netFormulary North of Tyne and Gateshead Area Prescribing Committee NHS
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 Formulary Chapter 13: Skin - Full Chapter
Notes:

North of Tyne and Gateshead Guidelines for the Management of Acne (from 12 years of age)

 Details...
13.01  Management of skin conditions
13.01.01  Vehicles
13.01.02  Suitable quantities for prescribing
13.01.03  Excipients and sensitisation
13.02  Emollient and barrier preparations to top
13.02.01  Emollients
Aquamax®
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Green plus
  • Approved for used in radiotherapy only.
 
   
Aqueous Cream BP
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Formulary
Green
  • Due to the SLS content to be used as a soap substitute only.
 
   
Aveeno® (Cream)
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Formulary
Green
 
   
Cetraben®
(Cream and ointment)
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Formulary
Green
 
   
Diprobase®
(Cream and ointment)
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Formulary
Green
 
   
DoubleBase®gel
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Formulary
Green
 
   
E45®
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Formulary
Green
 
   
Emulsifying Ointment BP
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Formulary
Green
 
   
Epaderm® emollient
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Formulary
Green
  • Hydromol® Ointment is made to the same formula and is more cost effective.
 
   
Epimax®
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Formulary
Green
 
   
Hydromol® ointment
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Green
  • 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
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Green
 
   
Oilatum® cream
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Green
 
   
Oilatum® Junior cream
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Green
 
   
Paraffin sterile liquid
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Green
 
   
QV®
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Green plus
  • Approved for used in radiotherapy only.
 
   
White Soft Paraffin BP
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Green
 
   
Yellow Soft Paraffin BP
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Formulary
Green
 
   
ZeroAQS®
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Formulary
Green
  • SLS free alternative to Aqueous Cream.
 
   
Zerobase®
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Formulary
Green
  • Alternative to Diprobase
 
   
Zerocream®
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Formulary
Green
  • Alternative to E45® Cream.
 
   
Zerodouble® Gel
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Green
  • Alternative to Doublebase gel.
 
   
Zeroveen® cream
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Green
  • Alternative to Aveeno
 
   
13.02.01  Emollients - preparations containing urea
Balneum® Plus cream
(Emollient preparation containing Urea)
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Formulary
Green
 
   
Calmurid® emollient
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Formulary
Green
 
   
Eucerin® Intensive
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Formulary
Green
 
   
13.02.01  Emollients - with antimicrobials
Dermol®
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Formulary
Green plus
 
   
13.02.01.01  Emollient bath and shower preparations
Oilatum® Bath Emollient
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Formulary
Green
 
   
Balneum® Bath Additive
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Formulary
Green
 
   
Cetraben®Bath additive
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Formulary
Green
 
   
Dermol 600® Bath Additive
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Formulary
Green plus
 
   
Dermol® 200 Shower emollient
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Formulary
Green
 
   
Dermol® 500 Lotion
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Formulary
Green
 
   
Diprobath® Bath Additive
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Formulary
Green
 
   
E45® Bath Additive
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Formulary
Green
 
   
Hydromol® bath and shower
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Formulary
Green
 
   
Oilatum® Plus emollient bath additive
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Formulary
Green
 
   
Oilatum® shower emollient gel
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Formulary
Green
 
   
Zerolatum® Bath Emollient
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Formulary
Green
  • Alternative to Oilatum®.
 
   
Zeroneum® Bath Emollient
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Formulary
Green
  • Alternative to Balneum®.
 
   
13.02.02  Barrier preparations to top
Dimeticone (Siopel®)
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Formulary
Green
 
   
Drapolene®
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Formulary
Green
 
   
Drapolene®
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Formulary
Green
 
   
Metanium®
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Formulary
Green
 
   
Sorbaderm® cream
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Formulary
Green
  • 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®
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Formulary
Green
 
   
Vasogen®
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Formulary
Green
 
   
Zinc and caster oil ointment BP
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Formulary
Green
 
   
Deegan's ointment
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Unlicensed Drug Unlicensed
Green plus
 
   
Sucrulfate cream
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Unlicensed Drug Unlicensed
Red
  • 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
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Formulary
Green
 
   
Crotamiton (Eurax®)
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Formulary
Green
 
   
Lidocaine 5% ointment
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Green
 
   
Lidocaine and prilocaine (EMLA®)
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Green
 
   
Lidocaine, Adrenaline, Tetracaine (Pliaglis®)
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Formulary
Green
 
   
Menthol and aqueous cream
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Formulary
Green

- available as Dermacool

 
   
13.04  Topical corticosteriods.
Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 2% (Diprosalic®)
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Formulary
Green
  • Scalp application
 
   
Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 3% (Diprosalic®)
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Green
  • Ointment
 
   
Betamethasone (as Valerate) 0.025% (Betnovate-RD®)
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Green

MODERATELY POTENT

  • Cream and ointment
 
   
Betamethasone (as Valerate) 0.1%
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Green

POTENT

  • Cream, ointment & scalp application
 
   
Betamethasone (as Valerate) 0.1% with Clioquinol 3% (Betnovate C®)
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Formulary
Green

POTENT

  • Cream and ointment
 
   
Betamethasone (as Valerate) 0.1% with Fucidic Acid 2% (Fucibet®)
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Green

POTENT

 
   
Betamethasone (as Valerate) 0.1% with Neomycin Sulphate 0.5% (was Betnovate-N®)
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Formulary
Green

POTENT

Cream and ointment

 
   
Clobetasol Propionate 0.05% (Dermovate®)
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Formulary
Green

VERY POTENT
Cream, ointment & scalp application

 
   
Clobetasol Propionate with neomycin and nystatin (Dermovate-NN®)
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Formulary
Green

VERY POTENT

Ointment

 
   
Clobetasone Butyrate 0.05% (Eumovate®)
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Formulary
Green

MODERATELY POTENT

Cream, ointment & scalp application

 
   
Fludroxycortide  (Haelan®)
(Tape)
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Formulary
Green

MODERATELY POTENT

 
   
Fluocinolone Acetonide 0.025% (Synalar®)
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Formulary
Green

POTENT
Cream, ointment & gel

 
   
Hydrocortisone 0.25% Crotamiton 10% (Eurax-HC®)
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Green

MILD

  • Cream
 
   
Hydrocortisone 0.5%, 1% & 2.5%
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Formulary
Green

MILD
Cream and ointment

 
   
Hydrocortisone 1% with Clotrimazole 1% (Canesten HC®)
(Cream)
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Green

MILD

 

 
   
Hydrocortisone 1% with Miconazole Nitrate 2% (Daktacort®)
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Formulary
Green

MILD

  • Cream and ointment
 
   
Hydrocortisone Acetate 1% with Fusidic Acid 2% (Fucidin H®)
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Formulary
Green

MILD

 
   
Hydrocortisone Butyrate 0.1% cream (Locoid®)
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Formulary
Green

POTENT

 
   
Nystaform-HC®
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Formulary
Green

MILD

  • Cream and ointment
 
   
Timodine®
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Formulary
Green

MILD

  • Cream
 
   
Trimovate® cream
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Formulary
Green

MODERATELY POTENT

  • Containing clobetasone 0.5%, oxytetracycline3% and nystatin 100,000units/g unlicensed unlicensed
  • If no licensed alternative is suitable, Trimovate is available as an imported medicine via Alliance Healthcare Distribution. In order for community pharmacies to be able to dispense this ULM, it must be prescribed generically as 'Clobetasone 0.05%/ Oxytetracycline 3%/ Nystatin 100,000 units/g cream (Special Order)'. Please note this will be at a significantly higher cost than the licensed version and will be subject to handling charges.
  • Further information can be found on the PSNC website.
 
   
13.04  Topical corticosteriod preparation potencies
13.05  Preparations for eczema and psoriasis
13.05.01  Preparations for eczema to top
Alitretinoin (Toctino®)
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Formulary
Red
High Cost Medicine
  • Approved for adults with severe chronic hand eczema that have not responded to potent topical corticosteroids in line with NICE.
 
Link  NICE TA177: Alitretinoin for the treatment of severe chronic hand eczema
   
Ichthammol
(Zinc paste and ichthammol bandage BP 1993)
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Formulary
Green
 
   
Zinc oxide bandage  (Viscopaste®)
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Formulary
Green
 
   
13.05.02  Preparations for psoriasis
5-Methoxypsoralen 20mg tablets
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Unlicensed Drug Unlicensed
Red
 
   
8-Methoxypsoralen 10mg tablets
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Unlicensed Drug Unlicensed
Red
 
   
Methoxypsoralen 1.2% bath additive
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Unlicensed Drug Unlicensed
Red
 
   
13.05.02  Topical preparations for psoriasis
Alphosyl HC® cream
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Formulary
Green
  • Cream containing coal tar extract 5%, hydrocortisone 0.5% and allantoin 2%
 
   
Calcipotriol 50mcg/g  (Dovonex®)
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Formulary
Green
  • 0.005% Cream and ointment
  • 0.005% scalp application

 
   
Calcipotriol 50mcg/g with Betamethasone 0.05%
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Formulary
Green
  • 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
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Formulary
Green
 
   
Coal tar in emulsifying ointment solution
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Formulary
Green
  • 1% unlicensedunlicensed
  • 2% unlicensedunlicensed
  • 5% unlicensedunlicensed
 
   
Coal tar lotion 1% (Exorex®)
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Formulary
Green
 
   
Cocois®
(Scalp application)
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Formulary
Green
 
   
Diprosalic ointment
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Formulary
Green
  • 0.05%/3%
 
   
Dithranol cream
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Formulary
Green
  • 0.1%, 0.25%,0.5%,1%, & 2% 
 
   
Dithranol pomade
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Formulary
Green
  • 0.2%, 0.4% & 0.6% unlicensedunlicensed
 
   
Sebco® scalp ointment
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Formulary
Green
 
   
Dithranol in Full Strength Lassar's Paste BP
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Unlicensed Drug Unlicensed
Red
  • 0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1%, 2%, 4%, 6% & 8%.
 
   
Dithranol with salycyclic acid 0.5%
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Unlicensed Drug Unlicensed
Red
  • 0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1%, 2%, 4%, 6%, 8% & 16%in emulsifying base.
 
   
Salicylic Acid in emulsifying ointment
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Unlicensed Drug Unlicensed
Green
  • 2%, 5%, 10% and 20%.
 
   
Tar Pomade (6% coal tar solution & 2% salycylic acid in emulsifying ointment)
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Unlicensed Drug Unlicensed
Green
 
   
Zinc and Coal Tar Paste (White's Tar Paste)
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Unlicensed Drug Unlicensed
Green
 
   
Zinc and Salicylic Acid Compound Paste  (Half Strength Lassar's Paste)
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Unlicensed Drug Unlicensed
Green
 
   
13.05.02  Oral retinoids for psoriasis
Acitretin (Neotigason®)
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Unlicensed Drug Unlicensed
Red
  • 10mg and 25mg capsules 
 
   
Fumaric acid esters
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Unlicensed Drug Unlicensed
Red
  • 30mg & 120mg tablets
 
   
13.05.03  Drugs affecting the immune response
Adalimumab (Humira®)
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Formulary
Red
High Cost Medicine
  • 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
 
Link  NICE TA146 Adalimumab for the treatment of adults with psoriasis
Link  NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
Link  NICE TA455 Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
Apremilast (Otezla®)
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Formulary
Red
High Cost Medicine
  • 10mg, 20mg & 30mg tablets
  • To be used in accordance with NICE guidance
 
Link  NICE TA419: Apremilast for treating moderate to severe plaque psoriasis
   
Brodalumab (Kyntheum® )
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Formulary
Red
High Cost Medicine
CCG

 

  • 210mg/1.5ml solution for injection in pre-filled syringes.
  • Approved for the treatment of moderate to severe plaque psoriasis in line with NICE 

 

 
Link  NICE TA511: Brodalumab for treating moderate to severe plaque psoriasis
   
Ciclosporin
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Formulary
Amber
  • Capsules & SF Solution 
    See section 8.2.2
 
   
Dimethyl fumarate (Skilarence®)
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Formulary
Red
High Cost Medicine
  • 120mg tablets
  • Approved for the treatment of moderate to severe plaque psoriasis in line with NICE
 
Link  NICE TA475 Dimethyl fumarate for treating moderate to severe plaque psoriasis
   
Etanercept (Enbrel®, Benapali® & Erelzi®)
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Formulary
Red
High Cost Medicine
  • Approved for psoriasis in line with NICE
  • Approved for the treatment of plaque psoriasis in children and young people in line with NICE
 
Link  NICE TA103: Psoriasis - efalizumab and etanercept
Link  NICE TA455 Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
Guselkumab (Tremfya®)
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Formulary
Red
High Cost Medicine
CCG
  • 100mg/1mL solution for injection
  • Approved for the treatment of moderate to severe plaque psoriasis in line with NICE
 
Link  NICE TA521: Guselkumab for treating moderate to severe plaque psoriasis
   
Infliximab (Remsima®, Inflectra®, Remicade®)
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Formulary
Red
High Cost Medicine
  • Approved for psoriasis in line with NICE.
 
Link  NICE TA134: Infliximab for psoriasis
   
Ixekizumab (Taltz®)
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Formulary
Red
High Cost Medicine
  • Approved for the treatment of moderate to severe plaque psoriasis in adults in line with NICE
 
Link  NICE TA442 Ixekizumab for treating moderate to severe plaque psoriasis
   
Cytotoxic Drug Methotrexate
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Formulary
Amber
 
   
Pimecrolimus cream (Elidel®)
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Formulary
Green plus
  • Approved for moderate disease on face and neck for those between 2 and 16 years in line NICE.
 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Secukinumab (Cosentyx®)
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Formulary
Red
High Cost Medicine
  • Approved for the treatment of plaque psoriasis in line with NICE.
 
Link  NICE TA350: Plaque Psoriasis
Link  NICE TA407: Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors
   
Tacrolimus ointment (Protopic® )
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Formulary
Green plus
  • Approved for moderate to severe disease atopic eczema in patients over 2 years in line with NICE.
 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Ustekinumab (Stelara®)
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Formulary
Red
High Cost Medicine
  • 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
 
Link  NICE TA180: Psoriasis - ustekinumab (Updated March 2017)
Link  NICE TA340: Ustekinumab for treating active psoriatic arthritis
Link  NICE TA455 Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
13.06  Acne and rosacea to top
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)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Azelaic Acid
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Formulary
Green
  • 15% (Finacea®) and 20% (Skinoren®) gel 
 
   
Benzoyl Peroxide 10% Aquagel and 5% gel (PanOxyl®)
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Formulary
Green
 
   
Benzoyl Peroxide 4% cream (Brevoxyl®)
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Formulary
Green
 
   
Benzoyl Peroxide 5% Gel (Acnecide®)
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Formulary
Green
 
   
Benzoyl Peroxide 5% with Clindamycin 1% (Duac® )
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Formulary
Green
 
   
13.06.01  Topical antibacterials for acne
Clindamycin  (Dalacin T®)
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Formulary
Green
  • 1% topical solution (alcohol – water basis)
  • 1% lotion (aqueous)
 
   
Erythromycin 2% topical solution (Stiemycin®)
(Solution)
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Formulary
Green
 
   
Erythromycin 40mg with Zinc Acetate 1.2% topical solution (Zineryt®)
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Formulary
Green
 
   
13.06.01  Topical retinoids and related preparations for acne
Adapalene 0.1% gel and cream (Differin®)
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Formulary
Green
 
   
Isotretinoin 0.05% gel (Isotrex® gel)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Isotretinoin 0.05% with erythromycin 2% (Isotrexin®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Tretinoin 0.025% with Clindamycin 1% gel (Treclin® )
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.06.01  Other topical preparations for rosacea to top
Brimonidine Tartate 0.33% gel (Mirvaso®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • For specialist initiation for the treatment of severe rosacea. Following specialist review of effectiveness, primary care can continue supply.
 
   
Ivermectin 1% cream (Soolantra®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 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
 note 

For information on the choice of oral antibiotics to treat acne, see the North East & Cumbria antimicrobial prescribing guideline for primary care

Oxytetracycline
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.06.02  Hormone treatment for acne
Co-Cyprindiol 2000/35
(Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)

View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 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)

View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 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
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 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 to top
Glutaraldehyde 10% paint (Glutarol®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Salicylic Acid
(in emulsifying ointment)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green

See section 13.5.2

 
   
Salicylic Acid 11% with Lactic Acid 4% (Salactol®)
(Gel)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Salicylic Acid 16.7% with Lactic Acid 16.7% Paint (Salactol®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green

In flexible collodion

 
   
Silver Nitrate 75% & 95% applicators
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 6 inch applicator
  • 95% pencils
  • 0.5% solution 
 
   
Trichloroacetic Acid
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Green
  • 10%, 75% & 90% solution.
 
   
13.07  Anogenital warts
Podophyllotoxin 0.15% cream (Warticon®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
Imiquimod 5% cream (Aldara®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • 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
Sunsense Ultra®
(Sunblock factor 50+)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Uvistat Ultrablock®
(Sunblock factor 30)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.08.01  Photodamage
Cytotoxic Drug Fluorouracil (Efudix®)
(5% cream)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • For the treatment of superficial malignant and premalignant skin lesions. To be initiated with advice of specialists.
 
   
Ingenol mebutate gel (Picato®)
(Gel)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 150 micrograms/g & 500 micrograms/g gel 
  • For the treatment non-hyperkeratotic, non-hypertrophic actinic keratosis
    in adults
 
   
13.08.02  Camouflagers to top
 note 

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)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Betamethasone 0.1%
(Scalp application)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Calcipotriol 50micrograms in 1ml
(Scalp application)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Clobetasol 0.05%
(Scalp application)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Coal Tar Extract 5% shampoo (Alphosyl 2 in 1®)
(Alcoholic)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Eucerin 5% Dry Scalp Shampoo
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Ketoconazole 2% shampoo (Nizoral®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Oilatum shampoo
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Polytar® liquid
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Shampoo containing a mixture of tar preparations & 0.3% Cade oil
 
   
Selenium Sulphide 2.5% shampoo (Selsun®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Simple shampoo
(Gentle/frequent)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.09  Hirsutism
Co-Cyprindiol 2000/35
(Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)

View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Tablets containing cyproterone acetate 2mg & ethinylestradiol 35 micrograms.
  • Note: generic co-cyprindiol is much cheaper than Dianette®
 
   
Eflornithine 11.5% cream (Vaniqa®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 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 to top
13.10.01.01  Antibacterial preparations only used topically
Mupirocin 2% Ointment (Bactroban®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
Polyfax® Ointment
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Silver Sulfadiazine 1% cream (Flamazine®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Nitrofurazone 0.2% Ointment
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Red
  • For limited use in burns/plastic surgery patients only.
 
   
13.10.01.02  Antibacterial preparations also used systemically
Fusidic Acid 2%
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green

Cream, ointment & gel

 
   
Metronidazole 0.75%
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green

Cream & gel

 
   
13.10.02  Antifungal preparations
Miconazole 0.16% spray
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green
 
Nystatin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Amorolfine 5% nail lacquer cream (Loceryl®)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
 
   
Clotrimazole 1% cream
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
 
   
Ketoconazole
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
  • 2% cream
  • shampoo
 
   
Miconazole 2% cream
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
 
   
Terbinafine 1% cream
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
 
   
13.10.03  Antiviral preparations
Aciclovir 5% cream
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.10.04  Parasiticidal preparations to top
13.10.04  Scabies
Permethrin 5% (Lyclear® Dermal Cream)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.10.04  Head lice
Dimeticone 4% lotion (Hedrin®)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green
 
Malathion 0.5% solution (aqueous & alcoholic)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green
 
   
Permethrin 1% (Lyclear® Creme Rinse)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.10.04  Crab lice
Permethrin 5% (Lyclear® Dermal Cream)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.10.04  Benzyl benzonate
13.10.04  Carbaryl to top
13.10.04  Dimeticone
13.10.04  Malathion
13.10.04  Permethrin
13.10.04  Phenothrin
13.10.05  Preparations for minor cuts and abrasions to top
Bismuth Subnitrate and Iodoform (B.I.P.P.) Paste
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • For use in ENT surgery & epistaxis
    1.25cm x 100cm & 2.5cm x 100cm impregnated gauze
 
   
Drapolene® cream
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Magnesium Sulphate Paste BP
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Proflavine Cream, BPC
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.10.05  Collodion
Collodion Flexible BP
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 2.5% castor oil & colophony 2.5% in a collodion base.
 
   
13.10.05  Skin tissue adhesive
Fibrin sealant (Artiss®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 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®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • For use in neurosurgery and vascular surgery.
 
   
Fibrin sealant (Evicel® Human Fibrin Glue)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green

2ml and 5ml kit

 
   
Fibrin sealant (Floseal® Matrix sealant)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Fibrin sealant (Tisseel Lyo® Fibrin Glue)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 2ml, 4ml & 10ml kit
  • Also approved for use in the treatment of mesh fixation in hernia repair.
 
   
Histoacryl Blue®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Indermil X-Fine®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
LiquiBand Optima®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
LiquiBand®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
TachoSil®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 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)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Lubricating jelly
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Plaster remover
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.11.01  Alcohols and saline
Alcohol hand rub gel
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Alcohol impregnated wipes
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green

Containing 70% isopropyl alcohol or methylated spirit (e.g. Clini-wipes®, Alcowipes®)

 
   
Industrial Methylated Spirit BP
(Solution & spray)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green

70% liquid & 70% spray

 
   
Isopropyl alcohol 70% Skin Preparation Swabs (Sterets®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Sodium Chloride 0.9%
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Sterile solution – bottles
  • 25ml & 100ml sachets(Normasol®)
  • 45ml plastic ampoules/pods (Miniversol®)
 
   
Water for Irrigation
(Sterile)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
13.11.02  Chlorhexidine salts to top
 note 

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®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 1% chlorhexidine acetate dusting powder.
 
   
Chlorhexidine 0.015% with Cetrimide 0.15%
(Solution)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Chlorhexidine Gluconate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 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
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 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
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Secondary care use only
 
   
Mediscrub®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Octenisan® wash
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Used in some trusts as an alternative to chlorhexidine scrub and Triclosan skin cleanser in MRSA prophylaxis/eradication.
 
   
13.11.04  Iodine and Chlorine
Povidone-Iodine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 2.5% dry powder spray
  • 10% alcoholic solution
  • 7.5% surgical scrub
  • 10% antiseptic solution (aqueous)
  • 0.35% sterile aqueous solution Red Traffic Light
    • approved for use in the prevention of surgical site infection in arthroplasty. 

 
   
Sodium Hypochlorite Solution 1%
View adult BNF View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Green
  • 1% sterilising solution.
 
   
13.11.05  Phenolics
Triclosan (Aquasept® & Manusept® )
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 1% or 2% skin cleanser
  • 0.5% hand rub
 
   
13.11.06  Oxidisers, and dyes
Hydrogen Peroxide Solution BP
View adult BNF View childrens BNF  Track Changes
Formulary
Green
  • 10 volume (3%) & 20 volume (6%) solutions.
 
   
Potassium Permanganate
 Track Changes
Formulary
Green
  • 400mg solution tablets
  • 5% solution unlicensedunlicensed - under review
 
   
Silver nitrate 0.5% Solution
(UNDER REVIEW)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Bonney's Blue Paint
(Brilliant green & crystal violet)
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Red
  • For limited use in some operating theatres only.
 
   
Crystal Violet 0.5% Paint
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Red
  • For limited use in some operating theatres/critical care areas only.
 
   
Magenta Paint BPC (Castellani's paint)
(UNDER REVIEW)
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Red

Paint containing magenta 0.4%, boric acid 0.8%, phenol 0.004%, resorcinol 8%, acetone and alcohol (or industrial methylated spirit).

 
   
13.11.07  Desloughing agents to top
Sterile Larvae (Maggots) (LarvE®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Used for the management of sloughy wounds.
 
   
13.11.07  Desloughing agents
13.11.07  Growth factor
13.12  Antiperspirants
Aluminimum Chloride  (Driclor®, Anhydrol Forte®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Aluminium chloride hexahydrate 20% solution in an alcoholic basis
 
   
Botulinum toxin type A
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Haem-agglutinin complex
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • For limited use as an alternative to surgery in some patients.
 
   
Glycopyrrolate 1% cream
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Green plus
  •  To be initiated by specialist.
 
   
13.13  Topical circulatory preparations
 ....
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
SMC
Scottish Medicines Consortium
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

Red

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.   

Amber

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.  

Green plus

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.  

Green

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.  

netFormulary