netFormulary North of Tyne, Gateshead and North Cumbria NHS
Area Prescribing Committee Formulary  
 Search
 Formulary Chapter 9: Nutrition and blood - Full Chapter
09.01  Anaemias and some other blood disorders
Oral Rehydration Salts (Dioralyte®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
09.01.01  Iron-deficiency anaemias
09.01.01.01  Oral iron
Ferrous Sulphate
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green
  • 200mg tablets (65mg iron).
 
Ferric maltol 30mg hard capsules (Ferracru®)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green plus
  • For the treatment of iron deficiency anemia in patients with or without inflammatory bowel disease.
  • To be initiated by specialist in inflammatory bowel disease or iron deficiency anaemia 
 
Link  Ferric Maltol for the treatment of iron-deficiency anaemia in Inflammatory Bowel Disease only
Link  Ferric Maltol for the treatment of iron-deficiency anaemia in patients without Inflammatory Bowel Disease
   
Ferrous Fumarate
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
  • First Choice oral liquid iron preparation140mg in 5ml syrup (45mg iron/5ml).
  • 210mg tablets (68mg iron/tablet).
 
   
Ferrous Gluconate
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green

300mg tablets (35mg iron)

 
   
Sodium Feredetate (Sodium ironedetate, Sytron®)
 Track Changes
Alternatives
Green
  • 190mg in 5ml sugar-free elixir (27.5mg iron/5ml).
 
   
09.01.01.01  Iron and folic acid
09.01.01.01  Compound iron preparations to top
09.01.01.02  Parenteral iron
Ferric Carboxymaltose 100ml in 2ml & 500mg in 10ml injections (Ferinject®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • For use as an alternative to iron dextran or iron sucrose. Approved for
    use by renal physicians, gastroenterologists and haematologists.
  • Unlicensed for use in children under 14 years of age. If used in this age-group, use should only be on the advice of a consultant with the informed consent of the patient and/or his/her parents/carers.
 
   
Iron Dextran 100ml in 2ml and 500mg in 10ml injections
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Iron Isomaltoside 1000mg in 10ml injection (Monofer®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Iron Sucrose 100mg in 5ml injection (Venofer®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
09.01.02  Drugs used in megaloblastic anaemias
Folic Acid
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 400 microgram and 5mg tablets
  • 2.5mg in 5ml sugar-free syrup
  • 15mg in 1ml injection unlicensedunlicensed
  • 30mg in 2ml injection
 
   
Hydroxocobalamin 1mg in 1ml injection
(Vitamin B12)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
09.01.03  Drugs used in hypoplastic, haemolytic, and renal anaemias
Eculizumab
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • For use in accordance with NICE and NHS England commissioning policies.
 
Link  Clinical Commissioning Policy: Eculizumab in the treatment of recurrence of C3 glomerulopathy postkidney transplant (all ages) Reference: NHS England: 16054/P
Link  NICE HST 1 - Eculizumab for treating atypical haemolytic uraemic syndrome
   
09.01.03  Erythropoietin
Darbepoetin Alfa
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Red
High Cost Medicine
  • 10, 15, 20, 30, 40, 50, 60, 80, 100, 150 & 300 microgram injections in prefilled syringes 
  • 20, 40, 60, 80, 100 & 300 microgram Sureclick® pens - approved for management of cancer treatment-induced anaemia in women receiving platinum-based chemotherapy for ovarian cancer 
  • Shared care arrangement in place for monitoring to be undertaken in primary care
 
Epoetin alfa (Eprex®)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Amber
High Cost Medicine
  • Prefilled syringes (various strengths)
    • Approved for management of cancer treatment-induced anaemia in
      women receiving platinum-based chemotherapy for ovarian cancer
    • No longer regularly used in NUTH

 
Link  NICE CG114: Anaemia in chronic kidney disease
Link  NICE TA323: Erythropoiesis‑stimulating agents during chemotherapy
   
Epoetin beta (NeoRecormon®)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Red
High Cost Medicine
  • Cartridges for use in RecopensPrefilled syringes
    • Approved for management of cancer treatment-induced anaemia
      in women receiving platinum-based chemotherapy for ovarian cancer.
    • No longer regularly used in NUTH.

  • Shared care arrangement in place for monitoring to be undertaken in primary care
 
Link  NICE CG114: Anaemia in chronic kidney disease
Link  NICE TA323: Erythropoiesis‑stimulating agents during chemotherapy
Link  Shared Care Guidelines for the Monitoring of Erythropoietin (Darbepoetin [Aranesp]) in the Treatment of Patients with Chronic Kidney Disease (CKD)
   
Methoxy Polyethylene Glycol-Epoetin Beta (Mircera®, Pegzerepoetin® alfa)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Amber
High Cost Medicine
  • 30, 50, 100, 120, 150, 200 & 250 microgram in 0.3ml and 360 microgram in 0.6ml injections in prefilled syringes.
  • Approved for use as a longer-acting alternative to darbepoetin in a
    small number of patients receiving peritoneal dialysis.
 
   
09.01.03  Iron overload to top
Deferasirox
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • Approved for iron chelation in patients with myelodysplastic syndromes (MDS) - (as per NECN Haematology Group Guidelines) and recommended for use in patients when treatment with desferrioxamine is no longer considered to be appropriate due to progressive iron overload despite maximally tolerated doses of desferrioxamine. 
 
   
Desferrioxamine Mesilate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
 
   
09.01.04  Drugs used in autoimmune thrombocytopenic purpura
Anagrelide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • For the treatment of thrombocythemiaas a 2nd line agent in patients poorly/non-responsive tohydroxycarbamide therapy.
 
   
Eltrombopag
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • For the treatment of adults with chronic immune (idiopathic) thrombocytopenia purpura in line with NICE.
 
Link  NICE TA293: Eltrombopag for treating chronic ITP
   
Romiplostim
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • For the treatment of adults with chronic immune (idiopathic) thrombocytopenia purpura in line with NICE.
 
Link  NICE TA221: Thrombocytopenic purpura - romiplostim
   
09.01.05  G6PD deficiency
09.01.06  Drugs used in neutropenia
Filgrastim (G-CSF) (Neupogen®, Ratiograstim®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • Available as Neupogen (original brand) and Ratiograstim – a
    biosimilar product.
 
   
Lenograstim (rHuG-CSF) (Granocyte®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • 263 microgram (33.6 million units) injection vials
 
   
Lipegfilgrastim (G-CSF)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Pegfilgrastim (G-CSF)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
 
   
09.01.07  Drugs used to mobilise stem cells
Plerixafor (Mozobil®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • Approved by NHS England Specialist Services for stem cell mobilisation for patients with Hodgkin’s disease, Non-Hodgkins lymphoma or multiple myeloma and meet the policy for Haematopoietic Stem Cell Transplantation.
 
   
09.02  Fluids and electrolytes to top
09.02.01  Oral preparations for fluid and electrolyte imbalance
09.02.01.01  Oral potassium
Potassium Chloride (Sando-K®)
View adult BNF View childrens BNF  Track Changes
First Choice
Green
  • Effervescent tablets (12mmol potassium 8 mmol chloride)
 
Potasium Chloride
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
  • 600mg m/r tablets – (8 mmol potassium) Green Traffic Light
    • For use where the effervescent tablets or syrup are unsuitable

  • 5mmol in 5ml sugar-free syrup (Kay-Cee-L) Green Traffic Light
  • 1mmol in 1ml carbohydrate free oral solution Red Traffic Light 
    • Approved for use in children with intractable epilepsy being
      treated with a ketogenic diet.

 
   
09.02.01.01  Potassium removal
Calcium Resonium®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Powder (Calcium polystyrene sulphonate)
 
   
Resonium A®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Powder (Sodium polystyrene sulphonate)
 
   
Sodium zirconium cyclosilicate (Lokelma®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
  • 5g and 10g oral powder
  • Approved for the treatment of hyperkalaemia in line with NICE
 
Link  NICE TA599: Sodium zirconium cyclosilicate for treating hyperkalaemia
   
09.02.01.02  Oral sodium and water
Sodium Chloride
 Track Changes
Formulary
Green
  • 600mg m/r tablets (Slow Sodium) - approx. 10 mmol sodium & chloride per tablet
  • 1mmol / ml oral solution Green Traffic Light 
    • Treatment should only be initiated with the advice of a specialist.

 
   
09.02.01.02  Oral rehydration therapy (ORT) to top
Dioralyte® Oral Rehydration Salts
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
09.02.01.03  Oral bicarbonate
Sodium Bicarbonate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 500mg capsules (500mg contains approx. 6 mmol each ofsodium and bicarbonate)
  • 1mmol/ml oral solution unlicensedunlicensed
 
   
09.02.02  Parenteral preparations for fluid and electrolyte imbalance
Steriflex 165®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Potassium chloride 0.3% (20mmol); sodium chloride 0.9%; and glucose 5% (500ml bag).
    • Approved for diabetic ketoacidosis in paediatric patients unlicensedunlicensed.

 
   
09.02.02.01  Electrolytes and water
Water for Infusion (Viaflo® - FE0304)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Approved for use by the North-East Assisted Ventilation Service (NEAVS).
 
   
09.02.02.01  Intravenous sodium
Sodium Chloride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 0.9% injection (5ml, 10ml & 20ml)
  • 0.9% IV infusion (100ml, 250ml, 500ml & 1000ml)
  • 0.9% irrigation (1000ml & 3000ml)
  • 0.45% IV infusion (500ml - Steriflex 2)
  • 1.8%, 2.7% & 5% Polyfusor infusion (500ml)
  • 30% injection (10ml)
 
   
Sodium Chloride and Glucose
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 0.9%/5% IV infusion (500ml - Sterfilex 3)
  • 0.18%/4% IV infusion (500ml & 1000ml)
  • 0.18%/10% IV infusion (500ml - Steriflex 19)
  • 0.45%/5% IV infusion (500ml - Steriflex 45)
 
   
09.02.02.01  Intravenous glucose to top
Glucose
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 5% IV infusion (100ml, 250ml, 500ml & 1000ml)
  • 10% IV infusion (500ml & 1000ml)
  • 20% IV infusion (500ml)
  • 50% Injection (50ml)
 
   
09.02.02.01  Intravenous potassium
Potassium Chloride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 15% injection Restricted Item Restricted
 
   
Potassium Chloride and Glucose
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 0.15%/5% IV infusion (1000ml - Steriflex 13)
  • 0.3%/5% IV infusion (1000ml - Steriflex 16)
  • 0.15%/10% IV infusion (500ml - Steriflex 106)
  • 0.3%/10% IV infusion (500ml - Steriflex 132)
  • 0.6%/5% IV infusion (500ml) - high strength
 
   
Potassium Chloride and Sodium Chloride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 0.15%/0.9% IV infusion (1000ml - Steriflex 12)
  • 0.3%/0.9% IV infusion (500ml & 1000ml - Steriflex 15)
  • 0.45%/0.9% IV infusion (1000ml) - high strength
  • 0.6%/0.9% IV infusion - high strength
 
   
Potassium Chloride, Sodium Chloride and Glucose
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 0.15%/0.45%/5% IV infusion (500ml - Intraven GV332)
  • 0.15%/0.18%/4% IV infusion (1000ml - Steriflex 14)
  • 0.3%/0.18%/4% IV infusion (1000ml - Steriflex 17)
  • 0.3%/0.45%/5% IV infusion (500ml) Paediatrics only
 
   
Potassium Phosphate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 17.42% injection Restricted Item Restricted
 
   
09.02.02.01  Bicarbonate and lactate
Sodium Bicarbonate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 1.26% IV infusion Polyfusor®
  • 1.4% IV infusion Polyfusor®
  • 2.74% IV infusion Polyfusor®
  • 8.4% IV infusion Polyfusor®
  • 8.4% injection (10ml & 50ml)
 
   
Sodium Lactate IV infusion
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 500ml & 1000ml
 
   
09.02.02.01  Water
Water for Injection
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 2ml, 5ml, 10ml, 20ml, 100ml & 500ml
 
   
Water for Irrigation
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 1000ml
 
   
Sterile oral water
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 100ml
 
   
09.02.02.02  Plasma and plasma substitutes
Human Albumin Solution
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 4.5% (50ml, 100ml & 500ml)
  • 20% (50ml & 100ml)
 
   
Plasma-lyte 148 with Glucose 5%
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Infusion in a balanced electrolyte solution containing Na+ 140 mmol, K+ 5 mmol, Mg2+ 1.5 mmol, acetate 27 mmol/litre. Gluconate 23 mmol/litre. Note calcium free.
    • Approved for use in paediatric theatres only.

 
   
09.02.02.02  Plasma substitutes to top
Dextran 40/Sodium Chloride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 10%/0.9% 
 
   
Gelatin (Isoplex®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 4%succinylated gelatin infusion in a balanced electrolyte solution containing Na+ 145 mmol, K+ 4 mmol, Mg2+ 0.9 mmol, Cl- 105 mmol, lactate 25 mmol/litre.
    • Mainly for use in critical care areas and other situations where the perceived advantages of a balanced electrolyte plasma substitute are likely to be clinically important. Note Not yet cleared for use in NUTH.

 
   
Gelatin (Volplex® or Gelofusine®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 4% succinylated gelatin infusion in sodium chloride 0.9% (500ml bags)
 
   
Tetrastarch (Tetraspan®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 6% & 10% tetrastarch infusions in a balanced electrolyte solution containing Na+ 140 mmol, K+ 4 mmol, Mg2+ 1 mmol, Cl- 118 mmol, Ca2+ 2.5 mmol, acetate 24 mmol, malate 5 mmol/litre.
    Contains calcium
 
   
Tetrastarch (Volulyte®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 6% tetrastarch infusion in a balanced electrolyte solution containing Na+ 137 mmol, K+ 4 mmol, Mg2+ 1.5 mmol, Cl110 mmol, acetate 34 mmol/litre.
    Contains calcium.
    • Mainly for use in indications where calcium containing fluids are unsuitable

 
   
Phoxilium 1.2mmol/l phosphate
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red
  • A haemofiltration and haemodialysis fluid containing Na+ 140 mmol, K+ 4 mmol, Mg2+ 0.6 mmol, Ca2+ 1.25mmol/l, Cl- 115.9 mmol/l, HCO3 - 30.0mmol/l, HPO4 2- 1.20mmol/l.
    • Approved for use in CRRT in patients not requiring reduced potassium or low bicarbonate.

 
   
09.03  Intravenous nutrition
 note 

Please contact Pharmacy for full details of Parenteral Nutrition Services

 

09.03  Supplementary preparations
09.04  Oral nutrition
09.04.01  Foods for special diets
09.04.02  Enteral nutrition to top
09.05  Minerals
09.05.01  Calcium and magnesium
09.05.01.01  Calcium supplements
Calcium Carbonate
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green
  • 1.25g chewable tablets (500mg, 12.6 mmol calcium).
  • 2.5g chewable tablets (1g, 25 mmol calcium).
  • 500mg in 5ml suspension unlicensedunlicensed.
 
Sandocal-1000®
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green
  • Sandocal 1000 tablets (calcium lactate gluconate, calcium carbonate & citric acid providing 1000mg, 25 mmol calcium).
 
Calcium 2.55mmol/5mL syrup
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
 
   
Calcium Chloride
View adult BNF View childrens BNF  Track Changes
Alternatives
Green plus
  • 5 mmol in 5ml & 10 mmol in 10ml injections.
  • 10% 10ml injection in syringes also used in some resuscitation boxes at Freeman Hospital - under review
 
   
Calcium Gluconate
View adult BNF View childrens BNF  Track Changes
Alternatives
Green plus
  • 10% 10ml injection (approx. 2.2mmol, 89mg calcium).
 
   
09.05.01.02  Hypercalcaemia and hypercalciuria
Disodium Pamidronate
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green
  • 30mg injection
 
Zoledronic Acid (Zometa®)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Red
  • 4mg injection
    For hypercalcaemia of malignancy and the prevention of skeletal events in patients with metastatic breast cancer. Prescribe by brand name (Zometa®) to avoid confusion with a different strength product used to treat osteoporosis and Paget’s disease
 
Cinacalcet
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
High Cost Medicine
  • Approved for the treatment of secondary hyperparathyroidism in patients with end stage renal disease on maintenance haemodialysis where parathyroid gland surgery has failed or is inappropriate. Red Traffic Light
  • Also for short term use to control symptoms prior to a second attempt at more definitive surgery. Red Traffic Light
  • Approved for patients with primary hyperparathyroidism (after January 2017Red Traffic Light
  • For use in existing patients with primary hyperparathyroidism (commenced prior to January 2017) for whom parathyroidectomy would be indicated based on serum calcium levels, symptoms and end – organ damage, but in whom parathyroidectomy is either not clinically appropriate or is contraindicated. It should be clearly documented as to why surgery is not an appropriate treatment option for the particular patient. Amber Traffic Light
 
Link  NICE TA117: Hyperparathyroidism - cinacalcet
   
Etelcalcetide (Parsabiv®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • 2.5mg/0.5ml, 5mg/1ml & 10mg/2ml solution for injection
  • Approved for the treatment of secondary hyperparathyroidism in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA448 Etelcalcetide for treating secondary hyperparathyroidism
   
Paricalcitol
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for use in patients with PTH levels < 800mcg/l but  whose treatment with alfacalcidol is restricted due to a high calcium level.
 
   
Calcitonin (Salmon®)
(Salcatonin)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
  • 400 units in 2ml injection - see section 6.6.1 for 200 units/dose nasal spray.
 
   
Sodium Clodronate
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green plus
  • 520mg & 800mg tablets
 
   
09.05.01.03  Magnesium to top
Magnesium Aspartate
View adult BNF View childrens BNF  Track Changes
Formulary
Green
  • 6.5g (10 mmol) sachets - first line for the treatment and prevention of magnesium deficiency.
  • 614.8mg (2.5mmol) tablets unlicensedunlicensed - for second line treatment in patients with short bowel syndrome.
 
   
Magnesium chloride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 10 mmol magnesium in 1 litre sodium chloride 0.9% with potassium chloride 0.15% (20 mmol) unlicensedunlicensed
  • 64mg sustained release tablets (2.6mmol magnesium) unlicensedunlicensed
 
   
Magnesium Glycerophosphate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 1g (4mmol) chewable tablets 
    • Use preparation with cheapest acquisition cost.
    • Yourmag®
    • Magnaphate® unlicensedunlicensed

  • 1mmol/ml suspension -available if supply problems with tablets unlicensedunlicensed.
 
   
Magnesium Sulphate
 Track Changes
Formulary
Red
  • 50% 2ml (4 mmol), 50% 10ml (20 mmol) & 10% 10ml (4mmol) injections 
  • 60 mmol in 500ml sodium chloride 0.9% infusion unlicensedunlicensed
 
   
09.05.02  Phosphorus
09.05.02.01  Phosphate supplements
Phosphate
(Solution)
View adult BNF View childrens BNF  Track Changes
Formulary
Red
  • 4.15 mmol phosphate in 10ml oral solution unlicensedunlicensed
 
   
Phosphate Polyfusor
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 500ml intravenous infusion containing 50mmol phosphate
    per 500ml (PO4 3- 100 mmol, K+ 19 mmol, and Na+ 162 mmol/litre).
 
   
Phosphate-Sandoz®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Effervescent tablets (phosphate 16.1 mmol, sodium 20.4mmol & potassium 3.1 mmol / tablet)
 
   
09.05.02.02  Phosphate-binding agents
Calcium Acetate (Phosex®, Renacet®)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green plus
  • Phosex® 1g tablets (containing 250mg, 6.2mmol of calcium) 
  • Renacet® 475mg (containing 120.25mg, 3mmol of calcium) &
    950mg tablets (containing 240.5mg, 6mmol of calcium)
 
Calcium Carbonate
View adult BNF View childrens BNF  Track Changes
Second Choice
Green
  • 1.25g & 2.5g chewable tablets (Calcichew)
    (Other formulations e.g. Remegel, Rennies, Rennie Soft gel and Settler’s.
    Tums are also stocked at the RVI for use in paediatric renal patients)
 
   
Osvaren®
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green plus
  • Tablets containing calcium acetate 435mg & Magnesium carbonate heavy 235mg.
  • For use, after calcium carbonate and calcium acetate, but before the
    much more expensive sevelamer and lanthanum.
 
   
Sevelamer Carbonate
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green plus
High Cost Medicine
  • 800mg f/c tablets.
  • 2.4g powder for oral suspension.

 
   
Sucroferric oxyhydroxide (Velphoro®)
View adult BNF View SPC online View childrens BNF  Track Changes
Third Choice
Green plus
High Cost Medicine
  • Approved for use by haemodialysis or peritoneal dialysis patients who cannot tolerate alternative phosphate binders or where these have been ineffective
 
   
Lanthanum (Fosrenol ®)
View adult BNF View SPC online View childrens BNF  Track Changes
Third Choice
Green plus
High Cost Medicine
 
   
09.05.03  Fluoride
Sodium Fluoride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Sodium fluoride 0.619% (75ml) toothpaste (Duraphat® 2800 ppm) prescription only medicine
  • Sodium fluoride 1.1% (51g) toothpaste (Duraphat® 5000 ppm) prescription only medicine
  • Sodium fluoride 0.05% mouthwash - approved for use within the dental hospital. 
 
   
09.05.04  Zinc to top
Zinc Sulphate (Solvazinc®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Zinc Sulphate 220mg capsules
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
09.05.05  Selenium
09.06  Vitamins
09.06.01  Vitamin A
Vitamin A
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • 20,000 unit injection - for the treatment of night blindness/ vitamin A deficiency as a result of malabsorption in patients with short bowel syndrome, ileal resection or pancreatic insufficiency unlicensedunlicensed.
 
   
Vitamins A and D
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Capsules containing vitamin A 4000 units, vitamin D 400 units
 
   
09.06.02  Vitamin B group
Pyridoxal Phosphate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 25mg tablets unlicensedunlicensed
  • 50mg capsules unlicensedunlicensed
 
   
Pyridoxine Hydrochloride
(Pyridoxine)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 10mg unlicensedunlicensed
  • 50mg tablets
 
   
Thiamine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 50mg & 100mg tablets
 
Link  NICE CG100: Management of alcohol-related physical complications
Link  NICE CG115: Alcohol dependence - diagnosis, assessment and management
   
Vitamin B & C injection (Pabrinex®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • IVHP injection (ascorbic acid 500mg, nicotinamide 160mg, pyridoxine
    hydrochloride 50mg, riboflavin 4mg & thiamine hydrochloride 250mg &
    1g anhydrous glucose / pair of ampoules) 
  • IMHP injection also used
 
Link  NICE CG100: Management of alcohol-related physical complications
Link  NICE CG115: Alcohol dependence - diagnosis, assessment and management
   
09.06.02  Oral vitamin B complex preparations to top
Vitamin B Tablets, Compound Strong
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Tablets (nicotinamide 20mg, pyridoxine hydrochloride 2mg, riboflavin 2mg & thiamine hydrochloride 5mg per tablet).
    • For short term use in refeeding syndrome only.

 
   
09.06.02  Other compounds
09.06.03  Vitamin C
Ascorbic Acid (Vitamin C)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 50mg, 100mg, 200mg & 500mg tabs
  • 500mg in 5ml injection unlicensedunlicensed
 
   
09.06.04  Vitamin D
Alfacalcidol
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 250 nanogram & 1 microgram capsules
  • 2 microgram/ml sugar-free oral drops – one drop containing approx. 100 nanograms of alfacalcidol 
  • 1 microgram in 0.5ml & 2 micrograms in 1ml injections
 
   
Colecalciferol
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 20microgram (800 units) capsules or tablets
    • For first line use in the long term maintenance treatment of patients with documented vitamin D deficiency following high strength therapy and also for use in patients with symptoms and insufficient levels. 
  • 500 microgram (20,000 units) capsules
    • For use in patients requiring high strength therapy for vitamin D deficiency. 
  • 2740iu/ml oral solution (Fultium®-D3 Drops) 
  • 1000iu and 3000iu buccal spray (DLux®) unlicensedunlicensed Red Traffic Light
    • Approved for use in paediatric parenteral nutrition patients with short bowel syndrome and adults with metabolic bone disease who have vitamin D deficiency despite previous treatment.
 
   
Colecalciferol 25,000 unit liquid (Invita D3® )
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary  
   
Ergocalciferol
(Calciferol)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 250 microg. (10,000 units) & 1.25mg (50,000 units) tablets.
    • A 3000 units in 1ml suspension (unlicensedunlicensed) may be supplied if colecalciferol oral solution is not available.

  • 7.5mg (300,000 units) in 1ml injection.
 
   
Calcium Carbonate 1.5g and Colecalciferol 10micrograms (400iu) (Accrete®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • First Choice combination
    • Film coated tablet containing calcium carbonate 1.5g and colecalciferol 10 micrograms (400 units)

 
   
Calcium Carbonate 1.5g and Colecalciferol 10micrograms (400iu) (Evacal®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Second Choice combination
    • Chewable tablet containing calcium carbonate 1.5g and colecalciferol 10 micrograms (400 units) approved as chewable option and also to be used in patients with peanut and soya allergy.

 
   
Calcium Phosphate 3.1g and Colecalciferol 20micrograms (800iu)  (Calfovit D3®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Second choice combination
    • Powder in sachets – calcium phosphate 3.1g (1.2g calcium) & Vitamin D3 800 units

 
   
Calcium and Ergocalciferol Tablets
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Second choice combination
    • Calcium lactate 300mg, calcium phosphate 150mg (Ca 97mg, 2.4 mmol) & ergocalciferol 10 micrograms (400 units).

 
   
09.06.05  Vitamin E
Alpha Tocopherol (Vedrop®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • 50mg in 1ml oral solution - approved for the treatrment of children with vitamin E deficiency due to fat malabsorption syndromes.
 
   
Alpha Tocopheryl Acetate
(Vitamin E)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • 500mg in 5ml suspension
  • 134mg (200 unit) capsules
 
   
09.06.06  Vitamin K to top
Phytomenadione
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green
  • 50 microgram in 0.25ml drops (NeoKay®) unlicensedunlicensed
  • 1mg capsule- preferred product for use in neonates
  • 10mg in 1ml injection unlicensedunlicensed
  • 2mg in 0.2ml mixed micelles injection (Konakion® MM
    Paediatric) – may be taken by mouth as well as being given by IM or IV injection
 
Menadiol Sodium Phosphate
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green
  • 10mg tablets - water soluble derivative of vitamin K for use in patients with fat malabsorption, especially in hepatic disease or biliary obstruction including cystic fibrosis patients.
 
   
09.06.07  Multivitamin preparations
Mutivitamins BPC
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green
  • Capsules containing ascorbic acid 15mg, nicotinamide 7.5mg, riboflavin 500 micrograms, thiamine HCl 1mg, vitamin A 2,500 units, & vitamin D 300 units
 
Dalivit®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Drops containing in each 0.6ml dose ascorbic acid 50mg, ergocalciferol
    400 units, nicotinamide 5mg, pyridoxine HCl 500 micrograms, riboflavin
    400 micrograms, thiamine 1mg & vitamin A 5,000 units)
    • Dalivit drops are to be retained for use in patients requiring a full supplement of vitamin A.

 
   
Healthy Start Vitamins
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • These formulations are prepared for the NHS and recommended in NICE guidance. DOH offers the Healthy Start Vitamins to pregnant women and children less than 4 years. They are only available through clinics and from midwives and are not prescribable on FP10 prescriptions
 
   
Abidec®
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green
  • Drops containing in each 0.6ml dose ascorbic acid 50mg, ergocalciferol
    400 units, nicotinamide 5mg, pyridoxine HCL 500micrograms, riboflavin
    400 micrograms, thiamine 1mg & vitamin A 1,333 units.
    To be used in children and adults.
 
   
09.06.07  Vitamin and mineral supplements and adjuncts to synthetic diets
DEKAs® Essentials multivitamins
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Approved for adult patients requiring multivitamin and mineral supplementation with Cystic Fibrosis
 
   
DEKAs® Plus multivitamins
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Approved for adult patients requiring multivitamin and mineral supplementation with Cystic Fibrosis
 
   
Forceval®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Capsules & junior capsules
    • For limited use as a vitamin and mineral supplement in patients with phenylketonuria The capsules are also approved as an oral supplement in burns patients with malnutrition or alcohol dependency and patients with major burns after discontinuation of IV therapy, and have also been approved for use in patients with severe anorexia nervosa. Treatment initiated with specialist advice.

  • Soluble
    • Approved for short term use in patients who are unable to swallow
      Forceval capsules.

 
   
Ketovite®
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
Renavit® tablets
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Water soluble vitamin supplementation therapy for maintenance haemodialysis patients only.
 
   
09.07  Bitters and tonics
09.08  Metabolic disorders
09.08.01  Drugs used in metabolic disorders to top
Ubiquinone (Coenzyme Q10, Ubidecarenone)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • 10mg, 30mg, & 100mg capsules 
  • 50mg in 5ml & 30mg in 1ml (150mg in 5ml) oral solution
    • nutritional supplement and antioxidant approved for use in the
      management of mitochondrial disorders.
    • approved for use under specialist consultant supervision in the
      management of patients with severe hyperlipidaemia who are not tolerating statins due to myopathy. Use in statin induced myopathy is subject to treatment being initiated by a consultant.

      Lipid clinic initiation only

 
   
Chenodexoycholic acid (Xenbilox®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • 250mg capsules
    • Approved for the treatment of Cerebrotendinous Xanthomatosis in line with NHS Commissioning Policy. NHS England will commission this drug for patients who are currently being treated (April 2017)
    • Approved for the treatment of inborn errors of bile acid synthesis (all ages) in line with NHS England Commissioning Policy
 
   
09.08.01  Wilsons disease
Penicillamine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 125mg & 250mg tablets - also used for the treatment ofcystinuria and rheumatoid arthritis – section 10.1.3
 
   
Trientine Dihydrochloride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
High Cost Medicine
  • 300mg capsules
    • Approved for the treatment of Wilsons disease in line with NHS England Commissioning Policy. NHS England will commission the treatment for patients who are currently being treated (April 2017)

 
   
Tiopronin
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Red
  • 500mg tablets - for use as 2nd line treatment for cystinuria in
    patients who fail to tolerate/respond to penicillamine unlicensedunlicensed.
 
   
09.08.01  Carnitine deficiency
Carnitine
(Levocarnitine)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • 30% oral solution
  • 1g in 5ml injection
 
   
09.08.01  Fabry's disease
Migalastat (Galafold ®)
 Track Changes
Formulary
Red
  • Approved for the treatment of Fabry's disease in line with NICE 
 
Link  Highly specialised technologies guidance HST4: Migalastat for treating Fabry disease
   
09.08.01  Gaucher's disease
Imiglucerase (Cerezyme®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • 400iu injection
 
   
09.08.01  Mucopolysaccharidosis I to top
Elosulfase alfa
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 5mg/5ml concentrate for solution for infusion -approved as a possible treatment for people with mucopolysaccharidosis type IV a (MPS IVa).
 
Link  NICE HST 2 - Elosulfase alfa for treating mucopolysaccharidosis type IVa
   
09.08.01  Pompe disease
09.08.01  Nephropathic cystinosis
Mercaptamine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
 
   
09.08.01  Urea cycle disorders
Sodium Phenylbutyrate
 Track Changes
Unlicensed Drug Unlicensed
Red
  • 500mg tablets - Licensed formulation marketed as Ammonaps
  • 1g in 5ml & 2g in 10ml injections
 
   
09.08.02  Acute porphyrias
09.08.02  Drugs unsafe for use in acute porphyrias to top
 ....
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