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Birmingham, Sandwell, Solihull and environs APC Formulary
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 Formulary Chapter 1: Gastro-intestinal system - Full Chapter
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01.01  Dyspepsia and gastro-oesophageal reflux disease
01.01.01  Antacids and simeticone
01.01.01  Aluminium and magnesium containing antacids
Magnesium Trisilicate Mixture BP
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First Choice
Green
Suspension
High sodium content
Use with caution in renal impairment 
Co-magaldrox
(Suspension)
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Second Choice
Green
When low sodium content is required. ££
Mucogel is most cost effective brand

Use with caution in renal impairment  
   
Antacid and Oxetacaine
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Restricted Drug Restricted
Red
Suspension
Specialist use only 
   
01.01.01  Antacid preparations containing simeticone
Simeticone
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Formulary
Green

Green   Drops
                  For use in infantile colic

Red For Endoscopy use

 
   
01.01.01  Antacid preparations containing dimeticone or local anaesthetics to top
01.01.02  Compound alginates and proprietary indigestion preparations
01.01.02  Compound alginate preparations
Peptac
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First Choice
Green
Suspension 
Gaviscon Infant
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Formulary
Green
Oral powder
 
   
01.02  Antispasmodics and other drugs altering gut motility
Botulinium Toxin A
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Formulary
Red

Achalasia

  • Use for SWB only in endoscopy
  • 100 units
 
   
01.02  Antimuscarinics
Atropine
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Formulary
Green
Injection 
   
Hyoscine Butylbromide (Buscopan®)
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Formulary
Green
Tablet 10mg, Injection 20mg/ml  
   
01.02  Other antispasmodics to top
Mebeverine Hydrochloride
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Formulary
Green
Tablet 135mg
Prescribe standard release tablets only; modified release (MR) preparations are non-formulary
 
   
Peppermint Oil
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Formulary
Green
Capsule E/C 0.2ml
 
   
Peppermint water
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Restricted Drug Restricted
Red
unlicensedunlicensed

For specialist use only 
   
01.02  Motility stimulants
Metoclopramide
(Tablets/Oral solution/Injection)
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Formulary
Green
Not recommended for patients aged 20 years and below due to risk of dystonic reactions
See MHRA guidance below for restrictions on use in younger patients
 
Link  MHRA update on dose and duration of use restrictions (April 2014)
   
Domperidone
(Tablets/Suspension/Suppositories)
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Formulary
Green
Second line

Domperidone is no longer recommended for the management of heartburn, bloating and stomach discomfort. See the link below for more information 
Link  MHRA advice on domperidone
   
01.03  Antisecretory drugs and mucosal protectants
01.03  Helicobacter pylori infection
Helicobacter Urea Breath Test
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Formulary
Green
  • in line with NICE/PHE guidance 
  •    
    Helicobacter Stool Antigen Test
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
  • in line with NICE/PHE guidance
  • check availibility of test in local laboratory. 
  •    
    01.03  NSAID-associated ulcers
    01.03.01  H2-receptor antagonists to top
    Ranitidine
    (Tablets 150mg, 300mg, Oral solution SF 75mg/5ml)
    View adult BNF View SPC online
    First Choice
    Green
    Prescribe standard release tablets only; modified release (MR) preparations are non-formulary
     
    Ranitidine (Effervescent tablet)
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    Second Choice
    Green
    High Cost Medicine
    For use in patients with swallowing difficulties or via nasogastric tubes only 
       
    Ranitidine IV
    View adult BNF View SPC online
    Formulary
    Red
    Injection 50mg/2ml
    For specialist use only 
       
    01.03.02  Selective antimuscarinics
    01.03.03  Chelates and complexes
    Bismuth subsalicylate (Pepto Bismol®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green

    For use in H Pylori eradication in penicillin allergy and previous clarithromycin, as per Antimicrobial guidelines.

     
    Link  Antimicrobial Primary Care Guidelines 2019 - Birmingham Antimicrobial Advisory Committee
       
    Sucralfate (Antepsin®)
    View adult BNF View SPC online
    Restricted Drug Restricted
    Red
    Tablet 1g, Suspension 500mg/5ml
    For specialist use only  
       
    01.03.04  Prostaglandin analogues
    Misoprostol (Cytotec®)
    View adult BNF View SPC online
    Formulary
    Amber Initiation

    Tablet 200mg
    For specialist initiation only

     
       
    01.03.05  Proton pump inhibitors (PPIs)
    Lansoprazole
    View adult BNF View SPC online
    First Choice
    Green
    Capsules 15mg, 30mg
    - Capsules are more cost effective than tablets
    - Can be opened and beads swallowed without crushing, or can be mixed with food or drink
     
    Omeprazole
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    First Choice
    Green
    Capsules 10mg, 20mg
    Capsules are more cost effective than tablets
    Most brands of capsules can be opened and beads swallowed without crushing, or can be mixed with food or drink
     
    Lansoprazole dispersible
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    Second Choice
    Green
    Orodispersible tablets 15mg, 30mg
    Orodispersible tablets cost twice as much as capsules
    Restricted Second choice - for use in patients with swallowing difficulties or who are on enteral tube feeding.
    Also licensed to be given via a NG tube or oral syringe if diluted in 5-10 ml water
     
       
    Omeprazole dispersible (Losec MUPS)
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    Second Choice
    Green
    Orodispersible tablets 10mg, 20mg
    ££- Orodispersible tablets are very significantly more expensive than capsules.
    For use in swallowing difficulties or via nasogastric tubes when beads in the capsule are too large and lansoprazole orodispersible are not acceptable (e.g. children with fine bore NG tubes).  
       
    Esomeprazole Injection
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    Formulary
    Red
    • Secondary care use only
     
       
    Omeprazole IV
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    Formulary
    Red
    IV Infusion 40mg vial- Hospital use only 
       
    01.03.06  Other ulcer-healing drugs to top
    01.04  Acute diarrhoea
    Oral Rehydration Salts
    View adult BNF View SPC online
    Formulary
    Green
    Powder
    Follow Scriptswitch advice for most cost-effective prescribing option 
       
    St Mark’s powder
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Unlicensed
    Specialist use only 
       
    St Mark’s recipe
    Formulary
    Amber Recommended

    For fluid and electrolyte replacement following diarrhoea

     
    Link  Click here for St Mark’s recipe
       
    01.04.01  Adsorbents and bulk-forming drugs
    01.04.02  Antimotility drugs
    Codeine
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
    Tablets 15mg, 30mg, Syrup 25mg/5ml 
       
    Loperamide
    View adult BNF View SPC online
    Formulary
    Green
    • Capsule 2mg, Syrup 1mg/5ml
      Capsules are more cost effective than tablets
    • Loperamide melts (orodispersible) tablets are reserved for high output stoma patients only
    • Not to be used if C.diff is suspected
      Caution in patients with a history of recent or repeated antibiotic use as increased risk of C.diff infection in this group
     
    Link  UKMI Q&A: High dose loperamide to reduce stoma output
       
    01.04.03  Enkephalinase Inhibitors
    01.05  Chronic bowel disorders to top
    01.05  Irritable bowel syndrome
    Eluxadoline
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    Formulary
    Amber Initiation
    • In line with NICE
    • Specialist initiation, transfer of prescribing supported by RICaD.
    • RICaD: Eluxadoline
     
    Link  NICE TA471: Eluxadoline for treating irritable bowel syndrome with diarrhoea
       
    01.05  Malabsorption syndromes
    01.05  Inflammatory bowel disease
    01.05  Antibiotic-associated colitis
    01.05  Diverticular disease to top
    01.05  Aminosalicylates
    01.05  Corticosteroids
    01.05  Food allergy
    01.05  Cytokine inhibitors
    Ustekinumab (Stelara®)
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    Formulary
    Red
    High Cost Medicine
    In line with NICE 
    Link  NICE TA456: Ustekinumab for moderately to severely active Crohn’s disease after previous treatment
    Link  NICE TA633: Ustekinumab for treating moderately to severely active ulcerative colitis
       
    01.05  Food Allergy to top
    01.05.01  Aminosalicylates
    Balsalazide Sodium (Colazide®)
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    Formulary
    Amber Recommended
    High Cost Medicine
     
       
    Mesalazine (Octasa®)
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    Formulary
    Amber Recommended
    High Cost Medicine

    Octasa is currently the preferred brand - name changed from Mesren® in Nov/Dec 2012

    Both strengths are more cost effective compared to Asacol®.
    Mesalazine should be prescribed by brand.

     
       
    Mesalazine (tablets, MR tablets, granules, suppositories, enemas)
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    Formulary
    Amber Recommended
    High Cost Medicine

    Octasa is preferred brand of choice UHB NHS FT
     
    Other brands – Pentasa, Asacol, Asacol MR, Salofalk (granules/enema), Mezavant XL.

     
       
    Mesalazine  (Mezavant® XL)
    View adult BNF View SPC online
    Formulary
    Amber Recommended
    High Cost Medicine

    For initiation by Consultant Gastroenterologists only, for patients non-compliant with other oral mesalazine preparations.

     
       
    Mesalazine (Salofalk®)
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    Formulary
    Amber Recommended
    High Cost Medicine

    Granules and enemas

     
       
    Sulfasalazine
    View adult BNF View SPC online
    Formulary
    Amber Recommended

    Plain tablets are more cost effective than enteric coated tablets.

     
       
    01.05.02  Corticosteroids
    01.05.02  Oral
    Budesonide 1mg orodispersible tablets (Jorveza®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red

    Specialist use only.

    Formulary status to be reviewed on publication of NICE TA (expected October 2019)

     
       
    Budesonide capsules
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    Formulary
    Amber Recommended
     
       
    Budesonide MMX (Cortiment®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
       
    Prednisolone
    (Tablets)
    View adult BNF View SPC online
    Formulary
    Green
    Tablets 5mg, EC 2.5mg, 5mg, Soluble 25mg
    Plain tablets are first line option.
    EC tablets are more expensive than plain tablets without any substantial evidence that they confer any GI benefits
    25mg tablets are more expensive per mg than 5mg tablets.
    Soluble tablets are significantly more expensive than normal tablets which can be crushed & dispersed (unlicensed).

    For short term use in acute exacerbation or 'flare-ups'of relevant conditions 
       
    01.05.02  Topical
    Budesonide (Budenofalk® )
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber Recommended

    2mg/dose foam enema

    Approved July 2018

     
       
    Hydrocortisone (Colifoam®)
    View adult BNF View SPC online
    Formulary
    Amber Recommended

    July 2020 Manufacturer informed that currerntly there is no active supply chain for ongoing supply from Mylan

    Foam enema 125mg /metered application
    First choice steroid foam enema for IBD
    However, mesalazine preparations preferred to steroids overall

     
       
    Prednisolone
    (retention enema, foam enema, suppositories)
    View adult BNF View SPC online
    Formulary
    Amber Recommended

    Retention Enema (20mg/100ml single dose pack, Predsol®)
    Foam Enema ££- Predfoam® discontinued, generic replacement is very expensive
    Suppositories - (5mg, Predsol®)

    For short term use in acute exacerbation or 'flare-ups'of relevant conditions

     
    Link  UKMI Q&A: oral prednisolone to intravenous (IV) hydrocortisone - equivalent dosing
       
    01.05.02  Parenteral to top
    01.05.03  Drugs affecting the immune response
    Azathioprine
    View adult BNF View SPC online
    Formulary
    Amber SC

    Tablets 25mg, 50mg
    Maintenance of remission of acute ulcerative colitis and Crohn’s disease in adults– unlicensed but in line with national guidelines.
     
    For use in Inflammatory Bowel Disease (IBD) as per effective shared care agreement (ESCA). See link below.

     
    Link  ESCA: Azathioprine in IBD
       
    Ciclosporin
    View adult BNF View SPC online
    Restricted Drug Restricted
    Red
    Capsules 10mg, 25mg, 50mg, 100mg, IV infusion 50mg/ml
    Treatment of ulcerative colitis- for specialist use only
    MHRA specify that ciclosporin must be prescribed and dispensed by brand as bioavailability differences exist between brands
     
       
    Mercaptopurine
    View adult BNF View SPC online
    Formulary
    Amber SC

    Tablet 50mg
    Maintenance of remission of acute ulcerative colitis and Crohn’s disease in adults – unlicensed but in line with national guidelines
     
    For use in Inflammatory Bowel Disease (IBD) as per effective shared care agreement (ESCA). See link below.

     
    Link  ESCA: Mercaptopurine in IBD
       
    Cytotoxic Drug Methotrexate
    View adult BNF View SPC online
    Formulary
    Amber SC
    • Tablets 2.5mg (2.5mg tablets preferred as per NPSA alert)
      Cytotoxic- do not crush and disperse in water
    • Parenteral injection:Metoject®PEN is the APC preferred brand.
    • Unlicensed liquid may be available if required

      For use in active Crohn's disease (unlicensed indication supported by APC) as per effective shared care agreement (ESCA). See link below.
     
    Link  ESCA: Methotrexate in active Crohn’s disease.
    Link  UKMI Q&A: Should patients drink alcohol whilst taking long-term low-dose methotrexate?
    Link  UKMI Q&A: What is the clinical significance of the interaction between methotrexate and penicillins? (Oct13)
       
    Tofacitinib (Xeljanz®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    CCG

    In line with NICE

     
    Link  NICE TA 547: Tofacitinib for moderately to severely active ulcerative colitis
       
    01.05.03  Cytokine inhibitors
    Adalimumab (Humira®)
    View adult BNF View SPC online
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Injection
    For specialist use only in line with NICE guidance below
     
    Link  NICE TA187: Crohn’s disease - infliximab (review) and adalimumab (review of TA40)
       
    Infliximab (Remicade®)
    View adult BNF View SPC online
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Infusion
    For specialist use only in line with NICE guidance below
    Commissioned in paediatrics by NHSE
     
    Link  NICE TA163: Ulcerative colitis (acute manifestations) Infliximab
    Link  NICE TA187: Crohn’s disease- infliximab (review) and adalimumab (review of TA40)
    Link  NICE TA329: Ulcerative Colitis (treatment)- Infliximab, adalimumab and golimumab
       
    01.05.03  Vedolizumab
    Vedolizumab (Entyvio®(infusion)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
  • For specialist use only in line with NICE guidance below  
  • Link  NICE TA342: Ulcerative colitis- vedolizumab
    Link  NICE TA352: Crohn’s disease after prior therapy- vedolizumab
       
    01.05.04  Food allergy
    01.06  Laxatives to top
    01.06.01  Bulk-forming laxatives
    Ispaghula Husk
    View adult BNF View SPC online
    Formulary
    Green
    Granules
    - Adequate fluid intake is important to prevent obstruction (6 – 8 cups per day) and should not to be taken immediately before bed
    - Unsuitable for frail patients who are likely to drink less than daily required volume of fluid
    - Fluid thickens on standing so should be taken as soon as possible as after mixing
    - Time to effect is approximately 48 – 72 hours
     
       
    01.06.02  Stimulant laxatives
    Bisacodyl
    View adult BNF View SPC online
    Formulary
    Green
    Tablet E/C 5mg, Suppository 10mg
     
       
    Co-danthramer
    View adult BNF View SPC online
    Restricted Drug Restricted
    Green
    Capsules 25/200, 75/1000
    Suspension 25/200 in 5ml, Strong suspension 75/1000 in 5ml
    Co-dantramer strong preferred as per palliative care formulary guidance

    For constipation in terminally ill patients only
     
       
    Co-danthrusate
    View adult BNF View SPC online
    Restricted Drug Restricted
    Green
    Capsules 50/60
    For constipation in terminally ill patients only  
       
    Dantron
    View adult BNF View SPC online
    Restricted Drug Restricted
    Green
    For constipation in terminally ill patients only 
       
    Docusate Sodium
    View adult BNF View SPC online
    Formulary
    Green
    Capsules 100mg, Liquid 50mg/5ml
    - Solution is utterly unpalatable - only fit for use down tubes)
    - Probably acts as a softening laxative as well as a stimulant
    - Time to effect is approximately 24 to 48 hours 
       
    Glycerol (Glycerin)
    View adult BNF View SPC online
    Formulary
    Green
    Suppository 
       
    Senna
    View adult BNF View SPC online
    Formulary
    Green
    Tablets 7.5mg; Syrup 7.5mg/5ml
    - Syrup is currently more cost effective than tablets
    - Time to effect approximately 8 to 12 hours
     
       
    01.06.02  Other Stimulant laxatives
    01.06.03  Faecal softeners
    01.06.04  Osmotic laxatives to top
    Lactulose
    View adult BNF View SPC online
    Formulary
    Green
    Solution 
       
    Macrogol (Laxido®)
    View adult BNF View SPC online
    Formulary
    Green
    Oral powder
    Prescribe as Laxido 
       
    Phosphates (Rectal) (Fletchers phosphate enema, fleet ready to use enema)
    View adult BNF View SPC online
    Formulary
    Green
    Enema 
       
    Sodium Citrate (Rectal)
    View adult BNF View SPC online
    Formulary
    Green
    Micro-enema
    Microlette®, Relaxit® and Micralax®  
       
    01.06.05  Bowel cleansing preparations
    Fleet Phospho-soda®
    View adult BNF View SPC online
    Formulary
    Red
    Oral solution 
       
    Macrogols (Klean-Prep®)
    View adult BNF View SPC online
    Formulary
    Red
    Oral powder 
       
    Macrogols (Moviprep®)
    View adult BNF View SPC online
    Formulary
    Red
    Oral powder sachet 
       
    Picolax®
    View adult BNF View SPC online
    Formulary
    Red
    Oral powder 
       
    01.06.06  Peripheral opiod-receptor antagonist
    Naloxegol (Moventig ®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
  • £££
  • For treating opioid-induced constipation- use in line with NICE.
     
  • Link  NICE TA345: naloxegol
       
    01.06.07  Other drugs used in constipation
    Linaclotide (Constella▼®)
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    Formulary
    Amber Recommended
    • For moderate to severe IBS-Constipation.
    • For patients who have not responded adequately to or cannot tolerate all other suitable treatment options BUT BEFORE other agents with higher costs.
     
       
    Prucalopride (Resolor ®)
    View adult BNF View SPC online
    Formulary
    Amber Recommended

    For use in men and women for chronic constipation.

     
    Link  NICE TA211: Constipation (women) - prucalopride
       
    01.07  Local preparations for anal and rectal disorders
    01.07.01  Soothing haemorrhoidal preparations to top
    Haemorrhoid relief ointment
    View adult BNF View SPC online
    Formulary
    Green
    Anusol® - other brands also available 
       
    Haemorrhoid relief suppositories
    View adult BNF View SPC online
    Formulary
    Green
    Anusol® - other brands also available 
       
    01.07.02  Compound haemorrhoidal preparations with corticosteroids
    Anusol-HC
    View adult BNF View SPC online
    Formulary
    Green
     
       
    Scheriproct® suppositories
    View adult BNF View SPC online
    Formulary
    Green
    Scheriproct ointment and suppositories  
       
    Uniroid HC
    View adult BNF View SPC online
    Formulary
    Green
    Ointment and suppositories
    Contains same ingredients as proctosedyl but is much more cost effective  
       
    01.07.03  Rectal sclerosants
    Oily phenol injection BP
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
       
    01.07.04  Management of anal fissures
    Glyceryl Trinitrate 0.4% (Rectogesic®)
    View adult BNF View SPC online
    First Choice
    Green
    Ointment 
    Diltiazem Cream 2%
    View adult BNF View SPC online
    Second Choice
    Green
    Cream
    ££££
    Unlicensed - for use only in patients intolerant of or unresponsive to GTN ointment
    Store in fridge
    One tube will last a month if used as 2cm application TWICE DAILY
     
       
    01.08  Stoma care
    01.09  Drugs affecting intestinal secretions to top
    Octreotide
    View adult BNF View SPC online
    Formulary
    Amber Initiation

    Injection
    For specialist gastroenterologist initiation for intestinal secretions

     
       
    01.09.01  Drugs affecting biliary composition and flow
    Obeticholic acid  (Ocaliva®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
  • In line with NICE 
  • Link  NICE TA443: Obeticholic acid for treating primary biliary cholangitis
       
    Ursodeoxycholic acid
    View adult BNF View SPC online
    Formulary
    Amber Recommended
     
       
    01.09.01  Other prepatations for biliary disorders
    01.09.02  Bile acid sequestrants
    Colestyramine
    View adult BNF View SPC online
    Formulary
    Amber Recommended

    Powder

     
       
    01.09.03  Aprotinin
    01.09.04  Pancreatin to top
    Pancreatin (Creon® products)
    View adult BNF View SPC online
    First Choice
    Amber Recommended


    Counsel patient on need for adequate hydration

     
    Pancreatin (Nutrizym 22®)
    View adult BNF View SPC online View childrens BNF
    Second Choice
    Amber Recommended

    Specialist dietician recommendation only

     
       
    Pancreatin (Pancrex® V)
    View adult BNF View SPC online
    Formulary
    Amber Recommended

    Powder

    Counsel patient on need for adequate hydration

     
       
     ....
     Non Formulary Items
    Lubiprostone  (Amitiza▼ ®)

    View adult BNF View SPC online
    Non Formulary
    Black

    Manufacturer has discontinued the product

     

    Link  NICE TA318: Lubiprostone for treating chronic idiopathic constipation
     
    Aluminimum Hydroxide

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Aluminium Only Preparations  (Alu-Cap®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Alverine Citrate  (Spasmonal®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Anugesic-HC

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    Non Formulary
     
    Arachis Oil

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Beclometasone  (Clipper®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Bowel Cleansing Solutions  (Citramag®)

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

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Citrafleet®

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Co-Phenotrope  (Lomotil®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Dexlansoprazole

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    Non Formulary
     
    Dicycloverine

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Docusate Sodium  (Norgalax® Micro-enema)

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

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Esomeprazole & Aspirin  (Axanum®)

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    Non Formulary
     
    Famotidine

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    Non Formulary
     
    Gastrocote

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    Non Formulary
    Black
    Suspension
     
    Gaviscon Advance

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    Non Formulary
    Black
     
    Gripe Mixture

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    Non Formulary
     
    Kaolin and Morphine Mixture

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    Non Formulary
     
    Lansoprazole as part of  (Heliclear®)

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    Non Formulary
     
    Laolin, Light

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    Non Formulary
    Black
     
    Lidocaine 5% ointment

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    Non Formulary
     
    Liquid Paraffin

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    Non Formulary
    Black
     
    Macrogol  (Movicol liquid®)

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    Non Formulary
     
    Magnesium Carbonate

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    Non Formulary
     
    Magnesium Hydroxide Mixture BP

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    Non Formulary
     
    Mebeverine Hydrochloride  (Colofac® MR)

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    Non Formulary
     
    Mesalazine  (Asacol® MR)

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    Non Formulary
     
    Mesalazine  (Ipocol®)

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    Non Formulary
     
    Mesalazine  (Mesren® MR)

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    Non Formulary
     
    Methycellulose  (Celevac®)

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    Non Formulary
    Black
     
    Methylnaltrexone  (Relistor®)

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    Non Formulary
     
    Controlled Drug  Morphine

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    Non Formulary
    Black
     
    Nizatidine

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    Non Formulary
     
    Olsalazine

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    Non Formulary
    Black
     
    Olsalazine Sodium  (Dipentum®)

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    Non Formulary
     
    Pancreatin  (Nutrizym® 10)

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    Non Formulary
     
    Pancreatin  (Pancrease® HL)

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    Non Formulary
     
    Pantoprazole

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    Non Formulary
     
    Pantoprazole IV  (Protium®)

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    Non Formulary
     
    Peppermint Oil MR Capsules  (Colpermin®)

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    Non Formulary
     
    Perinal

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    Non Formulary
     
    Peristeen Anal Irrigation

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    Non Formulary
    Black
     
    Phosphates (Oral)  (Diafalk®)

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    Non Formulary
     
    Phosphates (Oral)  (OsmoPrep®)

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    Non Formulary
     
    Proctofoam HC

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    Non Formulary
     
    Proctosedyl

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    Non Formulary
     
    Propantheline

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    Non Formulary
    Black
     
    Rabeprazole  (Pariet®)

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    Non Formulary
     
    Racecadotril  (Hidrasec®)

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    Non Formulary
     
    Ranitidine Bismuth Citrate  (Pylorid®)

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    Non Formulary
     
    Renie Duo

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    Non Formulary
     
    Rowachol

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    Non Formulary
     
    Rowachol®

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    Non Formulary
     
    Sodium citrate 0.3M

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    Non Formulary
     
    Sodium Cromoglicate  (Nalcrom®)

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    Non Formulary
     
    Sodium cromoglicate  (Nalcrom®)

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    Non Formulary
     
    Sodium hydrogen carbonate / sodium dihydrogen phosphate  (Lecicarbon A®)

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    Non Formulary
     
    Sodium Picosulfate

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    Non Formulary
    Black
     
    Sodium Picosulfate  (Dulco-lax®)

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    Non Formulary
     
    Sterculia  (Normacol®)

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    Non Formulary
     
    Sterculia  (Normacol® plus)

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    Non Formulary
     
    Stoma Care

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    Non Formulary
     
    Sulfasalazine  (Salazopyrin®)(Suppository, Retention enema)

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    Non Formulary
     
    Topal  (Topal®)

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    Non Formulary
     
    Tripotassium Dicitratobismuthate  (De-Noltab®)

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    Non Formulary Discontinued


    Tablet 120mg
     
    Ultraproct

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    Non Formulary
     
    VSL#3

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    Non Formulary
    Black
     
    Xyloproct®

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    Non Formulary
    Black
     
      
    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
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Prescribing in children

    The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

    The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
      

    Green

    Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

    Amber Initiation

    Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

    Amber Recommended

    Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

    Amber SC

    Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

    Red

    Medicines for initiation and maintenance prescribing by Specialists only.  

    Black

    Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

    Grey

    Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

    The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

    netFormulary