netFormulary NHS
Sunderland Joint Formulary
NHS Sunderland Clinical Commissioning Group
South Tyneside and Sunderland NHS Foundation Trust
 Search
 Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
12.01  Expand sub section  Drugs acting on the ear
12.01.01  Expand sub section  Otitis externa
12.01.01  Expand sub section  Astringent preparations
Acetic Acid (glacial) (1st line for mild otitis externa) (Earcalm ®)
View adult BNF View SPC online
Formulary

Ear spray: 2%

 
   
12.01.01  Expand sub section  Anti-inflammatory preparations
Betamethasone sodium phosphate
View adult BNF View SPC online
Formulary

Ear/eye/nose drops: 0.1%

 
   
Betamethasone with Neomycin  (Betnesol N®)
View adult BNF View SPC online
Formulary

Ear drops: 0.1% with neomycin sulfate 0.5%

 
   
Dexamethasone with framycetin sulfate and gramicidin (Sofradex®)
View adult BNF View SPC online
Formulary

Ear drops: 0.05% with framycetin sulfate 0.5% and gramicidin 0.005% (Sofradex®)

 
   
Dexamethasone with Neomycin (Otomize®)
View adult BNF View SPC online
Formulary

Ear spray: 0.1% with neomycin sulfate 3250 units/1 mL and glacial acetic acid 2% (Otomize®)

 
   
Flumetasone with Clioquinol  (Locorten-Vioform®)
View adult BNF View SPC online
Formulary

Ear drops: flumetasone (as pivalate) 0.02% and clioquinol 1% ear drops

 
   
Prednisolone sodium phosphate
View adult BNF View SPC online
Formulary

Eye/ear drops: 0.5%

 
   
Betamethasone (Betnovate Scalp application)
View adult BNF View SPC online
Formulary
Green +

unlicensedunlicensed Solution (as ear drops for eczema): 0.1% (Betnovate Scalp Application)

 
   
12.01.01  Expand sub section  Anti-infective preparations to top
Chloramphenicol
View adult BNF View SPC online
Formulary

Ear drops: 5%

 
   
Ciprofloxacin
View adult BNF View SPC online
Formulary
Green +

unlicensedunlicensed Eye drops: 0.3%

 

(Off-licence use)

 
Link  BNF advice for ciprofloxacin use in the ear
   
Clotrimazole
View adult BNF View SPC online
Formulary

Solution (as ear drops): 1%

 
   
Gentamicin
View adult BNF View SPC online
Formulary

Eye/ear drops: 0.3%

 
   
Gentamicin with hydrocortisone
View adult BNF View SPC online
Formulary
Green +

Ear drops: hydrocortisone 1% with gentamicin 0.3% (as sulfate) (Gentisone HC®)

 
   
Triamcinolone with neomycin, gramicidin and nystatin (Kenacomb Otic®)
View adult BNF View SPC online
Formulary
Green +

unlicensedunlicensed Ointment: 1 mg triamcinolone acetonide, 2.5 mg neomycin sulphate, 0.25mg gramicidin, 100,000 units nystatin per 5 g

 
   
Ichthammol glycerine
View adult BNF View SPC online
Formulary
Red

Solution

 
   
Boric acid (insufflation)
View adult BNF View SPC online
Formulary
Red

Powder: 10g

 
   
12.01.01  Expand sub section  Other aural preparations
12.01.02  Expand sub section  Otitis media
12.01.03  Expand sub section  Removal of ear wax
Almond Oil
View adult BNF View SPC online
Formulary

Ear drops

 
   
Olive Oil
View adult BNF View SPC online
Formulary

Ear drops

 
   
Sodium Bicarbonate
Formulary

Ear drops: 5%

 
   
12.02  Expand sub section  Drugs acting on the nose
12.02.01  Expand sub section  Drugs used in nasal allergy to top
12.02.01  Expand sub section  Antihistamines
Azelastine Hydrochloride
View adult BNF View SPC online
Formulary

Nasal spray: 140 micrograms (0.14 mL)/spray

 
   
Azelastine and fluticasone (Dymista®)
View adult BNF View SPC online
Formulary
Green +

Nasal spray: Azelastine 137 micrograms & fluticasone 50 micrograms/spray

Second line treatment following a trial of a combination of nasal steroid and oral antihistamine.

 
   
12.02.01  Expand sub section  Corticosteroids
Beclometasone Dipropionate
View adult BNF View SPC online
Formulary

Nasal spray: 50 micrograms/ spray

 
   
Betamethasone Sodium Phosphate
View adult BNF View SPC online
Formulary

Eye/ear/nose drops: 0.1%

 
   
Fluticasone furoate
View adult BNF View SPC online
Formulary

Nasal spray: 27.5 micrograms/spray

 
   
Fluticasone Propionate
View adult BNF View SPC online
Formulary

Nasal spray: 50 micrograms/spray
Nasal drops: 400 micrograms/unit dose

 
   
Mometasone Furoate
View adult BNF View SPC online
Formulary

Nasal spray: 50 micrograms/spray

 
   
12.02.01  Expand sub section  Cromoglicate
12.02.02  Expand sub section  Topical nasal decongestants
Sodium chloride
View adult BNF View SPC online View SMC online
Formulary

Nasal drops: 0.9%

 
   
12.02.02  Expand sub section  Sympathomimetics to top
Xylometazoline
View adult BNF View SPC online
Formulary

Nasal drops: 0.05%, 0.1%
Nasal spray: 0.1%

 
   
12.02.02  Expand sub section  Antimuscarinic
Ipratropium Bromide
View adult BNF View SPC online
Formulary

Nasal spray: 21 micrograms/spray

 
   
12.02.03  Expand sub section  Nasal preparations for infection
Bismuth and Iodoform Paste (BIPP)
View adult BNF View SPC online View SMC online
Formulary
Red

Impregnated gauze: 1.25cm x 100cm and 2.5cm x 100cm

 
   
Cocaine
View adult BNF View SPC online
Formulary
Red

unlicensedunlicensed Drops: 4%

 
   
12.02.03  Expand sub section  Nasal Staphylococci
Chlorhexidine Hydrochloride and Neomycin Suphate
View adult BNF View SPC online
Formulary

Naseptin®
Cream: chlorhexidine hydrochloride 0.1%, neomycin sulfate 0.5%
Contains peanut oil

 
   
Mupirocin
View adult BNF View SPC online
Formulary

Nasal ointment: 2% in white soft paraffin (Bactroban®)
2nd line for peanut allergy (in primary care)

 
   
Lidocaine and Phenylephrine
View adult BNF View SPC online
Formulary
Red

unlicensedunlicensed Nasal spray: 2.5ml

 
   
12.03  Expand sub section  Drugs acting on the oropharynx
12.03.01  Expand sub section  Drugs for oral ulceration and inflammation to top
Antacid with Oxetacaine
View adult BNF View SPC online
Formulary
Green +

unlicensedunlicensed Suspension


Used to relieve symptoms in patients who have had radiotherapy and may be of value in some patients with acute oesophagitis. Not for routine use as an antacid

 
   
Benzydamine
View adult BNF View SPC online
Formulary

Mouthwash: 0.15%
Spray: 0.15% 

 
   
Betamethasone
View adult BNF View SPC online
Formulary
Green +

Tablets (soluble): 500 micrograms (Betnesol®)
Used as mouth gargle

 
   
Caphosol®
View adult BNF View SPC online
Formulary

Oral rinse: 30 doses

 
   
Gelclair®
View adult BNF View SPC online
Formulary

Oral gel sachets: 15 mL

 
   
Hydrocortisone
View adult BNF View SPC online
Formulary

Mucoadhesive buccal tablets: 2.5mg

 
   
Lidocaine
View adult BNF View SPC online
Formulary
Green +

Spray: 10%

 
   
Lidocaine
View adult BNF View SPC online
Formulary
Green +

unlicensedunlicensed Lollies: 100mg

 
   
Mucogard®
View adult BNF View SPC online
Formulary

Oral rinse: 250ml

 
   
Orabase
View adult BNF View SPC online
Formulary

Paste: 30 g

 
   
12.03.02  Expand sub section  Oropharyngeal anti-infective drugs
12.03.02  Expand sub section  Oropharyngeal Fungal infections
Nystatin
View adult BNF View SPC online
Formulary

Oral suspension: 100,000 units/1 mL
1st line for oral candidiasis

 
   
Miconazole
View adult BNF View SPC online
Formulary

Oral gel (sugar-free): 24 mg/1 mL (20 mg/1 g) (Daktarin)     

 
   
Fluconazole
View adult BNF View SPC online
Formulary

Capsules: 50 mg, 150 mg, 200 mg Oral solution: 50 mg/5mL, 200 mg/5mL

 
   
12.03.02  Expand sub section  Oropharyngeal Viral infections
Chlorhexidine
View adult BNF View SPC online
Formulary

Mouthwash: 0.2% (contains alcohol)
Mouthwash (alcohol free): 0.2%
Spray: 0.2% – contains alcohol
Gel: 1%

 
   
12.03.03  Expand sub section  Lozenges and sprays
12.03.04  Expand sub section  Mouthwashes, gargles, and dentifrices to top
Hydrogen Peroxide
View adult BNF View SPC online
Formulary

Mouthwash: 1.5%, 6% (BP)

 
   
Tranexamic Acid Mouthwash
View adult BNF View SPC online
Formulary

Tablets: 500mg
For mouthwash: dissolve tablets in water as per hospital instruction

 
   
12.03.05  Expand sub section  Treatment of dry mouth
12.03.05  Expand sub section  Local Treatment
Biotene Oralbalance®
View adult BNF View SPC online
Formulary

Gel

 
   
BioXtra®
View adult BNF View SPC online
Formulary

Gel: 40 mL
Spray: 50 mL
Mouth rinse: 250 mL      

 
   
Glandosane®
View adult BNF View SPC online
Formulary

Spray

 
   
Orthana®
View adult BNF View SPC online
Formulary  
   
Saliveze®
View adult BNF View SPC online
Formulary  
   
Salivix®
View adult BNF View SPC online
Formulary  
   
Xerotin
View adult BNF View SPC online
Formulary

Spray (sugar-free):100 mL

 
   
Aequasyal
View adult BNF View SPC online
Formulary

By initiation of head and neck specialist only (2nd or 3rd line for patients undergoing radiotherapy)

 
   
12.03.05  Expand sub section  Systemic treatment
Pilocarpine Hydrochloride
View adult BNF View SPC online
Formulary
Green +

Tablets: 5 mg

 
   
 ....
 Non Formulary Items
Amphotericin Lozenges  (Fungilin®)

View adult BNF View SPC online
Non Formulary
 
Anaesthetic throat lozenges  (Tyrozets®)

View SPC online
Non Formulary
 
Benzocaine

View adult BNF View SPC online
Non Formulary
 
Budesonide  (Rhinocort Aqua®)

View adult BNF View SPC online
Non Formulary
 
Carmellose Sodium  (Orahesive®)

View adult BNF View SPC online
Non Formulary
 
Cerumol®

View adult BNF View SPC online
Non Formulary
 
Cetylpyridinium, Chlrocresol, Lidocaine  (Anbesol®)

View adult BNF View SPC online
Non Formulary
 
Chlorhexidine & Chlorobutanol  (Eludril®)

View adult BNF View SPC online
Non Formulary
 
Choline Salicylate  (Bonjela® Adult)

View adult BNF View SPC online
Non Formulary
 
Docusate Sodium 0.5%  (Waxsol®)

View adult BNF View SPC online
Non Formulary
 
Doxycycline

View adult BNF View SPC online
Non Formulary
 
Doxycycline  (Periostat®)

View adult BNF View SPC online
Non Formulary
 
Exterol®

View adult BNF View SPC online
Non Formulary
 
Flunisolide  (Syntaris®)

View adult BNF View SPC online
Non Formulary
 
Flurbiprofen lozenge

View adult BNF View SPC online
Non Formulary
 
Lidocaine and Cetylpyridinium  (Dentinox® Teething Gel)

View adult BNF View SPC online
Non Formulary
 
Luborant®

View adult BNF View SPC online
Non Formulary
 
Molcer®

View adult BNF View SPC online
Non Formulary
 
Otex®

View adult BNF View SPC online
Non Formulary
 
Prednisolone 0.5% with Neomycin 0.5%  (Predsol-N®)

View adult BNF View SPC online
Non Formulary
 
Salicylates - Salicylic acid  (Pyralvex®)

View adult BNF View SPC online
Non Formulary
 
Salinum®

View adult BNF View SPC online
Non Formulary
 
SST

View adult BNF View SPC online
Non Formulary
 
Thymol

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