Oxfordshire Clinical Commissioning Group Formulary

	Oxfordshire Clinical Commissioning Group
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Formulary Chapter 13: Skin - Full Chapter

13.08.01

Sunscreen preparations

Sunscreen preparations are regarded as drugs when prescribed for skin protection against ultraviolet radiation in abnormal cutaneous photosensitivity resulting from genetic disorders or photodermatoses, including vitiligo, those resulting from radiotherapy and chronic or recurrent herpes simplex labialis.

Prescriptions used in this way should be marked "ACBS" (Advisory Committee on Borderline Substances).

OCCG Sunscreen Policy

13.08.01

Photodamage

Fluorouracil cream (Efudix^®)

First Choice

First-line for multiple lesions in line with Oxfordshire Solar Keratosis Primary Care Treatment Pathway.

APCO January 2021.

Imiquimod 5% cream (Aldara®)
(Actinic Keratosis)

Second Choice

Second-line for multiple lesions in line with Oxfordshire Solar Keratosis Primary Care Treatment Pathway.

APCO January 2021.

Fluorouracil and Salicylic acid (Actikerall^® cutaneous solution)
(Actinic Keratosis)

Formulary

For single lesions or hyperkeratotic lesion in line with Oxfordshire Solar Keratosis Primary Care Treatment Pathway.

APCO January 2021.

Methyl-5-Aminolevulinate (Metvix^®)

Formulary

For prescribing by dermatologists only in secondary care. For photochemotherapy combining long-wave ultraviolet A radiation with a psoralen (PUVA) treatment only.

Actinica lotion

Formulary

For prescribing by dermatologists only in secondary care. For daylight photodynamic therapy (PDT).

APCO March 2018.

P20 cream (SPF 50)

Formulary

For prescribing by dermatologists only in secondary care. For daylight photodynamic therapy (PDT).

OCCG Guidelines: Solar Keratosis primary care treatment pathway

....

Non Formulary Items

Diclofenac Sodium 3% gel (Solaraze^®)

Non Formulary

Not recommended due to lack of evidence.

Imiquimod 3.75% cream (Zyclara^®)
(Actinic Keratosis)

Non Formulary

Not recommended due to insufficient evidence of advantage over other treatment options or cost efficacy.

APCO May 2007.

Ingenol mebutate (Picato^®)

Non Formulary

Not included in Solar Keratosis guidelines in line with MHRA warning

MHRA Warning: Ingenol mebutate gel (Picato▼): suspension of the licence due to risk of skin malignancy

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs
	Scottish Medicines Consortium

	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