Formulary Chapter 13: Skin - Full Chapter
|
13.02 |
Emollient and barrier preparations |
|
|
|
Aquamax®
|
Formulary
|
- Approved for used in radiotherapy only.
|
|
Aqueous Cream BP
|
Formulary
|
- Due to the SLS content to be used as a soap substitute only.
|
|
Aveeno® (Cream)
|
Formulary
|
|
|
Cetraben® (Cream and ointment)
|
Formulary
|
|
|
Diprobase® (Cream and ointment)
|
Formulary
|
|
|
DoubleBase®gel
|
Formulary
|
|
|
E45®
|
Formulary
|
|
|
Emulsifying Ointment BP
|
Formulary
|
|
|
Epaderm® emollient
|
Formulary
|
- Hydromol® Ointment is made to the same formula and is more cost effective.
|
|
Epimax®
|
Formulary
|
|
|
Hydromol® ointment
|
Formulary
|
- This product is also known locally as ‘Emulsifying Ointment RVI
Formula’. It is softer than emulsifying ointment BP. Epaderm ointment is made to the same formula, but is more expensive.
|
|
Hydrous® ointment
|
Formulary
|
|
|
Oilatum® cream
|
Formulary
|
|
|
Oilatum® Junior cream
|
Formulary
|
|
|
Paraffin sterile liquid
|
Formulary
|
|
|
QV®
|
Formulary
|
- Approved for used in radiotherapy only.
|
|
White Soft Paraffin BP
|
Formulary
|
|
|
Yellow Soft Paraffin BP
|
Formulary
|
|
|
ZeroAQS®
|
Formulary
|
- SLS free alternative to Aqueous Cream.
|
|
Zerobase®
|
Formulary
|
|
|
Zerocream®
|
Formulary
|
- Alternative to E45® Cream.
|
|
Zerodouble® Gel
|
Formulary
|
- Alternative to Doublebase gel.
|
|
Zeroveen® cream
|
Formulary
|
|
|
13.02.01 |
Emollients - preparations containing urea |
|
|
Balneum® Plus cream (Emollient preparation containing Urea)
|
Formulary
|
|
|
Calmurid® emollient
|
Formulary
|
|
|
Eucerin® Intensive
|
Formulary
|
|
|
13.02.01 |
Emollients - with antimicrobials |
|
|
Dermol®
|
Formulary
|
|
|
Dermol® 500 Lotion
|
Formulary
|
|
|
13.02.01.01 |
Emollient bath and shower preparations |
|
|
|
13.02.02 |
Barrier preparations |
|
|
Dimeticone (Siopel®)
|
Formulary
|
|
|
Drapolene®
|
Formulary
|
|
|
Drapolene®
|
Formulary
|
|
|
Metanium®
|
Formulary
|
|
|
Sorbaderm® cream
|
Formulary
|
- 2g, 28g & 92g barrier cream, 28ml pump spray, sterile 1ml no
sting barrier film foam applicator, sterile 3ml no sting barrier film foam applicator
|
|
Sudocrem®
|
Formulary
|
|
|
Vasogen®
|
Formulary
|
|
|
Zinc and caster oil ointment BP
|
Formulary
|
|
|
Deegan's ointment
|
Unlicensed
|
|
|
Sucrulfate cream
|
Unlicensed
|
- For limited use around gastrostomies when wound breakdown is thought to be aggravated by leakage of gastric acid.
|
|
13.03 |
Topical local anaesthetics and antipruritics |
|
|
Calamine lotion
|
Formulary
|
|
|
Crotamiton (Eurax®)
|
Formulary
|
|
|
Lidocaine 5% ointment
|
Formulary
|
|
|
Lidocaine and prilocaine (EMLA®)
|
Formulary
|
|
|
Lidocaine, Adrenaline, Tetracaine (Pliaglis®)
|
Formulary
|
|
|
Menthol and aqueous cream
|
Formulary
|
- available as Dermacool
|
|
13.04 |
Topical corticosteriods. |
|
|
Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 2% (Diprosalic®)
|
Formulary
|
|
|
Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 3% (Diprosalic®)
|
Formulary
|
|
|
Betamethasone (as Valerate) 0.025% (Betnovate-RD®)
|
Formulary
|
MODERATELY POTENT
|
|
Betamethasone (as Valerate) 0.1%
|
Formulary
|
POTENT
- Cream, ointment & scalp application
|
|
Betamethasone (as Valerate) 0.1% with Clioquinol 3% (Betnovate C®)
|
Formulary
|
POTENT
|
|
Betamethasone (as Valerate) 0.1% with Fucidic Acid 2% (Fucibet®)
|
Formulary
|
POTENT
|
|
Betamethasone (as Valerate) 0.1% with Neomycin Sulphate 0.5% (was Betnovate-N®)
|
Formulary
|
POTENT
Cream and ointment
|
|
Betamethasone (as valerate) medicated plasters (Betesil®)
|
Formulary
|
POTENT
- 2.25mg medicated plasters
|
|
Clobetasol Propionate 0.05% (Dermovate®)
|
Formulary
|
VERY POTENT Cream, ointment & scalp application
|
|
Clobetasol Propionate with neomycin and nystatin (Dermovate-NN®)
|
Formulary
|
VERY POTENT
Ointment
|
|
Clobetasone Butyrate 0.05% (Eumovate®)
|
Formulary
|
MODERATELY POTENT
Cream, ointment & scalp application
|
|
Fluocinolone Acetonide 0.025% (Synalar®)
|
Formulary
|
POTENT Cream, ointment & gel
|
|
Hydrocortisone 0.25% Crotamiton 10% (Eurax-HC®)
|
Formulary
|
MILD
|
|
Hydrocortisone 0.5%, 1% & 2.5%
|
Formulary
|
MILD Cream and ointment
|
|
Hydrocortisone 1% with Clotrimazole 1% (Canesten HC®) (Cream)
|
Formulary
|
MILD
|
|
Hydrocortisone 1% with Miconazole Nitrate 2% (Daktacort®)
|
Formulary
|
MILD
|
|
Hydrocortisone Acetate 1% with Fusidic Acid 2% (Fucidin H®)
|
Formulary
|
MILD
|
|
Hydrocortisone Butyrate 0.1% cream (Locoid®)
|
Formulary
|
POTENT
|
|
Nystaform-HC®
|
Formulary
|
MILD
|
|
Timodine®
|
Formulary
|
MILD
|
|
Trimovate® cream
|
Formulary
|
MODERATELY POTENT
|
|
|
13.04 |
Topical corticosteriod preparation potencies |
|
|
13.05 |
Preparations for eczema and psoriasis |
|
|
|
13.05.01 |
Preparations for eczema |
|
|
Alitretinoin (Toctino®)
|
Formulary
|
- Approved for adults with severe chronic hand eczema that have not responded to potent topical corticosteroids in line with NICE.
|
NICE TA177: Alitretinoin for the treatment of severe chronic hand eczema
|
Ichthammol (Zinc paste and ichthammol bandage BP 1993)
|
Formulary
|
|
|
Zinc oxide bandage (Viscopaste®)
|
Formulary
|
|
|
|
13.05.02 |
Preparations for psoriasis |
|
|
5-Methoxypsoralen 20mg tablets
|
Unlicensed
|
|
|
8-Methoxypsoralen 10mg tablets
|
Unlicensed
|
|
|
Methoxypsoralen 1.2% bath additive
|
Unlicensed
|
|
|
13.05.02 |
Topical preparations for psoriasis |
|
|
Alphosyl HC® cream
|
Formulary
|
- Cream containing coal tar extract 5%, hydrocortisone 0.5% and allantoin 2%
|
|
Calcipotriol 50mcg/g (Dovonex®)
|
Formulary
|
- 0.005% Cream and ointment
- 0.005% scalp application
|
|
Calcipotriol 50mcg/g with Betamethasone 0.05%
|
Formulary
|
- Gel and ointment (Dovobet®)
- approved for the treatment of scalp and mild to moderate non scalp plaque psoriasis vulgaris in adults.
- 60g cutaneous spray (Enstilar®)
- Approved for the treatment of plaque psoriasis
|
|
Coal tar 2% and salicylic acid 2% ointment
|
Formulary
|
|
|
Coal tar in emulsifying ointment solution
|
Formulary
|
- 1%
unlicensed
- 2%
unlicensed
- 5%
unlicensed
|
|
Coal tar lotion 1% (Exorex®)
|
Formulary
|
|
|
Cocois® (Scalp application)
|
Formulary
|
|
|
Diprosalic ointment
|
Formulary
|
|
|
Dithranol cream
|
Formulary
|
- 0.1%, 0.25%,0.5%,1%, & 2%
|
|
Dithranol pomade
|
Formulary
|
- 0.2%, 0.4% & 0.6%
unlicensed
|
|
Sebco® scalp ointment
|
Formulary
|
|
|
Dithranol in Full Strength Lassar's Paste BP
|
Unlicensed
|
- 0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1%, 2%, 4%, 6% & 8%.
|
|
Dithranol with salycyclic acid 0.5%
|
Unlicensed
|
- 0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1%, 2%, 4%, 6%, 8% & 16%in emulsifying base.
|
|
Salicylic Acid in emulsifying ointment
|
Unlicensed
|
|
|
Tar Pomade (6% coal tar solution & 2% salycylic acid in emulsifying ointment)
|
Unlicensed
|
|
|
Zinc and Coal Tar Paste (White's Tar Paste)
|
Unlicensed
|
|
|
Zinc and Salicylic Acid Compound Paste (Half Strength Lassar's Paste)
|
Unlicensed
|
|
|
13.05.02 |
Oral retinoids for psoriasis |
|
|
Acitretin (Neotigason®)
|
Unlicensed
|
|
|
Fumaric acid esters
|
Unlicensed
|
|
|
13.05.03 |
Drugs affecting the immune response |
|
|
Adalimumab
|
Formulary
|
- Approved for psoriasis in line with NICE.
- Approved for the treatment of moderate to severe hidradenitis suppurativa in line with NICE and NHS England Commissioning Policy
- Approved for the treatment of plaque psoriasis in children and young people in line with NICE
|
NICE TA146 Adalimumab for the treatment of adults with psoriasis
NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
NICE TA455 Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
|
Apremilast (Otezla®)
|
Formulary
|
- 10mg, 20mg & 30mg tablets
- To be used in accordance with NICE guidance
|
NICE TA419: Apremilast for treating moderate to severe plaque psoriasis
|
Brodalumab (Kyntheum® )
|
Formulary

|
- 210mg/1.5ml solution for injection in pre-filled syringes.
- Approved for the treatment of moderate to severe plaque psoriasis in line with NICE
|
NICE TA511: Brodalumab for treating moderate to severe plaque psoriasis
|
Ciclosporin
|
Formulary
|
- Capsules & SF Solution
See section 8.2.2
|
|
Dimethyl fumarate (Skilarence®)
|
Formulary
|
- 120mg tablets
- Approved for the treatment of moderate to severe plaque psoriasis in line with NICE
|
NICE TA475 Dimethyl fumarate for treating moderate to severe plaque psoriasis
|
Etanercept (Enbrel®, Benapali® & Erelzi®)
|
Formulary
|
- Approved for psoriasis in line with NICE
- Approved for the treatment of plaque psoriasis in children and young people in line with NICE
|
NICE TA103: Psoriasis - efalizumab and etanercept
NICE TA455 Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
|
Guselkumab (Tremfya®)
|
Formulary

|
- 100mg/1mL solution for injection
- Approved for the treatment of moderate to severe plaque psoriasis in line with NICE
|
NICE TA521: Guselkumab for treating moderate to severe plaque psoriasis
|
Infliximab (Remsima®, Inflectra®, Remicade®)
|
Formulary
|
- Approved for psoriasis in line with NICE.
|
NICE TA134: Infliximab for psoriasis
|
Ixekizumab (Taltz®)
|
Formulary
|
- Approved for the treatment of moderate to severe plaque psoriasis in adults in line with NICE
|
NICE TA442 Ixekizumab for treating moderate to severe plaque psoriasis
|
Methotrexate
|
Formulary
|
|
|
Pimecrolimus cream (Elidel®)
|
Formulary
|
- Approved for moderate disease on face and neck for those between 2 and 16 years in line NICE.
|
NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
|
Risankizumab (Skyrizi®)
|
Formulary
|
- Approved for the treatment of moderate to severe plaque psoriasis in line with NICE
|
NICE TA596: Risankizumab for treating moderate to severe plaque psoriasis
|
Secukinumab (Cosentyx®)
|
Formulary
|
- Approved for the treatment of plaque psoriasis in line with NICE.
|
NICE TA350: Plaque Psoriasis
NICE TA407: Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors
|
Tacrolimus ointment (Protopic® )
|
Formulary
|
- Approved for moderate to severe disease atopic eczema in patients over 2 years in line with NICE.
|
NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
|
Tildrakizumab (Ilumetri®)
|
Formulary
|
- 100 mg solution for injection in pre-filled syringe
- Approved for the treatment of moderate to severe plaque psoriasis in line with NICE
|
NICE TA575: Tildrakizumab for treating moderate to severe plaque psoriasis
|
Ustekinumab (Stelara®)
|
Formulary
|
- 45mg & 90mg SC injections approved for psoriasis and psoriatic arthritis in line with NICE.
- Approved for the treatment of plaque psoriasis in children and young people in line with NICE
|
NICE TA180: Psoriasis - ustekinumab (Updated March 2017)
NICE TA340: Ustekinumab for treating active psoriatic arthritis
NICE TA455 Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
|
|
|
|
13.06.01 |
Topical preparations for acne |
|
|
13.06.01 |
Benzoyl peroxide and azelaic acid |
|
|
Adapalene 0.1% and benzoyl peroxide 2.5% (Epiduo® Gel)
|
Formulary
|
|
|
Azelaic Acid
|
Formulary
|
- 15% (Finacea®) and 20% (Skinoren®) gel
|
|
Benzoyl Peroxide 10% Aquagel and 5% gel (PanOxyl®)
|
Formulary
|
|
|
Benzoyl Peroxide 4% cream (Brevoxyl®)
|
Formulary
|
|
|
Benzoyl Peroxide 5% Gel (Acnecide®)
|
Formulary
|
|
|
Benzoyl Peroxide 5% with Clindamycin 1% (Duac® )
|
Formulary
|
|
|
13.06.01 |
Topical antibacterials for acne |
|
|
Clindamycin (Dalacin T®)
|
Formulary
|
- 1% topical solution (alcohol – water basis)
- 1% lotion (aqueous)
|
|
Erythromycin 2% topical solution (Stiemycin®) (Solution)
|
Formulary
|
|
|
Erythromycin 40mg with Zinc Acetate 1.2% topical solution (Zineryt®)
|
Formulary
|
|
|
13.06.01 |
Topical retinoids and related preparations for acne |
|
|
Adapalene 0.1% gel and cream (Differin®)
|
Formulary
|
|
|
Isotretinoin 0.05% gel (Isotrex® gel)
|
Formulary
|
|
|
Isotretinoin 0.05% with erythromycin 2% (Isotrexin®)
|
Formulary
|
|
|
Tretinoin 0.025% with Clindamycin 1% gel (Treclin® )
|
Formulary
|
|
|
13.06.01 |
Other topical preparations for rosacea |
|
|
Brimonidine Tartate 0.33% gel (Mirvaso®)
|
Formulary
|
- For specialist initiation for the treatment of severe rosacea. Following specialist review of effectiveness, primary care can continue supply.
|
|
Ivermectin 1% cream (Soolantra®)
|
Formulary
|
- For the treatment of papulopustular rosacea in patients as second line treatment in patient who have failed topical metronidazole.
|
|
13.06.02 |
Oral preparations for acne |
|
|
13.06.02 |
Oral antibiotics for acne |
|
|
|
Lymecycline
|
First Choice
|
|
|
Oxytetracycline
|
Second Choice
|
|
|
Clarithromycin
|
Third Choice
|
|
|
Minocycline
|
Restricted
|
- Note: not be prescribed for the treatment of acne in new patients (July 2019).
|
Items which should not routinely be prescribed in primary care
|
13.06.02 |
Hormone treatment for acne |
|
|
Co-Cyprindiol 2000/35 (Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)
|
Formulary
|
- Tablets containing cyproterone acetate 2mg & ethinylestradiol 35 micrograms.
- Note: generic co-cyprindiol is much cheaper than Dianette®
|
|
Co-Cyprindiol 2000/35 (Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)
|
Formulary
|
- Tablets containing cyproterone acetate 2mg & ethinylestradiol 35 micrograms
– generic co-cyprindiol is much cheaper than Dianette®
|
|
13.06.02 |
Oral retinoid for acne |
|
|
Isotretinoin capsules
|
Formulary
|
- 5mg, 10mg, 20mg & 40mg capsules
- Isotretinoin is a toxic drug only to be prescribed by or under the supervision of a consultant dermatologist – see BNF and product literature.
|
|
13.07 |
Preparations for warts and calluses |
|
|
Glutaraldehyde 10% paint (Glutarol®)
|
Formulary
|
|
|
Salicylic Acid (in emulsifying ointment)
|
Formulary
|
See section 13.5.2
|
|
Salicylic Acid 11% with Lactic Acid 4% (Salactol®) (Gel)
|
Formulary
|
|
|
Salicylic Acid 16.7% with Lactic Acid 16.7% Paint (Salactol®)
|
Formulary
|
In flexible collodion
|
|
Silver Nitrate 75% & 95% applicators
|
Formulary
|
- 6 inch applicator
- 95% pencils
- 0.5% solution
|
|
Trichloroacetic Acid
|
Unlicensed
|
|
|
|
Podophyllotoxin 0.15% cream (Warticon®)
|
Formulary
|
|
|
Imiquimod 5% cream (Aldara®)
|
Formulary
|
- Second line specialist use for treatment of ano-genital warts (mainly in genitourinary medicine [GUM] clinics).
|
|
13.08 |
Sunscreens and camouflagers |
|
|
13.08.01 |
Sunscreen preparations |
|
|
|
Note: Only to be prescribed as per ACBS criteria:
- When prescribed for skin protection against ultraviolet radiation and/or visible light in abnormal cutaneous photosensitivity causing severe cutaneous reactions in genetic disorders (including xeroderma pigmentosum and porphyrias), severe photodermatoses (both idiopathic and acquired) and in those with increased risk of ultraviolet radiation causing severe adverse effects due to chronic disease (such as haematological malignancies), medical therapies and/or procedures.
- Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for CCGs
|
|
Sunsense Ultra® (Sunblock factor 50+)
|
Formulary
|
|
|
Uvistat Sun Cream® (Sunblock factor 30)
|
Formulary
|
|
|
13.08.01 |
Photodamage |
|
|
Fluorouracil (Efudix®) (5% cream)
|
Formulary
|
- For the treatment of superficial malignant and premalignant skin lesions.
|
|
|
|
Products from the Dermacolor® Camouflage Crème and Veil cover cream ranges are included in this Formulary. They are classified as borderline substances and can be prescribed on FP10 prescription forms (marked ACBS) for postoperative scars and other deformities and as an adjunctive therapy in the relief of emotional disturbances due to disfiguring skin disease, such as vitiligo. |
|
13.09 |
Shampoos and other preparations for scalp and hair conditions |
|
|
Betamethasone 0.05%, salicylic acid 2% (Diprosalic ® ) (Scalp application)
|
Formulary
|
|
|
Betamethasone 0.1% (Scalp application)
|
Formulary
|
|
|
Calcipotriol 50micrograms in 1ml (Scalp application)
|
Formulary
|
|
|
Clobetasol 0.05% (Scalp application)
|
Formulary
|
|
|
Coal Tar Extract 5% shampoo (Alphosyl 2 in 1®) (Alcoholic)
|
Formulary
|
|
|
Eucerin 5% Dry Scalp Shampoo
|
Formulary
|
|
|
Ketoconazole 2% shampoo (Nizoral®)
|
Formulary
|
|
|
Oilatum shampoo
|
Formulary
|
|
|
Polytar® liquid
|
Formulary
|
- Shampoo containing a mixture of tar preparations & 0.3% Cade oil
|
|
Selenium Sulphide 2.5% shampoo (Selsun®)
|
Formulary
|
|
|
Simple shampoo (Gentle/frequent)
|
Formulary
|
|
|
|
Co-Cyprindiol 2000/35 (Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)
|
Formulary
|
- Tablets containing cyproterone acetate 2mg & ethinylestradiol 35 micrograms.
- Note: generic co-cyprindiol is much cheaper than Dianette®
|
|
Eflornithine 11.5% cream (Vaniqa®)
|
Formulary
|
- Approved for use as a second-line treatment of facial hirsutism in patients where co-cyprindiol is ineffective, contra-indicated or considered inappropriate. Treatment should be initiated by or on the specific advice of an appropriate specialist - endocrinologist (or gynaecologist).
|
|
13.09 |
Androgenetic alopecia |
|
|
13.10 |
Anti-infective skin preparations |
|
|
13.10.01 |
Antibacterial preparations |
|
|
13.10.01.01 |
Antibacterial preparations only used topically |
|
|
Mupirocin 2% Ointment (Bactroban®)
|
Formulary
|
|
|
Polyfax® Ointment
|
Formulary
|
|
|
Silver Sulfadiazine 1% cream (Flamazine®)
|
Formulary
|
|
|
Nitrofurazone 0.2% Ointment
|
Unlicensed
|
- For limited use in burns/plastic surgery patients only.
|
|
13.10.01.02 |
Antibacterial preparations also used systemically |
|
|
Fusidic Acid 2%
|
Formulary
|
Cream, ointment & gel
|
|
Metronidazole 0.75%
|
Formulary
|
Cream & gel
|
|
13.10.02 |
Antifungal preparations |
|
|
Miconazole 0.16% spray
|
First Choice
|
|
|
Nystatin
|
Formulary
|
- 100,000iu/g cream - UNDER REVIEW
|
|
Amorolfine 5% nail lacquer cream (Loceryl®)
|
Alternatives
|
|
|
Clotrimazole 1% cream
|
Alternatives
|
|
|
Ketoconazole
|
Alternatives
|
|
|
Miconazole 2% cream
|
Alternatives
|
|
|
Terbinafine 1% cream
|
Alternatives
|
|
|
13.10.03 |
Antiviral preparations |
|
|
Aciclovir 5% cream
|
Formulary
|
|
|
13.10.04 |
Parasiticidal preparations |
|
|
|
Permethrin 5% (Lyclear® Dermal Cream)
|
Formulary
|
|
|
|
Dimeticone 4% lotion (Hedrin®)
|
First Choice
|
|
|
Malathion 0.5% solution (aqueous & alcoholic)
|
Second Choice
|
|
|
Permethrin 1% (Lyclear® Creme Rinse)
|
Formulary
|
|
|
|
Permethrin 5% (Lyclear® Dermal Cream)
|
Formulary
|
|
|
13.10.04 |
Benzyl benzonate |
|
|
|
|
|
|
13.10.04 |
Phenothrin |
|
|
13.10.05 |
Preparations for minor cuts and abrasions |
|
|
Bismuth Subnitrate and Iodoform (B.I.P.P.) Paste
|
Formulary
|
- For use in ENT surgery & epistaxis
1.25cm x 100cm & 2.5cm x 100cm impregnated gauze
|
|
Drapolene® cream
|
Formulary
|
|
|
Magnesium Sulphate Paste BP
|
Formulary
|
|
|
Proflavine Cream, BPC
|
Formulary
|
|
|
|
Collodion Flexible BP
|
Formulary
|
- 2.5% castor oil & colophony 2.5% in a collodion base.
|
|
13.10.05 |
Skin tissue adhesive |
|
|
Fibrin sealant (Artiss®)
|
Formulary
|
- 2ml, 4ml & 10ml prefilled syringe.
- For use in plastic surgery to close dead spaces, adhere skin graft, close simple wounds and stabilise bone grafts.
|
|
Fibrin sealant (Bioglue®)
|
Formulary
|
- For use in neurosurgery and vascular surgery.
|
|
Fibrin sealant (Evicel® Human Fibrin Glue)
|
Formulary
|
2ml and 5ml kit
|
|
Fibrin sealant (Floseal® Matrix sealant)
|
Formulary
|
|
|
Fibrin sealant (Tisseel Lyo® Fibrin Glue)
|
Formulary
|
- 2ml, 4ml & 10ml kit
- Also approved for use in the treatment of mesh fixation in hernia repair.
|
|
Histoacryl Blue®
|
Formulary
|
|
|
Indermil X-Fine®
|
Formulary
|
|
|
LiquiBand Optima®
|
Formulary
|
|
|
LiquiBand®
|
Formulary
|
|
|
TachoSil®
|
Formulary
|
- 4.8 & 9.5 cm 2 Haemostatic (collagen sponge coated with fibrinogen and thrombin) - for use in liver and renal surgery.
|
|
13.11 |
Skin cleansers, antiseptics, and desloughing agents |
|
|
Gigasept PA (Solution)
|
Formulary
|
|
|
Lubricating jelly
|
Formulary
|
|
|
Plaster remover
|
Formulary
|
|
|
13.11.01 |
Alcohols and saline |
|
|
Alcohol hand rub gel
|
Formulary
|
|
|
Alcohol impregnated wipes
|
Formulary
|
Containing 70% isopropyl alcohol or methylated spirit (e.g. Clini-wipes®, Alcowipes®)
|
|
Industrial Methylated Spirit BP (Solution & spray)
|
Formulary
|
70% liquid & 70% spray
|
|
Isopropyl alcohol 70% Skin Preparation Swabs (Sterets®)
|
Formulary
|
|
|
Sodium Chloride 0.9%
|
Formulary
|
- Sterile solution – bottles
- 25ml & 100ml sachets(Normasol®)
- 45ml plastic ampoules/pods (Miniversol®)
|
|
Water for Irrigation (Sterile)
|
Formulary
|
|
|
13.11.02 |
Chlorhexidine salts |
|
|
|
In June 2014 information was published highlighting the risk of severe chemical injuries associated with the use of both alcohol-based and water-based chlorhexidine solutions for skin disinfection in premature infants. This was based on Yellow Card reports and reports identified in the literature. A European review has since considered the MHRA evidence together with additional information from spontaneous reporting and published literature The risk appears to be higher in infants born before 32 weeks of gestation than in full term infants and in the first 2 weeks of life than in later life.
Advice for healthcare professionals:
When using alcohol-based or water-based chlorhexidine solutions on premature infants, bear in mind the risk of severe chemical injuries. Use the minimum amount of chlorhexidine solution required and do not allow the solution to pool. Remove any excess solution and any soaked materials, drapes, or gowns from the skin. Use single-use containers where possible. There is a danger of accidentally using too much solution from a multiple-use container. Monitor patients frequently to detect and manage cutaneous side effects at an early stage. Please report any adverse events through the Yellow Card Scheme:www.mhra.gov.uk/yellowcard |
|
Chlorhexidine (CX Antiseptic Dusting Powder®)
|
Formulary
|
- 1% chlorhexidine acetate dusting powder.
|
|
Chlorhexidine 0.015% with Cetrimide 0.15% (Solution)
|
Formulary
|
|
|
Chlorhexidine Gluconate
|
Formulary
|
- 0.02% & 0.05% solutions, 25ml & 100ml sachets
- 0.5% solution in 70% methylated spirit (pink, colourless & red staining)
- 2.5% in 70% methylated spirit wipes
- 0.5% hand rub (contains 70% isopropyl alcohol + emollients)
- 4% surgical scrub
- 2% in 70% isopropyl alcohol wipes (Sanicloth® & Clinell®)
- Skin swabs & skin cleanser
- 3ml & 10.5ml applicators (Chloraprep®)
- 1% Obstetric cream
|
|
Prontosan
|
Formulary
|
- Solution containing Betaine 0.1% (surfactant) and Polyhexanide 0.1% (a chlorhexidine polymer). Mainly for use from 40ml plastic ampoules.
Also available as a gel.
- To be prescribed/used only on the advice of tissue viability specialists.
|
|
13.11.03 |
Cationic surfactants and soaps |
|
|
Infacare Baby Bath Additive
|
Formulary
|
|
|
Mediscrub®
|
Formulary
|
|
|
Octenisan® wash
|
Formulary
|
- Used in some trusts as an alternative to chlorhexidine scrub and Triclosan skin cleanser in MRSA prophylaxis/eradication on secondary care advice.
|
|
13.11.04 |
Iodine and Chlorine |
|
|
Povidone-Iodine
|
Formulary
|
- 2.5% dry powder spray
- 10% alcoholic solution
- 7.5% surgical scrub
- 10% antiseptic solution (aqueous)
- 0.35% sterile aqueous solution

- approved for use in the prevention of surgical site infection in arthroplasty.
|
|
Sodium Hypochlorite Solution 1%
|
Unlicensed
|
|
|
|
Triclosan (Aquasept® & Manusept® )
|
Formulary
|
- 1% or 2% skin cleanser
- 0.5% hand rub
|
|
13.11.06 |
Oxidisers, and dyes |
|
|
Hydrogen Peroxide Solution BP
|
Formulary
|
- 10 volume (3%) & 20 volume (6%) solutions.
|
|
Silver nitrate 0.5% Solution (UNDER REVIEW)
|
Formulary
|
|
|
Bonney's Blue Paint (Brilliant green & crystal violet)
|
Unlicensed
|
- For limited use in some operating theatres only.
|
|
Crystal Violet 0.5% Paint
|
Unlicensed
|
- For limited use in some operating theatres/critical care areas only.
|
|
Magenta Paint BPC (Castellani's paint) (UNDER REVIEW)
|
Unlicensed
|
Paint containing magenta 0.4%, boric acid 0.8%, phenol 0.004%, resorcinol 8%, acetone and alcohol (or industrial methylated spirit).
|
|
Potassium Permanganate
|
Unlicensed
|
- 5% solution
unlicensed
|
|
13.11.07 |
Desloughing agents |
|
|
|
|
Aluminimum Chloride (Driclor®, Anhydrol Forte®)
|
Formulary
|
- Aluminium chloride hexahydrate 20% solution in an alcoholic basis
|
|
Botulinum toxin type A
|
Formulary
|
|
|
Haem-agglutinin complex
|
Formulary
|
- For limited use as an alternative to surgery in some patients.
|
|
Glycopyrrolate 1% cream
|
Unlicensed
|
- To be initiated by specialist.
|
|
13.13 |
Topical circulatory preparations |
|
|
.... |
Key |
|
|
Cytotoxic Drug
|
|
Controlled Drug
|
|
High Cost Medicine
|
|
Cancer Drugs Fund
|
|
NHS England |
|
Homecare |
|
CCG |
|
Traffic Light Status Information
Status |
Description |

|
Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment.
In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.
|

|
Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement.
The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber.
If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care. |

|
Drugs normally recommended or initiated by hospital specialist, but where the provision of an information leaflet may be appropriate to facilitate continuing treatment by GPs. Many of these information sheets are in the process of development. |

|
Drugs where prescribing by GPs is appropriate. Drugs not classified as Red, Amber or Green Plus (formerly blue in North of Tyne) are generally classified as ‘Green’ by default. The Green drugs listed here include those products normally initiated by hospital specialists where there was a need for discussion and debate as to the category in which they should be placed. |
|
|
|