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Sunderland Joint Formulary
NHS Sunderland Clinical Commissioning Group
South Tyneside and Sunderland NHS Foundation Trust
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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.01  Bronchodilators
03.01  Asthma
03.01  Chronic obstructive pulmonary disease
03.01  Croup
03.01.01  Adrenoceptor agonists to top
03.01.01.01  Selective Beta2 agonists
Formoterol
(Long acting beta agonist)
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First Choice Breath actuated DPI: 6mcg/puff, 12mcg/puff 
Salbutamol
(Short acting beta agonist)
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First Choice Metered dose inhaler (MDI): 100mcg/puff
Breath actuated MDI: 100mcg/puff
Breath actuated dry powder inhaler (DPI): 100mcg/puff, 200mcg/puff
Nebules: 2.5mg/2.5ml, 5mg/2.5ml
Injection: 500mcg/1ml, 5mg/5ml
 
Salmeterol
(Long acting beta agonist)
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First Choice Inhaler (MDI): 25mcg/puff
Breath actuated inhaler (Accuhaler): 50mcg/puff 
Terbutaline
(short acting beta agonist)
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Second Choice Breath actuated DPI (Turbohaler): 500mcg/puff 
   
Indacaterol
(Long acting beta agonist)
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Alternatives Breezhaler breath actuated DPI: 150mcg, 300mcg 
   
03.01.01.01  Short-acting beta2 agonists
03.01.01.01  Long-acting beta2 agonists
03.01.01.02  Other adrenoceptor agonists
03.01.02  Antimuscarinic bronchodilators to top
Aclidinium (Eklira Genuair)
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Formulary

Eklira Genuair® breath actuated DPI: 375mcg/puff (equivalent to 322mcg aclidinium)

 

 
   
Glycopyrronium (Seebri breezhaler)
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Formulary

Seebri Breezhaler® breath actuated DPI: 50mcg/puff (equivalent to 44mcg glycopyrronium)

 

 
   
Ipratropium
(Short acting muscarinic antagonists (SAMA))
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Alternatives

Inhaler (MDI): 20mcg/puff
Nebules: 250mcg/1ml, 500mcg/2ml

It is recommended that nebulised ipratropium should be administered via a mouthpiece and NOT a facial mask due to the risk or precipitating glaucoma.

20mcg/puff inhaler is an alternative for chronic asthma.

 
   
Tiotropium
(Long acting muscarinic antagonist (LAMA))
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Alternatives

HandiHaler® Dry powder inhaler device and refill: 18mcg
Refill: 18mcg
Respimat®: 2.5mcg

Braltus Zonda Dry powder inhaler : 10mcg (first choice option if tiotropium dry powder inhaler is required).

Tiotropium Respimat is a step 4 option for chronic asthma and may be useful for patients with COPD who can not use a dry powder inhaler.

 

 
   
03.01.03  Theophylline
Theophylline
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First Choice

Theophylline SR
Nuelin SA® tablets: 175mg, 250mg
Uniphyllin® tablets: 200mg, 300mg, 400mg

N.B. Modified release preparations must be prescribed by brand name

Theophylline liquid
50mg/5mL (Dilatrane®)
50mg/5mL
150mg/5mL

 
Aminophylline (Phyllocontin)
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Second Choice

SR tablets: 225mg

Prescribe by brand name.

 
   
Aminophylline IV
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Formulary
Red
Injection: 250mg/10ml 
   
03.01.04  Compound bronchodilator preparations
Tiotropium & olodaterol (Spiolto Respimat)
(LABA/LAMA)
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Formulary

Inhalation solution via respimat device: 2.5 microgram/2.5 microgram

First choice for new patients

 
   
Umeclidinium & vilanterol (Anoro Ellipta)
(Base choice of LABA/LAMA combination on which LAMA has been prescribed previously and best device for patient)
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Formulary

Anoro Ellipta® breath actuated DPI: 55/22mcg/puff

First choice for new patients

 
   
Aclidinium and formoterol inhaler (Duaklir Genuair )
(LAMA/LABA)
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Formulary

Duaklir Genuair® breath actuated DPI: 340/12mcg/puff

 
   
Beclomethasone/Formoterol/Glycopyrronium 87/5/9 (Trimbow)
(ICS/LABA/LAMA)
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Formulary

Trimbow®   87/5/9mcg MDI

Triple therapy inhaler -ICS/LABA/LAMA for COPD.

If spacer required, manufacturer recommends AeroChamberPlus.

Formulary approved for use in COPD only.

 

 
   
Fluticasone Furoate/Umeclidinium bromide/Vilanterol 92/55/22mcg (Trelegy Ellipta)
(ICS/LAMA/LABA)
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Formulary

Trelegy Ellipta ® 92/55/22 mcg Dry Powder Inhaler

Triple therapy ICS/LAMA/LABA inhaler for COPD.

Formulary approved for use in COPD only.

 

 
   
Glycopyrrolate/ indacaterol inhaler (Ultibro Breezhaler)
(LABA/LAMA)
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Formulary

Ultibro breezhaler: device and capsules containing powder for inhalation

Each dose delivers indacaterol 85 micrograms/glycopyrronium 43 micrograms

 
   
03.01.05  Peak flow meters, inhaler devices and nebulisers
03.01.05  Peak flow meters
03.01.05  Drug delivery devices to top
Drug Delivery Device (AeroChamber Plus)
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Formulary Infant (orange with mask)
Child (yellow with mask)
Adult (blue with or without mask) 
   
Drug Delivery Device (Volumatic)
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Formulary Available with or without paediatric mask 
   
03.01.05  Nebulisers
03.01.05  Nebuliser Diluent
03.02  Corticosteroids
Beclometasone (Clenil Modulite)
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Formulary Beclometasone is the first line corticosteroid; Clenil is first choice for asthma

Clenil Modulite CFC-free MDI: 50mcg, 100mcg, 200mcg, 250mcg per puff

N.B. CFC-free beclometasone must be prescribed by brand name 
   
Beclometasone (Qvar)
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Formulary Beclometasone is the first line corticosteroid

QVAR CFC-free MDI: 50mcg, 100mcg per puff
QVAR breath-actuated MDI: 50mcg, 100mcg per puff
Extra-fine particle inhaler

N.B. CFC-free beclometasone must be prescribed by brand name.

50mcg QVAR is equivalent to 100mcg for a conventional beclometasone inhaler and 100mcg is equivalent to 250mcg conventional beclometasone. 
   
Fluticasone propionate
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Formulary Alternative corticosteroid

CFC-free MDI: 50mcg, 125mcg, 250mcg per puff 
   
Budesonide
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Formulary Alternative corticosteroid

Breath actuated DPI (Turbohaler): 100mcg, 200mcg, 400mcg per puff
Respules: 250mcg/1ml, 500mcg/1ml, 500mcg/2ml 
   
Budesonide and formoterol (DuoResp Spiromax)
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Formulary

DuoResp Spiromax ® 

160/4.5: Budesonide with formoterol 160/4.5mcg per puff
320/9: Budesonide with formoterol 320/9mcg per puff

Not a first-line choice on the Sunderland COPD guideline for newly diagnosed COPD patients. May be continued in existing patients if guideline alternatives are unsuitable.

 
   
Beclometasone and formoterol (Fostair)
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Formulary

Fostair ® CFC-free MDI: 100/6mcg per puff 
Fostair ® CFC-free MDI: 200/6mcg/puff

N.B. Extra fine-particle aerosol - 100mcg of beclomethasone in Fostair ® is equivalent to a 250mcg dose in a conventional beclomethasone metered dose inhaler

Fostair ® NEXThaler (breath actuated DPI): 100/6mcg, 200/6mcg per puff

The 100/6mcg inhalers are first choice ICS/LABA combination inhalers in the Sunderland COPD guideline.

The 200/6mcg inhalers are approved for use in the treatment of ASTHMA only.

 
   
Budesonide and formoterol (Symbicort)
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Formulary

Symbicort Turbohaler® 
100/6: Budesonide with formoterol 100/6mcg per puff
200/6: Budesonide with formoterol 200/6mcg per puff
400/12: Budesonide with formoterol 400/12 mcg per puff

 

Not a first-line choice on the Sunderland COPD guideline for newly diagnosed COPD patients. May be continued in existing patients if guideline alternatives are unsuitable.

 
   
Fluticasone furoate & vilanterol (Relvar Ellipta)
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Formulary

Revlar Ellipta Dry Powder Inhaler

92/22: Fluticasone 92mcg & Vilanterol 22mcg per dose inhaler

First choice for new patients

 

184/22: Fluticsone184 mcg & Vilanterol 22mcg per dose inhaler 

Approved for use in the treatment of ASTHMA only.

 
   
Fluticasone propionate and salmeterol (Seretide)
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Formulary

Seretide Evohaler ®
50/25 mcg, 125/25mcg and 250/25mcg

Seretide Accuhaler ®
100/50mcg (for paediatric use only)
250/50mcg (for use in asthma only)
500/50mcg (for use in asthma only)

Approved for the treatment of ASTHMA only

Not a first line choice on the Sunderland COPD guideline for new patients. Can be continued in existing patients if guideline options are unsuitable.

 
   
Fluticasone propionate and formoterol (Flutiform)
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Formulary

Flutiform® MDI


50/5mcg per puff
125/5mcg per puff
250/10mcg per puff

 
   
03.03  Cromoglicate, related therapy and leukotriene receptor antagonists
03.03.01  Cromoglicate and related therapy to top
03.03.01  Related therapy
03.03.02  Leukotriene receptor antagonists
Montelukast
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Formulary Tablets: 10mg
Chewable tablets: 4mg, 5mg
Sachets: 4mg
 
   
03.03.03  Phosphodiesterase type-4 inhibitors
Roflumilast (Daxas)
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Formulary
Green +

Tablets: 500 micrograms

 
Link  NICE TA 461 - Roflumilast for treating chronic obstructive pulmonary disease
   
03.04  Antihistamines, hyposensitisation, and allergic emergencies
03.04.01  Antihistamines to top
03.04.01  Non-sedating antihistamines
Cetirizine
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First Choice Tablets: 10mg
Oral solution: 5mg/5ml 
Loratadine
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First Choice Tablets: 10mg
Oral solution: 5mg/5ml 
Fexofenadine
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Alternatives Tablets: 120mg, 180mg

Only after trialling other options 
   
03.04.01  Sedating antihistamines
Chlorphenamine
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Formulary Tablets: 4mg
Syrup: 2mg/5ml
Injection: 10mg/1ml 
   
Hydroxyzine
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Formulary Tablets: 10mg, 25mg
Syrup: 10mg/5ml 
   
Alimemazine
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Alternatives
Red
Tablets*: 10mg
Syrup*: 7.5mg/5ml, 30mg/5ml
*Hospital use only as pre-medication in paediatric patients 
   
03.04.02  Allergen Immunotherapy
Benralizumab (Fasenra®)
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Formulary
Red
High Cost Medicine
NHS England
  • Approved for treating severe eosinophilic asthma in adults in line with NICE 
  • Link  NICE TA 565: Benralizumab for treating severe eosinophilic asthma
       
    Grass pollen extract (Grazax)
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    Formulary
    Amber

    Oral lyophilisate containing grass pollen extract 75,000 units

     
       
    Mepolizumab (Nucala)
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    Formulary
    Red
    High Cost Medicine

    Powder for solution for injection: 100mg

     
    Link  NICE TA 431: Mepolizumab for treating severe refractory eosinophilic asthma
       
    03.04.02  Omalizumab
    Omalizumab (Xolair)
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    Formulary
    Red
    High Cost Medicine
    Prefilled syringe: 75mg/0.5ml, 150mg/1ml

    Review effectiveness after 16 weeks of commencing treatment 
    Link  NICE TA278: Asthma (severe, persistent, patients aged 6+, adults) - omalizumab (rev TA133, TA201)
    Link  NICE TA339: Omalizumab for previously treated chronic spontaneous urticaria
       
    Reslizumab
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    Formulary
    Red

    Vials: 25mg, 100mg

     
    Link  NICE TA 479: Reslizumab for treating severe eosinophilic asthma
       
    03.04.03  Allergic emergencies to top
    03.04.03  Anaphylaxis
    Adrenaline / epinephrine (Emerade)
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    Formulary

    Autoinjector: 500 micrograms (Emerade®)

     
       
    Adrenaline / epinephrine (EpiPen & Jext)
    (For home use only)
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    Formulary

    Auto-injector: 150 micrograms, 300 micrograms

    Use either Jext® or Epipen® but do not interchange

     
       
    Adrenaline / epinephrine 1 in 1,000
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    Formulary Injection: 500 micrograms/0.5ml, 1mg/1ml 
       
    03.04.03  Angioedema
    C1 Esterase Inhibitor (Berinert)
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    First Choice
    Red
    High Cost Medicine

    Injection: powder for reconstitution, 500 unit vial and 1,500 unit vial (Berinert®)

    Treatment of hereditary angioedema (HAE) and pre-procedure prevention

     
    Icatibant (Firazyr)
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    Second Choice
    Red
    High Cost Medicine
    Pre-filled syringe: 30mg/3ml (Firazyr)
    Symptomatic treatment of acute episodes of hereditary angioedema (HAE) 
       
    03.04.03  Intramuscular adrenaline (epinephrine)
    03.04.03  Intravenous adrenaline (epinephrine)
    03.04.03  Self-administration of adrenaline (epinephrine) to top
    03.05  Respiratory stimulants and pulmonary surfactants
    03.05.01  Respiratory stimulants
    Doxapram (Dopram)
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    Formulary
    Red
    Injection: 100mg/5ml
    Infusion: 2mg/1ml in 5% glucose (500ml) 
       
    03.05.02  Pulmonary surfactants
    Poractant Alfa
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    Formulary
    Red
    High Cost Medicine
    Vials: 120mg, 240mg 
       
    03.06  Oxygen
    03.06  Long-term oxygen therapy to top
    03.06  Short burst oxygen therpary
    03.06  Ambulatory oxygen therapy
    03.06  Oxygen therapy equipment
    03.06  Arrangements for supplying oxygen
    03.07  Mucolytics to top
    Carbocisteine
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    First Choice Capsules: 375mg
    Oral liquid: 125mg/5ml, 250mg/5ml 
    Mannitol
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    Formulary
    Red
    Inhalation powder, hard capsule (for use with disposable inhaler device): 40mg
    Available through a managed pathway in line with NICE criteria
    Only to be prescribed by secondary care from April 2016 in line with NHS England Clinical Commissioning Policy 
    Link  For treating cystic fibrosis
    Link  NHS England Clinical Commissioning Policy
       
    N-Acetylcysteine
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    Unlicensed Drug Unlicensed
    Green +
    solution for nebulisation 
       
    03.07  Dornase alfa
    Dornase Alfa (Pulmozyme)
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    Formulary
    Red
    High Cost Medicine
    Vial: 2.5mg (2500 units)/2.5ml

    Only to be prescribed by secondary care from April 2016 in line with NHS England Clinical Commissioning Policy 
    Link  NHS England Clinical Commissioning Policy
       
    03.07  Hypertonic Sodium Chloride
    Sodium chloride 7% (Hypertonic) (Nebusal)
    First Choice Nebuliser solution: 4ml 
    Sodium chloride 0.9%
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    Second Choice Nebuliser solution: 10ml 
       
    03.08  Aromatic inhalations
    03.09  Cough preparations
    03.09.01  Cough suppressants to top
    Codeine Linctus BP
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    Formulary 15mg/5ml 
       
    Pholcodine Linctus, BP
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    Formulary

    5mg/5ml,

     
       
    03.09.01  Palliative care
    03.09.02  Expectorant and demulcent cough preparations
    Simple Linctus, BP
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    Formulary  
       
    Simple Linctus, Paediatric BP
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    Formulary *Hospital use only 
       
    03.10  Systemic nasal decongestants
    03.11  Antifibrotics
    Pirfenidone (Esbriet)
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    Formulary
    Red
    High Cost Medicine
    Capsules: 267mg

    Newcastle tertiary referral 
    Link  NICE TA 504: Pirfenidone for treating idiopathic pulmonary fibrosis
       
     ....
     Non Formulary Items
    Acrivastine

    View adult BNF View SPC online
    Non Formulary
     
    Adrenaline / Epinephrine  (Anapen)

    View adult BNF View SPC online
    Non Formulary
     
    Alpha-1 antitrypsin  (Respreeza)

    View adult BNF View SPC online
    Non Formulary
     
    Ammonia and Ipecacuanha Mixture BP

    View adult BNF View SPC online
    Non Formulary
     
    Bambuterol  (Bambec)

    View adult BNF View SPC online
    Non Formulary
     
    Bee and Wasp Allergen Extracts  (Pharmalgen)

    View adult BNF View SPC online
    Non Formulary
     
    Beractant  (Survanta)

    View adult BNF View SPC online
    Non Formulary
    High Cost Medicine
     
    Bilastine  (Ilaxten)

    View adult BNF View SPC online
    Non Formulary
     
    C1 esterase inhibitor  (Cinryze )

    View adult BNF View SPC online
    Non Formulary
    High Cost Medicine
     
    Ciclesonide  (Alvesco)

    View adult BNF View SPC online
    Non Formulary
     
    Clemastine  (Tevegil)

    View adult BNF View SPC online
    Non Formulary
     
    Codeine Linctus, Paediatric BP

    View adult BNF View SPC online
    Non Formulary
     
    Conestat Alfa  (Ruconest)

    View adult BNF View SPC online
    Non Formulary
    High Cost Medicine
     
    Cyproheptadine  (Periactin)

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    Non Formulary
     
    Desloratadine  (Neoclarityn)

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    Non Formulary
     
    Dextromethorphan / quinidine  (Nuedexta)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (Able Spacer®)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (Babyhaler)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (E-Z Spacer®)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (E-Z Spacer®)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (Haleraid)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (Nebuchamber)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (Nebuhaler)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (PARI Vortex® Spacer)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (Pocket Chamber®)

    View adult BNF View SPC online
    Non Formulary
     
    Drug Delivery Device  (Spinhaler®)

    View adult BNF View SPC online
    Non Formulary
     
    Duovent

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    Non Formulary
     
    Ephedrine Hydrochloride

    View adult BNF View SPC online
    Non Formulary
     
    Erdosteine  (Erdotin)

    View adult BNF View SPC online
    Non Formulary
     
    Fenoterol

    View adult BNF View SPC online
    Non Formulary
     
    Flo-Tone MDI

    View adult BNF View SPC online
    Non Formulary
     
    Fluticasone propionate and salmeterol  (AirFluSal Forspiro )

    View adult BNF View SPC online
    Non Formulary
     
    Grass and Tree Pollen Extract  (Pollinex®)

    View adult BNF View SPC online
    Non Formulary
     
    House dust mite allergen immunotherapy  (Mitizax)

    View adult BNF View SPC online
    Non Formulary
     
    Ipratropium bromide with salbutamol  (Combivent)

    View adult BNF View SPC online
    Non Formulary
     
    Ivacaftor

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    Non Formulary
    High Cost Medicine
     
    Karvol

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    Non Formulary
     
    Ketotifen  (Zaditen®)

    View adult BNF View SPC online
    Non Formulary
     
    Levocetirizine  (Xyzal)

    View adult BNF View SPC online
    Non Formulary
     
    Low range peak flow meter  (Mini-Wright)

    View adult BNF View SPC online
    Non Formulary
     
    Low range peak flow meter  (Pocketpeak)

    View adult BNF View SPC online
    Non Formulary
     
    Mecysteine  (Visclair)

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    Non Formulary
     
    Menthol and Eucalyptus Inhalation BP 1980

    View adult BNF View SPC online
    Non Formulary
     
    Mizolastine  (Mizollen®)

    View adult BNF View SPC online
    Non Formulary
     
    Mometasone Furoate  (Asmanex)

    View adult BNF View SPC online
    Non Formulary
     
    Nedocromil  (Tilade® CFC-free inhaler)

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    Non Formulary
     
    Nintedanib

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    Non Formulary
     
    Nintedanib  (Ofev®)

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    Non Formulary
     
    Nintedanib  (Vargatef)

    View adult BNF View SPC online
    Non Formulary
    High Cost Medicine
     
    Olodaterol  (Striverdi Respimat)

    View adult BNF View SPC online
    Non Formulary
     
    Orciprenaline Sulphate  (Alupent®)

    View adult BNF View SPC online
    Non Formulary
     
    Pholcodine Linctus, Strong, BP

    View adult BNF View SPC online
    Non Formulary
     
    Promethazine  (Phenergan)

    View adult BNF View SPC online
    Non Formulary
     
    Pseudoephedrine Hydrochloride  (Gulpseud)

    View adult BNF View SPC online
    Non Formulary
     
    Pseudoephedrine Hydrochloride  (Sudafed)

    View adult BNF View SPC online
    Non Formulary
     
    Rupatadine  (Rupafin)

    View adult BNF View SPC online
    Non Formulary
     
    Sodium chloride 3% (Hypertonic)  (MucoClear)

    Non Formulary
     
    Sodium chloride 6% (hypertonic)  (MucoClear)

    View adult BNF View SPC online
    Non Formulary
     
    Sodium Cromoglicate

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    Non Formulary
     
    Sodium Cromoglicate  (Comogen Easi-Breathe®)

    View adult BNF View SPC online
    Non Formulary
     
    Sodium Cromoglicate  (Intal®)

    View adult BNF View SPC online
    Non Formulary
     
    Standard range peak flow meter  (MicroPeak)

    View adult BNF View SPC online
    Non Formulary
     
    Standard range peak flow meter  (Mini-Wright)

    View adult BNF View SPC online
    Non Formulary
     
    Standard range peak flow meter  (Piko-1)

    View adult BNF View SPC online
    Non Formulary
     
    Standard range peak flow meter  (Pocketpeak)

    View adult BNF View SPC online
    Non Formulary
     
    Standard range peak flow meter  (Vitalograph)

    View adult BNF View SPC online
    Non Formulary
     
    Umeclidinium  (Incruse Ellipta)

    View adult BNF View SPC online
    Non Formulary
     
    Zafirlukast  (Accolate®)

    View adult BNF View SPC online
    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 SPCs
    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

    Drugs for hospital use or use by a specialist within specialist centre only. Initiation and monitoring of treatment should remain under the total responsibility of the appropriate hospital clinician or specialist. These drugs should only be prescribed under the direct supervision of that clinician or specialist and are not suitable for shared care arrangements. The drug should be supplied via the hospital or specialist centre for the duration of treatment.   

    Amber

    These are specialist drugs which must be initiated by secondary care specialist prescribers, but with the potential to transfer prescribing to primary care within written and agreed shared care protocols and according to the agreed process for transfer of care. For these drugs, in order to ensure patient safety, some aspects of care must remain with the specialist due to their complexity e.g. monitoring of disease or drug response. Other more routine aspects can be transferred to the GP e.g. monitoring of adverse effects and supply of the medicine. The specific responsibilities of the specialist and GP are defined in the shared care agreement for each drug. Shared care agreements are still under development for some amber drugs. Until these are available, it would be expected that any shared care request from secondary care to a GP would be accompanied by written information which defines prescribing and monitoring responsibilities. The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care.   

    Green +

    Drugs which should usually be initiated in secondary care, or by a specialist clinician, but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case.  

    Green

    These are defined as new and established drugs, which may be prescribed, initiated, changed or maintained on FP10 by the GP and, if appropriate, discontinued without recourse to secondary care. N.B. DRUGS NOT IDENTIFIED IN THE FORMULARY BY A RED, AMBER OR GREEN+ SYMBOL ARE CLASSIFIED AS GREEN.   

    netFormulary