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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 13: Skin - Full Chapter
13.06  Expand sub section  Acne and rosacea
Clindamycin
(Antibacterial agent not for continual use)
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First Choice
Green

1% Topical solution

1% lotion

 

 
Erythromycin 40mg with Zinc Acetate 12mg/mL (Zineryt®)
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Formulary
Green

30ml, 90ml

 
   
Erythromycin 2%topical solution
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Formulary
Green
 
   
Benzoyl Peroxide
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Formulary
Green

5% gel           

 
   
Azelaic Acid
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Formulary
Green

15% gel Finacea

20% cream Skinoren

 
   
Adapalene
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Formulary
Green

0.1%  gel and cream

 

1st line topical retinoids

 
   
Adapalene/Benzoyl Peroxide (Epiduo)
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Formulary
Green

Adapalene 0.1%

 
   
Ivermectin cream
(Approved for the topical treatment of inflammatory lesions of papulopustular rosacea in adults for use after more established therapies such metronidazole gel and azelaic acid have failed.)
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Formulary
Green

 

topical preperations for rosacea

 
   
13.06.01  Expand sub section  Topical preparations for acne
13.06.01  Expand sub section  Benzoyl peroxide and azelaic acid
13.06.01  Expand sub section  Topical antibacterials for acne
13.06.01  Expand sub section  Other topical preparations for acne to top
13.06.02  Expand sub section  Oral preparations for acne
Co-Cyprindiol 2000/35
(Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)
Black Triangle
(For use in women only)
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First Choice
Green

Tablet

Generic co-cyprindiol is much cheaper than Dianette

 
Co-Cyprindiol
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Green

Generic co-cyprindiol is much cheaper than dianette

 
   
Isotretinoin
(Isotretinoin is a toxic drug that must only be prescribed by or under the supervision of a consultant dermatologist.)
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Formulary
Red

5mg and 20mg 

Supplied in accordance with companies pregnancy prevention programme.

women of child bearing age will only be supplied 1 month. See BNF for further details.

 
Link  MHRA Drug Safety Update (Dec 2014): Isotretinoin (Roaccutane): reminder of possible risk of psychiatric disorders
Link  MHRA Drug Safety Update (Oct 2017): Isotretinoin (Roaccutane): rare reports of erectile dysfunction and decreased libido
Link  MHRA Drug Safety Update (Jun 2019): Oral retinoid medicines„: revised and simplified pregnancy prevention educational materials for healthcare professionals and women
   
13.06.02  Expand sub section  Oral antibiotics for acne
Oxytetracycline
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Formulary
Green

 

Last line oral preperations for acne

 
   
Lymecycline
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Formulary
Green

 

Last line oral preperation for acne

 
   
Doxycycline
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Formulary
Green

 

Last line oral preperations for acne

 
   
Erythromycin
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Formulary
Green

 

Last line preperations for acne

 
   
13.06.02  Expand sub section  Hormone treatment for acne
13.06.02  Expand sub section  Oral retinoid for acne
 ....
 Non Formulary Items
Abrasive Agents  (Brasivol®)

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Non Formulary
 
Antibacterials  (Stiemycin®)

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Non Formulary
 
Antibacterials  (Zindaclin®)

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Non Formulary
 
Azelaic Acid  (Finacae®)

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Non Formulary
 
Benzoyl Peroxide  (Brevoxyl®)

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Non Formulary
 
Benzoyl Peroxide  (PanOxyl®)

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Non Formulary
 
Benzoyl Peroxide 5% with Clindamycin 1%  (Duac® Once Daily)

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Non Formulary
 
Benzoyl Peroxide with antimcrobials  (Quinoderm®)

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Non Formulary
 
Brimonidine gel  (Mirvaso®)

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Non Formulary
 
Clindamycin/ tretinoin gel  (Treclin®)

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Non Formulary
 
Corticosteroids  (Actinac®)

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Non Formulary
 
Isotretinoin  (Roaccutane®)

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Non Formulary
 
Nicotinamide  (Nicam®)

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Non Formulary
 
Salicylic Acid  (Acnisal®)

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Non Formulary
 
Salicylic Acid 3% w/w, Sulphur 3% w/w in Aqueous Cream

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Non Formulary
 
Salicylic Acid in White Soft Paraffin

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to 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.   

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