| Formulary Chapter 13: Skin - Full Chapter
|
| 13.02.01 |
Emollients |
|
|
Epimax® Original cream
|
First Choice
|
See Emollient Prescribing Guidelines.
Mimics Diprobase. Available as a squeeze bottle (flexi-dispenser), which may be difficult for patient with dexterity problems. Suitable as a soap substitute.
APCO March 2020.
|
|
|
Epimax® ointment
|
First Choice
|
See Emollient Prescribing Guidelines.
Alternative to Epaderm® (manufacturing process produces a creamier texture) More cost-effective than Hydromol® and Zeroderm® (WSP).
APCO March 2020
|
|
|
Epimax ® ExCetra Cream
|
Second Choice
|
See Emollient Prescribing Guidelines.
Equivalent to Cetraben®.
APCO March 2020.
|
|
|
Emollient preparation containing Urea (Balneum® cream)
|
Formulary
|
See Emollient Prescribing Guidelines.
For severe dry skin (e.g. ichthyosis). Contains ceramide which is a lipid lamella mimicking agent resulting in transepidermal water loss of 24hrs.
APCO March 2020.
|
|
|
Epimax® Isomol gel
|
Formulary
|
See Emollient Prescribing Guidelines.
Cost effective alternative to Aproderm®, Doublebase® & Zerodouble®.
Available as a squeeze bottle (flexi-dispenser) which may be difficult for patients with dexterity problems.
APCO March 2020.
|
|
|
Fifty:50® ointment
|
Formulary
|
See Emollient Prescribing Guidelines.
Prescribe by brand. Price will vary if prescribed as 50:50 or generically.
APCO March 2020.
|
 MHRA: Fire Risk - Paraffin-based skin emollients on dressings or clothing
|
Hydromol® Intensive Cream
|
Formulary
|
In line with OCCG Wound Management Formulary
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO May 2015.
|
|
|
imuDERM® emollient
|
Formulary
|
See Emollient Prescribing Guidelines.
Urea 5% + glycerine 5%. Very competitively priced, effective moisture-preserving emollient.
Natural moisturising factor – constituents of product improve hydration of the stratum corneum.
APCO March 2020.
|
|
|
Oilatum® cream
|
Formulary
|
See Emollient Prescribing Guidelines. Contains povidone which
confers a TEWL of 12hrs.
Please see OCCG Wound Management Formulary.
APCO March 2020.
|
|
|
Dermol® cream
|
 Restricted
|
See Emollient Prescribing Guidelines.
- Reserve for where there is a concern about Staph colonisation.
- Intermittent use can reduce frequency of infection related flares of atopic eczema.
- This should be targeted and short term use only.
APCO March 2020.
|
|
|
Emollin® spray
|
Restricted
|
See Emollient Prescribing Guidelines.
Only for difficult to reach areas or patients unable to use alternative preparations as this is not the most cost effective preparation.
Covers three times the skin area as equivalent volume of cream/ointment.
APCO March 2020.
|
|
|
Epimax ® Paraffin-Free ointment
|
Restricted
|
See Emollient Prescribing Guidelines.
May be suitable where flammability is an issue.
APCO March 2020.
|
|
|
Epimax® Oatmeal Cream
|
Restricted
|
See Emollient Prescribing Guidelines.
Colloidal oatmeal containing emollients are borderline substances & may only be prescribed in accordance with the advice of the Advisory Committee on Borderline Substances (ACBS) for the clinical conditions listed (see current BNF).
They may be considered for children who are sensitive to other emollients but should not be used routinely.
APCO March 2020.
|
|
|
|
|
|
|
|
|
|
|
|
|
| 13.02.01 |
Emollients - preparations containing urea |
|
|
| 13.02.01 |
Emollients - with antimicrobials |
|
|
| 13.02.01.01 |
Emollient bath and shower preparations |
|
|
| .... |
| Non Formulary Items |
Allpresan® foam cream
(Basic and Intensive)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollient Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Alpha Keri Bath®
(Emollient bath additive)
|
Non Formulary
|
Not recommended due to lack of evidence.
See Emollients Prescribing Guidelines.
APCO March 2020. |
|
|
AproDerm® colloidal cream
|
Non Formulary
|
Epimax® Oatmeal Cream is the most cost-effective formulation. See Emollient Prescribing Guidelines.
APCO March 2020.
|
|
|
Aquadrate® cream
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available. See Emollient Prescribing Guideline.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Aquamax® cream
|
Non Formulary
|
Cream is in a tub therefore prone to contamination. |
|
|
AquaMax® wash
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Aqueous Cream BP
|
Non Formulary
|
See Emollient Prescribing Guidelines. No longer recommended for prescribing as an emollient or soap substitute as it contains 'SLS' which is skin irritant. APCO January 2017. |
UKMI Q&A: Why is aqueous cream no longer recommended as a leave on moisturiser?
|
Aveeno® Cream
|
Non Formulary
|
Epimax® Oatmeal Cream is the most cost-effective formulation. See Emollient Prescribing Guidelines.
APCO March 2020.
|
|
|
Balneum® Emollient bath additive
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Balneum® Plus cream
(Emollient preparation containing Urea)
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Cetraben® Cream
|
Non Formulary
|
Not recommended. Prescribe Epimax® ExCetra cream which is equivalent and more cost-effective. See Emollient Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Cetraben®Bath additive
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Dermatonics® Heel Balm
|
Non Formulary
|
Due to lack of good quality evidence comparing emollients. Can be purchased over the counter supported by Clinical Commissioning Policy 88d.
APCO September 2011. |
|
|
Diprobase® Cream
|
Non Formulary
|
Consider Epimax® Original cream which has the same ingredients and is a more cost effective alternative. See Emollient Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Diprobase® Ointment
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
DoubleBase Dayleve® Gel
|
Non Formulary
|
Formulation designed to offer the convenience of as little as twice daily application.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Doublebase® Emollient Bath Additive
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Doublebase® Emollient Shower Gel
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Doublebase® Emollient Wash Gel
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
DoubleBase® Gel
|
Non Formulary
|
Consider Epimax® Isomol gel which has similar ingredients and is a more cost effective alternative. See Emollient Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
E45® Cream
|
Non Formulary
|
Relatively short barrier protection effect. Contains parabens (skin sensitiser).
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient Bath Additive (Aveeno®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive (Dermalo®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive (Diprobath®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive (E45®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive (Imuderm®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive (Oilatum®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive (QV®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive (Zerolatum®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive with Antimicrobials (Dermol®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive with Antimicrobials (Dermol®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additive with Antimicrobials (Emulsiderm®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additives (Zeroneum®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient Bath Additives (Zerozole®)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient preparation (Decubal® Clinic)
|
Non Formulary
|
Not suitable for prescribing as not in the Drug Tariff. |
|
|
Emollient preparation (Dermamist® 10% spray)
|
Non Formulary
|
Consider Emollin spray but only for difficult to reach areas or patients unable to use alternative preparations. See Emollient Prescribing Guidelines.
|
|
|
Emollient preparation (Drapolene® Cream)
|
Non Formulary
|
Not suitable for prescribing as not in the Drug Tariff.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation (Epaderm® Cream)
|
Non Formulary
|
Not recommended as more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation (Epaderm® Ointment)
|
Non Formulary
|
Consider Epimax ointment® as a more cost effective alternative. See Emollient Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emollient preparation (Hewletts® Cream)
|
Non Formulary
|
Not suitable for prescribing as not in the Drug Tariff. |
|
|
Emollient preparation (Kamillosan®)
|
Non Formulary
|
Not suitable for prescribing as not in the Drug Tariff.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation (Keri®)
|
Non Formulary
|
Not suitable for prescribing as not in the Drug Tariff. |
|
|
Emollient preparation (Linola® Gamma)
|
Non Formulary
|
Not suitable for prescribing as not in the Drug Tariff. |
|
|
Emollient preparation (Lipobase® Cream)
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available. |
|
|
Emollient preparation (Neutogena® Dermatological Cream)
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation (Ultrabase® Cream)
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation (Vaseline Dermacare®)
|
Non Formulary
|
Not suitable for prescribing as not in the Drug Tariff.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation (ZeroAQS® Cream)
|
Non Formulary
|
Claims to mimic Aqueous cream (no SLS). Not recommended as the cream is in a tub therefore prone to contamination. |
|
|
Emollient preparation (Zeroguent® Cream)
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation containing Urea (Calmurid® Cream)
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation containing Urea (E45® Itch Relief Cream)
|
Non Formulary
|
Consider imuDERM® as a more cost effective alternative.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation containing Urea (Nutraplus® Cream)
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Emollient preparation with antimicrobials (Eczmol® Cream)
|
Non Formulary
|
Consider Dermol as a more cost effective alternative only under these conditions: - Reserve for where there is a concern about Staph colonisation.
- Intermittent use can reduce frequency of infection related flares of atopic eczema.
- This should be targeted and short term use only.
|
|
|
Emollient preparation with antimicrobials (Zerolatum® Plus)
(Bath)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Emulsifying Ointment BP
|
Non Formulary
|
Not recommended as contains 3% sodium lauryl sulphate which can be irritant to normal skin. |
MHRA: Fire Risk - Paraffin-based skin emollients on dressings or clothing
|
Enopen® Cream
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Eucerin® Intensive Cream
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Eumocream®
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Flexitol® Heel Balm
|
Non Formulary
|
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO September 2011. |
|
|
Footmender All in One Diabetic®
|
Non Formulary
|
Not recommended. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO January 2021. |
|
|
Hydromol® bath and shower
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Hydromol® Cream
|
Non Formulary
|
Contains sodium pyrollidine carboxylate that is a natural moisturising factor and parabens (skin sensitiser). More cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Hydromol® Ointment
|
Non Formulary
|
Consider Epimax® ointment as a more cost effective alternative. See Emollient Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Lanolin emollient spray
(Evolve plus)
|
Non Formulary
|
Not suitable for prescribing as not in the Drug Tariff.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Liquid and White Soft Paraffin Ointment (50:50)
|
Non Formulary
|
Prescribe as Fifty:50® ointment as a more cost effective brand. |
MHRA: Fire Risk - Paraffin-based skin emollients on dressings or clothing
|
Oilatum® Plus
(Emollient bath additive)
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Oilatum® Shower emollient gel
|
Non Formulary
|
Not recommended due to lack of evidence. See Emollients Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
QV® cream
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available. Contains parabens (skin senitiser).
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
Skin Salvation Cream®
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available. |
|
|
Unguentum M® Cream
|
Non Formulary
|
Not recommended as there are more cost effective alternatives available.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D. |
|
|
White Soft Paraffin BP
|
Non Formulary
|
White petroleum jelly unlikely to be tolerated as a leave on emollient. |
MHRA: Fire Risk - Paraffin-based skin emollients on dressings or clothing
|
Yellow Soft Parafin BP
|
Non Formulary
|
Yellow petroleum jelly unlikely to tolerated as a leave on emollient. |
MHRA: Fire Risk - Paraffin-based skin emollients on dressings or clothing
|
Zerobase® Cream
|
Non Formulary
|
Consider Epimax® Original cream which has similar ingredients and is a more cost effective alternative. See Emollient Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
|
|
|
Zerocream®
|
Non Formulary
|
See Emollient Prescribing Guidelines.
Mimics E45.
APCO March 2020. |
|
|
Zeroderm® ointment
|
Non Formulary
|
Epimax® ointment is more cost-effective.
See Emollient Prescribing Guidelines.
APCO March 2020. |
|
|
Zerodouble® Gel
|
Non Formulary
|
Consider Epimax® Isomol gel which has similar ingredients and is a more cost effective alternative. See Emollient Prescribing Guidelines.
Can be purchased over the counter, in line with Clinical Commissioning Policy 88D.
APCO March 2020. |
|
|
Zeroveen® Cream
|
Non Formulary
|
Not included in the Emollient Prescribing Guidelines.
|
|
|
| |
Key |
|
|
|
|
Cytotoxic Drug
|
|
|
Controlled Drug
|
|
High Cost Medicine
|
|
Cancer Drugs Fund
|
|
NHS England |
|
Homecare |
|
CCG |
|
Traffic Light Status Information
| Status |
Description |
|
Red: Medicines which should only be prescribed in secondary care by a specialist. |
|
Amber Continuation: Medicines which should be initiated or recommended by a specialist for continuation in primary care. The specialist must notify the GP that the prescribing responsibility has been transferred. |
|
Amber Shared Care Protocol: Medicines which are appropriate to be initiated and stabilised by a specialist, once stabilised the medicine may be appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement. The shared care protocol must be approved by the Area Prescribing Committee Oxfordshire (APCO). |
|
Green: Medicines which are suitable for initiation and ongoing prescribing within primary care. |
|
Brown: Medicines which should only be prescribed in restricted circumstances. |
|
Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety. |
|
not used |
|
|
|
