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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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01.03.01  Expand sub section  H2-receptor antagonists
Ranitidine
(Tablets 150mg, 300mg, Oral solution SF 75mg/5ml)
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First Choice
Green

Prescribe standard release tablets only; modified release (MR) preparations are non-formulary. 

The supply disruption recommendations relating to H2As as a result of the issues around ranitidine are likely to remain prevalent for the foreseeable future.  Where a patient has previously been prescribed ranitidine, the most likely course of action will be to step up to PPIs or down to antacids/alginates.  H2As should be reserved as an option of last resort for patients who do not respond to other treatments and combinations.

Please reserve H2As for exceptional cases in order to preserve supplies.  Where an H2A is indicated, please use the lowest dose of the least costly agent available in your locality.  You will need to liaise with local community pharmacists to establish availability in your area as national availability will not necessarily translate to local availability

 
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.

The supply disruption recommendations relating to H2As as a result of the issues around ranitidine are likely to remain prevalent for the foreseeable future.  Where a patient has previously been prescribed ranitidine, the most likely course of action will be to step up to PPIs or down to antacids/alginates.  H2As should be reserved as an option of last resort for patients who do not respond to other treatments and combinations.

Please reserve H2As for exceptional cases in order to preserve supplies.  Where an H2A is indicated, please use the lowest dose of the least costly agent available in your locality.  You will need to liaise with local community pharmacists to establish availability in your area as national availability will not necessarily translate to local availability

 
Link  Dept of Health and Social Care (2019): Ranitidine: all formulations. Supply disruption alert - second update
   
Ranitidine IV
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Formulary
Red
Injection 50mg/2ml
For specialist use only 
   
 ....
 Non Formulary Items
Cimetidine

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Non Formulary
Black
 
Famotidine

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Non Formulary
 
Nizatidine

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Non Formulary
 
Ranitidine Bismuth Citrate  (Pylorid®)

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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
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Link to adult BNF
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Link to children's BNF
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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.  

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