 60mg 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.1 Nitrates Glyceryl trinitrate aerosol spray 400mcg/metered spray; tablets 500 micrograms The tablets should be discarded after 8 weeks in use, so the spray generally provides better value for money. 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.2 Calcium-channel blockers Verapamil tablets 40mg, 80mg,120mg; MR capsules 120mg; MR tablets 240mg; oral solution 40mg in 5ml 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.2 Calcium-channel blockers Nifedipine capsules 5mg, 10mg; Modified release - prescribers should specify the brand to be dispensed (see BNF) Potential confusion between MR brands probably means that a drug that does not require modified release formulations, such as amlodipine, is preferable for treatment of hypertension. If using MR nifedipine, prescribe by brand. 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.2 Calcium-channel blockers Diltiazem Standard MR tablets 60mg; Longer-acting formulations - prescriber should specify the brand to be dispensed (see BNF). Prescribe longer-acting formulations by brand name.
2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.2 Calcium-channel blockers Amlodipine tablets 5mg, 10mg 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.3 Other antianginal Nicorandil tablets 10mg, 20mg 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.3 Other antianginal Ivabradine tablets 5mg, 7.5mg For use in line with NICE's guidance. 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2.6.3 Other antianginal Ranolazine tablets 2. Cardiovascular system 2.6 Nitrates, Calcium-channel blockers and other antianginal 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.6.4 Peripheral vasodilators and related 2.8.1 Parenteral anticoagulants Naftidrofuryl Tinzaparin capsules 100mg injection syringe 2500 units, 3500 units, 4500 units, 10,000 units, 14,000 units, 18,000 units Hospital doctors should only ask GPs to prescribe this (1) if a shared care document has been agreed by the hospital and relevant primary care organisation or (2) as part of palliative care 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.1 Parenteral anticoagulants Heparin sodium or calcium Subcutaneous injection 5,000units in 0.2ml; pre-filled syringes 5,000units in 0.2ml, Hospital doctors should only ask GPs to prescribe this (1) if a shared care document has been agreed by the hospital and relevant primary care organisation or (2) as part of palliative care 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.1 Parenteral anticoagulants Enoxaparin injection syringe 20mg in 0.2ml, 40mg in 0.4ml, 60mg in 0.6ml, 80mg in 0.8ml, 100mg in 1ml, 120mg in 0.8ml, 150mg in 1ml Hospital doctors should only ask GPs to prescribe this (1) if a shared care document has been agreed by the hospital and relevant primary care organisation or (2) as part of palliative care 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.1 Parenteral anticoagulants Dalteparin injection syringe 2500 units, 5000 units, 7500 units, 10,000 units, 12,500 units, 15,000 units, 18,000 units Hospital doctors should only ask GPs to prescribe this (1) if a shared care document has been agreed by the hospital and relevant primary care organisation or (2) as part of palliative care 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.2 Oral anticoagulants Phenindione tablets 10mg, 25mg, 50mg 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.2 Oral anticoagulants Dabigatran etexilate capsules, 110mg, 150mg NICE TA guidance exists 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.2 Oral anticoagulants Rivaroxaban tablets 15mg, 20mg NICE TA guidance exists 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.2 Oral anticoagulants Apixaban tablets 2.5mg, 5mg NICE TA guidance exists 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.2 Oral anticoagulants Edoxaban tablets 15mg, 30mg, 60mg NICE TA guidance exists 2. Cardiovascular system 2.8 Anticoagulants and protamine 2.8.2 Oral anticoagulants Warfarin 2. Cardiovascular system 2.9 Antiplatelet 2.9 Prasugrel 2. Cardiovascular system 2.9 Antiplatelet 2.9 Dipyridamole tablets 500mcg, 1mg, 3mg, 5mg tablets 5mg, 10mg tablets 25mg, 100mg; MR capsules 200mg; oral liquid 50mg in 5ml Use in line with NICE's guidance Use in line with NICE's guidance 2. Cardiovascular system 2.9 Antiplatelet 2.9 Clopidogrel tablets 75mg Use in line with NICE's guidance 2. Cardiovascular system 2.9 Antiplatelet 2.9 Aspirin tablets dispersible 75mg Enteric coated tablets cost more than dispersible tablets.
2. Cardiovascular system 2.9 Antiplatelet 2.9 Asasantin Retard 2. Cardiovascular system 2.9 Antiplatelet 2.9 Ticagrelor 2. Cardiovascular system 2. Cardiovascular system 2.11 Antifibrinolytic and haemostatics 2.11 Antifibrinolytic and haemostatics 2.11 Etamsylate 2.11 Tranexamic acid 2. Cardiovascular system 2.12 Lipid-regulating Statins Simvastatin 2. Cardiovascular system 2.12 Lipid-regulating Other Colestyramine (cholestyramine) Capsules, aspirin 25 mg, dipyridamole 200 mg (m/r) tablets 90mg tablets 500mg tablets 500mg See comments column tablets 10mg, 20mg, 40mg, 80mg powder 4g per sachet (Questran Light ); powder, 4g sachets (Questran ) tablets 5mg, 10mg, 20mg, 40mg Use in line with NICE's guidance Use in line with NICE's guidance Rosuvastatin costs much more than generic atorvastatin. It should only be considered in the following circumstances: 1. Adults with familial hypercholesterolaemia, only if the maximum tolerated dose of atorvastatin (check the patient is taking it) fails to achieve the recommended reduction of LDL cholesterol of >50% from the baseline concentration before treatment. 2. Cardiovascular system 2.12 Lipid-regulating Statins Rosuvastatin See comments column 2. None of simvastatin ( 20mg), atorvastatin ( 10mg daily) or pravastatin 40mg is tolerated by the patient. Rosuvastatin may or may not be tolerated. Atorvastatin or rosuvastatin could be tried every other day or twice weekly (unlicensed frequency). 3. There is a potentially serious drug interaction (marked with a black dot in the BNF) with simvastatin, atorvastatin and pravastatin, but not with rosuvastatin, that cannot be avoided other than by using rosuvastatin (a clinical pharmacist should be consulted to look for a way of avoiding the interaction other than by using rosuvastatin). 2. Cardiovascular system 2.12 Lipid-regulating Other Colesevelam tablets 625mg Costs more than colestyramine, but the latter may not be tolerated. 2. Cardiovascular system 2.12 Lipid-regulating Statins Atorvastatin tablets 10mg, 20mg, 40mg, 80mg 2. Cardiovascular system 2.12 Lipid-regulating Statins Pravastatin tablets 10mg, 20mg, 40mg 2. Cardiovascular system 2.12 Lipid-regulating Other Omacor (omega-3 acid ethyl esters) capsules 1g (Omacor ). 2. Cardiovascular system 2.12 Lipid-regulating Fibrates Fenofibrate capsules (micronised) 67mg, 200mg, 267mg; tablets (micronised) 160mg 2. Cardiovascular system 2.12 Lipid-regulating Other Ezetimibe tablets 10mg For use in line with NICE's guidance. 2. Cardiovascular system 2.12 Lipid-regulating Fibrates Bezafibrate tablets 200mg; MR tablets 400mg 3. Respiratory system 3.1 Bronchodilators 3.1.1.1 Selective beta2 agonists Indacaterol 150 microgram inhalation powder, hard capsules; 300 microgram inhalation powder, hard capsules
3. Respiratory system 3.1 Bronchodilators 3.1.1.1 Selective beta2 agonists Salbutamol Aerosol inhalation 100 micrograms/metered inhalation; Airomir Autohaler (breathactuated) 100 micrograms/metered inhalation; Ventolin Accuhaler 200micrograms/blister; Nebules, 2.5mg in 2.5ml, 5mg in 2.5ml 3. Respiratory system 3.1 Bronchodilators 3.1.1.1 Selective beta2 agonists Terbutaline Turbohaler 500mcg/inhalation; Respules 5mg in 2ml 3. Respiratory system 3.1 Bronchodilators 3.1.1.1 Selective beta2 agonists Salmeterol aerosol inhalation 25mcg/metered inhalation; Accuhaler 50mcg/blister; 3. Respiratory system 3.1 Bronchodilators 3.1.1.1 Selective beta2 agonists Formoterol Turbohaler 6mcg/inhalation, 12mcg/inhalation; inhalation capsules 12mcg 3. Respiratory system 3.1 Bronchodilators 3.1.2 Antimuscarinic bronchodilators Tiotropium dry powder inhaler 18mcg capsule; Respimat solution for inhalation 2.5micrograms/metered inhalation 3. Respiratory system 3.1 Bronchodilators 3.1.2 Antimuscarinic bronchodilators Aclidinium bromide Dry powder inhaler 375 mcgs(= aclidinium 322 mcg)/inhalation (delivered dose) for use with Eklira Genuair device 3. Respiratory system 3.1 Bronchodilators 3.1.2 Antimuscarinic bronchodilators Glycopyrronium bromide Inhalation powder 50 mcg, hard capsule, for use with Seebri Breezhaler device 3. Respiratory system 3.1 Bronchodilators 3. Respiratory system 3.1 Bronchodilators 3. Respiratory system 3.1 Bronchodilators 3.1.2 Antimuscarinic bronchodilators 3.1.2 Antimuscarinic bronchodilators Ipratropium bromide Umeclidinium 3.1.4 Compound bronchodilators Anoro Ellipta aerosol inhalation 20mcg/metered inhalation; nebuliser solution 250mcg in 1ml, 500mcg in 2ml unit dose vials inhalation powder 55 micrograms (Incruse Ellipta) inhalation powder umeclidinium 55micrograms + vilanterol 22micrograms 3. Respiratory system 3.1 Bronchodilators 3.1.4 Compound bronchodilators Duaklir Genuair inhalation powder aclidinium 340micrograms + formoterol 12micrograms 3. Respiratory system 3.1 Bronchodilators 3.1.3 Theophylline Theophylline MR tablets (Uniphyllin Continus) 200mg, 300mg, 400mg; MR capsules 60mg, 125mg, 250mg (Slo-Phyllin) Rate of absorption can vary between brands. Maintain the patient on the brand s/he has been stabilised on.
3. Respiratory system 3.1 Bronchodilators 3.1.3 Theophylline Aminophylline MR tablets (Phyllocontin) 225mg, 350mg; 3. Respiratory system 3. Respiratory system 3.1.5 Peak flow meters, inhaler devices and nebulisers 3.1.5 Peak flow meters, inhaler devices and nebulisers 3.1.5 Drug delivery devices 3.1.5 Peak flow meters spacer devices Vitalograph (standard & child) 3. Respiratory system 3.2 Corticosteroids 3.2 Fostair aerosol inhalation, beclometasone dipropionate 100mcg, formoterol fumarate 6mcg per metered inhalation. NEXThaler (dry powder inhaler containing beclometasone dipropionate 100mcg plus formoterol fumarate 6mcg per metered inhalation.) 3. Respiratory system 3.2 Corticosteroids 3.2 Symbicort 3. Respiratory system 3.2 Corticosteroids 3.2 DuoResp Spiromax Turbohaler 100/6, 200/6, 400/12 dry powder for inhalation 160mcg/4.5mcg and 320mcg/9mcg. Containing budesonide (160mcg and 320mcg) and formoterol (4.5mcg and 9mcg) 3. Respiratory system 3.2 Corticosteroids 3.2 Flutiform aerosol inhalation 50 and 125 (aerosol containing 5mcg formoterol plus 50/125 mcg fluticasone/metered inhalation. aerosol inhalation 250 (aerosol containing 10mcg formoterol plus 250 mcg fluticasone/metered inhalation) 3. Respiratory system 3.2 Corticosteroids 3.2 Relvar Ellipta dry powder for inhalation 92mcg/22mcg and 184mcg/22mcg. Containing vilanterol 22micrograms plus fluticasone furoate 92/184micrograms per delivered dose. 3. Respiratory system 3.2 Corticosteroids 3.2 Seretide Accuhaler 100, 250, 500 (dry powder breath-actuated disc inhaler containing 50mcg salmeterol plus 100/250/500mcg fluticasone) Evohaler 50, 125, 250 (aerosol containing 25mcg salmeterol plus 50/125/250mcg fluticasone/metered inhalation) At the highest dose, Accuhalers (powder devices) cost much less than Evohalers (pressurised aerosols) and avoid use of HFA propellants which are greenhouse gases.
3. Respiratory system 3.2 Corticosteroids 3.2 Sirdupla aerosol inhalation 125 and 250 (aerosol containing 25mcg salmetrol plus 125/250mcg fluticasone/metered inhalation) 3. Respiratory system 3.2 Corticosteroids 3.2 Fluticasone Evohaler aerosol inhalation 50mcg/metered inhalation, 125mcg/metered inhalation, 250mcg/metered inhalation; Accuhaler 50mcg/blister, 100mcg/blister, 250mcg/blister, 500mcg/blister 3. Respiratory system 3.2 Corticosteroids 3.2 Budesonide Turbohaler 100mcg/inhalation, 200mcg/inhalation, 400mcg/inhalation; Respules 500mcg in 2ml, 1mg in 2ml 3. Respiratory system 3.2 Corticosteroids 3.2 Beclometasone dipropionate CFC-free aerosol inhalation 50mcg/metered inhalation, 100mcg/metered inhalation, 250mcg/metered inhalation (Clenil Modulite ); CFC-free aerosol inhalation 50mcg/metered inhalation, 100mcg/metered inhalation (Qvar ); Breath-actuated aerosol inhalation 50 micrograms/metered inhalation, 100micrograms/metered inhalation (Qvar Autohaler, Qvar Easi-Breathe) CFC-free beclomethasone inhalers are not interchangeable and should be prescribed by brand name. Clenil Modulite is probably the best buy for new prescriptions. 3. Respiratory system 3.2 Corticosteroids 3.2 Mometasone dry powder inhaler 200micrograms/metered inhalation, 400micrograms/metered inhalation Exceptional case 3. Respiratory system 3.03 Cromoglicate and related therapy and leukotriene receptor antagonists 3.3.3 Zafirlukast tablets 20 mg 3. Respiratory system 3.03 Cromoglicate and related therapy and leukotriene receptor antagonists 3.3.3 Montelukast tablets 10mg; chewable tablets 4mg, 5mg granules 4mg 3. Respiratory system 3.4 Antihistamines, hyposensitisation, and allergic emergencies 3.4.1 Cetirizine tablets 10mg; oral solution sugar free 1mg/ml 3. Respiratory system 3.4 Antihistamines, hyposensitisation, and allergic emergencies 3.4.1 Loratadine tablets 10mg; syrup 5mg in 5ml 3. Respiratory system 3. Respiratory system 3.4 Antihistamines, hyposensitisation, and allergic emergencies 3.4 Antihistamines, hyposensitisation, and allergic emergencies 3.4.1 Promethazine hydrochloride 3.4.1 Hydroxyzine tablets 10mg, 25mg; elixir 5mg in 5ml tablets 10mg, 25mg syrup 10mg in 5ml
3. Respiratory system 3.4 Antihistamines, hyposensitisation, and allergic emergencies 3.4.1 Chlorphenamine tablets 4mg; syrup 2mg in 5ml; 3. Respiratory system 3.4 Antihistamines, hyposensitisation, and allergic emergencies 3.4.3 Adrenaline/ epinephrine pre-filled auto-injector delivering 150 micrograms (EpiPen Junior, Emerade, Jext), 300 micrograms (EpiPen, Emerade, Jext), 500 micrograms (Emerade) Prescribe using the brand name 3. Respiratory system 3.7 Mucolytics 3.7 Carbocisteine capsules 375mg; oral liquid 250mg in 5ml For use in line with NICE guidance 3. Respiratory system 3.7 Mucolytics 3.7 Dornase alfa 3. Respiratory system 3.7 Mucolytics 3.7 Hypertonic sodium chloride nebuliser solution nebuliser solution 3%, 6%, 7% GPs should not be asked to prescribe this unless a local shared care protocol has been agreed. 3. Respiratory system 3.8 Aromatic inhalations 3.8 Menthol and eucalyptus 3. Respiratory system 3.9 Cough 3.9.1 Pholcodine inhalation sugar-free linctus 5mg in 5ml 3. Respiratory system 3.9 Cough 3.9.1 Codeine linctus 15mg in 5ml 3. Respiratory system 3.9 Cough 3.9.2 Simple linctus, linctus paediatric 4.1 Hypnotics and anxiolytics 4.1.1 Hypnotics Zaleplon capsules 5mg, 10mg When a short acting hypnotic is indicated NICE recommend the cheapest of short-acting benzodiazepine, zaleplon, zolpidem or zopiclone. Zolpidem and zopiclone are currently the lowest cost. 4.1 Hypnotics and anxiolytics 4.1.1 Hypnotics Zopiclone tablets 3.75mg, 7.5mg When a short acting hypnotic is indicated NICE recommend the cheapest of short-acting benzodiazepine, zaleplon, zolpidem or zopiclone. Zolpidem and zopiclone are currently the lowest cost. 4.1 Hypnotics and anxiolytics 4.1.1 Hypnotics Zolpidem tartrate tablets 5mg, 10 mg When a short acting hypnotic is indicated NICE recommend the cheapest of short-acting benzodiazepine, zaleplon, zolpidem or zopiclone. Zolpidem and zopiclone are currently the lowest cost. 4.1 Hypnotics and anxiolytics 4.1.1 Hypnotics Temazepam tablets 10mg, 20mg; oral solution 10mg in 5ml When a short acting hypnotic is indicated NICE recommend the cheapest of short-acting benzodiazepine, zaleplon, zolpidem or zopiclone. Zolpidem and zopiclone are currently the lowest cost. 4.1 Hypnotics and anxiolytics 4.1.2 Lorazepam tablets 1mg, 2.5mg 4.1 Hypnotics and anxiolytics 4.1.2 Diazepam tablets 2mg, 5mg, 10mg; oral solution 2mg in 5ml. rectal tubes 2.5mg in 1.25ml, 5mg in 2.5ml, 10mg in 2.5ml 4.1 Hypnotics and anxiolytics 4.1.2 Chlordiazepoxide capsules 5mg, 10mg 4.1 Hypnotics and anxiolytics 4.1.2 Buspirone tablets 5mg, 10mg 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Trifluoperazine tablet 1mg, 5mg; oral solution 5mg in 5ml
4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Sulpiride tablets 200mg, 400mg; oral solution 200mg in 5ml. 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Quetiapine tablets 25mg, 100mg 150mg, 200mg, 300mg; MR tablets 50mg, 200mg, 300mg, 400mg An NWL shared care document exists; see the shared care documents folder on this site. 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Olanzapine tablets 2.5mg, 5mg, 7.5mg, 10mg, 15mg; orodispersible tablets 5mg, 10mg, 15mg, 20mg Orodispersible tablets cost more than standard tablets. An NWL shared care document exists; see the shared care documents folder on this site. 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Chlorpromazine hydrochloride tablets 25mg, 50mg, 100mg; oral solution 25mg in 5ml, 100mg in 5ml 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Aripiprazole tablets 5mg, 10mg, 15mg, 30mg; orodispersible tablets 10mg, 15mg oral solution 1mg in 1ml An NWL shared care document exists; see the shared care documents folder on this site. 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Amisulpride tablets 50mg, 100mg, 200mg, 400mg; oral solution 100mg in 1ml An NWL shared care document exists; see the shared care documents folder on this site. 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Risperidone tablets 500micrograms, 1mg, 2mg, 3mg, 4mg, 6mg, orodispersible tablets 500micrograms, 1mg, 2mg, 4mg Orodispersible tablets cost much more than standard tablets. An NWL shared care document exists; see the shared care documents folder on this site. 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Haloperidol capsules 500 micrograms; tablets 1.5mg, 5mg, 10mg, 20mg; oral liquid 10mg in 5ml; injection 5mg in 1ml 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Flupentixol 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Zuclopenthixol tablets 3mg tablets 2mg, 10mg, 25mg 4.2 Drugs used in psychoses and related 4.2.1 Antipsychotic Levomepromazine tablets 25mg,injection 25mg/ml 4.2 Drugs used in psychoses and related 4.2.2 Antipsychotic depot injections 4.2 Drugs used in psychoses and related 4.2.2 Antipsychotic depot injections 4.2 Drugs used in psychoses and related 4.2.2 Antipsychotic depot injections 4.2 Drugs used in psychoses and related 4.2.2 Antipsychotic depot injections 4.2 Drugs used in psychoses and related 4.2.2 Antipsychotic depot injections 4.2 Drugs used in psychoses and related 4.2.2 Antipsychotic depot injections Aripiprazole Flupentixol decanoate Fluphenazine decanoate Haloperidol (as decanoate) Paliperidone Pipotiazine palmitate depot injection 400mg depot injection 20mg/ml, 100mg/ml, 200mg/ml depot injection 25mg/ml, 100mg/ml depot injection 50mg/ml, 100mg/ml injection 50mg, 75mg, 100mg, 150mg depot injection 50mg/ml For use in palliative care An NWL shared care document exists; see the shared care documents folder on this site. An NWL shared care document exists; see the shared care documents folder on this site.
4.2 Drugs used in psychoses and related 4.2.2 Antipsychotic depot injections Risperidone depot injection 25mg, 37.5mg, 50mg An NWL shared care document exists; see the shared care documents folder on this site. 4.2 Drugs used in psychoses and related 4.2.2 Antipsychotic depot injections Zuclopenthixol decanoate depot injection 200mg/ml, 500mg/ml 4.2 Drugs used in psychoses and related 4.2.3 Antimanic Valproic acid e/c tablets 250mg, 500mg 4.2 Drugs used in psychoses and related 4.2.3 Antimanic Lithium citrate liquid 520mg in 5ml (Priadel ); oral solution 509mg in 5ml (Li-liquid ); Prescribe by brand name. An NWL shared care document exists; see the shared care documents folder on this site. 4.2 Drugs used in psychoses and related 4.2.3 Antimanic Lithium carbonate MR tablets 200mg, 400mg (Priadel, Camcolit, Liskonum ) Prescribe by brand name. An NWL shared care document exists; see the shared care documents folder on this site 4.03 Antidepressant 4.3.1 Tricyclic and related antidepressant Clomipramine capsules, 10mg, 25mg, 50mg 4.03 Antidepressant 4.3.1 Tricyclic and related antidepressant Trazodone capsules 50mg, 100mg; tablets 150mg; liquid 50mg in 5ml 4.03 Antidepressant 4.3.1 Tricyclic and related antidepressant Lofepramine tablets 70mg; oral suspension 70mg in 5ml 4.03 Antidepressant 4.3.1 Tricyclic and related antidepressant Imipramine tablets 10mg, 25mg 4.03 Antidepressant 4.3.1 Tricyclic and related antidepressant Amitriptyline hydrochloride tablets 10mg, 25mg, 50mg; oral solution 25mg in 5ml, 50mg in 5ml 4.03 Antidepressant 4.3.1 Tricyclic and related antidepressant Nortriptyline tablets 10mg, 25mg 4.03 Antidepressant 4.3.2 Monoamine-oxidase inhibitors Moclobemide tablets 150mg 4.03 Antidepressant 4.3.2 Monoamine-oxidase inhibitors Phenelzine tablets 15mg 4.03 Antidepressant 4.03 Antidepressant 4.3.3 Selective serotonin reuptake inhibitors 4.3.3 Selective serotonin reuptake inhibitors Sertraline Fluoxetine tablets 50mg, 100mg capsules 20mg; liquid 20mg in 5ml dispersible tablets 20mg 4.03 Antidepressant 4.3.3 Selective serotonin reuptake inhibitors Citalopram tablets 10mg, 20mg, 40mg; oral solution 40mg/ml sugar free 4.03 Antidepressant 4.3.3 Selective serotonin reuptake inhibitors Paroxetine tablets 20mg, 30mg 4.03 Antidepressant 4.3.4 Other antidepressant Duloxetine capsules 30mg, 60mg For use in neuropathic pain e.g. In palliative care. Not included in the Integrated Formulary for treatment of depression or generalised anxiety disorder. 4.03 Antidepressant 4.3.4 Other antidepressant Venlafaxine tablets 37.5mg, 75mg; MR tablets 75mg, 150mg, 225 mg Plain tablets cost less than MR formulations. 4.03 Antidepressant 4.3.4 Other antidepressant Mirtazapine tablets 15mg, 30mg, 45mg; Orodispersible (soluble) tablets 15mg, 30mg, 45mg
4.03 Antidepressant 4.3.4 Other antidepressant Vortioxetine tablets 5mg, 10mg, 20mg 4.4 Central nervous system stimulants 4.4 Methylphenidate hydrochloride tablets 5mg, 10mg; MR capsules 10mg, 20mg, 30mg (Equasym XL); MR capsules 10mg, 20mg, 30mg, 40mg (Medikinet XL); MR tablets 18mg, 27mg, 36mg (Concerta XL ) Shared care documents are in use in some parts of NWL. 4.4 Central nervous system stimulants 4.4 Atomoxetine Capsules, 10mg, 18mg, 25mg, 40mg, 60mg, 80mg Shared care documents are in use in some parts of NWL. 4.4 Central nervous system stimulants 4.4 4.4 Central nervous system stimulants 4.4 Dexamfetamine sulphate Lisdexamfetamine mesilate 4.4 Central nervous system stimulants 4.4 Modafinil 4.5 Drugs used in the treatment of obesity 4.5.1 Orlistat 4.6 Drugs used in nausea and vertigo 4.6 Prochlorperazine tablets 5mg capsules 30mg, 50mg, 70mg tablets 100mg, 200mg capsules 120mg tablets 5mg, buccal tablets 3mg; syrup 5mg in 5ml Shared care documents are in use in some parts of NWL. Shared care documents are in use in some parts of NWL. 4.6 Drugs used in nausea and vertigo 4.6 Metoclopramide 4.6 Drugs used in nausea and vertigo 4.6 Domperidone 4.6 Drugs used in nausea and vertigo 4.6 Cyclizine tablets 10mg; oral solution 5mg in 5ml; injection 10mg in 2ml tablets 10mg; suspension 5mg in 5ml; suppositories 30mg tablets 50 mg; injection 50mg in 1ml 4.6 Drugs used in nausea and vertigo 4.6 4.6 Drugs used in nausea and vertigo 4.6 Hyoscine hydrobromide Betahistine dihydrochloride 4.6 Drugs used in nausea and vertigo 4.6 Ondansetron tablets 300micrograms tablets 8mg 16mg tablets 4mg, 8mg; oral solution4mg/5ml; injection 2mg/ml 4.7 Analgesics 4.7.1 Non-opioid analgesics and compound analgesic Paracetamol tablets 500mg; dispersible tablets 500mg; oral suspension sugar free 120mg in 5ml, 250mg in 5ml Suppositories cost much more than tablets and liquids 4.7 Analgesics 4.7.1 Non-opioid analgesics and compound analgesic Co-dydramol tablets 10/500 4.7 Analgesics 4.7.1 Non-opioid analgesics and compound analgesic Co-codamol tablets 8/500, 30/500; dispersible tablets 8/500, 30/500 Dispersible tablets cost more than plain tablets
4.7 Analgesics 4.7.1 Non-opioid analgesics and compound analgesic Aspirin dispersible tablets 300mg 4.7 Analgesics 4.7.1 Non-opioid analgesics and compound analgesic Nefopam tablets 30mg 4.7 Analgesics 4.7.2 Opioid analgesics Fentanyl buccal tablets 100micrograms, 200micrograms, 400micrograms, 600micrograms, 800micrograms; nasal spray (PecFent) 100micrograms/spray, 400micrograms/spray; patches 12mcg, 25mcg, 37.5mcg, 50mcg, 75mcg and 100mcg/hour all for 72 hours Buccal tablets and nasal spray are only included for use in palliative care. Mezolar is currently the only brand available in the 37.5mcg/hr strength. 4.7 Analgesics 4.7.2 Opioid analgesics Morphine sulphate tablets (Sevredol ) 10mg, 20mg, 50mg ; MR tablets (Morphgesic SR ) 10mg, 30mg, 60mg, 100mg; MR capsules (Zomorph ) 10mg, 30mg, 60mg, 100mg, 200mg ; MR capsules (MXL ) 30mg, 60mg, 90mg, 120mg, 150mg, 200mg ; MR tablets (MST ) 5mg; oral solution 10mg in 5ml, 100mg in 5ml; MR suspension 20mg/sachet, 30mg/sachet, 60mg/sachet, 100mg/sachet, 200mg/sachet; suppositories 10mg,15mg, 30mg; injections 10mg/ml, 15mg/ml, 20mg/ml, 30mg/ml oral strong opioid. Reserve MR suspension sachets for people who cannot take MR tablets 4.7 Analgesics 4.7.2 Opioid analgesics Diamorphine injection 5mg, 10mg, 30mg, 100mg, 500mg 4.7 Analgesics 4.7.2 Opioid analgesics Methadone 4.7 Analgesics 4.7.2 Opioid analgesics Oxycodone tablets 5mg; injection 10mg/ml capsules 5mg, 10mg, 20mg; MR tablets 5mg, 10mg, 20mg, 40mg, 80mg; oral solution 5mg in 5ml, 50mg in 5ml; injection 10mg in 1ml; 50mg in 1ml 4.7 Analgesics 4.7.2 Opioid analgesics Tapentadol 50mg, 75mg; MR tablets 50mg, 100mg, 150mg, 200mg, 250mg Included in the IF for restricted use: it should be initiated in secondary care and only used in line with the protocol approved by that hospital's New Drugs Panel or equivalent.
4.7 Analgesics 4.7.2 Opioid analgesics Tramadol hydrochloride Capsule 50mg MR tablets 100mg, 150mg, 200mg. MR capsules, 50mg, 100mg, 150mg, 200mg 4.7 Analgesics 4.7.2 Opioid analgesics Dihydrocodeine tablets 30 mg 4.7 Analgesics 4.7.2 Opioid analgesics Codeine phosphate Tablets codeine phosphate 15 mg, 30 mg, 60 mg 4.7 Analgesics 4.7.2 Opioid analgesics Buprenorphine patches '5' patch (releasing 5 micrograms/hour for 7 days), '10' patch (releasing 10 micrograms/hour for 7 days), '20' patch (releasing 20 micrograms/hour for 7 days); patch 35 micrograms/hour, 52.5 micrograms per hour; 70 micrograms per hour all for 96 hours; sublingual tablets 200micrograms, 400micrograms 4.7 Analgesics 4.7.4 Antimigraine Sumatriptan tablets 50mg, 100mg; injection pre-filled syringe and refill pack 6mg in 0.5ml; nasal spray 10mg in 0.1ml, 20mg in 0.1ml 4.7 Analgesics 4.7.4 Antimigraine Zolmitriptan 4.7 Analgesics 4.7.4 Antimigraine Pizotifen orodispersible tablets 2.5mg, 5mg tablets 500 micrograms, 1.5 mg 4.7 Analgesics 4.7.4 Antimigraine Naratriptan tablets 2.5mg 4.7 Analgesics 4.7.4 Antimigraine Almotriptan tablets 12.5mg 4.8 Antiepileptics 4.8.1 Vigabatrin tablets 500mg; powder 500mg/sachet 4.8 Antiepileptics 4.8.1 Topiramate tablets 25mg, 50mg, 100mg, 200mg; sprinkle capsules 15mg, 25mg, 50mg 4.8 Antiepileptics 4.8.1 Tiagabine 4.8 Antiepileptics 4.8.1 Sodium valproate tablets 5mg, 10mg, 15mg ec tablets 200mg, 500mg; MR tablets 200mg, 300mg, 500mg; crushable tablets 100mg; liquid (sugar-free) 200mg in 5ml; solution 4.8 Antiepileptics 4.8.1 Primidone tablet 250 mg
4.8 Antiepileptics 4.8.1 Pregabalin capsules 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg For use in line with NICE's guidance 4.8 Antiepileptics 4.8.1 Phenytoin capsules phenytoin sodium 25mg, 50mg, 100mg, 300mg; tablets phenytoin sodium 100mg; chewable tablets phenytoin 50mg; suspension phenytoin 30mg in 5ml 4.8 Antiepileptics 4.8.1 Phenobarbital tablets 15mg, 30mg, 60mg; elixir 15mg/5ml 4.8 Antiepileptics 4.8.1 Oxcarbazepine tablets 150mg, 300mg, 600mg; oral suspension 300mg in 5ml 4.8 Antiepileptics 4.8.1 Levetiracetam tablets 250mg, 500mg, 750mg, 1g; oral liquid 500mg in 5ml 4.8 Antiepileptics 4.8.1 Lamotrigine tablets 25mg, 50mg, 100mg, 200mg; dispersible tablets 5mg, 25mg, 100mg 4.8 Antiepileptics 4.8.1 Perampanel 4.8 Antiepileptics 4.8.1 Gabapentin tablets 2mg, 4mg,6mg, 8mg, 10mg, 12mg capsules 100mg, 300mg, 400mg. Tablets 600mg 4.8 Antiepileptics 4.8.1 Ethosuximide capsules 250 mg 4.8 Antiepileptics 4.8.1 Clonazepam 4.8 Antiepileptics 4.8.1 Clobazam 4.8 Antiepileptics 4.8.1 Carbamazepine tablet 500micrograms tablets 10mg; tablets 100mg, 200mg, 400mg; MR tablets 200mg, 400mg; tablets chewable 100mg, 200mg; liquid 100mg in 5ml 4.8 Antiepileptics 4.8.1 Retigabine tablets 50mg, 100mg, 200mg, 300mg, 400mg; starter pack 4.8 Antiepileptics 4.8.1 Lacosamide tablets 50mg, 100mg, 150mg, 200mg; Syrup, 50mg in 5ml 4.8 Antiepileptics 4.8.1 Zonisamide capsules 25mg, 50mg, 100mg 4.9 Drugs used in parkinsonism and related 4.9 Drugs used in parkinsonism and related 4.9.1 Selegiline 4.9.1 Rotigotine tablets 1.25mg, 5mg, 10mg; oral liquid 10mg in 5ml patches 2mg/24hr, 4mg/24hr, 6mg/24hr, 8mg/24hr
4.9 Drugs used in parkinsonism and related 4.9.1 Ropinirole tablets 250microgram, 500micrograms, 1mg, 2mg, 5mg; MR tablets 2mg, 4mg, 8mg; starter pack; follow-on pack 4.9 Drugs used in parkinsonism and related 4.9 Drugs used in parkinsonism and related 4.9.1 Rasagiline mesilate tablet 1 mg 4.9.1 Pramipexole tablets 88microgram, 180micrograms, 350micrograms, 700micrograms; MR tablets 260micrograms, 520micrograms, 1.05mg, 1.57mg, 2.1mg, 2.62mg, 3.15mg 4.9 Drugs used in parkinsonism and related 4.9 Drugs used in parkinsonism and related 4.9.1 Entacapone 4.9.1 Co-careldopa tablets 200mg tablets 12.5/50, contain levodopa 50mg and carbidopa 12.5mg (Sinemet 62.5 ); tablets 10/100, contain levodopa 100mg and carbidopa 10mg; tablets 25/250, contain levodopa 250mg and carbidopa 25mg; tablets 25/100, contain levodopa 100mg and carbidopa 25mg; tablets 25/100, modifiedrelease, contain levodopa 100mg and carbidopa 25mg (Half Sinemet CR ). tablets 50/200, modifiedrelease, contain levodopa 200mg and carbidopa 50mg (Sinemet CR ); 4.9 Drugs used in parkinsonism and related 4.9.1 Co-beneldopa capsules 12.5/50 contain levodopa 50mg and benserazide 12.5mg; 25/100 contain levodopa 100mg and benserazide 25mg; 50/200 contain levodopa 200mg and benserazide 50mg; dispersible tablets 12.5/50, 25/100; MR capsules 25/100 (Madopar CR ) contain levodopa 100mg and benserazide 25mg 4.9 Drugs used in parkinsonism and related 4.9.1 Stalevo tablets 4.9 Drugs used in parkinsonism and related 4.9 Drugs used in parkinsonism and related 4.9.1 Amantadine 4.9.2 Trihexyphenidyl capsules 100mg tablets 2mg, 5mg; syrup 5mg in 5ml
4.9 Drugs used in parkinsonism and related 4.9.2 Procyclidine tablets 5mg; sugar free syrup 2.5mg in 5ml, 5mg in 5ml 4.9 Drugs used in parkinsonism and related 4.9 Drugs used in parkinsonism and related 4.9 Drugs used in parkinsonism and related 4.9.2 4.9.3 Drugs used in essential tremor, chorea, tics, and related 4.9.3 Drugs used in essential tremor, chorea, tics, and related Orphenadrine hydrochloride Riluzole Tetrabenazine tablet 50 mg tablets 50mg tablets 25mg For use in line with NICE's guidance. GPs should only be asked to prescribe this if a local shared care protocol has been agreed. 4.10 Drugs used in substance dependence 4.10 Drugs used in substance dependence 4.10.1 Alcohol dependence Acamprosate calcium 4.10.1 Alcohol dependence Disulfiram tablet 333 mg tablets 200mg 4.10 Drugs used in substance dependence 4.10 Drugs used in substance dependence 4.10.1 Alcohol dependence Nalmefene 4.10.2 Nicotine dependence Varenicline tablets 18mg Tablets, f/c, varenicline (as tartrate) 500 micrograms, 1 mg For use in line with NICE's guidance. 4.10 Drugs used in substance dependence 4.10.2 Nicotine dependence Nicotine patches (all strengths); chewing gum 2mg, 4mg; sublingual tablet 2mg; lozenge 1mg, 2mg, 4mg; inhalation 10mg; nasal spray 4.10 Drugs used in substance dependence 4.10.3 Opioid dependence Methadone sugar-free oral solution 1mg in 1ml 4.10 Drugs used in substance dependence 4.10.3 Opioid dependence Buprenorphine + naloxone Suboxone 2mg/500micrograms; 8mg/2mg sublingual tablets 4.10 Drugs used in substance dependence 4.10.3 Opioid dependence Buprenorphine sublingual tablets 400micrograms, 2mg, 8mg 4.10 Drugs used in substance dependence 4.10.3 Opioid dependence Naltrexone 4.11 Drugs used for dementia 4.11 Rivastigmine tablets 50mg capsules 1.5mg, 3mg, 4.5mg, 6mg; oral solution 2mg/ml; patches 4.6mg/24 hours, 9.5mg/24 hours 4.11 Drugs used for dementia 4.11 Memantine tablets 10mg, 20mg; treatment initiation pack; oral solution 5mg/actuation 4.11 Drugs used for dementia 4.11 Galantamine tablets 8mg, 12mg; MR capsules 8mg, 16mg, 24mg oral solution 4mg in 1ml 4.11 Drugs used for dementia 4.11 Donepezil tablets 5mg, 10mg 5. Infections 5.1 Antibacterial 5.1.1 Penicillins Phenoxymethylpenicillin (penicillin V) tablets 250mg; sugar-free oral solution 125mg in 5ml, 250mg in 5ml Refer to local anti-bacterial guidelines