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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.07  Expand sub section  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  Expand sub section  Dornase alfa
Dornase Alfa (Pulmozyme®)
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Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
03.07  Expand sub section  Hypertonic Sodium Chloride
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  Expand sub section  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
   
 ....
 Non Formulary Items
Acetylcysteine
(Mucolytic)

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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.

 
Mecysteine  (Visclair®)

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Non Formulary

Discontinued in August 2013.

 
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.

 
  
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  

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