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 897214 GINETTE TABS 701469 ORATANE 10MG Acne Isotretinoin 20mg 701471 ORATANE 20MG Sulphonamides and combinations Trimethoprim 80mg; sulphamethoxazole 400mg 700972 MEDITRIM 480MG Tetracyclines Doxycycline HCl 100mg 716944 CYCLIDOX 100MG Tetracyclines Minocycline 100mg 788295 CYCLIMYCIN 100MG Tetracyclines Minocycline 50mg 788287 CYCLIMYCIN 50MG Tetracyclines Oxytetracycline HCl 250mg 895029 OXY 250MG ALLERGIC RHINITIS (With Asthma / <12 years old) Anti-Histamines Cetirizine dihydrochloride 10mg tab 704359 AUSTELL CETIRIZINE 10MG
J30 Anti-Histamines Cetirizine 1mg/ml syrup 708117 CETIRIZINE-HEXAL 1MG/1ML Anti-Histamines Loratadine 10mg tab 707313 SIMAYLA LORATADINE 10MG Anti-Histamines Loratadine 5mg/5ml 701640 LORAHIST SYRUP Glucocorticosteroids Beclomethasone dipropionate 50ug Aqueous 897937 CLENIL AQUEOUS NASAL SPRAY Glucocorticosteroids Fluticasone 50mcg 714595 FLONASE ALZHEIMER'S DISEASE Alzheimer's disease Donepezil HCl 10mg 714065 ARIKNOW 10MG 715040 DONECEPT 10MG G30 Alzheimer's disease Donepezil HCl 5mg 714066 ARIKNOW 5MG 715039 DONECEPT 5MG Alzheimer's disease Galantamine 8mg 891875 REMINYL CR 8MG Alzheimer's disease Galantamine 16mg 714433 REMINYL CR 16MG Alzheimer's disease Galantamine 24mg 714432 REMINYL CR 24MG Alzheimer's disease Rivastigamine 1.5mg 848557 EXELON 1.5 MG CAPS Alzheimer's disease Rivastigamine 3.0mg 848565 EXELON 3.0 MG CAPS
Alzheimer's disease Rivastigamine 4.5mg 848573 EXELON 4.5 MG CAPS Alzheimer's disease Rivastigamine 6.0mg 848581 EXELON 6.0 MG CAPS ANXIETY Others Buspirone HCl 10mg 825719 PASRIN 10MG TAB F41 SSRI Fluoxetine 20mg 894303 DEPROZAN 20MG SSRI Citalopram 20mg 713583 ARROW CITALOPRAM 702769 TALOMIL 20MG SSRI Paroxetine 20mg 705122 SERRAPRESS 20MG 705633 XET 20MG Beta-blockers Propranolol 40mg 806560 INDOBLOK 40MG TAB ATTENTION DEFICIT DISORDER (ADHD) Others Methylphenidate HCl 10mg 761044 RITALIN 10MG TABS 702505 METHYLPHENIDATE Only for patients under HCL- DOUGLAS 18 years of age F90 Others Methylphenidate HCl 20mg 701627 RITALIN LA 20MG CAPS Others Methylphenidate HCl 18mg 704161 CONCERTA 18MG Others Methylphenidate HCl 27mg 714559 CONCERTA 27MG
Others Methylphenidate HCl 36mg 704162 CONCERTA 36MG Others Methylphenidate HCl 54mg 704163 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 703544 CLORIX 150MG TAB 703547 CLORIX 300MG TAB 713583 ARROW CITALOPRAM 702769 TALOMIL 20MG Fluoxetine HCI 20mg cap 894303 DEPROZAN 20MG 705064 ZYDUS-FLUOXETINE 20MG Paroxetine 20mg 705122 SERRAPRESS 20MG 705633 XET 20MG Escitalopram 10mg 718743 ZITOLEX 10MG 719547 ACCORD ESCITALOPRAM 10MG Escitalopram 20mg 718744 ZITOLEX 20MG 719548 ACCORD ESCITALOPRAM 20MG Sertraline 50mg 719972 DYNA-SERTRALINE 50MG 705420 SERDEP 50MG TAB Sertraline 100mg 719973 DYNA-SERTRALINE 100MG 715935 SERDEP100MG TAB Venlafaxine HCL 37.5mg Venlafaxine HCL 37.5mg 710972 ODIVEN 37.5MG TABS 706399 VENLOR XR 37.5MG Venlafaxine HCL 75mg 706402 VENLOR XR 75MG 718361 VENLAFAXINE UNICORN XR 75mg
Serotonin and Noradrenaline re-uptake Venlafaxine HCL 150mg 706404 VENLOR XR 150MG 718362 VENLAFAXINE UNICORN XR 150mg Tricyclics Amitriptyline HCI 25mg 784230 TREPILINE 25MG TAB Tricyclics Clomipramine HCI 10mg 847410 EQUINORM 10MG Tricyclics Clomipramine HCI 25mg 703381 CLOMIDEP 25MG Tricyclics Dothiepin HCI 25mg 800198 THADEN 25MG CAPS Tricyclics Dothiepin HCI 75mg 800201 THADEN 75MG CAPS Tricyclics Imipramine HCI 10mg 724661 ETHIPRAMINE 10MG TAB Tricyclics Imipramine HCI 25mg 724688 ETHIPRAMINE 25MG TAB Anti-epileptics Lamotrigine 25mg 709539 DYNA-LAMOTRIGINE 25MG Anti-epileptics Lamotrigine 50mg 709537 DYNA-LAMOTRIGINE 50MG 710885 LAMIDUS 50MG Anti-epileptics Lamotrigine 100mg 709540 DYNA-LAMOTRIGINE 100MG 710887 LAMIDUS 100MG Anti-epileptics Lamotrigine 200mg 709541 DYNA-LAMOTRIGINE 200MG 710888 LAMIDUS 200MG Other Mirtazapine 15mg 721209 MIRADEP 15MG 710802 MYLAN-MIRTAZAPINE 15MG Other Mirtazapine 30mg 721210 MIRADEP 30MG 710803 MYLAN-MIRTAZAPINE 30MG Anti-psychotics Risperidone 1mg 717997 RISNIA 1MG 711512 ZOXADON 1MG Anti-psychotics Risperidone 2mg 717998 RISNIA 2MG 711513 ZOXADON 2MG Other Agomelatine 25mg 716215 VALDOXANE 25MG TAB ECZEMA Emoliients and Lotion Aqueous Cream 400g 711963 EPI-MAX JUNIOR L20.9 Emoliients and Lotion Aqueous Cream 500g 723800 Epizone A L30.9 Emoliients and Lotion Emulsifying ointment 500g 883164 UNG EMULSIFICANS
Emoliients and Lotion Emulsifying ointment 500g 727797 EPIZONE E Cortico-steroids Hydrocortisone 25g 720011 DILUCORT CREAM 720038 DILUCORT OINTMENT Cortico-steroids Hydrocortisone 1g/100g 745472 MYLOCORT 1GM/100GM CREAM 745448 MYLOCORT 1GM/100GM OINT Cortico-steroids Betamethasone 1mg/g 833037 TOPIVATE 1MG/GM CREAM 708348 BETNOVATE 1MG/GM OINTMENT LENOVATE 0.1% Cortico-steroids Betamethasone 0.1% 800171 LENOVATE 0.1% OINT 800163 CREAM Cortico-steroids Methylprednisolone 1mg/g 793108 ADVANTAN CREAM 793086 ADVANTAN OINTMENT Cortico-steroids Methylprednisolone 1mg/g 793116 ADVANTAN FATTY OINT Anti-Histamines Chlorpheniramine 2mg/5ml SYR 702145 ALLERGEX 2MG/5ML SYR Anti-Histamines Chlorpheniramine 4mg 702072 ALLERGEX 4mg tablet 702129 ALLERHIST 4MG CAP Anti-Histamines Chlorpheniramine 4mg 703162 RHINETON 4MG TABS Fungicide Selenium 25mg/ml 763179 SELSUN SHAMPOO 2.5% Topical Cortico-steroids Fluocinolone 0.25mg/g 768294 SYNALAR GEL 0.25MG/G Cortico-steroids Betamethason 1mg/g 824208 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 854247 CIMLOK 200MG 854255 CIMLOK 400MG 712134 AUSTAC 150MG 712135 AUSTAC 300MG Proton pump Lansoprazole 15mg 708052 LANCAP 15MG Proton pump Lansoprazole 30mg 708053 LANCAP 30MG
Proton pump Omeprazole 20mg 704629 NOZER 20MG Proton pump Omeprazole 10mg 703461 OMEZ 10MG Proton pump Pantoprazole 20mg 715610 PANTOCID 20MG Proton pump Pantoprazole 40mg 708031 PANTOCID 40MG GOUT Anti-gout Colchicine 0.5mg 715271 LENNON-COLCHICINE 0.5MG M10.99 Anti-gout Allopurinol 758329 PURICOS 300MG TABS Anti-gout Allopurinol 758310 PURICOS 100MG TABS INSOMNIA Others Zolpidem 10mg 703986 ZOLNOXS G47.0 Others Zopiclone 7.5mg 700722 ZOPIVANE 7.5MG TAB MIGRAINE(Prophylaxis ONLY) Anti-Migraine agents Clonidine HCl 0.025mg 788317 MENOGRAINE 0.025MG G43 Beta-receptor blockers Propranolol HCl 10mg 806552 INDOBLOK 10MG Beta-receptor blockers Propranolol HCl 40mg 806560 INDOBLOK 40MG Tricyclics Amitriptyline HCI 25mg 784230 TREPILINE 25MG TAB Tricyclics Imipramine HCI 10mg 724661 ETHIPRAMINE 10MG TAB Tricyclics Imipramine HCI 25mg 724688 ETHIPRAMINE 25MG TAB OSTEOARTHRITIS Analgesic and Antipyretics Paracetamol 500mg tab 745723 NAPAMOL 500MG TAB M15 Non selective COX Diclofenac sod. 100mg 827592 PANAMOR SR 100MG TAB Non selective COX Diclofenac sod 25mg Non selective COX Diclofenac sod 50mg tab 786012 MERCK-DICLOFENAC 25MG 786020 MERCK-DICLOFENAC 50MG
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 824852 RANFEN 200MG 701654 RANFEN 400MG 782807 SANDOZ IBUPROFEN 600MG TAB 806447 NAPFLAM 250MG 808474 NAPFLAM 500MG Non selective COX Indomethacin 25mg 704725 ARTHREXIN 25MG ARROW MELOXICAM Selective COX2 Meloxicam 15mg 704828 FLEXOCAM 15MG 711325 15MG ARROW MELOXICAM Selective COX2 Meloxicam 7.5mg 704829 FLEXOCAM 7.5MG 711324 7.5MG Specific COX2 - COXIB Etoricoxib 60mg 709108 ARCOXIA 60MG TAB OSTEOPOROSIS Biphosphonates Alendronate 10mg 703937 OSTEOBON 10MG TAB M81 Biphosphonates Alendronate 70mg 705067 OSTEOBON 70MG TAB Biphosphonates Alendronate 70mg 718742 FEMAX 70MG TAB Biphosphonates Ibandronic acid 150mg tab 721721 BONIVA 150MG TAB Vitamin D2 Ergocalciferol 50 000iu 711640 CALCIFEROL Calcium Selective oestrogen receptor modulators Calcium carbonate 1250mg; Vitamin D3 400iu Raloxifene HCl 60mg 889211 B-CAL-D TAB 847461 EVISTA 60MG Dual action bone agents Strontium ranelate 705534 PROTOS 2g/sachet
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 708636 DOVOBET OINTMENT 717191 XAMIOL GEL 828726 DIPROSALIC LOTION Cortico-steroids Betamethasone [as dipropionate] 0;5mg; salicylic acid 30mg/g 720380 DIPROSALIC OINT Cortico-steroids Betamethasone as valerate 824208 BETNOVATE SCALP LOTION Dermatologicals Calcipotriol 837393 DOVONEX SCALP Dermatologicals Coal tar 835595 POLYTAR Dermatologicals Coal tar 772615 TRITAR SHAMPOO Dermatologicals Tazarotene 0.05% 837474 ZORAK 0.05% GEL Dermatologicals Tazarotene 0.1% 837482 ZORAK 0.1% GEL
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
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
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.
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
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
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
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)
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
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