• 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 

• First Choice oral liquid iron preparation - 140mg in 5ml syrup (45mg iron/5ml).
• 210mg tablets (68mg iron/tablet).

300mg tablets (35mg iron)

• 190mg in 5ml sugar-free elixir (27.5mg iron/5ml).

• 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.

• 400 microgram and 5mg tablets
• 2.5mg in 5ml sugar-free syrup
• 15mg in 1ml injection unlicensed
• 30mg in 2ml injection

• For use in accordance with NICE and NHS England commissioning policies.

• 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
  
  

• 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

• 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.

• 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. 

• For the treatment of thrombocythemiaas a 2nd line agent in patients poorly/non-responsive tohydroxycarbamide therapy.

• For the treatment of adults with chronic immune (idiopathic) thrombocytopenia purpura in line with NICE.

• For the treatment of adults with chronic immune (idiopathic) thrombocytopenia purpura in line with NICE.

• Available as Neupogen (original brand) and Ratiograstim – a
  biosimilar product.

• 263 microgram (33.6 million units) injection vials

• 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.

• 600mg m/r tablets – (8 mmol potassium) 
  
  • For use where the effervescent tablets or syrup are unsuitable
  
  
• 5mmol in 5ml sugar-free syrup (Kay-Cee-L) 
• 1mmol in 1ml carbohydrate free oral solution  
  
  • Approved for use in children with intractable epilepsy being
    treated with a ketogenic diet.
  
  

• Powder (Calcium polystyrene sulphonate)

• Powder (Sodium polystyrene sulphonate)

• 600mg m/r tablets (Slow Sodium) - approx. 10 mmol sodium & chloride per tablet
• 1mmol / ml oral solution  
  
  • Treatment should only be initiated with the advice of a specialist.
  
  

• 500mg capsules (500mg contains approx. 6 mmol each ofsodium and bicarbonate)
• 1mmol/ml oral solution unlicensed

• Potassium chloride 0.3% (20mmol); sodium chloride 0.9%; and glucose 5% (500ml bag).
  
  • Approved for diabetic ketoacidosis in paediatric patients unlicensed.
  
  

• Approved for use by the North-East Assisted Ventilation Service (NEAVS).

• 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)

• 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)

• 5% IV infusion (100ml, 250ml, 500ml & 1000ml)
• 10% IV infusion (500ml & 1000ml)
• 20% IV infusion (500ml)
• 50% Injection (50ml)

• 15% injection  Restricted

• 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

• 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

• 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

• 17.42% injection  Restricted

• 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)

• 500ml & 1000ml

• 2ml, 5ml, 10ml, 20ml, 100ml & 500ml

• 1000ml

• 100ml

• 4.5% (50ml, 100ml & 500ml)
• 20% (50ml & 100ml)

• 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.
  
  

• 10%/0.9% 

• 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.
  
  

• 4% succinylated gelatin infusion in sodium chloride 0.9% (500ml bags)

• 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

• 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
  
  

• 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.
  
  

• 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

• 10% 10ml injection (approx. 2.2mmol, 89mg calcium).

• 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. 
• Also for short term use to control symptoms prior to a second attempt at more definitive surgery. 
• Approved for patients with primary hyperparathyroidism (after January 2017) 
• 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. 

• 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

• Approved for use in patients with PTH levels < 800mcg/l but  whose treatment with alfacalcidol is restricted due to a high calcium level.

• 400 units in 2ml injection - see section 6.6.1 for 200 units/dose nasal spray.

• 520mg & 800mg tablets

• 6.5g (10 mmol) sachets - first line for the treatment and prevention of magnesium deficiency.
• 614.8mg (2.5mmol) tablets unlicensed - for second line treatment in patients with short bowel syndrome.

• 10 mmol magnesium in 1 litre sodium chloride 0.9% with potassium chloride 0.15% (20 mmol) unlicensed
• 64mg sustained release tablets (2.6mmol magnesium) unlicensed

• 1g (4mmol) chewable tablets 
  
  • Use preparation with cheapest acquisition cost.
  • Yourmag®
  • Magnaphate® unlicensed
  
  
• 1mmol/ml suspension -available if supply problems with tablets unlicensed.

• 50% 2ml (4 mmol), 50% 10ml (20 mmol) & 10% 10ml (4mmol) injections 
• 60 mmol in 500ml sodium chloride 0.9% infusion unlicensed

• 4.15 mmol phosphate in 10ml oral solution unlicensed

• 500ml intravenous infusion containing 50mmol phosphate
  per 500ml (PO4 3- 100 mmol, K+ 19 mmol, and Na+ 162 mmol/litre).

• Effervescent tablets (phosphate 16.1 mmol, sodium 20.4mmol & potassium 3.1 mmol / tablet)

• 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)

• 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.

• 800mg f/c tablets.
• 2.4g powder for oral suspension.
  
  

• Approved for use by haemodialysis or peritoneal dialysis patients who cannot tolerate alternative phosphate binders or where these have been ineffective

• Sodium fluoride 0.619% (75ml) toothpaste (Duraphat® 2800 ppm) 
• Sodium fluoride 1.1% (51g) toothpaste (Duraphat® 5000 ppm) 
• Sodium fluoride 0.05% mouthwash - approved for use within the dental hospital. 

• 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 unlicensed.

• Capsules containing vitamin A 4000 units, vitamin D 400 units

• 25mg tablets unlicensed
• 50mg capsules unlicensed

• 10mg unlicensed
• 50mg tablets

• 50mg & 100mg tablets

• 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

• Tablets (nicotinamide 20mg, pyridoxine hydrochloride 2mg, riboflavin 2mg & thiamine hydrochloride 5mg per tablet).
  
  • For short term use in refeeding syndrome only.
  
  

• 50mg, 100mg, 200mg & 500mg tabs
• 500mg in 5ml injection unlicensed

• 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

• 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®) unlicensed 
  
  • 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.

• 250 microg. (10,000 units) & 1.25mg (50,000 units) tablets.
  
  • A 3000 units in 1ml suspension (unlicensed) may be supplied if colecalciferol oral solution is not available.
  
  
• 7.5mg (300,000 units) in 1ml injection.

• First Choice combination
  
  • Film coated tablet containing calcium carbonate 1.5g and colecalciferol 10 micrograms (400 units)
  
  

• 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.
  
  

• Second choice combination
  
  • Powder in sachets – calcium phosphate 3.1g (1.2g calcium) & Vitamin D3 800 units
  
  

• Second choice combination
  
  • Calcium lactate 300mg, calcium phosphate 150mg (Ca 97mg, 2.4 mmol) & ergocalciferol 10 micrograms (400 units).
  
  

• 50mg in 1ml oral solution - approved for the treatrment of children with vitamin E deficiency due to fat malabsorption syndromes.

• 500mg in 5ml suspension
• 134mg (200 unit) capsules

• 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.

• 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.
  
  

• 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

• 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.

• Approved for adult patients requiring multivitamin and mineral supplementation with Cystic Fibrosis

• Approved for adult patients requiring multivitamin and mineral supplementation with Cystic Fibrosis

• 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.
  
  

• Water soluble vitamin supplementation therapy for maintenance haemodialysis patients only.

• 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
  
  

• 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)
  
  

• 125mg & 250mg tablets - also used for the treatment ofcystinuria and rheumatoid arthritis – section 10.1.3

• 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)
  
  

• 500mg tablets - for use as 2nd line treatment for cystinuria in
  patients who fail to tolerate/respond to penicillamine unlicensed.

• 30% oral solution
• 1g in 5ml injection

• Approved for the treatment of Fabry's disease in line with NICE 

• 400iu injection

• 5mg/5ml concentrate for solution for infusion -approved as a possible treatment for people with mucopolysaccharidosis type IV a (MPS IVa).

• 500mg tablets - Licensed formulation marketed as Ammonaps
• 1g in 5ml & 2g in 10ml injections