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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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01.06.02  Expand sub section  Stimulant laxatives
Bisacodyl
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Formulary
Green
Tablet E/C 5mg, Suppository 10mg
 
   
Co-danthramer
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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
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Restricted Drug Restricted
Green
Capsules 50/60
For constipation in terminally ill patients only  
   
Dantron
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Restricted Drug Restricted
Green
For constipation in terminally ill patients only 
   
Docusate Sodium
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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)
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Formulary
Green
Suppository 
   
Senna
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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  Expand sub section  Other Stimulant laxatives
 ....
 Non Formulary Items
Docusate Sodium  (Norgalax® Micro-enema)

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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
 
  
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
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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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