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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.01  Bronchodilators
03.01.01  Adrenoceptor agonists
03.01.01.01  Selective Beta2 agonists
03.01.01.01  Short-acting beta2 agonists
Salbutamol
(Ventolin® Evohaler)
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Formulary
Green
 
   
Salbutamol
(Easyhaler®)
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Formulary
Green
 
   
Salbutamol 500micrograms/1ml
(Injection)
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Formulary
Red

Secondary care use only. 

 
   
Salbutamol 5mg/5ml
(Infusion)
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Formulary
Red

Secondary care use only. 

 
   
Terbutaline (Bricanyl® Turbohaler)
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Formulary
Green
 
   
03.01.01.01  Long-acting beta2 agonists to top
Formoterol fumarate (Oxis® Turbohaler)
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Formulary
Green

For COPD patients use Oxis® 12 Turbohaler in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Olodaterol (Striverdi Respimat®)
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Formulary
Green

In line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Formoterol Fumarate (Atimos® Modulite)
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Restricted Drug Restricted
Brown

Atimos® should not be initiated for new patients for COPD or asthma.

People whose treatment with Atimos® is not recommended in the Guidance on COPD Management in Primary care—Inhaled Therapies or Maintenance Management of Asthma – Inhaled and Oral Therapies (adults) but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

NB. For asthma use ICS/LABA combination inhaler as per guidance.

 
   
Formoterol fumarate (Easyhaler 12micrograms/dose)
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Restricted Drug Restricted
Brown

Formoterol Easyhaler® should not be initiated for new patients for COPD or asthma.

People whose treatment with Formoterol easyhaler® is not recommended in the Guidance on COPD Management in Primary care—Inhaled Therapies or Maintenance Management of Asthma – Inhaled and Oral Therapies (adults) but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

NB. For asthma use ICS/LABA combination inhaler as per guidance.

 
   
Salmeterol
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Restricted Drug Restricted
Brown

Salmeterol 25mcg should not be initiated for new patients for COPD or asthma.

People whose treatment with Salmeterol 25mcg is not recommended in the Guidance on COPD Management in Primary care—Inhaled Therapies or Maintenance Management of Asthma – Inhaled and Oral Therapies (adults) but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

NB. For asthma use ICS/LABA combination inhaler as per guidance.

 
   
03.01.01.02  Other adrenoceptor agonists
03.01.02  Antimuscarinic bronchodilators
Aclidinium (Eklira Genuair®)
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Formulary
Green

In line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Ipratropium Bromide
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Formulary
Green
 
   
Tiotropium (Spiriva® 18mcg inhalation)
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Formulary

Restricted Item Brown Traffic Light  Spiriva® 18mcg should not be initiated for new patients with COPD.

People whose treatment with Spiriva® 18mcg is not recommended in the Guidance on COPD Management in Primary care - Inhaled Therapies, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

APCO March 2017.

 
Link  MHRA Drug Safety Update: Safety studies of spiriva Respimat vs Handihaler
   
Tiotropium (Spiriva® Respimat 2.5mcg)
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Formulary

Green Traffic Light  In line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

Amber Traffic Light  For the treatment of asthma only as an add-on in adult patients who are currently treated with a combination of inhaled corticosteroids and long-acting beta2-agonists and who experienced one or more severe exacerbations in the previous year. See Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO March 2015.

 
   
Umeclidinium (Incruse Ellipta®)
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Formulary
Green

In line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
03.01.03  Theophylline
 note 

Theophylline has a narrow therapeutic index and troublesome interactions (especially with macrolides & nicotine).


N.B.
PRESCRIBE BY BRAND - Be aware that oral modified release brands of theophylline and aminophylline are NOT interchangeable. All patients need to be maintained on the same brand as initally prescribed for them.

 

Aminophylline (Phyllocontin Continus®)
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Formulary
Green

Prescribe by brand.

See Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
Aminophylline IV
(Injection)
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Formulary
Red

Secondary care use only. 

 
Link  UKMI Q&A: Conversion of IV aminophylline dose to oral aminophylline or theophylline
   
Theophylline (Nuelin® SA)
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Formulary
Green

Prescribe by brand.

 
   
Theophylline (Uniphyllin® Continus)
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Formulary
Green

Prescribe by brand.

 
   
03.01.04  Compound bronchodilator preparations
Aclidinium and Formoterol (Duaklir Genuair®)
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Formulary
Green

In line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Tiotropium & Olodaterol (Spiolto Respimat®)
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Formulary
Green

In line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Umeclidinium & Vilanterol (Anoro Ellipta®)
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Formulary
Green

In line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
03.01.05  Peak flow meters, inhaler devices and nebulisers to top
03.01.05  Peak flow meters
Low range peak flow meter
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Formulary
Green
 
   
Standard range peak flow meter
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Formulary
Green
 
   
03.01.05  Drug delivery devices
Volumatic®
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First Choice
Green

Available as adult or paediatric spacer.

 
AeroChamber Plus®
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Second Choice
Green

Second choice for patients who cannot manage with a volumatic® or if their inhalers do not fit a volumatic®. 

 
   
Aerochamber Plus Flow-Vu spacer®
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Restricted Drug Restricted
Brown

Includes a visual tool that helps count breathes, assure correct use and delivery. For use in patients with carers (including children).

APCO May 2019. 

 
   
Haleraid®
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Formulary
Red

Restricted to secondary care only for patients with dexterity problems. 

NB: Not available on FP10. Patients may be advised to purchase in primary care.

 
   
03.01.05  Nebulisers
03.01.05  Nebuliser Diluent
03.02  Corticosteroids to top
Beclometasone (Clenil Modulite®)
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First Choice
Green

First choice for CFC-free inhaled corticosteroid. 

Prescribe by brand as Clenil Modulite® and QVAR® brands of beclometasone inhalers are not dose equivalent.

For asthma see Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

 
Beclometasone and Formoterol (Fostair NEXThaler®)
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Formulary
Green

For asthma see Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

Available as:

  • Beclometasone 100 microgram / Formoterol 6 microgram
  • Beclometasone 200 microgram / Formoterol 6 microgram

APCO September 2017.

 
   
Beclometasone and Formoterol (Fostair®)
(200mcg/6mcg)
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Formulary
Green

For asthma see Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
Budesonide (Pulmicort®)
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Formulary
Green

For asthma see Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
Fluticasone Furoate & Vilanterol (Relvar Ellipta®)
(184mcg/22mcg)
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Formulary
Green

For asthmatic patients when medium or high dose ICS/LABA required as per Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
Fluticasone Propionate and Salmeterol (AirFluSal Forspiro®)
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Formulary
Green

For COPD - For patients on existing seretide accuhaler therapy only. Generic equivalent of seretide® 500 accuhaler.

APCO January 2016.

NB. For Asthma - Not included in Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

 
   
Fluticasone Propionate and Salmeterol (AirFluSal® MDI)
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Formulary
Green

In asthma patients when medium or high dose ICS/LABA required as per Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

Available as: 

  • Fluticasone propionate 250 microgram/ Salmeterol 25 microgram
  • Fluticasone propionate 125 microgram/ Salmeterol 25 microgram

APCO September 2017.

 
   
Fluticasone Propionate and Salmeterol (Seretide®50)
(Evohaler)
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Formulary
Green

For asthma see Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
Beclometasone and Formoterol (Fostair®)
(100mcg/6mcg)
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Formulary

Green Traffic Light  In line with Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

Restricted Item Brown Traffic Light  Restricted in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Budesonide and Formoterol (Symbicort® Turbohaler)
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Formulary

Green Traffic Light  For management of asthma as per Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

Restricted Item Brown Traffic Light  Restricted in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Fluticasone Furoate & Vilanterol (Relvar Ellipta®)
(92mcg/22mcg)
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Formulary

Green Traffic Light  For asthmatic patients when medium or high dose ICS/LABA required as per Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

Restricted Item Brown Traffic Light  Restricted in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Fluticasone Furoate & Vilanterol & Umeclidinium (Trelegy Ellipta®)
(92mcg/55mcg/22mcg dry powder inhaler)
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Restricted Drug Restricted
Brown

Restricted in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO January 2018.

 
   
Fluticasone Propionate (Flixotide®)
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Restricted Drug Restricted
Brown

Flixotide® should not be initiated for new patients for asthma.

People whose treatment with Flixotide® is not recommended in Maintenance Management of Asthma – Inhaled and Oral Therapies (adults) but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

 
   
Fluticasone Propionate and Salmeterol (Seretide®)
(All other strengths and preparations)
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Restricted Drug Restricted
Brown

Restricted for existing patients only.

NB: Seretide® 500 accuhaler is not included in Guidance on COPD Management in Primary care - Inhaled Therapies.

NB: Only Seretide® 50 evohaler is included in the Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

 
Link  British guideline on the management of asthma
   
Formoterol fumarate, beclometasone dipropionate and glycopyrronium bromide  (Trimbow® Inhaler)
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Restricted Drug Restricted
Brown

Triple therapy '3 in 1' inhaler for COPD, for use in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

Another option in place of current fostair/ spiriva respimat.

APCO November 2017.

 
   
Beclometasone (Easyhaler®)
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Restricted Drug Restricted
Brown

Beclometasone easyhaler® should not be initiated for new patients for asthma.

People whose treatment with Beclometasone easyhaler® is not recommended in Maintenance Management of Asthma – Inhaled and Oral Therapies (adults) but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

Dry-powder inhaler available as 200micrograms per dose DPI.

 
   
Budesonide and Formoterol (Symbicort®)
(Pressurised MDI)
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Restricted Drug Restricted
Brown

Restricted with in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Ciclesonide (Alvesco®)
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Restricted Drug Restricted
Brown

For patients who require an inhaled corticosteroid, who have unacceptable side effects caused by standard and high dose corticosteroid despite thorough post-dose mouth rinsing, use of a spacer and treatment of candidiasis.

See Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
03.03  Cromoglicate, related therapy and leukotriene receptor antagonists
03.03.01  Cromoglicate and related therapy
Sodium Cromoglicate (Intal®)
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Formulary
Green
 
   
03.03.02  Leukotriene receptor antagonists
Montelukast (Singulair®)
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Formulary

Green Traffic Light  In line with Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

Brown Traffic Light  For spontaneous urticaria in line with Management Guideline for Spontaneous Urticaria with/without Angioedema in Adults

APCO November 2017.

 
Link  Medicines for Children leaflet: Montelukast for asthma
   
03.03.03  Phosphodiesterase type-4 inhibitors
Roflumilast (Daxas®)
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Formulary
Amber Continuation

For treating chronic obstructive pulmonary disease as per NICE TA461. To be initiated by the specialist and transferred to GP after three months in line with Roflumilast amber continuation guideline. 

APCO November 2017.

 
Link  NICE TA461: Roflumilast for treating chronic obstructive pulmonary disease
   
03.04  Antihistamines, hyposensitisation, and allergic emergencies to top
03.04.01  Antihistamines
03.04.01  Non-sedating antihistamines
Cetirizine
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Restricted Drug Restricted
Brown

Available to purchase over the counter.

Only prescribe if required on a continuous basis for chronic rhinosinusitis and chronic urticaria, in line with Clinical Commissioning Policy 88D

For spontaneous urticaria in line with Management Guideline for Spontaneous Urticaria with/without Angioedema in Adults

 
Loratadine
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Restricted Drug Restricted
Brown

Available to purchase over the counter.

Only prescribe if required on a continuous basis for chronic rhinosinusitis and chronic urticaria, in line with Clinical Commissioning Policy 88D

For spontaneous urticaria in line with Management Guideline for Spontaneous Urticaria with/without Angioedema in Adults

 
Fexofenadine
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Restricted Drug Restricted
Brown

Restricted for use where cetirizine, loratadine and chlorphenamine have been tried or are not suitable. 

APCO July 2014. 

For spontaneous urticaria in line with Management Guideline for Spontaneous Urticaria with/without Angioedema in Adults

 
   
Acrivastine (Benadryl® Allergy Relief)
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Restricted Drug Restricted
Brown

Available to purchase over the counter.

Only prescribe if required on a continuous basis for chronic rhinosinusitis and chronic urticaria, in line with Clinical Commissioning Policy 88D

 
   
03.04.01  Sedating antihistamines
Chlorphenamine Maleate (Piriton®)
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Restricted Drug Restricted
Brown

Available to purchase over the counter.

Only prescribe if required on a continuous basis for chronic rhinosinusitis and chronic urticaria, in line with Clinical Commissioning Policy 88D

 
Promethazine (Phenergan®)
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First Choice
Green
 
Hydroxyzine
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Formulary
Green
 
   
Alimemazine (Vallergan®)
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Restricted Drug Restricted
Brown

Second line to promethazine in both paediatric and dermatology patients.

 
   
Cyproheptadine (Periactin®)
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Formulary
Amber Continuation

For use as part of paediatric oncology anti-emetic policy.

 
   
03.04.02  Allergen Immunotherapy
Bee and Wasp Allergen Extracts (Pharmalgen®)
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Formulary
Red

For the treatment of bee and wasp venom allergy a sper NICE TA246.

APCO March 2012.

 
Link  NICE TA246: Pharmalgen for the treatment of bee and wasp venom allergy
   
Benralizumab (Fasenra®)
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Formulary
Red
NHS England

For treating severe eosinophilic asthma as per NICE TA565.

Funded by specialised commissioning.

APCO May 2019.

 
Link  NICE TA565: Benralizumab for treating severe eosinophilic asthma
   
Grass pollen extract (Grazax®)
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Formulary
Red

Specialist prescribing only for paediatric patients with severe allergic rhinitis where other treatments have failed.

APCO January 2019.

 
   
Mepolizumab (Nucala®)
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Formulary
Red
NHS England

For treating severe refractory eosinophilic asthma as per NICE TA431.

Funded by specialised commissioning.

APCO March 2017.

 
Link  NICE TA431: Mepolizumab for treating severe refractory eosinophilic asthma
   
Reslizumab (Cinquil®)
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Formulary
Red
NHS England

For treating severe eosinophilic asthma as per NICE TA479. 

Funded by specialised commissioning. 

APCO November 2017.

 
Link  NICE TA479: Reslizumab for treating severe eosinophilic asthma
   
03.04.02  Omalizumab to top
Omalizumab (Xolair®)
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Formulary
Red
High Cost Medicine

For the treatment of:

  • Severe persistent allergic asthma as per NICE TA133 (APCO May 2013).
  • Previously treated chronic spontaneous urticarial as per NICE TA339. Prior Approval required. APCO July 2015.

 
Link  NICE TA278: Omalizumab for treating allergic asthma
Link  NICE TA339: Omalizumab for previously treated chronic spontaneous urticaria
   
03.04.03  Allergic emergencies
03.04.03  Anaphylaxis
Adrenaline / epinephrine (Epipen®)
(Auto-injector)
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First Choice
Green

Two injection devices should be prescribed and carried at all times to treat symptoms until medical assistance is available.

NB: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously. Prescribers should specify the brand to be dispensed.

From 1 October 2017 the Human Medicines (Amendment) Regulations 2017 will allow all schools to buy adrenaline auto-injector (AAI) devices without a prescription, for emergency use in children who are at risk of anaphylaxis but their own device is not available or not working (e.g. because it is broken, or out-of-date).

 
Adrenaline / epinephrine (Intravenous)
(For home IV iron patients)
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Formulary
Red

Hospital to supply epipen along with iron.

APCO January 2014.

 
   
Adrenaline / Epinephrine 1 in 10,000 (dilute)
(Anaphylaxis)
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Formulary
Red

Secondary care use only. 

 
   
Adrenaline / Epinephrine 1 in 1000
(Injection)
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Formulary
Red

Secondary care use only. 

 
   
03.04.03  Angioedema
Conestat Alfa (Ruconest®)
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Formulary
Red
High Cost Medicine
NHS England

Specialist prescribing only for angioedema. Funded by specialised commissioning.

APCO March 2020.

 
   
03.05  Respiratory stimulants and pulmonary surfactants
03.05.01  Respiratory stimulants to top
Doxapram (Dopram®)
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Formulary
Red

Secondary care use only. 

 
   
03.05.02  Pulmonary surfactants
Poractant Alfa (Curosurf®)
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Formulary
Red
High Cost Medicine

For the treatment and prophylaxis of neonatal respiratory distress syndrome (Neonatal consultants only).

Funded by specialised commissioning.

 
   
03.06  Oxygen
03.07  Mucolytics
Carbocisteine
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Formulary
Green
 
   
Ivacaftor
(Kalydeco)
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Formulary
Red
High Cost Medicine

For the treatment of cystic fibrosis (CF) in patients age 6 years and older who have a G551D mutation in the CFTR gene.

APCO March 2017.

 
   
Lumacaftor + Ivacaftor (Orkambi®)
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Formulary
Red

Specialist prescribing only for the treatment of cystic fibrosis in adults.

Funded by specialised commissioning.

APCO January 2020.

 
Link  NHSE Policy Statement: Cystic Fibrosis Modulator Therapies
Link  NICE TA398: Lumacaftor–ivacaftor for treating cystic fibrosis homozygous for the F508del mutation
   
Tezacaftor + Ivacaftor (Symkevi®)
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Formulary
Red

Specialist prescribing only for the treatment of Cystic Fibrosis in adults and children.

Funded by specialised commissioning.

APCO January 2020.

 
Link  NHSE Policy Statement: Cystic Fibrosis Modulator Therapies
   
03.07  Dornase alfa
Dornase Alfa (Pulmozyme®)
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Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
03.07  Hypertonic Sodium Chloride to top
Sodium Chloride 7% (Resp-Ease®)
(Hypertonic nebuliser solution)
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Formulary
Amber Continuation

Suitable for prescribing following initiation or recommendation from secondary care, for use as a mucolytic in bronchiectasis. 

NB. Resp-Ease® is more cost-effective than Nebusal hypertonic saline. 

APCO May 2017. 

 
   
03.07  Mannitol
Mannitol dry powder for inhalation
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Formulary
Red
High Cost Medicine

For treating cystic fibrosis as per NICE TA266.

Funded by specialised commissioning.

APCO January 2013.

 
Link  NICE TA266: Cystic fibrosis - mannitol dry powder for inhalation
   
03.08  Aromatic inhalations
03.09  Cough preparations
03.09.01  Cough suppressants
Pholcodine Linctus, BP
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Formulary
Green

Available to purchase over the counter. 

 
   
03.09.01  Palliative care to top
03.09.02  Expectorant and demulcent cough preparations
Simple Linctus, BP
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Formulary
Green

Available to purchase over the counter. 

 
   
03.10  Systemic nasal decongestants
Pseudoephedrine Hydrochloride
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Formulary
Green
 
   
03.11  Antifibrotics
Nintedanib (Ofev®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
NHS England

For treating idiopathic pulmonary fibrosis as per NICE TA347.

APCO March 2016.

 
Link  NICE TA379:Nintedanib for treating idiopathic pulmonary fibrosis
   
Pirfenidone (Esbriet®)
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Formulary
Red
High Cost Medicine
NHS England

For treating idiopathic pulmonary fibrosis as per NICE TA504.

APCO March 2018.

 
Link  NICE TA504: Idiopathic pulmonary fibrosis - pirfenidone
   
 ....
 Non Formulary Items
Acetylcysteine
(Mucolytic)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Adrenaline / Epinephrine  (Emerade®)

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Non Formulary

Two injection devices should be carried at all times to treat symptoms until medical assistance is available.

NB: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously. Prescribers should specify the brand to be dispensed.

From 1 October 2017 the Human Medicines (Amendment) Regulations 2017 will allow all schools to buy adrenaline auto-injector (AAI) devices without a prescription, for emergency use in children who are at risk of anaphylaxis but their own device is not available or not working (e.g. because it is broken, or out-of-date).

 
Adrenaline / Epinephrine  (Jext®)

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Non Formulary

Two injection devices should be carried at all times to treat symptoms until medical assistance is available.

NB: Ensure that training is given to all patients, for all prescriptions, irrespective of whether patients have received or used the product previously. Prescribers should specify the brand to be dispensed.

From 1 October 2017 the Human Medicines (Amendment) Regulations 2017 will allow all schools to buy adrenaline auto-injector (AAI) devices without a prescription, for emergency use in children who are at risk of anaphylaxis but their own device is not available or not working (e.g. because it is broken, or out-of-date).

 
Alpha-1 antitrypsin  (Respreeza®)

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Non Formulary
 
Ammonia and Ipecacuanha Mixture BP

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Non Formulary
 
Bambuterol  (Bambec®)

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Non Formulary
 
Beclometasone  (Qvar®)

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Non Formulary

NB. Clenil Modulite® is first line.

Prescribe by brand as Clenil Modulite® and QVAR® brands of beclometasone inhalers are not dose equivalent.

 
Beractant  (Survanta®)

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Non Formulary
High Cost Medicine
 
Bilastine  (Ilaxten®)

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Non Formulary
 
Budesonide and Formoterol  (DuoResp Spiromax®)

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Non Formulary

NB: Please prescribe by brand. This is a different device to Symbicort® and requires different inhaler technique. 

NB: Not included in Guidance on COPD Management in Primary care - Inhaled Therapies or Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

 
Budesonide and Formoterol  (Fobumix Easyhaler®)

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Non Formulary
 
C1 Esterase Inhibitor  (Berinert®)

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Non Formulary
High Cost Medicine
 
C1 esterase inhibitor  (Cinryze® )

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Non Formulary
High Cost Medicine
 
Clemastine  (Tevegil®)

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Non Formulary
 
Codeine Linctus BP

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Non Formulary
 
Codeine Linctus, Paediatric BP

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Non Formulary
 
Compressors  (Omron® compAIR CX)

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Non Formulary
 
Compressors  (Omron® CX3)

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Non Formulary
 
Compressors  (System 22® CR60)

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Non Formulary
 
Compressors  (Turboneb®)

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Non Formulary
 
Desloratadine  (Neoclarityn®)

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Non Formulary
 
Dextromethorphan / quinidine  (Nuedexta®)

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Non Formulary
 
Diphenhydramine  (Nytol® Simply Sleep Hot Chocolate)

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Non Formulary
 
Drug Delivery Device  (Babyhaler®)

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Non Formulary
 
Drug Delivery Device  (E-Z Spacer®)

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Non Formulary
 
Drug Delivery Device  (E-Z Spacer®)

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Non Formulary
 
Drug Delivery Device  (Nebuchamber®)

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Non Formulary
 
Drug Delivery Device  (Nebuhaler®)

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Non Formulary
 
Drug Delivery Device  (PARI Vortex® Spacer)

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Non Formulary
 
Drug Delivery Device  (Pocket Chamber®)

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Non Formulary
 
Drug Delivery Device  (Spinhaler®)

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Non Formulary
 
Ephedrine Hydrochloride

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Non Formulary
 
Erdosteine  (Erdotin®)

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Non Formulary
Black

Not recommended due to lack of evidence.

APCO March 2007.

 
Flo-Tone MDI

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Non Formulary
 
Fluticasone Propionate and Formoterol  (Flutiform®)

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Non Formulary
 
Fluticasone Propionate and Salmeterol  (Aloflute®)

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Non Formulary
 
Fluticasone Propionate and Salmeterol  (Sereflo®)

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Non Formulary
 
Fluticasone Propionate and Salmeterol  (Sirdupla®)

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Non Formulary
Black

Not recommended for use in asthma.

APCO January 2016.

 
Formoterol Fumarate  (Foradil®)

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Non Formulary
 
Glycopyrrolate and Indacaterol  (Ultibro Breezhaler®)

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Non Formulary
Black

Not recommended for use.

APCO May 2015.

Link  NICE New Medicine Evidence Summary 33: indacaterol/glycopyrronium (Ultibro Breezhaler)
 
Glycopyrronium  (Seebri breezhaler®)

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Non Formulary
Black

Not recommended due to insufficient evidence.

APCO January 2013.

 
Grass and Tree Pollen Extract  (Pollinex®)

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Non Formulary
 
Home Compressors with Nebulisers  (AC 200® HI FLO)

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Non Formulary
 
Home Compressors with Nebulisers  (AC 4000®)

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Non Formulary
 
Home Compressors with Nebulisers  (Aquilon®)

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Non Formulary
 
Home Compressors with Nebulisers  (De-Vibiss 4650®)

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Non Formulary
 
Home Compressors with Nebulisers  (De-Vibiss 5650®)

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Non Formulary
 
Home Compressors with Nebulisers  (Econoneb®)

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Non Formulary
 
Home Compressors with Nebulisers  (Freeway Freedom®)

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Non Formulary
 
Home Compressors with Nebulisers  (PARI BOY Mobile® S)

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Non Formulary
 
Home Compressors with Nebulisers  (PARI JuniorBOY ®S)

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Non Formulary
 
Home Compressors with Nebulisers  (PARI TurboBOY® S)

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Non Formulary
 
Home Compressors with Nebulisers  (Porta-Neb®)

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Non Formulary
 
Home Compressors with Nebulisers  (Tourer®)

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Non Formulary
 
Home Compressors with Nebulisers  (ultima®)

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Non Formulary
 
Home Compressors with Nebulisers  (World Traveller® HI FLO)

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Non Formulary
 
House dust mite allergen immunotherapy  (Mitizax®)

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Non Formulary
 
Icatibant  (Firazyr®)

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Non Formulary
High Cost Medicine
 
Indacaterol  (Onbrez)

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Non Formulary
 
Ipratropium bromide and Fenoterol  (Duovent®)

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Non Formulary
 
Ipratropium bromide and Salbutamol  (Combivent®)
(Nebuliser solution)

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Non Formulary
 
Jet Nebulisers  (Medix® Lifecare Nebuliser System)

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Non Formulary
 
Jet Nebulisers  (Medix® Lifecare Nebuliser Chamber)

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Non Formulary
 
Jet Nebulisers  (PARI LC® SPRINT)

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Non Formulary
 
Jet Nebulisers  (PARI LC® SPRINT BABY)

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Non Formulary
 
Jet Nebulisers  (Sidestream® Durable)

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Non Formulary
 
Jet Nebulisers  (Ventistream®)

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Non Formulary
 
Karvol

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Non Formulary
 
Ketotifen  (Zaditen®)

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Non Formulary
 
Levocetirizine  (Xyzal®)

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Non Formulary
 
Mecysteine  (Visclair®)

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Non Formulary

Discontinued in August 2013.

 
Menthol and Eucalyptus Inhalation BP 1980

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Non Formulary
 
Controlled Drug  Methadone Hydrochloride  (Methadone® Linctus)

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Non Formulary

Methadone linctus is less suitable for prescribing for cough in terminal disease (has a tendency to accumulate).

 
Mizolastine  (Mizollen®)

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Non Formulary
 
Mometasone Furoate  (Asmanex®)

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Non Formulary
 
Nedocromil  (Tilade® CFC-free inhaler)

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Non Formulary
 
Orciprenaline Sulphate  (Alupent®)

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Non Formulary
 
Pholcodine Linctus, Strong, BP

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Non Formulary
 
Rupatadine  (Rupafin®)

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Non Formulary
Black

In line with Guideline for Spontaneous Urticaria with/without Angioedema in Adults.

APCO November 2017.

 
Simple Linctus, Paediatric BP

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Non Formulary
 
Sodium Chloride

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Non Formulary
 
Sodium Chloride 3%  (MucoClear®)
(Hypertonic nebuliser solution)

Non Formulary
Black

Not on OUH formulary.

APCO May 2017.

 
Sodium chloride 6%  (MucoClear®)
(Nebuliser solution)

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Non Formulary
Black

Not on OUH formulary.

APCO May 2017.

 
Sodium chloride 7%  (Nebusal®)
(Hypertonic nebuliser solution)

Non Formulary
Black

Resp-Ease® hypertonic saline is more cost-effective.

APCO May 2017.

 
Theophylline  (Slo-Phyllin®)

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Non Formulary

Slo-Phyllin 60/125/250mg capsules are now discontinued due to manufacturing issues. Prescribers will need to review and switch all affected patients who still require theophylline, from Slop-hyllin to alternative preparations. 

More advice from the specialist teams will be available shortly.

Please see the alert here.

 
Tiotropium  (Braltus® 10mcg inhalation powder)

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Non Formulary
Black

Not recommended for use as device not in line with OCCG Guidance on COPD Management in Primary care - Inhaled Therapies and safety concerns regarding pre-metered dose.  

APCO July 2017.

Link  MHRA Drug Safety Update: Braltus (tiotropium)- risk of inhalation of capsule if placed in the mouthpiece of the inhaler
 
Ultrasonic Nebulisers  (F16 Wave®)

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Non Formulary
 
Ultrasonic Nebulisers  (Liberty®)

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Non Formulary
 
Ultrasonic Nebulisers  (Omron MicroAIR®)

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Non Formulary
 
Ultrasonic Nebulisers  (Omron® NE-U17)

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Non Formulary
 
Ultrasonic Nebulisers  (Ultra Neb ®2000)

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Non Formulary
 
Zafirlukast  (Accolate®)

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Non Formulary
 
  
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