North East and North Cumbria
ICS Formulary
 
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3 Respiratory system

*Important*

The NENC ICB Respiratory Network recommends that all inhalers should be prescribed by brand for patient safety, to ensure that the correct device is dispensed to support correct technique and avoid patient confusion and medication errors.

Choice of inhaler device should be based on patient ability to use. Devices should be chosen based on availability for the type of drug to be prescribed and the patient’s ability to use it.

Refer to local guidelines for information on preferred options.

Note: All new patients should be started on the updated formulary choices as per local/national guidelines.

When inhalers are removed from the formulary, existing, stable, patients should continue to receive the non-formulary device. Treatment should not be changed unless a full face to face review has been conducted.

03-07 Mucolytics

Acetylcysteine
Formulary
  • 600mg effervescent tablets.
  • Green Green for licensed indications.
  • Green plus For use on specialist advice in the treatment of idiopathic pulmonary fibrosis.
  • For the prevention of x-ray contrast media induced renal damage Red Traffic Light.

 


Green View adult BNF  View SPC online  View childrens BNF
Carbocisteine
Formulary
  • 375mg capsules.
  • 750mg/10ml oral solution in sachets: first choice liquid preparation for adult patients.
  • 250mg in 5ml syrup.

Green View adult BNF  View SPC online  View childrens BNF
Sodium Chloride 0.9%
Formulary
  • Nebuliser solution: 10ml 

Green View adult BNF  View SPC online  View childrens BNF
Ivacaftor
Formulary
  • Approved for the treatment of cystic fibrosis in patients who have a faulty mutation in the CFTR gene in line with NHS England Clinical Commissioning Policy. 
  • Only available from:
    • South Tees Hopsitals NHS Foundation Trust
    • The Newcastle upon Tyne Hospitals NHS Foundation Trust
Link  Commissioning statement: Ivacaftor, tezacaftor/ivacaftor, lumacaftor/ivacaftor and elexacaftor/tezacaftor/ivacaftor for cystic fibrosis
Link  MHRA Drug Safety Update (Feb 2022): Ivacaftor, tezacaftor, elexacaftor (Kaftrio▼) in combination with ivacaftor (Kalydeco): risk of serious liver injury; updated advice on liver function testing

Red View adult BNF  View SPC online  View childrens BNF  HCD
Lumacaftor and Ivacaftor Orkambi®
Formulary
  • Ivacaftor 125mg/lumacaftor 100mg & ivacaftor 200mg/lumacaftor tablets
  • Ivacaftor 95mg/lumacaftor 75mg, ivacaftor 125mg/lumacaftor 100mg &
    ivacaftor 188mg/lumacaftor 188mg granules in sachet
  • Approved for the treatment of cystic fibrosis in patients 1 year and older who are homozygous for the F508del mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene in line with NHS England Specialised Commissioning Policy (SSC2538)
  • Only available from:
    • South Tees Hopsitals NHS Foundation Trust
    • The Newcastle upon Tyne Hospitals NHS Foundation Trust
Link  Commissioning statement: Ivacaftor, tezacaftor/ivacaftor, lumacaftor/ivacaftor and elexacaftor/tezacaftor/ivacaftor for cystic fibrosis
Link  NICE TA398: Lumacaftor–ivacaftor for treating cystic fibrosis homozygous for the F508del mutation

Red View adult BNF  View SPC online  View childrens BNF  HCD
Tezacaftor and ivacaftor  Symkevi®
Formulary
  • Ivacaftor 75g/tezacaftor 50mg tablet & ivacaftor 100mg/tezacaftor 150mg tablet
  • Approved for the treatment of cystic fibrosis in line with NHS England Commissioning Policy
  • Only available from:
    • South Tees Hopsitals NHS Foundation Trust
    • The Newcastle upon Tyne Hospitals NHS Foundation Trust

 

Link  Commissioning statement: Ivacaftor, tezacaftor/ivacaftor, lumacaftor/ivacaftor and elexacaftor/tezacaftor/ivacaftor for cystic fibrosis

Red View adult BNF  View SPC online  View childrens BNF  HCD
Tezacaftor with ivacaftor and elexacaftor Kaftrio®
Formulary
  • Ivacaftor 75g/tezacaftor 50mg/elexacaftor 100mg & Ivacaftor 37.5mg/tezacaftor 25mg/elexacaftor 50mg tablet
  • Approved for the treatment of cystic fibrosis in line with NHS England Commissioning Policy
  • Only available from:
    • South Tees Hopsitals NHS Foundation Trust
    • The Newcastle upon Tyne Hospitals NHS Foundation Trust

 

Link  Commissioning statement: Ivacaftor, tezacaftor/ivacaftor, lumacaftor/ivacaftor and elexacaftor/tezacaftor/ivacaftor for cystic fibrosis
Link  MHRA Drug Safety Update (Feb 2022): Ivacaftor, tezacaftor, elexacaftor (Kaftrio▼) in combination with ivacaftor (Kalydeco): risk of serious liver injury; updated advice on liver function testing

Red View adult BNF  View SPC online  View childrens BNF  HCD