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 Formulary Chapter 14: Immunological products and vaccines - Full Chapter
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14.01  Expand sub section  Active immunity
14.01  Expand sub section  Immunisation schedule
14.02  Expand sub section  Passive immunity
14.03  Expand sub section  Storage and use
14.04  Expand sub section  Vaccines and antisera to top
14.04  Expand sub section  Anthrax vaccine
14.04  Expand sub section  BCG vaccines
BCG vaccine diagnostic agent
(Tuberculline purified protein derivative (PPD))
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Formulary
Green
 
Link  PHE: Advice on administering 2 live vaccines at the same time
Link  Tuberculosis: The green book, chapter 32
   
BCG vaccine Intradermal
(Bacillus calmette-guerin vaccine)
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Formulary
Green
 
Link  PHE: Advice on administering 2 live vaccines at the same time
Link  Tuberculosis: The green book, chapter 32
   
14.04  Expand sub section  Botulism antitoxin
Botulism antitoxin
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Formulary
Red

Secondary care use only:

  • Contains specific antitoxic globulins that have the power of neutralising the toxins formed by types A,B & E of Clostridium Botulinum.
  • For post-exposure prophylaxis of botulism and for the treatment of persons thought to be suffering from botulism.

 
   
14.04  Expand sub section  Cholera vaccine
Cholera vaccine (Dukoral®)
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Formulary
Green
 
Link  Cholera: the green book, chapter 14
   
14.04  Expand sub section  Diphtheria vaccines to top
Boostrix-IPV
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Formulary
Green

Contains: Diphtheria, tetanus, pertussis (acellular, component) and poliomyelitis (inactivated) vaccine (adsorbed, reduced antigen(s) content)

 
Link  Diphtheria: the green book, chapter 15
Link  Pertussis: the green book, chapter 24
Link  Polio: the green book, chapter 26
Link  Tetanus: the green book, chapter 30
   
Infanrix IPV®
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Formulary
Green

Contains: Diphtheria, tetanus, pertussis (acellular, component) and poliomyelitis (inactivated) vaccine (adsorbed).

 
Link  Diphtheria: the green book, chapter 15
Link  Pertussis: the green book, chapter 24
Link  Polio: the green book, chapter 26
Link  Tetanus: the green book, chapter 30
   
Infanrix-IPV+Hib®
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Formulary
Green

Contains: Diphtheria, tetanus, pertussis (acellular component), poliomyelitis (inactivated), and Haemophilus influenzae type b conjugate vaccine (adsorbed).

 
Link  Diphtheria: the green book, chapter 15
Link  Haemophilus influenzae type b (Hib): the green book, chapter 16
Link  Pertussis: the green book, chapter 24
Link  Polio: the green book, chapter 26
Link  Tetanus: the green book, chapter 30
   
Pediacel®
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Formulary
Green

Contains: Diphtheria, Tetanus, Pertussis (Acellular, Component), Poliomyelitis (Inactivated) and Haemophilus Type b Conjugate Vaccine (Adsorbed)(DTaP/IPV/Hib).

 
Link  Diphtheria: the green book, chapter 15
Link  Pertussis: the green book, chapter 24
Link  Polio: the green book, chapter 26
Link  Tetanus: the green book, chapter 30
   
Repevax®
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Formulary
Green

Contains: Adsorbed Diphtheria [low dose], Tetanus, Pertussis (Acellular, Component) and Inactivated Poliomyelitis Vaccine (dTaP/IPV).

 
Link  Diphtheria: the green book, chapter 15
Link  Pertussis: the green book, chapter 24
Link  Polio: the green book, chapter 26
Link  Tetanus: the green book, chapter 30
   
Revaxis®
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Formulary
Green

Contains: Adsorbed Diphtheria [low dose], Tetanus and Inactivated Poliomyelitis (Td/IPV) vaccine

 
Link  Diphtheria: the green book, chapter 15
Link  Pertussis: the green book, chapter 24
Link  Polio: the green book, chapter 26
Link  Tetanus: the green book, chapter 30
   
14.04  Expand sub section  Haemophilus influenzae type B vaccine
Haemophilus influenzae type B (Menitorix®)
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Formulary
Green
 
Link  Haemophilus influenzae type b (Hib): the green book, chapter 16
   
14.04  Expand sub section  Hepatitis A vaccine
Hepatitis A vaccine Single Component (Avaxim®)
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Formulary
Green
 
Link  Hepatitis A: the green book, chapter 17
   
Hepatitis A vaccine Single Component (Epaxal®)
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Formulary
Green
 
Link  Hepatitis A: the green book, chapter 17
   
Hepatitis A vaccine Single Component (Havrix Monodose®)
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Formulary
Green
 
Link  Hepatitis A: the green book, chapter 17
   
Hepatitis A vaccine Single Component (Vaqta® Paediatric)
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Formulary
Green
 
Link  Hepatitis A: the green book, chapter 17
   
14.04  Expand sub section  Hepatitis B vaccine
Hepatitis B vaccine Single Component (Fendrix®)
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Formulary
Red

Secondary care use only.

Funded by specialised commissioning.

APCO January 2021.

 

May not be available on the NHS if being given for travel.

 
   
14.04  Expand sub section  Human papilloma virus vaccine
Human papilloma virus vaccine (Gardasil®)
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Formulary

Green Traffic Light Vaccine of choice for the national immunisation program as per Green Book.

Red Traffic Light For men who have sex with men (MSM). Prescribed by Specialist Sexual Health Services and HIV clinics. NHS E/PHE funded. 

APCO September 2018.  

 
Link  DoH: HPV vaccination and cervical cancer: addressing the myths
Link  Human papillomavirus (HPV): the green book, chapter 18a
   
Human papilloma virus vaccine (Cervarix®)
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Formulary
Green
 
Link  DoH: HPV vaccination and cervical cancer: addressing the myths
Link  Human papillomavirus (HPV): the green book, chapter 18a
   
14.04  Expand sub section  Influenza vaccine to top
Influenza vaccine
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Formulary
Green

Cost-effective brands include:

  • Enzira®: 2017 NHS price - £5.25.
  • Influvac®: 2017 NHS Price - £5.22.


NB. Intanza® is black listed, see below for more details.

 
Link  Influenza: the green book, chapter 19
Link  Public Health England: The national flu immunisation programme
   
Live attenuated Influenza vaccine  (Fluenz Tetra®)
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Formulary
Green

Part of national vaccination programme.

Intranasal vaccine (Fluenz tetra®) is a live vaccine licensed for children aged 2-18ys and has different contraindications and precautions to vaccines given by injection, see SPC for more details.

APCO September 2013. 

 
Link  Public Health England: The national flu immunisation programme
Link  Public Health England: Childhood flu programme: information for healthcare practitioners
Link  PHE: Advice on administering 2 live vaccines at the same time
Link  Influenza: the green book, chapter 19
Link  Which flu vaccine should children have?
   
14.04  Expand sub section  Measles vaccine
14.04  Expand sub section  Measles, Mumps and Rubella (MMR) vaccine
Measles, Mumps and Rubella Vaccine, Live (MMR)
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Formulary
Green
 
Link  Measles: the green book, chapter 21
Link  Mumps: the green book, chapter 23
Link  Rubella: the green book, chapter 28
Link  PHE: Advice on administering 2 live vaccines at the same time
   
14.04  Expand sub section  Meningococcal vaccines
Meningococcal A, C, W135, and Y conjugate vaccine (Menveo®)
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Formulary
Green

May not be available on the NHS if being given for travel.

 
Link  Meningococcal: the green book, chapter 22
   
Meningococcal group B Vaccine (Bexsero®)
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Formulary

Green Traffic Light  For primary immunisation schedule and asplenia/hyposplenia schedules as per Green Book.

Red Traffic Light  For patients receiving eculizumab for atypical Haemolytic Uraemic Syndrome (aHUS).

 
Link  Meningococcal: the green book, chapter 22
   
Meningococcal group C conjugate vaccine
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Formulary
Green

Brands include: Meningitec®, Menjugate Kit®, NeisVac-C®

 
Link  Meningococcal: the green book, chapter 22
Link  Public Health England: Changes to the meningococcal C conjugate (MenC) vaccine schedule 2013 to 2015: advice for healthcare professionals
   
Meningococcal polysaccharide A, C, W135 and Y vaccine (ACWY Vax®)
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Formulary
Green

May not be available on the NHS if being given for travel.

 
Link  Meningococcal: the green book, chapter 22
   
14.04  Expand sub section  Mumps vaccine
14.04  Expand sub section  Pertussis vaccine to top
14.04  Expand sub section  Pneumococcal vaccines
23-valent pneumococcal polysaccharide vaccine (Previously known as Pneumovax® II)
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Formulary
Green
 
Link  Pneumococcal: the green book, chapter 25
   
Pneumococcal polysaccharide conjugate vaccine (adsorbed) (Prevenar 13®)
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Formulary
Green
 
Link  Pneumococcal: the green book, chapter 25
   
14.04  Expand sub section  Poliomyelitis vaccines
14.04  Expand sub section  Rabies vaccine
Rabies vaccine
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Formulary
Green

May not be available on the NHS if being given for travel.

 
Link  HPA: Guidelines on managing rabies post-exposure prophylaxis
Link  Rabies: the green book, chapter 27
   
14.04  Expand sub section  Rotavirus vaccine
Rotavirus vaccine (Rotarix®)
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Formulary
Green

Oral suspension.

 
Link  PHE: Advice on administering 2 live vaccines at the same time
Link  Rotavirus: the green book, chapter 27b
   
14.04  Expand sub section  Rubella vaccine to top
14.04  Expand sub section  Smallpox vaccine
14.04  Expand sub section  Tetanus vaccines
14.04  Expand sub section  Tick-borne encephalitis vaccine
14.04  Expand sub section  Typhoid vaccines
Polysaccharide Typhoid Vaccine (Typherix®)
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Formulary
Green
 
   
Polysaccharide vaccine for injection (Typhim Vi®)
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Formulary
Green
 
   
Typhoid Live Oral vaccine (Vivotif®)
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Formulary
Green
 
   
14.04  Expand sub section  Varicella-zoster vaccine to top
Varicella Zoster vaccine (Zostavax®)
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Formulary
Green

In the latest JCVI guidance and as part of national vaccination programme.

APCO September 2013. 

 
Link  Public Health England Q&A for healthcare professionals: Vaccination against shingles for adults aged 70 and 79
Link  PHE: Advice on administering 2 live vaccines at the same time
Link  Shingles: the green book chapter 28a
   
Varicella-zoster vaccine (Varilrix®)
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Formulary
Green
 
Link  PHE: Advice on administering 2 live vaccines at the same time
Link  Varicella: the green book, chapter 34
   
14.04  Expand sub section  Yellow fever vaccine
14.05  Expand sub section  Immunoglobulins
Rabies immunoglobulin
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Formulary
Red

For use following recommendation by a Microbiologist (Registrar or Consultant)
The requestor must use the PHE “Request form for Rabies Post Exposure Treatment”. 

 
Link  HPA: Guidelines on managing rabies post-exposure prophylaxis
   
14.05  Expand sub section  Specific immunoglobulins
14.05  Expand sub section  Interferons
INTERFERON GAMMA-1b (Immukin®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
14.05.01  Expand sub section  Normal immunoglobulin to top
Normal immunoglobulin (Privigen®)
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First Choice
Red
High Cost Medicine

Do not substitute brands in established patients, but use Privigen for newly initiated patients.   

Secondary care use only.

 
Normal Immunoglobulin (Cuvitru®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. NB. Replaces Subcuvia®.

APCO January 2018.

 
   
Normal Immunoglobulin (Flebogamma® DIF)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
Normal immunoglobulin (Gammanorm®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
Normal Immunoglobulin (Gammaplex®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
Normal Immunoglobulin (Gamunex®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. Funded by specialised commissioning.

APCO November 2017.

 
   
Normal Immunoglobulin (Hizentra®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
Normal Immunoglobulin (Intratect®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
Normal immunoglobulin (Iqymune®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. Funded by specialised commissioning.

APCO November 2017.

 
   
Normal Immunoglobulin (Kiovig®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
Normal Immunoglobulin (Octagam®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
Normal Immunoglobulin (Subgam®)
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Formulary
Red

Prescribe by brand.

Secondary care use only. 

 
   
14.05.02  Expand sub section  Disease-specific immunoglobulins
Hepatitis B immunoglobulin (HBIG)
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Formulary
Red

Secondary care use only. 

 
Link  Immunoglobulin: when to use
   
Tetanus immunoglobulin
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Formulary
Red

Secondary care use only. 

 
Link  Immunoglobulin: when to use
   
Varicella-Zoster immunoglobulin (VZIG)
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Formulary
Red

Varicella-zoster immunoglobulin (VZIG) prophylaxis is recommended for individuals who fulfil all of the following three criteria:

  • Significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period,
  • At increased risk of severe chickenpox i.e. immunosuppressed individuals, neonates and pregnant women,
  • No antibodies to varicella-zoster virus (VZV). Urgent VZV antibody testing can be performed within 24 hours.

 
Link  Immunoglobulin: when to use
   
14.05.03  Expand sub section  Anti-D (Rho) immunoglobulin
Anti-D (Rh0) Immunoglobulin
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Formulary
Red

For routine antenatal anti-D prophylaxis for RhD-negative women as per NICE TA156.

 
Link  NICE TA156: Anti-D in pregnant women
   
14.06  Expand sub section  International travel
 ....
 Non Formulary Items
Anthrax vaccine

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Non Formulary
 
Diphtheria antitoxin

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Non Formulary

Available from Centre for Infections (Tel (020) 8200 6868) or in Northern Ireland from Public Health Laboratory, Belfast City Hospital (Tel (028) 9032 9241).

 
Hepatitis A vaccine with Hepatitis B vaccine  (Twinrix®, Ambirix®)

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Non Formulary
Black

Not NHS Hepatitis B vaccine is not funded by NHS for travel purposes.  

APCO May 2017. 

Link  Hepatitis A: the green book, chapter 17
Link  Hepatitis B: the green book, chapter 18
 
Hepatitis A vaccine with typhoid vaccine  (Hepatyrix®)

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Non Formulary
Black

Prescribing Hep A and typhoid separately is more cost-effective.

APCO May 2017. 

Link  Hepatitis A: the green book, chapter 17
Link  Typhoid: the green book, chapter 33
 
Hepatitis A vaccine with typhoid vaccine  (ViATIM®)

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Non Formulary
Black

Prescribing Hep A and typhoid separately is more cost-effective.

APCO May 2017. 

Link  Hepatitis A: the green book, chapter 17
Link  Typhoid: the green book, chapter 33
 
Hepatitis B vaccine Single Component  (Engerix B®)

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Non Formulary

May not be available on the NHS if being given for travel.

 
Hepatitis B vaccine Single Component  (HBvaxPRO®)

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Non Formulary

May not be available on the NHS if being given for travel.

 
Influenza Vaccine  (Intanza®)

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Non Formulary
Black

Not recommended due lack of evidence of improved efficacy compared to standard therapy.

APCO July 2011.

 
Japanese Encephalitis Vaccine  (Ixiaro®)

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Non Formulary

May not be available on the NHS if being given for travel.

 
Malaria vaccine  (Mosquirix®)

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Non Formulary
 
Normal Immunoglobulin  (Aragam®)

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Non Formulary
 
Normal immunoglobulin  (Gammagard S/D®)

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Non Formulary
High Cost Medicine
 
Normal immunoglobulin  (Subcuvia®)

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Non Formulary
Black

Being discontinued.

 
Normal immunoglobulin  (Vigam®)

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Non Formulary
High Cost Medicine
 
Poliomyelitis Vaccine Inactivated (Salk)
(Inactivated poliomyelitis vaccine (IPV))

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Non Formulary
 
Poliomyelitis Vaccine Live (oral)

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Non Formulary
 
Polysaccharide vaccine with hepatitis A vaccine

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Non Formulary

Prescribing Hep A and typhoid separately is more cost-effective.

 
Tick-borne encephalitis vaccine

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Non Formulary

May not be available on the NHS if being given for travel.

Link  Tick-borne encephalitis: the green book, chapter 31
 
Travel vaccines
(Vaccines administered exclusively for the purposes of travel)

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Non Formulary
Black

BCG requires the ‘should not be prescribed on the NHS exclusively for the purposes of travel’ caveat.

APCO September 2019.

 
Varicella-zoster vaccine  (Varivax®)

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Non Formulary
Link  Varicella: the green book, chapter 34
 
Yellow fever vaccine (Live)

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Non Formulary

May not be available on the NHS if being given for travel.

Available at designated Yellow Fever Centres only.

Link  PHE: Advice on administering 2 live vaccines at the same time
Link  UKMI Q&A: Is Yellow Fever vaccine safe whilst breastfeeding
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Red: Medicines which should only be prescribed in secondary care by a specialist.  

Amber Continuation

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

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

Green: Medicines which are suitable for initiation and ongoing prescribing within primary care.   

Brown

Brown: Medicines which should only be prescribed in restricted circumstances.  

Black

Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.  

OCCG Green

not used  

netFormulary