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 Formulary Chapter 9: Nutrition and blood - Full Chapter
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09.01  Expand sub section  Anaemias and some other blood disorders
Oral Rehydration Salts (Dioralyte®)
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Formulary
Green
 
 
09.01.01  Expand sub section  Iron-deficiency anaemias
09.01.01.01  Expand sub section  Oral iron
Ferrous Sulphate
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First Choice
Green
  • 200mg tablets (65mg iron).
 
Ferric maltol 30mg hard capsules (Ferracru®)
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Alternatives
Green plus

  • For the treatment of iron deficiency anemia in patients with or without inflammatory bowel disease.

  • To be initiated by specialist in inflammatory bowel disease or iron deficiency anaemia 

 
Link  Ferric Maltol for the treatment of iron-deficiency anaemia in Inflammatory Bowel Disease only
Link  Ferric Maltol for the treatment of iron-deficiency anaemia in patients without Inflammatory Bowel Disease
 
Ferrous Fumarate
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Alternatives
Green
  • First Choice oral liquid iron preparation140mg in 5ml syrup (45mg iron/5ml).
  • 210mg tablets (68mg iron/tablet).
 
 
Ferrous Gluconate
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Alternatives
Green

300mg tablets (35mg iron)

 
 
Sodium Feredetate (Sodium ironedetate, Sytron®)
Alternatives
Green
  • 190mg in 5ml sugar-free elixir (27.5mg iron/5ml).
 
 
09.01.01.01  Expand sub section  Iron and folic acid
09.01.01.01  Expand sub section  Compound iron preparations to top
09.01.01.02  Expand sub section  Parenteral iron
Ferric Carboxymaltose 100ml in 2ml & 500mg in 10ml injections (Ferinject®)
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Formulary
Red
  • For use as an alternative to iron dextran or iron sucrose. Approved for
    use by renal physicians, gastroenterologists and haematologists.
  • Unlicensed for use in children under 14 years of age. If used in this age-group, use should only be on the advice of a consultant with the informed consent of the patient and/or his/her parents/carers.
 
Link  MHRA Drug Safety Update (Nov 2020): Ferric carboxymaltose (Ferinject▼): risk of symptomatic hypophosphataemia leading to osteomalacia and fractures
 
Iron Dextran 100ml in 2ml and 500mg in 10ml injections
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Formulary
Red
 
 
Iron Isomaltoside 1000mg in 10ml injection (Monofer®)
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Formulary
Red
 
 
Iron Sucrose 100mg in 5ml injection (Venofer®)
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Formulary
Red
 
 
09.01.02  Expand sub section  Drugs used in megaloblastic anaemias
Folic Acid
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Formulary
Green
  • 400 microgram and 5mg tablets
  • 2.5mg in 5ml sugar-free syrup
  • 15mg in 1ml injection unlicensedunlicensed
  • 30mg in 2ml injection
 
 
Hydroxocobalamin 1mg in 1ml injection
(Vitamin B12)
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Formulary
Green
 
Link  NICE NG239: Vitamin B12 deficiency in over 16s: diagnosis and management
 
09.01.03  Expand sub section  Drugs used in hypoplastic, haemolytic, and renal anaemias
Eculizumab
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Formulary
Red
High Cost Medicine
  • 300mg/30ml solution for infusion
  • Approved treating atypical haemolytic uraemic syndrome in adults and children in line with NICE

Paroxysmal nocturnal haemoglobinuria treatment is only commissioned from:

  • King’s College Hospital NHS Foundation Trust, London - London and South East
  • Leeds Teaching Hospitals NHS Trust - Rest of United Kingdom
 
Link   NICE TA647: Eculizumab for treating relapsing neuromyelitis optica (terminated appraisal)
Link  Clinical Commissioning Policy: Eculizumab in the treatment of recurrence of C3 glomerulopathy postkidney transplant (all ages) Reference: NHS England: 16054/P
Link  NICE HST 1 - Eculizumab for treating atypical haemolytic uraemic syndrome
Link  NICE TA636: Eculizumab for treating refractory myasthenia gravis (terminated appraisal)
 
Pegcetacoplan (Aspaveli®)
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Formulary
Red
  • 1080mg/20 solution for infusion
  • Approved for the treatment paroxysmal nocturnal haemoglobinuria in adults who have anaemia after at least 3 months of treatment with a C5 inhibitor in line with NICE and NHSE Commissioning Policy.
  • Paroxysmal nocturnal haemoglobinuria treatment is only commissioned from:
    • King’s College Hospital NHS Foundation Trust, London - London and South East
    • Leeds Teaching Hospitals NHS Trust - Rest of United Kingdom

 

 
Link  NICE TA778: Pegcetacoplan for treating paroxysmal nocturnal haemoglobinuria
 
Ravulizumab (Ultomiris®)
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Formulary
Red
  • 300mg/30ml & 1,100mg/11ml concentrate for solution for infusion
  • Approved for the treatment of paroxysmal nocturnal haemoglobinuria in adults in line with NICE
  • Approved for the treatment of atypical haemolytic uraemic syndrome in line with NICE
  • Paroxysmal nocturnal haemoglobinuria treatment is only commissioned from 
    • King’s College Hospital NHS Foundation Trust, London - London and South East
    • Leeds Teaching Hospitals NHS Trust - Rest of United Kingdom
 
Link  NICE TA698: Ravulizumab for treating paroxysmal nocturnal haemoglobinuria
Link  NICE TA710: Ravulizumab for treating atypical haemolytic uraemic syndrome
 
Roxadustat (Evrenzo® )
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Formulary
Red
  • 20mg, 50mg, 70mg, 100mg and 150mg tablets
  • Approved for treating symptomatic anaemia associated with chronic kidney disease in adults in line with NICE
 
Link  NICE TA807: Roxadustat for treating symptomatic anaemia in chronic kidney disease
 
09.01.03  Expand sub section  Erythropoietin
Darbepoetin Alfa (Aranesp®)
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First Choice
Red
High Cost Medicine

  • 10, 15, 20, 30, 40, 50, 60, 80, 100, 150 & 300 microgram injections in prefilled syringes 

  • 20, 40, 60, 80, 100 & 300 microgram Sureclick® pens - approved for management of cancer treatment-induced anaemia in women receiving platinum-based chemotherapy for ovarian cancer 



  • Monitoring: monitoring of erythropeoetin (darbepoetin) in adult patients can be undertaken by GPs under a shared care arrangement Amber

 
Epoetin delta
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Formulary
Red
 
 
Epoetin theta
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Formulary
Red
 
 
Epoetin zeta
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Formulary
Red
 
Link  MHRA Drug Safety Update (Jan 2018): Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (SCARs)
 
Epoetin alfa (Eprex®)
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Alternatives
Red
High Cost Medicine
  • Prefilled syringes (various strengths)
    • Approved for management of cancer treatment-induced anaemia in
      women receiving platinum-based chemotherapy for ovarian cancer
    • No longer regularly used in NUTH
 
Link  MHRA Drug Safety Update (Jan 2018): Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (SCARs)
Link  NICE NG203: Chronic kidney disease: assessment and management
Link  NICE TA323: Erythropoiesis‑stimulating agents during chemotherapy
Link  Shared Care Guidelines for the Monitoring of Erythropoietins in the Treatment of Patients with Chronic Kidney Disease (CKD)
 
Epoetin beta (NeoRecormon®)
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Alternatives
Red
High Cost Medicine

  • Cartridges for use in RecopensPrefilled syringes


    • Approved for management of cancer treatment-induced anaemia
      in women receiving platinum-based chemotherapy for ovarian cancer.

    • No longer regularly used in NUTH.



  • Monitoring: monitoring of erythropeoetin (epoetin beta) in adult patients can be undertaken by GPs under a shared care arrangement Amber

 
Link  MHRA Drug Safety Update (Jan 2018): Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (SCARs)
Link  NICE NG203: Chronic kidney disease: assessment and management
Link  NICE TA323: Erythropoiesis‑stimulating agents during chemotherapy
Link  Shared Care Guidelines for the Monitoring of Erythropoietins in the Treatment of Patients with Chronic Kidney Disease (CKD)
 
Methoxy Polyethylene Glycol-Epoetin Beta (Mircera®, Pegzerepoetin® alfa)
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Alternatives
Red
High Cost Medicine
  • 30, 50, 100, 120, 150, 200 & 250 microgram in 0.3ml and 360 microgram in 0.6ml injections in prefilled syringes.
  • Approved for use as a longer-acting alternative to darbepoetin in a
    small number of patients receiving peritoneal dialysis.
 
Link  MHRA Drug Safety Update (Jan 2018): Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (SCARs)
 
09.01.03  Expand sub section  Iron overload to top
Deferasirox
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Formulary
Red
High Cost Medicine
  • Approved for iron chelation in patients with myelodysplastic syndromes (MDS) - (as per NECN Haematology Group Guidelines) and recommended for use in patients when treatment with desferrioxamine is no longer considered to be appropriate due to progressive iron overload despite maximally tolerated doses of desferrioxamine. 
  • Approved for the treatment of iron overload for trasnfused and non-tranfused patients with chronic inherited anaemias (all ages) in line with NHSE Specialised Commissioning Policy
 
 
Deferiprone (Ferriprox®)
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Formulary
Red
High Cost Medicine
 
 
Desferrioxamine Mesilate
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Formulary
Red
High Cost Medicine
  • Approved for the treatment of iron overload for trasnfused and non-tranfused patients with chronic inherited anaemias (all ages) in line with NHSE Specialised Commissioning Policy
 
 
09.01.04  Expand sub section  Drugs used in autoimmune thrombocytopenic purpura
Anagrelide
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Formulary
Red
  • For the treatment of thrombocythemiaas a 2nd line agent in patients poorly/non-responsive tohydroxycarbamide therapy.
 
 
Avatrombopag (Doptelet®)
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Formulary
Red
High Cost Medicine
  • Approved for the treatment of severe thrombocytopenia in people with chronic liver disease needing a planned invasive procedure in line with NICE
  • Approved for treating primary chronic immune thrombocytopenia in adults in line with NICE

 

 
Link  NICE TA626: Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
Link  NICE TA853: Avatrombopag for treating primary chronic immune thrombocytopenia
 
Caplacizumab (Cablivi ®)
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Formulary
Red
High Cost Medicine

  • 10mg solution for injection

    • Approved with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura in adults, and in young people aged 12 years and over who weigh at least 40 kg in line with NICE



 
Link  NICE TA667: Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura
 
Eltrombopag
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Formulary
Red
High Cost Medicine
  • For the treatment of adults with chronic immune (idiopathic) thrombocytopenia purpura in line with NICE.
 
Link  NICE TA293: Eltrombopag for treating chronic ITP
 
Lusutrombopag
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Formulary
Red

  • 3mg film-coated tablets

  • Approved as an option for treating severe thrombocytopenia in adults with chronic liver disease having planned invasive procedures in line with NICE

 
Link  NICE TA617: Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
 
Romiplostim
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Formulary
Red
High Cost Medicine
  • For the treatment of adults with chronic immune (idiopathic) thrombocytopenia purpura in line with NICE.
 
Link  NICE TA221: Thrombocytopenic purpura - romiplostim
 
09.01.05  Expand sub section  G6PD deficiency
09.01.06  Expand sub section  Drugs used in neutropenia
Filgrastim (G-CSF) (Neupogen®, Ratiograstim®)
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Formulary
Red
High Cost Medicine
  • Available as Neupogen (original brand) and Ratiograstim – a
    biosimilar product.
 
 
Lenograstim (rHuG-CSF) (Granocyte®)
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Formulary
Red
High Cost Medicine
  • 263 microgram (33.6 million units) injection vials
 
 
Lipegfilgrastim (G-CSF)
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Formulary
Red
 
 
Pegfilgrastim (G-CSF)
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Formulary
Red
High Cost Medicine
 
 
09.01.07  Expand sub section  Drugs used to mobilise stem cells
Plerixafor (Mozobil®)
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Formulary
Red
High Cost Medicine
  • Approved by NHS England Specialist Services for stem cell mobilisation for patients with Hodgkin’s disease, Non-Hodgkins lymphoma or multiple myeloma and meet the policy for Haematopoietic Stem Cell Transplantation.
 
 
09.02  Expand sub section  Fluids and electrolytes to top
09.02.01  Expand sub section  Oral preparations for fluid and electrolyte imbalance
09.02.01.01  Expand sub section  Oral potassium
Potassium Chloride (Sando-K®)
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First Choice
Green
  • Effervescent tablets (12mmol potassium 8 mmol chloride)
 
Potassium Chloride
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Alternatives
Green

5mmol in 5ml sugar-free syrup (Kay-Cee-L) 

 
 
09.02.01.01  Expand sub section  Potassium removal
Calcium Resonium®
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Formulary
Red
  • Powder (Calcium polystyrene sulphonate)
 
 
Patiromer calcium (as Patiromer sorbitex calcium)Black Triangle
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Formulary
  • Approved for the treatment of hyperkalaemia in adults in line with NICE Green plus
  • Approved for emergency acute treatment Red

 

 
Link  NICE TA623: Patiromer for treating hyperkalaemia
 
Potassium Removal Polystyrene Sulphonate Resin Powder (Calcium polystyrene sulphonate) (Sorbisterit)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
Resonium A®
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Formulary
Red
  • Powder (Sodium polystyrene sulphonate)
 
 
Sodium zirconium cyclosilicateBlack Triangle (Lokelma®)
View adult BNF View SPC online View childrens BNF
Formulary
  • 5g and 10g oral powder 
  • Approved for the treatment of hyperkalaemia in adults in line with NICE Green plus
  • Approved for emergency acute treatment Red



 

 
Link  NICE TA599: Sodium zirconium cyclosilicate for treating hyperkalaemia
 
09.02.01.02  Expand sub section  Oral sodium and water
Sodium Chloride
Formulary
Green
  • 600mg m/r tablets (Slow Sodium) - approx. 10 mmol sodium & chloride per tablet
  • 1mmol/ml oral solution Green Traffic Light unlicensed 
    • Treatment should only be initiated with the advice of a specialist.
  • 5mmol/1ml oral solution Green plus unlicensed
    • Treatment should only be initiated with the advice of a specialist in accordance with NPPG/RCPCH Position Statement
 
Link  RCPCH & NPPG Position Statement - Using Standardised Concentraions of Unlicensed Liquid Medicines in Children
 
St Marks solution
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Restricted Drug Restricted
Green plus
  • Specialist initiation for use in patients with a short bowel.
  • Usually prepared at home
 
Link  Using St Mark’s electrolyte solution
 
09.02.01.02  Expand sub section  Oral rehydration therapy (ORT) to top
Dioralyte® Oral Rehydration Salts
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
 
09.02.01.03  Expand sub section  Oral bicarbonate
Sodium Bicarbonate
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Formulary
Green
  • 500mg capsules (500mg contains approx. 6 mmol each ofsodium and bicarbonate)
  • 1mmol/ml oral solution unlicensedunlicensed
 
 
Sodium hydrogen carbonate (Nephrotrans)
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Formulary
Green plus

Capsules: 500 mg

 
 
09.02.02  Expand sub section  Parenteral preparations for fluid and electrolyte imbalance
Steriflex 165®
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • Potassium chloride 0.3% (20mmol); sodium chloride 0.9%; and glucose 5% (500ml bag).
    • Approved for diabetic ketoacidosis in paediatric patients unlicensedunlicensed.

 
 
Trometamol (THAM)
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Formulary
Red
 
 
09.02.02.01  Expand sub section  Electrolytes and water
Hartmann’s solution (compound sodium lactate)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Infusion: 500ml, 1000ml

 
 
Water for Injection  (Viaflo® - FE0304)
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
  • Approved for use by the North-East Assisted Ventilation Service (NEAVS)
    • to be prescribed in boxes of 10
 
 
09.02.02.01  Expand sub section  Intravenous sodium
Sodium Chloride
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Formulary
Green
  • 0.9% injection (5ml, 10ml & 20ml)
  • 0.9% IV infusion (100ml, 250ml, 500ml & 1000ml)
  • 0.9% irrigation (1000ml & 3000ml)
  • 0.45% IV infusion (500ml - Steriflex 2)
  • 1.8%, 2.7% & 5% Polyfusor infusion (500ml)
  • 30% injection (10ml)
 
 
Sodium Chloride and Glucose
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Formulary
Green
  • 0.9%/5% IV infusion (500ml - Sterfilex 3)
  • 0.18%/4% IV infusion (500ml & 1000ml)
  • 0.18%/10% IV infusion (500ml - Steriflex 19)
  • 0.45%/5% IV infusion (500ml - Steriflex 45)
 
 
09.02.02.01  Expand sub section  Intravenous glucose to top
Glucose
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Formulary
Green
  • 5% IV infusion (100ml, 250ml, 500ml & 1000ml)
  • 10% IV infusion (500ml & 1000ml)
  • 20% IV infusion (500ml)
  • 50% Injection (50ml)
 
 
09.02.02.01  Expand sub section  Intravenous potassium
Premixed potassium infusion bags
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Formulary
Red

Infusion: 0.15% (10 mmol) potassium chloride & 0.9% sodium chloride 500ml
Infusion: 0.15% (20 mmol) potassium chloride & 0.9% sodium chloride 1000ml
Infusion: 0.15% (10 mmol) potassium chloride & 5% glucose 500ml
Infusion: 0.15% (20 mmol) potassium chloride & 5% glucose 1000ml
Infusion: 0.15% (10 mmol) potassium chloride & 10% glucose 500ml
Infusion:  0.15% (10 mmol) potassium chloride, 0.18% sodium chloride & 4%  glucose 500ml
Infusion:  0.15% (20 mmol) potassium chloride, 0.18% sodium chloride & 4%  glucose 1000ml
Infusion:  0.15% (10 mmol) potassium chloride, 0.9% sodium chloride & 5%  glucose 500ml
Infusion:  0.2% (13.5 mmol) potassium chloride & 0.9% sodium chloride 500ml
Infusion: 0.2% (27 mmol) potassium chloride & 0.9% sodium chloride 1000ml
Infusion:  0.2% (13.5 mmol) potassium chloride & 5% glucose 500ml
Infusion:  0.2% (27 mmol) potassium chloride & 5% glucose 1000ml
Infusion:  0.2% (13.5 mmol) potassium chloride, 0.18% sodium chloride & 4% glucose 500ml
Infusion: 0.2% (27 mmol) potassium chloride, 0.18% sodium chloride & 4% glucose 1000ml
Infusion:  0.3% (20 mmol) potassium chloride & 0.9% sodium chloride 500ml
Infusion: 0.3% (40 mmol) potassium chloride & 0.9% sodium chloride 1000ml
Infusion: 0.3% (20 mmol) potassium chloride & 5% glucose 500ml
Infusion:  0.3% (40 mmol) potassium chloride & 5% glucose 1000ml
Infusion: 0.3% (20 mmol) potassium chloride & 10% glucose 500ml
Infusion:  0.3% (20 mmol) potassium chloride & 20% glucose 500ml
Infusion:  0.3% (20 mmol) potassium chloride, 0.18% sodium chloride & 4% glucose 500ml
Infusion: 0.3% (40 mmol) potassium chloride, 0.18% sodium chloride & 4% glucose 1000ml
Infusion:  0.3% (20 mmol) potassium chloride, 0.45% sodium chloride & 5% glucose 500ml
Infusion:  0.3% (20 mmol) potassium chloride, 0.9% sodium chloride & 5% glucose 500ml
Infusion:  0.6% (40 mmol) potassium chloride & 0.9% sodium chloride 500ml
Infusion:  0.6% (40 mmol) potassium chloride & 5% glucose 500ml

 

 
 
09.02.02.01  Expand sub section  Bicarbonate and lactate
Sodium Bicarbonate
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Formulary
Red
  • 1.26% IV infusion Polyfusor®
  • 1.4% IV infusion Polyfusor®
  • 2.74% IV infusion Polyfusor®
  • 8.4% IV infusion Polyfusor®
  • 8.4% injection (10ml & 50ml)
 
 
Sodium Lactate IV infusion
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Formulary
Red
  • 500ml & 1000ml
 
 
09.02.02.01  Expand sub section  Water
Water for Injection
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 2ml, 5ml, 10ml, 20ml, 100ml & 500ml
 
 
Water for Irrigation
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Formulary
Green
  • 1000ml
 
 
Sterile oral water
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Formulary
Green
  • 100ml
 
 
09.02.02.02  Expand sub section  Plasma and plasma substitutes
Human Albumin Solution
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Formulary
Red
  • 4.5% (50ml, 100ml & 500ml)
  • 20% (50ml & 100ml)
 
 
Plasma-lyte 148 with Glucose 5%
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Formulary
Red
  • Infusion in a balanced electrolyte solution containing Na+ 140 mmol, K+ 5 mmol, Mg2+ 1.5 mmol, acetate 27 mmol/litre. Gluconate 23 mmol/litre. Note calcium free.
    • Approved for use in paediatric theatres only.

 
 
09.02.02.02  Expand sub section  Plasma substitutes to top
Dextran 40/Sodium Chloride
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 10%/0.9% 
 
 
Gelatin (Isoplex®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 4%succinylated gelatin infusion in a balanced electrolyte solution containing Na+ 145 mmol, K+ 4 mmol, Mg2+ 0.9 mmol, Cl- 105 mmol, lactate 25 mmol/litre.
    • Mainly for use in critical care areas and other situations where the perceived advantages of a balanced electrolyte plasma substitute are likely to be clinically important. Note Not yet cleared for use in NUTH.

 
 
Gelatin (Volplex® or Gelofusine®)
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Formulary
Red
  • 4% succinylated gelatin infusion in sodium chloride 0.9% (500ml bags)
 
 
Tetrastarch (Tetraspan®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 6% & 10% tetrastarch infusions in a balanced electrolyte solution containing Na+ 140 mmol, K+ 4 mmol, Mg2+ 1 mmol, Cl- 118 mmol, Ca2+ 2.5 mmol, acetate 24 mmol, malate 5 mmol/litre.
    Contains calcium
 
 
Tetrastarch (Volulyte®)
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Formulary
Red
  • 6% tetrastarch infusion in a balanced electrolyte solution containing Na+ 137 mmol, K+ 4 mmol, Mg2+ 1.5 mmol, Cl110 mmol, acetate 34 mmol/litre.
    Contains calcium.
    • Mainly for use in indications where calcium containing fluids are unsuitable

 
 
Phoxilium 1.2mmol/l phosphate
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Restricted Drug Restricted
Red
  • A haemofiltration and haemodialysis fluid containing Na+ 140 mmol, K+ 4 mmol, Mg2+ 0.6 mmol, Ca2+ 1.25mmol/l, Cl- 115.9 mmol/l, HCO3 - 30.0mmol/l, HPO4 2- 1.20mmol/l.
    • Approved for use in CRRT in patients not requiring reduced potassium or low bicarbonate.

 
 
09.03  Expand sub section  Intravenous nutrition
 note 

Please contact Pharmacy for full details of Parenteral Nutrition Services

 

09.03  Expand sub section  Supplementary preparations
09.04  Expand sub section  Oral nutrition
Growth Faltering in Primary Care
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Formulary  
Link  North of Tyne, Gateshead and North Cumbria - Guidance for the management of Growth Faltering in Primary Care
 
Oral Nutritional Supplements
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Formulary  
Link  North of Tyne, Gateshead and North Cumbria Oral Nutritional Supplements (ONS) guidance
 
Preterm Infants in Primary Care
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Formulary  
Link  North of Tyne, Gateshead and North Cumbria - Guidance for the management of Preterm Infants in Primary Care
 
09.04.01  Expand sub section  Foods for special diets
 note 

 

 

Sapropterin dihydrochloride (Kuvan®)
View adult BNF View SPC online View SMC online View childrens BNF
Formulary
Red

  • Approved for the treatment of hyperphenylalaninaemia in phenylketonuria in line with NICE

 
Link  NICE TA729: Sapropterin for treating hyperphenylalaninaemia in phenylketonuria
 
09.04.02  Expand sub section  Enteral nutrition to top
09.05  Expand sub section  Minerals
09.05.01  Expand sub section  Calcium and magnesium
09.05.01.01  Expand sub section  Calcium supplements
Calcium Carbonate
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First Choice
Green
  • 1.25g chewable tablets (500mg, 12.6 mmol calcium).
  • 2.5g chewable tablets (1g, 25 mmol calcium).
  • 500mg in 5ml suspension unlicensedunlicensed.
 
Calvive 1000®
(formerly Sandocal)
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First Choice
Green
  • Calvive 1000 tablets [2263 mg of calcium lactate gluconate and 1750 mg of calcium carbonate (equivalent to 1000 mg or 25 mmol of calcium)]
 
Calcium Chloride
View adult BNF View childrens BNF
Alternatives
Red
  • Injection:10% equivalent to calcium 6.8 mmol/10 mL
 
 
Calcium Gluconate
View adult BNF View childrens BNF
Alternatives
Red
  • Injection: 10%, equivalent to calcium 2.25 mmol/10 mL
 
 
09.05.01.02  Expand sub section  Hypercalcaemia and hypercalciuria
Zoledronic Acid (Zometa®)
View adult BNF View SPC online View childrens BNF
First Choice
Red
  • 4mg injection
    For hypercalcaemia of malignancy and the prevention of skeletal events in patients with metastatic breast cancer. Prescribe by brand name (Zometa®) to avoid confusion with a different strength product used to treat osteoporosis and Paget’s disease
 
Cinacalcet
View adult BNF View SPC online View childrens BNF
Formulary
High Cost Medicine

  • Approved for the treatment of secondary hyperparathyroidism in patients with end stage renal disease on maintenance haemodialysis where parathyroid gland surgery has failed or is inappropriate. Red Traffic Light

  • Also for short term use to control symptoms prior to a second attempt at more definitive surgery. Red Traffic Light

  • Approved for patients with primary hyperparathyroidism for whom parathyroidectomy would be indicated based on serum calcium levels, symptoms and end organ damage, but in whom parathyroidectomy is either not clinically appropriate or is contraindicated. It is not normally commissioned if serum calcium concentration is <2.85mmol/L Amber

 
Link  County Durham and Tees Valley Shared Care Protocol: Cinacalcet
Link  North of Tyne, Gateshead and North Cumbria Cinacalcet Shared Care Guidance
Link  South Tyneside and Sunderland - Cinacalcet Shared Care Guidance
Link  NICE TA117: Hyperparathyroidism - cinacalcet
 
Disodium Pamidronate
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 30mg injection
 
 
Etelcalcetide (Parsabiv®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
  • 2.5mg/0.5ml, 5mg/1ml & 10mg/2ml solution for injection
  • Approved for the treatment of secondary hyperparathyroidism in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA448 Etelcalcetide for treating secondary hyperparathyroidism
 
Paricalcitol
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • Approved for use in patients with PTH levels < 800mcg/l but  whose treatment with alfacalcidol is restricted due to a high calcium level.
 
 
Calcitonin (Salmon®)
(Salcatonin)
View adult BNF View SPC online View childrens BNF
Alternatives
Red
  • 400 units in 2ml injection
 
 
Sodium Clodronate
View adult BNF View SPC online View childrens BNF
Alternatives
Green plus

  • 520mg & 800mg tablets

 
 
09.05.01.03  Expand sub section  Magnesium to top
Magnesium Aspartate
View adult BNF View childrens BNF
Formulary
Green
  • 6.5g (10 mmol) sachets - first line for the treatment and prevention of magnesium deficiency.
  • 614.8mg (2.5mmol) tablets unlicensedunlicensed - for second line treatment in patients with short bowel syndrome.
 
 
Magnesium chloride
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 10 mmol magnesium in 1 litre sodium chloride 0.9% with potassium chloride 0.15% (20 mmol) unlicensedunlicensed
  • 64mg sustained release tablets (2.6mmol magnesium) unlicensedunlicensed
 
 
Magnesium Glycerophosphate
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 1g (4mmol) chewable tablets 
    • Use preparation with cheapest acquisition cost.
    • Yourmag®
    • Magnaphate® unlicensedunlicensed

  • 1mmol/ml suspension -available if supply problems with tablets unlicensedunlicensed.
 
 
Magnesium Sulphate
Formulary
Red
  • 50% 2ml (4 mmol), 50% 10ml (20 mmol) & 10% 10ml (4mmol) injections 
  • 60 mmol in 500ml sodium chloride 0.9% infusion unlicensedunlicensed
 
 
09.05.02  Expand sub section  Phosphorus
09.05.02.01  Expand sub section  Phosphate supplements
Phosphate
(Solution)
View adult BNF View childrens BNF
Formulary
Red
  • 4.15 mmol phosphate in 10ml oral solution unlicensedunlicensed
 
 
Phosphate Polyfusor
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 500ml intravenous infusion containing 50mmol phosphate
    per 500ml (PO4 3- 100 mmol, K+ 19 mmol, and Na+ 162 mmol/litre).
 
 
Phosphate-Sandoz®
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • Effervescent tablets (phosphate 16.1 mmol, sodium 20.4mmol & potassium 3.1 mmol / tablet)
 
 
Sodium glycerophosphate
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
09.05.02.02  Expand sub section  Phosphate-binding agents
Calcium Acetate (Phosex®, Renacet®)
View adult BNF View SPC online View childrens BNF
First Choice
Green plus
  • Phosex® 1g tablets (containing 250mg, 6.2mmol of calcium) 
  • Renacet® 475mg (containing 120.25mg, 3mmol of calcium) &
    950mg tablets (containing 240.5mg, 6mmol of calcium)
 
Osvaren®
View adult BNF View SPC online View childrens BNF
Second Choice
Green plus
  • Tablets containing calcium acetate 435mg & Magnesium carbonate heavy 235mg.
  • For use, after calcium carbonate and calcium acetate, but before the
    much more expensive sevelamer and lanthanum.
 
 
Sucroferric oxyhydroxide (Velphoro®)
View adult BNF View SPC online View childrens BNF
Third Choice
Green plus
High Cost Medicine
  • Approved for use by haemodialysis or peritoneal dialysis patients who cannot tolerate alternative phosphate binders or where these have been ineffective
 
 
Calcium Carbonate
View adult BNF View childrens BNF
Formulary
Green
  • 1.25g & 2.5g chewable tablets (Calcichew)
    (Other formulations e.g. Remegel, Rennies, Rennie Soft gel and Settler’s.
    Tums are also stocked at the RVI for use in paediatric renal patients)
 
 
Sevelamer Carbonate
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
High Cost Medicine
  • 800mg f/c tablets.
  • 2.4g powder for oral suspension

 
 
Lanthanum Carbonate
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
High Cost Medicine
 
 
09.05.03  Expand sub section  Fluoride
Sodium Monofluorophosphate
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
 
 
Sodium Fluoride
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
  • Sodium fluoride 0.619% (75ml) toothpaste (Duraphat® 2800 ppm) prescription only medicine
  • Sodium fluoride 1.1% (51g) toothpaste (Duraphat® 5000 ppm) prescription only medicine
  • Sodium fluoride 0.05% mouthwash - approved for use within the dental hospital.
  • In line with NHS England’s guidance on conditions for which over the counter items should not be routinely prescribed, the ICB does not support the routine prescribing of medicines or preparations for dental conditions (including toothpastes such as Duraphat®, ulcer healing preparations, antibiotics and analgesics) on GP FP10 prescriptions except in the following circumstances:
    • After head and neck cancer treatment on the recommendation of a Head & Neck or Restorative Dental Consultant.
    • For patients receiving palliative care as part of ongoing symptom control.

Dentists must signpost patients to purchase products or issue prescriptions (NHS or private) for medicines to meet the identified dental needs of their patients. If a patient receives treatment as a private patient, they must always be given a private prescription.

 

 

 
 
Stannous Fluoride
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
 
 
09.05.04  Expand sub section  Zinc to top
Zinc Sulphate (Solvazinc®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
 
Zinc Sulphate 220mg capsules
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
 
09.05.05  Expand sub section  Selenium
Selenium
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
09.06  Expand sub section  Vitamins
09.06.01  Expand sub section  Vitamin A
Vitamin A
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
  • 20,000 unit injection - for the treatment of night blindness/ vitamin A deficiency as a result of malabsorption in patients with short bowel syndrome, ileal resection or pancreatic insufficiency unlicensedunlicensed.
 
 
Vitamins A and D
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • Capsules containing vitamin A 4000 units, vitamin D 400 units
 
 
09.06.02  Expand sub section  Vitamin B group
Pyridoxal Phosphate
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 25mg tablets unlicensedunlicensed
  • 50mg capsules unlicensedunlicensed
 
 
Pyridoxine Hydrochloride
(Pyridoxine)
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 10mg unlicensedunlicensed
  • 50mg tablets
 
 
Pyridoxine Hydrochloride Injection
View adult BNF View SPC online View childrens BNF
Formulary
Red

Injection: 50 mg/2 mL

 
 
Thiamine
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 50mg & 100mg tablets
 
Link  NICE CG100: Management of alcohol-related physical complications
Link  NICE CG115: Alcohol dependence - diagnosis, assessment and management
 
Vitamin B & C injection (Pabrinex®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • IVHP injection (ascorbic acid 500mg, nicotinamide 160mg, pyridoxine
    hydrochloride 50mg, riboflavin 4mg & thiamine hydrochloride 250mg &
    1g anhydrous glucose / pair of ampoules) 
  • IMHP injection also used
 
Link  NICE CG100: Management of alcohol-related physical complications
Link  NICE CG115: Alcohol dependence - diagnosis, assessment and management
 
09.06.02  Expand sub section  Oral vitamin B complex preparations to top
Vitamin B Tablets, Compound Strong
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • Tablets (nicotinamide 20mg, pyridoxine hydrochloride 2mg, riboflavin 2mg & thiamine hydrochloride 5mg per tablet).

 
Link  Regional Medicines Optimisation Committee (RMOC) Position Statement Oral vitamin B supplementation in alcoholism - November 2019
 
09.06.02  Expand sub section  Other compounds
09.06.03  Expand sub section  Vitamin C
Ascorbic Acid (Vitamin C)
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 50mg, 100mg, 200mg & 500mg tabs
  • 500mg in 5ml injection unlicensedunlicensed
 
 
09.06.04  Expand sub section  Vitamin D
 note 

COVID-19 rapid guideline: vitamin D

This guideline covers vitamin D use in the context of COVID‑19. It is for adults, young people and children in hospitals and community settings. Vitamin D is important for bone and muscle health. Supplementation should not be offered solely to prevent COVID-19

NICE NG187

Alfacalcidol
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 250 nanogram & 1 microgram capsules
  • 2 microgram/ml sugar-free oral drops – one drop containing approx. 100 nanograms of alfacalcidol 
  • 1 microgram in 0.5ml & 2 micrograms in 1ml injections
 
 
Calcitriol
View adult BNF View SPC online View childrens BNF
Formulary
Green plus

Capsules: 0.25 micrograms, 0.5 micrograms

 
 
Colecalciferol
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 20 microgram (800 units) capsules or tablets
    • For first line use in the long term maintenance treatment of patients with documented vitamin D deficiency following high strength therapy and also for use in patients with symptoms and insufficient levels. 
  • 80 microgram (3,200 units) capsules
    • For use in patients with malabsorption such as patients who have had bariatric surgery and require higher maintenance doses 
  • 500 microgram (20,000 units) capsules.
    • For use in patients requiring high strength therapy for vitamin D deficiency. 
  • 2740iu/ml oral solution (Fultium®-D3 Drops) 
  • 1000iu and 3000iu buccal spray (DLux®) unlicensedunlicensed Red Traffic Light
    • Approved for use in paediatric parenteral nutrition patients with short bowel syndrome and adults with metabolic bone disease who have vitamin D deficiency despite previous treatment.
 
 
Colecalciferol 25,000 unit liquid (Invita D3® )
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
 
Ergocalciferol
(Calciferol)
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 250 microg. (10,000 units) & 1.25mg (50,000 units) tablets.
    • A 3000 units in 1ml suspension (unlicensedunlicensed) may be supplied if colecalciferol oral solution is not available.

  • 7.5mg (300,000 units) in 1ml injection.
 
 
Calcium Carbonate and Colecalciferol
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • Accrete®
    • Film coated tablet containing calcium carbonate 1.5g and colecalciferol 10 micrograms (400 units)
  • Adcal D3®
    • Chewable tablet containing calcium carbonate 1.5g and colecalciferol 400 units (contains soya and sucrose)
    • Effervescent tablet containing calcium carbonate 1.5g and colecalciferol 400 units
  • Cacit D3®
    • Effervescent granule sachet containing calcium carbonate 1.25g and colecalciferol 440 units
  • Calcichew D3 Forte®
    • Chewable table containing calcium carbonate 1.25g and colecalciferol 400 units
  • Evacal®
    • Chewable tablet containing calcium carbonate 1.5g and colecalciferol 400 units
      • approved as chewable option and also to be used in patients with peanut and soya allergy 
 
 
Calcium and Ergocalciferol Tablets
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • Calcium lactate 300mg, calcium phosphate 150mg (Ca 97mg, 2.4 mmol) & ergocalciferol 10 micrograms (400 units).
 
 
09.06.05  Expand sub section  Vitamin E
Alpha Tocopherol (Vedrop®)
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
  • 50mg in 1ml oral solution - approved for the treatrment of children with vitamin E deficiency due to fat malabsorption syndromes.
 
 
Alpha Tocopheryl Acetate
(Vitamin E)
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
  • 500mg in 5ml suspension
  • 134mg (200 unit) capsules
 
 
Alpha Tocopheryl Acetate Injection
View adult BNF View SPC online View childrens BNF
Formulary
Red

Injection: 100mg/2ml

 
 
09.06.06  Expand sub section  Vitamin K to top
Phytomenadione
View adult BNF View SPC online View childrens BNF
First Choice
Green
  • 50 microgram in 0.25ml drops (NeoKay®) unlicensedunlicensed
  • 1mg capsule- preferred product for use in neonates
  • 10mg in 1ml injection unlicensedunlicensed
  • 2mg in 0.2ml mixed micelles injection (Konakion® MM
    Paediatric) – may be taken by mouth as well as being given by IM or IV injection
 
Menadiol Sodium Phosphate
View adult BNF View SPC online View childrens BNF
Second Choice
Green
  • 10mg tablets - water soluble derivative of vitamin K for use in patients with fat malabsorption, especially in hepatic disease or biliary obstruction including cystic fibrosis patients.
 
 
09.06.07  Expand sub section  Multivitamin preparations
Mutivitamins BPC
View adult BNF View SPC online View childrens BNF
First Choice
Green
  • Capsules containing ascorbic acid 15mg, nicotinamide 7.5mg, riboflavin 500 micrograms, thiamine HCl 1mg, vitamin A 2,500 units, & vitamin D 300 units
 
Dalivit®
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • Drops containing in each 0.6ml dose ascorbic acid 50mg, ergocalciferol
    400 units, nicotinamide 5mg, pyridoxine HCl 500 micrograms, riboflavin
    400 micrograms, thiamine 1mg & vitamin A 5,000 units)
    • Dalivit drops are to be retained for use in patients requiring a full supplement of vitamin A.

 
 
Abidec®
View adult BNF View SPC online View childrens BNF
Alternatives
Green
  • Drops containing in each 0.6ml dose ascorbic acid 50mg, ergocalciferol
    400 units, nicotinamide 5mg, pyridoxine HCL 500micrograms, riboflavin
    400 micrograms, thiamine 1mg & vitamin A 1,333 units.
    To be used in children and adults.
 
 
09.06.07  Expand sub section  Vitamin and mineral supplements and adjuncts to synthetic diets
DEKAs® Essentials multivitamins
View adult BNF View SPC online View childrens BNF
Formulary
Green plus

  • Approved for adult patients requiring multivitamin and mineral supplementation with Cystic Fibrosis

 
 
DEKAs® Plus multivitamins
View adult BNF View SPC online View childrens BNF
Formulary
Green plus

  • Approved for adult patients requiring multivitamin and mineral supplementation with Cystic Fibrosis

 
 
Forceval®
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
  • Capsules
    • For limited use as a vitamin and mineral supplement in patients with phenylketonuria The capsules are also approved as an oral supplement in burns patients with malnutrition or alcohol dependency and patients with major burns after discontinuation of IV therapy, and have also been approved for use in patients with severe anorexia nervosa. Treatment initiated with specialist advice.
  • Soluble
    • Approved for short term use in patients who are unable to swallow
      Forceval capsules.
 
 
Ketovite®
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
 
 
Renavit® tablets
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
  • Water soluble vitamin supplementation therapy for maintenance haemodialysis patients only.
 
 
09.07  Expand sub section  Bitters and tonics
09.08  Expand sub section  Metabolic disorders
Ubidecarenone
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
09.08.01  Expand sub section  Drugs used in metabolic disorders to top
Asfotase alfa (Strensiq®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
NHS England
  • 40mg/ml & 100mg/ml solution for injection
  • Approved for the treatment of paediatric-onset and juvenile-onset hypophosphatasia in line with NICE and NHS England Commissioning Policy
 
Link  NICE HST23: Asfotase alfa for treating paediatric-onset hypophosphatasia
 
Betaine
(Homocystinuria)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
Calcium Levomefolate (Prefolic)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
Nitisinone
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
Ubiquinone (Coenzyme Q10, Ubidecarenone)
View adult BNF View SPC online View childrens BNF
Formulary
Green plus
  • 10mg, 30mg, & 100mg capsules 
  • 50mg in 5ml & 30mg in 1ml (150mg in 5ml) oral solution
    • nutritional supplement and antioxidant approved for use in the
      management of mitochondrial disorders.
    • approved for use under specialist consultant supervision in the
      management of patients with severe hyperlipidaemia who are not tolerating statins due to myopathy. Use in statin induced myopathy is subject to treatment being initiated by a consultant.

      Lipid clinic initiation only

 
 
Velmanase alfa (Lamzede ®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 10mg powder for solution for infusion
  • Approved for treating alpha-mannosidosis in line with NICE
 
Link  NICE HST29: Velmanase alfa for treating alpha-mannosidosis
 
Chenodexoycholic acid (Xenbilox®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

  • 250mg capsules


    • Approved for the treatment of Cerebrotendinous Xanthomatosis in line with NHS Commissioning Policy. NHS England will commission this drug for patients who are currently being treated (April 2017)

    • Approved for the treatment of inborn errors of bile acid synthesis (all ages) in line with NHS England Commissioning Policy



 
 
09.08.01  Expand sub section  Wilsons disease
Penicillamine
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 125mg & 250mg tablets - also used for the treatment ofcystinuria and rheumatoid arthritis – section 10.1.3
 
 
Zinc Acetate (Wilzin®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
Trientine Dihydrochloride
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
  • 300mg capsules
    • Approved for the treatment of Wilsons disease in line with NHS England Commissioning Policy. NHS England will commission the treatment for patients who are currently being treated (April 2017)
 
 
Tiopronin
View adult BNF View SPC online View childrens BNF
Unlicensed Drug Unlicensed
Red
  • 500mg tablets - for use as 2nd line treatment for cystinuria in
    patients who fail to tolerate/respond to penicillamine unlicensedunlicensed.
 
 
09.08.01  Expand sub section  Carnitine deficiency
Carnitine
(Levocarnitine)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
  • 30% oral solution
  • 1g in 5ml injection
 
 
09.08.01  Expand sub section  Fabry's disease
Agalsidase Alfa
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
 
Agalsidase Beta
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
 
Migalastat (Galafold ®)
Formulary
Red
  • Approved for the treatment of Fabry's disease in line with NICE 
 
Link  Highly specialised technologies guidance HST4: Migalastat for treating Fabry disease
 
Pegunigalsidase alfa (Elfabrio®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 20mg/10ml concentrate for solution for infusion
  • Approved for treating Fabry disease in line with NICE and NHSE Specialised Commissioning guidance
 
Link  NICE TA915: Pegunigalsidase alfa for treating Fabry’s disease
 
09.08.01  Expand sub section  Gaucher's disease
Imiglucerase (Cerezyme®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
  • 400iu injection
 
 
Velaglucerase
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
09.08.01  Expand sub section  Mucopolysaccharidosis I to top
Elosulfase alfa
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 5mg/5ml concentrate for solution for infusion:
    • treating mucopolysaccharidosis type 4A in people of all ages
 
Link  NICE HST19 - Elosulfase alfa for treating mucopolysaccharidosis type 4A
 
Galsulfase (Naglazyme®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
IdursulfaseBlack Triangle
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
Laronidase (Aldurazyme®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
 
09.08.01  Expand sub section  Pompe disease
Alglucosidase Alfa (Myozyme®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
 
Avalglucosidase alfa (Nexviadyme®)
View adult BNF View SPC online View SMC online View childrens BNF
Formulary
Red
High Cost Medicine
NHS England
  • 100mg powder for concentrate for solution for infusion
  • Approved for treating Pompe disease in line with NICE
 
Link  NICE TA821: Avalglucosidase alfa for treating Pompe disease
 
Cipaglucosidase alfa (CIPA) (Pombiliti®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • 105mg powder for concentrate for solution for infusion vials
  • Approved with with miglustat (Opfolda) for treating late-onset Pompe disease in adults in line with NICE and NHSE Specialised Commissioning guidance


For information only - as there are no providers within the North East & Cumbria area that are commissioned to provide this service

 
Link  NICE TA912: Cipaglucosidase alfa with miglustat for treating late-onset Pompe disease
 
09.08.01  Expand sub section  Nephropathic cystinosis
Mercaptamine
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
 
09.08.01  Expand sub section  Urea cycle disorders
Arginine
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
Carglumic Acid (Carbaglu®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
 
Sodium Benzoate
Formulary
Red
 
 
Sodium Phenylbutyrate
Unlicensed Drug Unlicensed
Red
  • 500mg tablets - Licensed formulation marketed as Ammonaps
  • 1g in 5ml & 2g in 10ml injections
 
 
09.08.02  Expand sub section  Acute porphyrias
Givosiran (Givlaari®)
View adult BNF View SPC online View SMC online View childrens BNF
Formulary
Red

  • Approved for treating acute hepatic porphyria (AHP) in adults and young people aged 12 and older in line with NICE, only if:

    • they have clinically confirmed severe recurrent attacks (4 attacks or more within 12 months) and

    • the company provides it according to the commercial arrangement.



 
Link  NICE HST 16: Givosiran for treating acute hepatic porphyria
 
Human Arginate
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
 
09.08.02  Expand sub section  Drugs unsafe for use in acute porphyrias to top
 ....
 Non Formulary Items
Ferric derisomaltose  (Diafer)

View adult BNF View SPC online View childrens BNF
Non Formulary
Red

Solution for injection: 100 mg/2 mL

  
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
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment. In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances. For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing.  

Amber

Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.  

Green plus

Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), 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. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs.  

Green

Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care.  

Black

NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria.   

Brown

UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review.  

Not Recomended

NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status.  

netFormulary