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 Formulary Chapter 13: Skin - Full Chapter
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13.02  Emollient and barrier preparations
13.02.01  Emollients
Cetraben®
(cream/ointment)
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Formulary
Green

note Consider ExCetra cream as more cost effective alternative to Cetraben cream

Ointment also suitable for use as a soap substitute or as bath additive.

 
   
Diprobase®
(ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Doublebase®
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Consider Isomol or Zerodouble as more cost effective alternatives.

May also be applied before washing, showering or bathing.

 
   
Emulsifying Ointment
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Formulary
Green
 
   
Epimax®/ Diprobase ®
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Also suitable for use as soap substitute.

Epimax first line choice as more cost effective.

 

 
   
Epimax®/ Epaderm®/ Hydromol®
(ointment)
View adult BNF View childrens BNF
Formulary
Green

note Epimax ointment 1st line as more cost effective option and same active ingredients as Epaderm.

For use as emollient/bath additive or as barrier cream.

 
   
ExCetra®
(cream)
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Formulary
Blue

note Similar to Cetraben cream

 
   
Isomol®/Zerodouble®
(gel)
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Formulary
Blue

note Also suitable for use as a soap substitute.

Similar to Doublebase gel.

 
   
Liquid paraffin, white soft paraffin 50/50
(ointment)
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Formulary
Green

note Preservative and fragrance free.

Very greasy.

 
   
Lubricating jelly
Formulary
Green
 
   
Propylene glycol in aqueous cream
(20% w/w)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014.

unlicensed Unlicensed. 

Restricted Item Dermatology recommendation only.

Use when urea based products are ineffective, unsuitable or not tolerated.

Can also be used as a barrier cream

 
   
Unguentum M®
(cream)
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Formulary
Green

note Consider Zeroguent as a more cost effective alternative

 
   
White Soft Paraffin
(ointment)
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Formulary
Green
 
   
ZeroAQS®
(cream)
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Formulary
Blue

note Similar to aqueous cream but does not contain SLS. Suitable for use as leave-on emollient or soap substitute.

 
   
Zerobase®
(cream)
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Formulary
Blue

Similar to Diprobase cream

 
   
Zerocream ®
(cream)
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Formulary
Blue

note Also suitable for use as a soap substitute.

Similar to E45 cream.

 
   
Zeroderm®
(ointment)
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Formulary
Blue

note Also suitable for use as a soap substitute or bath additive.

Similar to Epaderm ointment.

 
   
Zeroguent®
(cream)
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Formulary
Blue

note Similar to Unguentum M cream

 
   
Epimax Paraffin-free
(ointment)
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Restricted Drug Restricted
Green

Restricted Item For use only in patients intolerant to paraffin-containing products.

Note: MHRA safety warnings re: fire risks also apply to paraffin-free emollients.

 
   
Aqueous Cream
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green

note Not recommended by dermatology specialists. Consider alternative emollients, e.g. ZeroAQS (does not contain SLS).

 
Link  MHRA Drug Safety Update March 2013: Aqueous cream may cause skin irritation
Link  Patient information: Aqueous cream may cause skin irritation
   
13.02.01  Emollients - preparations containing urea
Urea 10%
(cream)
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Formulary
Amber Recommended

e.g. Eucerin Intensive® , Calmurid®

 
   
Urea 25% (Dermatonics Once®)
(Heel Balm)
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Formulary
Green

For use in podiatry only

 
   
Urea 25% (Allpresan® Diabetic)
(foam cream)
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Formulary
Blue

For use in podiatry only

 
   
13.02.01  Emollients - with antimicrobials
Dermol®
(500 lotion/cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Note: Contains an antimicrobial. Not recommended for long term use.

Also suitable for use as a soap substitute.

 
   
Emulsiderm® Emollient
(bath additive)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Not a first line bath additive. Contains antimicrobial.

 
   
13.02.01.01  Emollient bath and shower preparations to top
Dermalo®
(bath additive)
View adult BNF View SPC online View childrens BNF
First Choice
Green

note First line bath emollient. Fragrance-free.

Also suitable for application to skin after showering.

 
Hydromol®
(bath and shower emollient)
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Formulary
Green

note Fragrance-free.

 
   
Oilatum® Emollient
(bath additive)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Contains fragrance.

Consider Zerolatum as more cost-effective alternative.

 
   
Zerolatum® Emollient
(bath additive)
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Formulary
Blue

note Fragrance-free. Similar to Oilatum bath additive.

 
   
13.02.02  Barrier preparations
Zinc and Castor Oil
(ointment)
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First Choice

First line barrier preparation

 
LBF® Sterile Barrier Film
(applicator/ cream)
Formulary
Green

Refer to Wound Formulary for further details

 
Link  NHS Southern Health Wound Formulary
   
Metanium®
(ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Restricted Item At UHS, second line barrier preparation - for Critical Care and Child Health only

 
   
Sudocrem®
(cream)
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Formulary
Green
 
   
Drapolene®
(cream)
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Formulary
Green
 
   
13.03  Topical local anaesthetics and antipruritics
Calamine BP
(lotion)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Crotamiton
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note For itch after scabies

 
   
Menthol 0.5% in aqueous cream
(cream)
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Formulary
Amber Recommended

note Prescribe by brand name in primary care to avoid specials dispensing (e.g. Arjun®, Dermacool®)

 
   
13.04  Topical corticosteriods.
Hydrocortisone 0.5% & 1%
(cream/ointment)
View adult BNF View SPC online View childrens BNF
First Choice
Green
 
Betamethasone dipropionate 0.05% with salicylic acid 2% (Diprosalic®)
(scalp application)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Betamethasone dipropionate 0.05% with salicylic acid 3% (Diprosalic®)
(ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Betamethasone valerate 0.025% (Betnovate-RD®)
(cream/ointment)
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Formulary
Green
 
   
Betamethasone valerate 0.1%
(cream/ointment)
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Formulary
Green
 
   
Betamethasone valerate 0.1% (Betacap®)
(scalp application)
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Formulary
Green
 
   
Betamethasone valerate 0.1% with fusidic acid 2% (Fucibet®)
(cream)
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Formulary
Green

note For short-term use

 
   
Betamethasone valerate 0.1% with neomycin 0.5%
(cream/ointment)
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Formulary
Green

note For short-term use

 
   
Clobetasol propionate 0.05%
(cream/ointment)
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Formulary
Green
 
   
Clobetasol propionate 0.05% with neomycin and nystatin
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Prescribe as generic - Dermovate-NN brand discontinued

 
   
Clobetasone butyrate 0.05% (Eumovate®)
(cream/ointment)
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Formulary
Green
 
   
Clobetasone butyrate 0.05% with oxytetracycline 3% and nystatin (Trimovate®)
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Restricted Item Not usually a first-line treatment option. For short-term use only in accordance with product licence (refer to SPC) for treatment of steroid responsive dermatoses where candidal and/or bacterial infection is present, suspected or likely to occur.

Note: nystatin is not effective against dermatophytes and risk of resistance with overuse of topical antibiotics.

 

Black Not supported locally for off label use in chronic wound management (see below)

 
   
Diflucortolone valerate 0.3% (Nerisone Forte®)
(oily cream)
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Formulary
Amber Recommended
 
   
Fludroxycortide
(tape)
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Formulary
Amber Recommended

note Prescribe as generic - Haelan brand discontinued Sept 2016

 
   
Fluticasone propionate 0.005% (Cutivate®)
(ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Fluticasone propionate 0.05% (Cutivate®)
(cream)
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Formulary
Amber Recommended
 
   
Hydrocortisone 1% with clotrimazole 1% (Canesten HC®)
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note For short-term use

 
   
Hydrocortisone 1% with fusidic acid 2% (Fucidin H®)
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note For short-term use

 
   
Hydrocortisone 1% with miconazole 2% (Daktacort®)
(cream/ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note For short-term use

 
   
Hydrocortisone butyrate 0.1% (Locoid®)
(cream/ointment)
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Formulary
Amber Recommended
 
   
Mometasone furoate 0.1%
(cream/ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Salicylic acid 5%, with propylene glycol 47.5% in clobetasol propionate 0.05% (Dermovate®)
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Restricted Item Dermatology recommendation only

note Refer to British Association of Dermatologists Specials List 2014 for further details

unlicensed unlicensed

 
   
Tri-Adcortyl®
(ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Red

note Contains triamcinolone, gramicidin, neomycin and nystatin 

Restricted Item ENT only

unlicensed unlicensed

 
   
13.04  Topical corticosteriod preparation potencies
13.05  Preparations for eczema and psoriasis to top
Coconut oil 25%
(in emulsifying ointment)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Salicylic acid 2% & sulphur 2%
(in aqueous cream)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Salicylic acid 2%/5%/10%/20%
(in emulsifying ointment)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014.

unlicensed Unlicensed

 
   
Zinc and salicylic acid (Lassar's paste, half strength)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

Where other barrier treatments ineffective

 
   
Zinc and salicylic acid BP (Lassar's paste)
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Formulary
Green
 
   
13.05.01  Preparations for eczema
Alitretinoin
(caps)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Restricted Item Specialist prescribing only.

Routinely reimbursed by CCG if NICE TA177 eligibility criteria fulfilled.

IFR application required for exceptional use.

 
Link  NICE TA177 - Alitretinoin for severe chronic hand eczema
   
Ichthammol 1% & zinc oxide 15%
(in yellow soft paraffin)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Ichthammol glycerin BPC
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Zinc paste and ichthammol (Ichthopaste)
(bandage)
Formulary
Amber Recommended
 
   
13.05.02  Preparations for psoriasis
Dimethyl fumarate (Skilarence®)
(gastro-resistant tab)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA475: Dimethyl fumarate for moderate to severe plaque psoriasis
   
Fumaric acid esters (Fumaderm® )
(tab)
Formulary
Red

Restricted Item Dermatology only; for psoriasis

unlicensed Unlicensed

 
   
Methoxypsoralen
(tab/gel/paint/bath lotion)
Formulary
Red

Restricted Item Dermatology only - for PUVA

unlicensed Unlicensed

 
   
13.05.02  Topical preparations for psoriasis
Cade oil & salicylic acid
(in emulsifying ointment )
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Calcipotriol 50mcg/g
(ointment)
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Formulary
Green
 
   
Calcipotriol with betamethasone
(ointment/gel/foam)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Coal tar (Psoriderm®)
(bath emulsion, cream)
View adult BNF View SPC online View childrens BNF
Formulary
Blue
 
   
Coal tar 5% (Exorex®)
(emulsion)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Coal tar BP
(in yellow soft paraffin)
Formulary
Amber Recommended

2%, 5% and 10%

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Coal tar solution BP 3.3% with propylene glycol 20%
(in Synalar® gel)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Coal tar solution BP 5%
(in 0.025% betamethasone valerate ointment)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Coal tar solution BP 6% & salicylic acid 2% (Coal tar Scalp Pomade)
(in emulsifying ointment)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Coal tar solution BP 6% & salicylic acid 6%
(in Unguentum M cream)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Coal tar, salicylic acid & sulphur (Sebco ®)
(scalp ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Crude coal tar in white soft paraffin
Formulary
Amber Recommended
 
   
Dithranol
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note For short term use

 
   
Dithranol in Lassar's Paste
(0.1%, 0.5%, 1%, 2%, 4%, 8%, 10% & 15%)
Formulary
Red

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Tacalcitol (Curatoderm®)
(ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
13.05.02  Oral retinoids for psoriasis
Acitretin
(caps)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Specialist prescribing only

 
   
13.05.03  Drugs affecting the immune response to top
Adalimumab/ adalimumab biosimilar (Humira®, Imraldi®, Amgevita®) (dermatology)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

note Specify brand.

Restricted Item Specialist centres only for moderate to severe hidradenitis suppurativa - commissioned by NHS England in accordance with NICE TA392.

Amgevita and Imraldi are black triangle

 
Link  NICE TA146: Adalimumab for adults with psoriasis
Link  NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for plaque psoriasis in children and young people
   
ApremilastBlack Triangle
(tab)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA419: Apremilast for moderate to severe plaque psoriasis
   
Cytotoxic Drug Azathioprine (dermatology)
(tab)
View adult BNF View SPC online View childrens BNF
Formulary
Amber SCG
 
Link  Shared Care Guideline for Azathioprine or Mercaptopurine (GP summary)
   
Brodalumab
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA511:Brodalumab for treating moderate to severe plaque psoriasis
   
Certolizumab pegol (Cimzia®)
(dermatology) (injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA574: Certolizumab pegol for treating moderate to severe plaque psoriasis
   
Ciclosporin (dermatology)
(caps/oral liq)
View adult BNF View SPC online View childrens BNF
Formulary
Amber SCG

Prescribe by brand name

 
Link  Shared Care Guideline for Ciclosporin (GP Summary)
   
Diphenylcyclopropenone in acetone 0.00001-6.0% w/v
Formulary
Red

Restricted Item Dermatology only

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

Red Triangle Topical immunotherapy - highly sensitising. To be applied only by trained professionals. Wear gloves when handling.

 
   
DupilumabBlack Triangle (Dupixent®) (dermatology)
(subcutaneous injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
NHS England
CCG
BlueTeq

Restricted Item Specialist use only for atopic dermatitis in eligible adult patients (see NICE TA534) - commissioned by CCGs.

Commissioned by NHS England for adolescent patients 12 to 18 years if the patient is seen within a specialist treatment centre (e.g. specialised paediatric dermatology and/or paediatric allergy) and meets the criteria set out in NICE TA534. Also available via MHRA EAMS for patients aged 6 to 11 years with severe atopic dermatitis who are candidates for systemic therapy and where existing therapies are not advisable. Note: use in children <12 years is off label. Paediatric patients must be registered via Blueteq.

 

 

Red Triangle Currently non-formulary for severe asthma (awaiting NICE TA guidance - due Jan 2021)

 
Link  NICE TA534: Dupilumab for treating moderate to severe atopic dermatitis
   
Etanercept/etanercept biosimilar (Enbrel®, Benepali®, Erelzi®) (dermatology)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

note Specify brand.

Benepali and Erelzi are black triangle

 
Link  NICE TA103: Efalizumab and etanercept for adults with psoriasis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for plaque psoriasis in children and young people
   
Guselkumab
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA 521: Guselkumab for treating moderate to severe plaque psoriasis
   
Hydroxychloroquine (dermatology)
(tab)
View adult BNF View SPC online View childrens BNF
Formulary
Amber SCG

Restricted Item Supported only for use in indications detailed in Shared Care guidelines.

Not for use in Covid-19 treatment/prevention outside of clinical trials (see links below). Seek further advice from infection control specialist/pharmacy team.

 
Link  Shared Care Guideline for Hydroxychloroquine (GP Summary) May 2017
Link  EMA statement: COVID-19: chloroquine and hydroxychloroquine only to be used in clinical trials or emergency use programmes April 2020
Link  MHRA Advice March 2020: Do not use hydroxychlorquine or chloroquine for Covid-19 treatment except within a clinical trial
Link  NHS England/UK Chief Medical Officers’ joint letter: Novel coronavirus: clinical trials April 2020
Link  NPA Advice for Pharmacists on sales or supply of chloroquine/hydroxychloroquine for Covid-19 treatment/prevention
   
Infliximab/infliximab biosimilar (dermatology)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

note Specify brand (e.g. Remicade®, Remsima®, Inflectra®, Flixabi®, Zessly®)

 
Link  NICE TA134: Infliximab for adults with psoriasis
   
IxekizumabBlack Triangle (Taltz®)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA442 : Ixekizumab for moderate to severe plaque psoriasis
   
Cytotoxic Drug Mercaptopurine (dermatology)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber SCG

unlicensed 10mg tablets unlicensed

 
Link  Shared Care Guideline for Azathioprine or Mercaptopurine (GP Summary)
   
Cytotoxic Drug Methotrexate (dermatology)
(tab/injection)
View adult BNF View SPC online View childrens BNF
Formulary
Amber SCG

note Once weekly.

 
Link  National Patient Safety Agency: Improving compliance with oral methotrexate
Link  Shared Care Guideline for Methotrexate (GP summary)
   
Mycophenolate sodium (mycophenolic acid) (dermatology)
(tab)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Dermatology only

unlicensed Off label use

 
   
Pimecrolimus (Elidel®)
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
Link  NICE TA82: Tacrolimus and pimecrolimus for atopic eczema
   
SecukinumabBlack Triangle (Cosentyx®) (dermatology)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA350: Secukinumab for moderate to severe plaque psoriasis
   
Tacrolimus
(ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

0.03% and 0.1%

 
Link  MHRA Drug Safety Update: Tacrolimus ointment (Protopic): possible risk of malignancies including lymphomas and skin cancers
Link  NICE TA82: Tacrolimus and pimecrolimus for atopic eczema
   
TildrakizumabBlack Triangle (Ilumetri®)
(dermatology) (injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA575: Tildrakizumab for treating moderate to severe plaque psoriasis
   
Ustekinumab (Stelara®) (dermatology)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

note 45mg, 90mg injections (130mg not licensed for dermatology indications).

 
Link  NICE TA180: Ustekinumab for moderate to severe psoriasis
Link  NICE TA455 : Adalimumab, etanercept and ustekinumab for plaque psoriasis in children and young people
   
13.06  Acne and rosacea
13.06.01  Topical preparations for acne and rosacea
13.06.01  Benzoyl peroxide and azelaic acid
Benzoyl Peroxide
(gel)
View adult BNF View SPC online View childrens BNF
First Choice
Green

Self Care Self Care Medicine

 
Azelaic acid 20% (Skinoren®)
(cream)
View adult BNF View SPC online View childrens BNF
Alternatives
Green

note Alternative if benzoyl peroxide not tolerated

 
   
13.06.01  Topical antibacterials for acne
Clindamycin 1%
(topical solution/gel)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Clindamycin 1% and tretinoin 0.025%
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Clindamycin with benzoyl peroxide  (Duac® Once Daily)
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Erythromycin 2% with isotretinoin 0.05%
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
13.06.01  Topical retinoids and related preparations for acne to top
Adapalene 0.1%
(gel/cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Adapalene and benzoyl peroxide (Epiduo®)
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note  Mild to moderate papulopustular acne: Epiduo 0.1% gel (adapalene 0.1%/benzoyl peroxide 2.5%)

note  Moderate to severe papulopustular acne: Epiduo 0.3% gel (adapalene 0.3%/benzoyl peroxide 2.5%)

 
   
13.06.01  Other topical preparations for acne and rosacea
Brimonidine
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note For patients with rosacea who have failed to respond to, or are intolerant of, other options, or have psychological distress due to persistent redness.

 
Link  MHRA Drug Safety Update: Brimonidine gel - risk of exacerbation of rosacea
Link  MHRA Drug Safety Update: Brimonidine gel - risk of systemic cardiovascular effects; not to be applied to damaged skin
   
Ivermectin
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note First line option for papulopustular rosacea

 
   
13.06.02  Oral preparations for acne
13.06.02  Oral antibiotics for acne
Lymecycline
(caps)
View adult BNF View SPC online View childrens BNF
First Choice
Green
 
Oxytetracycline
(tablets)
View adult BNF View SPC online View childrens BNF
First Choice
Green
 
Doxycycline
(caps/dispersible tab)
View adult BNF View SPC online View childrens BNF
Formulary
Green

noteDispersible tabs only if patient cannot swallow caps.

Second-line to oxytetracycline/lymecycline for acne.

 
   
Erythromycin
(tab/liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Not a first-line option in acne.

 
   
13.06.02  Hormone treatment for acne
Co-cyprindiol
(tab)
View adult BNF View SPC online View childrens BNF
Formulary
Blue
 
   
13.06.02  Oral retinoid for acne to top
Isotretinoin
(cap)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Hospital only

 
Link  MHRA Drug Safety Update: Isotretinoin - rare reports of erectile dysfunction and decreased libido
   
13.07  Preparations for warts and calluses
Salicylic acid
(ointment/topical paint)
View adult BNF View childrens BNF
First Choice
Green

note May be purchased OTC. 

For palmar/plantar warts, corns, calluses.

 
Camellia sinensis (green tea) leaf extract (Catephen 10% ®)
(ointment)
View adult BNF View SPC online
Formulary
Red

Restricted Item For use by sexual health clinics (Solent NHS Trust) ONLY

For the cutaneous treatment of external genital and perianal warts in immunocompetent patients (adults) when other treatments have failed

 
   
Diphenylcyclopropenone in acetone 0.00001-6.0% w/v
Formulary
Red

Restricted Item Dermatology only

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

Red Triangle Topical immunotherapy - highly sensitising. To be applied only by trained professionals. Wear gloves when handling.

 
   
Formaldehyde 0.75% (Veracur®)
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Imiquimod 5%
(cream in single-use sachets)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

For anogenital warts.

Restricted Item Not supported for treatment of actinic keratoses.

 
   
Podophyllin Compound Paint BP
View adult BNF View childrens BNF
Formulary
Amber Recommended

note Contains podophyllum resin 0.15% w/v.

 
Link  Summary of Product Characteristics
   
Podophyllotoxin 0.15%
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Podophyllotoxin 0.5%
(topical solution)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Salicylic acid
(in emulsifying ointment)
Formulary
Amber Recommended

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Salicylic acid with lactic acid (Salactol®)
(topical paint)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

note May be purchased OTC

For palmar/plantar warts, corns, calluses.

 
   
Silver nitrate ('caustic')
(pencil/stick)
Formulary
Green
 
   
13.08  Sunscreens and camouflagers
13.08.01  Sunscreen preparations
Dundee reflectant sunscreens
(coffee, coral, pink, beige)
Formulary
Amber Recommended

Restricted Item Dermatology recommendation only

note From British Association Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Sunsense ® Ultra (SPF 50+)
(suncream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Borderline substance (ACBS).

 
   
Uvistat ® (SPF 30)
(suncream)
Formulary
Green

Borderline substance (ACBS).

 
   
13.08.01  Photodamage
Cytotoxic Drug Fluorouracil 5% (Efudix®)
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Treatment of choice for actinic keratoses - recommended by Community Dermatology services (see guidance here).

 
   
Cytotoxic Drug Fluorouracil and salicylic acid  (Actikerall®)
(solution)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Methyl aminolevulinate (Metvix®)
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Dermatology only

 
   
5-Aminolaevulinic acid (Ameluz®)
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Dermatology only

 
   
13.08.02  Camouflagers to top
Camouflage cosmetics
Formulary
Amber Recommended

Restricted Item As advised by specialist service.

Borderline substances (ACBS).

 
   
Hydroquinone 5%, hydrocortisone 1% and tretinoin 0.1% (Pigmanorm®)
(cream)
Formulary
Red

unlicensed Unlicensed

Restricted Item Dermatology only.

 
   
13.09  Shampoos and other preparations for scalp and hair conditions
Capasal® Therapeutic
(shampoo)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Salicylic acid 0.5% w/w; coconut oil 1% w/w; distilled coal tar 1% w/w.

 
   
Cetrimide and undecenoic acid (Ceanel Concentrate®)
(shampoo)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Coal tar 4% (Polytar®)
(scalp shampoo)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Coal tar extract 5% (alcoholic) (Alphosyl 2 in 1®)
(shampoo)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Ketoconazole 2%
(shampoo)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
13.09  Hirsutism
Eflornithine (Vaniqa®)
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

note Only when other available options are inappropriate or ineffective

 
   
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%
(cream/ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Silver sulfadiazine 1% (Flamazine®)
(cream)
View adult BNF View childrens BNF
Formulary
Green

note For infected burns and ulcers

 
   
13.10.01.02  Antibacterial preparations also used systemically
Fusidic acid 2%
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Metronidazole 0.75%
(gel)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

note Dermatology initiation for acute exacerbation of rosacea.

Also for fungating tumours.

 
   
Sodium fusidate 2% (Fucidin®)
(ointment)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
13.10.02  Antifungal preparations
Amorolfine 5%
(nail lacquer)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

note For mild, distal fungal nail injections in up to 2 nails.

Can be purchased OTC (Pharmacy only).

 
   
Clotrimazole 1%
(cream/solution/powder)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Can be purchased OTC.

 
   
Ketoconazole 2%
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Miconazole 2%
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Can be purchased OTC.

 
   
Terbinafine 1%
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Can be purchased OTC for athlete's foot or Dhobie itch/jock itch.

 
   
13.10.03  Antiviral preparations
Aciclovir 5%
(cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note Can be purchased OTC for cold sores.

 
   
13.10.04  Parasiticidal preparations to top
Dimeticone
(lotion/cutaneous solution)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note For head lice.

Self Care Self Care Medicine. Can be purchased OTC (e.g. Hedrin®).

 
   
Ivermectin
(tablets)
View adult BNF View childrens BNF
Formulary
Red

Restricted Item  On microbiology advice only

unlicensed Unlicensed

 
   
Malathion 0.5%
(aqueous liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note For head and pubic lice. Second line option for scabies.

Self Care Self Care Medicine. Can be purchased OTC (e.g. Derbac-M®).

 
   
Permethrin 5%
(dermal cream)
View adult BNF View SPC online View childrens BNF
Formulary
Green

note First line for scabies. 

Self Care Self Care Medicine. Can be purchased OTC.

 
   
13.10.05  Preparations for minor cuts and abrasions
Magnesium sulfate paste BP
Formulary
Green
 
   
Proflavine 0.1%
(cream)
Formulary
Green
 
   
13.10.05  Collodion
Flexible collodion BP
Formulary
Green
 
   
13.11  Skin cleansers, antiseptics, and desloughing agents
Didecyldimonium chloride 1% wash (Stellisep med)
(lotion)
Formulary
Green

From NHS logistics

 
   
Octenidine 0.3%  (Octenisan®)
(lotion)
Formulary
Green

From NHS logistics

 
   
13.11.01  Alcohols and saline
Acetone BP
Formulary
Green
 
   
Alcohol 70%
(gel)
Formulary
Green

From NHS Logistics.

 
   
Industrial Methylated Spirit 70%/95% (IMS)
Formulary
Green
 
   
Isopropyl alcohol 70%
(swabs/wipes)
Formulary
Green
 
   
Sodium chloride 0.9%  (Normal saline)
(sterile solution)
Formulary
Green

note For wound irrigation. 

Refer to Wound Formulary for further details.

 
   
13.11.02  Chlorhexidine salts to top
Chlorhexidine
(hand rub)
Formulary
Green

From NHS Logistics.

 
   
Chlorhexidine gluconate 0.05%
(sterile solution)
Formulary
Green

From NHS Logistics.

 
   
Chlorhexidine gluconate 0.5%
(alcoholic solution)
Formulary
Green

From NHS Logistics.

 
   
Chlorhexidine gluconate 1%
(obstetric cream)
Formulary
Green
 
   
Chlorhexidine gluconate 4%
(surgical scrub)
Formulary
Green

From NHS Logistics

 
   
13.11.03  Cationic surfactants and soaps
Chlorhexidine and cetrimide
(1litre bottles)
Formulary
Green
 
   
Chlorhexidine and cetrimide (Tisept®)
(solution in sachets)
Formulary
Green

From NHS Logistics.

 
   
13.11.04  Iodine and Chlorine
Iodine alcoholic solution BP
Formulary
Green
 
   
Iodine aqueous solution BP
Formulary
Green
 
   
Povidone iodine 10%
(alcoholic solution)
Formulary
Green

From NHS Logistics.

 
   
Povidone iodine 10%
(aqueous solution)
Formulary
Green

From NHS Logistics.

 
   
Povidone iodine 2.5%
(dry powder spray)
Formulary
Green
 
   
Povidone iodine 7.5%
(surgical scrub)
Formulary
Green

From NHS Logistics.

 
   
13.11.05  Phenolics
13.11.06  Oxidisers, and dyes
Eosin 2%
(solution)
Formulary
Red

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
Hydrogen peroxide 10 Vol (3%)
(sterile solution)
View adult BNF View childrens BNF
Formulary
Green
 
   
Hydrogen peroxide BP
(solution)
View adult BNF View childrens BNF
Formulary
Green

10 Vol (3%)

20 Vol (6%)

 
   
Potassium permanganate (Permitabs®)
(400mg tablet to prepare topical solution)
View adult BNF View childrens BNF
Formulary
Green

Red Triangle Should be dispensed in original container (i.e. as whole pack) only (see safety bulletin on risks of accidental ingestion below).

 
Link  Medicines Safety Bulletin: Risk of death or serious harm from accidental ingestion of potassium permanaganate preparations
Link  UKMi Medicines Q&A: What is the evidence for the use of potassium permanganate preparations?
   
13.11.07  Desloughing agents to top
Sterile larvae  (Maggots)
Formulary
Red

Restricted Item Specialist use only

 
   
13.11.07  Desloughing agents
13.12  Antiperspirants
Aluminium chloride hexahydrate 20%
(alcoholic solution in a roll-on bottle)
View adult BNF View SPC online View childrens BNF
First Choice
Green

Self Care Self Care Medicine. Can be purchased OTC.

 
Propantheline bromide (Pro-Banthine®)
(tablets)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

note For hyperhidrosis (licensed indication), or consider oxybutynin or trospium (off-label).

 
   
Botulinum toxin type A
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Restricted Item Dermatology only. For severe hyperhidrosis.

 
Link  DPC Agreed Indications Botulinum Toxin (September 2013)
   
Glycopyrronium (glycopyrrolate) 0.05%
(aqueous topical solution)
Formulary
Amber Initiation

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

Restricted Item Dermatology only - for use in iontophoresis, second-line to tap water. To be initiated in secondary care.

 
   
Glycopyrronium (glycopyrrolate) 2% (Formula A)
(in cetomacrogol cream)
Formulary
Red

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

Restricted Item Dermatology only.

 
   
13.14  Miscellaneous
Plaster remover
Formulary
Green
 
   
Sugar Paste (thick)
Formulary
Amber Recommended
 
   
Tacrolimus
(in Orabase® paste)
Formulary
Red

0.1% and 0.3%

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

 
   
 ....
 Non Formulary Items
Clobetasone butyrate 0.05% with oxytetracycline 3% and nystatin  (Trimovate®)
(cream)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Non formulary for chronic wound management as per DPC decision

Link  DPC Update October 2018
 
Colloidal/natural oatmeal
(cream)

View adult BNF View SPC online View childrens BNF
Non Formulary

e.g. Aveeno®/Zeroveen®/Aproderm Oatmeal®/Epimax® Oatmeal

 
Dermol® 200
(shower emulsion)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dermol® 600
(bath additive)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dermol® Wash
(cutaneous emulsion)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
E45®
(bath oil/ wash cream)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
E45®
(cream)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Emollient shower products

Non Formulary
Black

(all brands except Hydromol)

 
Erythromycin and zinc acetate  (Zineryt®)
(cutaneous solution)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Eucerin® Anti-redness
(cream)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
 
Finasteride  (Propecia®)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Hydromol ®
(cream)

View adult BNF View childrens BNF
Non Formulary

Ointment is formulary (green)

 
Ingenol mebutate Black Triangle  (Picato®)
(gel)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Discontinued by manufacturers following EMA safety review.

Link  Jan 2020: Class 2 Medicines Recall LEO Laboratories Ltd, Picato 150 mcg/g gel
Link  Jan 2020: EMA suspends Picato while review of skin cancer risk continues
Link  MHRA Drug Safety Update Oct 2019: Ingenol mebutate gel (Picato): increased incidence of skin tumours seen in some clinical studies
 
Minoxidil  (Regaine®)
(scalp solution/foam)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Other scalp preparations  (Cocois®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Permethrin  (Lyclear® Creme Rinse)
(lotion)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

note For head lice.

Not recommended due to concerns about insufficient contact time and evidence of resistance.

 
Silk garments  (e.g. Dermasilk®)

Non Formulary
Black
 
Sirolimus (rapamycin)
(ointment/cream)

Non Formulary

unlicensed Unlicensed

Available in various strengths as a special.

Although 0.1% and 0.5% preparations are included in the current BAD Specials List, this product has not yet been evaluated locally and all formulations are therefore currently non-formulary.

 

 
  
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
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine

Traffic Light Status Information

Status Description

Green

Suitable for prescribing by all in both primary and secondary care.  

Amber Recommended

Specialist recommended but suitable for continuation in primary care.  

Amber Initiation

Specialist initiated but suitable for continuation in primary care.  

Amber SCG

Specialist initiated and for continuation in primary care under a locally approved shared care guideline.  

Red

Suitable for prescribing in specialist settings (secondary care) only.   

Red Specialist Centre

Secondary care medicines to be used under specialised commissioning arrangements only.  

Blue

For primary care, either via FP10 or supplied through specialist services. These products may be stocked by hospital pharmacies only for supply to primary care units/wards or for continuing supplies for patients admitted on therapy.  

Black

Not recommended for use.  

netFormulary