Formulary Chapter 9: Nutrition and blood - Full Chapter
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09.01 |
Anaemias and some other blood disorders |
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Caplacizumab (Calblivi®) (infusion/ subcutaneous injection )
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Formulary
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NICE TA667:Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura (aTTP) in adults
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Efmoroctocog alfa (Elocta®)
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Formulary

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Vonicog alfa (Veyvondi®) (injection)
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Formulary

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Commissioned by NHS England for treatment and prevention of bleeding in adults with von Willebrand disease. NHS England commissioning policy
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09.01.01 |
Iron-deficiency anaemias |
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Ferric maltol (Feraccru®) (capsule)
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Formulary
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Gastroenterology specialist initiation only.
Only for patients with IBD unable to tolerate other iron preparations
Each capsule contains 30mg elemental iron
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DPC August 2016
DPC October 2016
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Ferrous fumarate (syrup/tablet/capsule)
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Formulary
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Ferrous sulfate (tablet)
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Formulary
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Each tablet contains ferrous sulfate 200mg equivalent to 65mg elemantal iron
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Sodium feredetate 190mg/5ml (oral solution)
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Formulary
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Contains 27.5mg elemental iron per 5ml
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09.01.01.01 |
Iron and folic acid |
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Ferrous fumarate and folic acid (Pregaday®) (tablets)
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Formulary
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Each tablet contains ferrous fumarate 322mg (equivalent to 100mg elemental iron) and folic acid 0.35mg
Licensed for use in second and third trimester of pregnancy for prophylaxis against iron deficiency and megaloblastic anaemia of pregnancy
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09.01.01.01 |
Compound iron preparations |
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09.01.01.02 |
Parenteral iron |
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Ferric Derisomaltose (Monofer®) (injection)
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First Choice
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previously known as 'iron isomaltoside'. Name changed in Sept 2020
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Ferric Carboxymaltose (Ferinject®) (injection)
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Formulary
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Drug of choice in antenatal and postnatal women. See local Trust Guideline.
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MHRA Nov 2020: Ferric carboxymaltose (Ferinject▼): risk of symptomatic hypophosphataemia leading to osteomalacia and fractures
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Iron Sucrose (Venofer®) (injection)
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Formulary
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09.01.02 |
Drugs used in megaloblastic anaemias |
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Hydroxocobalamin (Vitamin B12) (injection)
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First Choice
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IM injection preferred over oral administration for non-dietary vitamin B12 deficiency
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Cyanocobalamin (vitamin B12) (1,000 micrograms (1mg) tablets/capsules)
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Second Choice
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For use only when patients are unable to receive hydroxocobalamin injections (e.g. during COVID-19).
Self Care Medicine: Patients should be recommended to self purchase unless they meet the exception criteria outlined in the NHS England Guidance on conditions for which over the counter items should not routinely be prescribed in primary care (section 4.1.2 Vitamins and Minerals)
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British Society for Haematology (BSH) guidance on Vitamin B12 replacement during the COVID-19 pandemic
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Cyanocobalamin (vitamin B12) (50 micrograms tablets)
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Second Choice
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For use only when patients are unable to receive hydroxocobalamin injections (e.g. during COVID-19).
Self Care Medicine: Not usually suitable for prescribing on the NHS. Patients should be recommended to self purchase unless they meet the exception criteria outlined in the NHS England Guidance on conditions for which over the counter items should not routinely be prescribed in primary care (section 4.1.2 Vitamins and Minerals)
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British Society for Haematology (BSH) guidance on Vitamin B12 replacement during the COVID-19 pandemic
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Folic Acid (tablet/liquid)
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Formulary
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09.01.03 |
Drugs used in hypoplastic, haemolytic, and renal anaemias |
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Emicizumab (injection)
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Formulary
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Clinical Commissioning Policy: Emicizumab as prophylaxis in people with congenital haemophilia A with factor VIII inhibitors (all ages)
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Eculizumab (Soliris®) (injection)
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for atypical haemolytic uraemic syndrome (see NICE HST1 guidance)
Non-formulary for relapsing NMO (see NICE TA647 terminated appraisal link below).
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NICE HST1:Eculizumab for treating atypical haemolytic uraemic syndrome
NICE TA647: Eculizumab for treating relapsing neuromyelitis optica (terminated appraisal)
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Darbepoetin Alfa (Aranesp®) (injection)
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Formulary
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NICE NG8: Chronic kidney disease: managing anaemia
NICE TA323: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
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Epoetin alfa (Eprex®) (injection)
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Formulary
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NICE NG8: Chronic kidney disease: managing anaemia
NICE TA323: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
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Epoetin beta (NeoRecormon®) (injection)
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Formulary
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also for paediatric renal patients
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NICE NG8: Chronic kidney disease: managing anaemia
NICE TA323: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
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09.01.03 |
Iron overload |
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Deferasirox (Exjade®) (dispersible tablet)
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Formulary
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For use as per commissioning criteria set by NHS England
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Deferiprone (Ferriprox®) (tablet)
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Formulary
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For use as per commissioning criteria set by NHS England
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Desferrioxamine mesilate (injection)
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Formulary
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09.01.04 |
Drugs used in autoimmune thrombocytopenic purpura |
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Anagrelide (Xagrid®) (capsule)
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Formulary
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Consultant haematologist recommendation only
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Avatrombopag (Doptelet®) (tablets)
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Formulary
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Expected date of UK availability November 2020
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NICE TA626:Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
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Eltrombopag (Revolade®) (tablet)
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Formulary
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NICE TA293: Eltrombopag for treating chronic immune (idiopathic) thrombocytopenic purpura
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Lusutrombopag (Mulpleo®) (tablets)
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Formulary
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NICE TA617: Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
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Romiplostim (Nplate®) (injection)
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Formulary
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NICE TA221: Romiplostim for the treatment of chronic immune (idiopathic) thrombocytopenic purpura
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09.01.06 |
Drugs used in neutropenia |
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Filgrastim (injection)
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Formulary
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Specify brand
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Pegfilgrastim (injection)
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Formulary
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For sarcoma only
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09.01.07 |
Drugs used to mobilise stem cells |
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Plerixafor (injection)
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Formulary
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For use as per commissioning criteria set by NHS England
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NHS England Clinical Commissioning Policy Plerixafor for stem cell mobilisation in adults and children
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09.02 |
Fluids and electrolytes |
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09.02.01 |
Oral preparations for fluid and electrolyte imbalance |
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09.02.01.01 |
Oral potassium |
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Potassium Chloride (Kay-Cee-L®) (liquid)
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Formulary
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Potassium Chloride (Sando-K®) (Effervescent tablet)
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Formulary
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Potassium Chloride (Slow-K®) (modified release tablet)
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Formulary
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09.02.01.01 |
Potassium removal |
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Calcium polystyrene sulfonate (Calcium Resonium®) (powder)
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Formulary
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Powder for oral or rectal suspension
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Patiromer sorbitex calcium (Veltassa®) (sachets)
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Formulary
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for acute use
for chronic use
For use only in accordance with recommendations in NICE TA623
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NICE TA623 Patiromer for treating hyperkalaemia
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Sodium zirconium cyclosilicate (Lokelma) (sachets)
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Formulary
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For use only in accordance with recommendations in NICE TA599
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NICE TA599: Sodium zirconium cyclosilicate for treating hyperkalaemia
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09.02.01.02 |
Oral sodium and water |
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Sodium Chloride (Slow Sodium®) (modified release tablet)
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Formulary
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09.02.01.02 |
Oral rehydration therapy (ORT) |
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High sodium powders
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Formulary
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Nutrition team only. Patients may prepare themselves following advice and recipe from specialist/nutrition team.
Unlicensed
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UKMi Q&A: What is St Mark’s Electrolyte Mix (solution)?
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Oral Rehydration Salts
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Formulary
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- Electrolade on FP10
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09.02.01.03 |
Oral bicarbonate |
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Sodium Bicarbonate (capsule)
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Formulary
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09.02.02 |
Parenteral preparations for fluid and electrolyte imbalance |
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Cardioplegia (Plegivex®)
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Formulary
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Heparin (500 units in sodium chloride 0.9% 500ml)
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Formulary
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09.02.02.01 |
Electrolytes and water |
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Histidine, tryptophan, ketoglutarate (Custodiol® HTK) (perfusion solution)
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Formulary
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Restricted - for specialist cardiac surgery use only. For administration into renal arteries as renal protection during open thoracoabdominal aortic aneurysm repair surgery.
use for this indication is off label
Classed as a Medical device - CE Marked
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NHS Improvement Patient Safety Alert: perfusion solutions April 2018
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Plasma-Lyte 148; Plasma-Lyte 148 with Glucose 5% (intravenous infusion)
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Formulary
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For use in Southampton Children’s Hospital as alternative to compound sodium lactate (Hartmann’s) and as standard fluid of choice.
Contains potassium (K+) 5mmol/L
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09.02.02.01 |
Intravenous sodium |
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Ringers Solution (intravenous infusion)
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Formulary
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Sodium Chloride and Glucose Intravenous Infusion
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Formulary
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Sodium chloride 0.18% and glucose 4% intravenous infusion
Sodium chloride 0.45% and glucose 2.5% intravenous infusion
Sodium chloride 0.45% and glucose 5% intravenous infusion
Sodium chloride 0.9% and glucose 5% intravenous infusion
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Sodium Chloride Intravenous
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Formulary
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Sodium chloride 0.45% intravenous infusion
Sodium chloride 0.9% intravenous infusion
Sodium chloride 5% intravenous infusion
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09.02.02.01 |
Intravenous glucose |
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Glucose Intravenous
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Formulary
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Glucose 5% intravenous infusion
Glucose 10% intravenous infusion
Glucose 20% intravenous infusion
Glucose 50% intravenous infusion
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09.02.02.01 |
Intravenous potassium |
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Potassium Chloride and Glucose Intravenous Infusion
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Formulary
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Potassium chloride 0.2% and glucose 5% (containing approx. 13.5mmol potassium chloride) 500ml bags
Potassium chloride 0.2% and glucose 5% (containing approx. 27mmol potassium chloride) 1L bags
Potassium chloride 0.3% and glucose 5% (containing 40mmol potassium chloride) 1L bags
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Potassium Chloride and Sodium Chloride Intravenous Infusion
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Formulary
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Potassium chloride 0.15%, sodium chloride 0.45% and glucose 5% (containing 10mmol potassium chloride) 500ml bags
Potassium chloride 0.15%, sodium chloride 0.45% and glucose 10% (containing 10mmol potassium chloride) 500ml bags
Potassium chloride 0.15%, sodium chloride 0.18% and glucose 10% (containing 10mmol potassium chloride) 500ml bags
Potassium chloride 0.2% and glucose 5% (containing approx. 13.5mmol potassium chloride) 500ml bags
Potassium chloride 0.2% and glucose 5% (containing approx. 27mmol potassium chloride) 1L bags
Potassium chloride 0.2% and sodium chloride 0.9% (containing approx. 13.5mmol potassium chloride) 500ml bags
Potassium chloride 0.2% and sodium chloride 0.9% (containing approx. 27mmol potassium chloride) 1L bags
Potassium chloride 0.2%, glucose 4% and sodium chloride 0.18% (containing approx. 13.5mmol potassium chloride) 500ml bags
Potassium chloride 0.2%, glucose 4% and sodium chloride 0.18% (containing approx. 27mmol potassium chloride) 1L bags
Potassium chloride 0.3% and sodium chloride 0.9% (containing 20mmol potassium chloride) 500ml bags
Potassium chloride 0.3% and sodium chloride 0.9% (containing 40mmol potassium chloride) 1L bags
Potassium chloride 0.3%, sodium chloride 0.45% and glucose 5% (containing 20mmol potassium chloride) 500ml bags
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09.02.02.01 |
Bicarbonate and lactate |
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Compound Sodium Lactate BP (known as Hartmann's solution) (intravenous infusion)
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Formulary
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Sodium bicarbonate (injection)
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Formulary
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Sodium bicarbonate 1.26%, 1.4%, 2.74%, 4.2% intravenous infusion
Sodium bicarbonate 8.4% intravenous infusion
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Water for Injection
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Formulary
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09.02.02.02 |
Plasma and plasma substitutes |
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Gelofusine (intravenous infusion)
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Formulary
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Human albumin (solution for intravenous infusion)
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Formulary
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Human albumin 4.5% solution
Human albumin 20% solution
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09.03 |
Intravenous nutrition |
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Seek specialist advice from Adult Nutrition Team or relevant paediatric Pharmacist |
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Susoctocog alfa (Obizur®)
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Formulary
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In line with clinical commissioning policy
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Clinical Commissioning Policy: Susoctocog alfa for treating bleeding episodes in people with acquired haemophilia A (all ages)
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09.04.01 |
Foods for special diets |
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09.04.02 |
Enteral nutrition |
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09.05.01 |
Calcium and magnesium |
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09.05.01.01 |
Calcium supplements |
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Calcium carbonate (chewable tablet/effervescent tablet)
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Formulary
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Chewable tablets first-line.
Effervescent tablets reserved to aid administration in those unable to take chewable tablets.
Choose brand with lowest acquisition cost and prescribe by brand name to avoid confusion.
Refer to section 9.6.4 for calcium and vitamin D3.
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Calcium carbonate and calcium lactate gluconate (Calvive 1000®) (effervescent tab)
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Formulary
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Formerly Sandocal®
Chewable tablets first line.
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Calcium Chloride (10mmol in 10ml injection)
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Formulary
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Calcium Gluconate (10% injection (10ml))
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Formulary
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Calcium lactate + calcium gluconate (Alliance Calcium Syrup®) (liquid)
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Formulary
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0.51mmol/ml of Calcium
Specialist recommendation for paediatric patients only.
Licensed as a nutritional supplement, not a medicine.
Primary care to prescribe by brand name.
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09.05.01.02 |
Hypercalcaemia and hypercalciuria |
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Cinacalcet (Mimpara®) (tablet)
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Formulary
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Endocrinologist use only
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NICE TA117: Cinacalcet for the treatment of secondary hyperparathyroidism in patients with end-stage renal disease on maintenance dialysis therapy
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Etelcalcetide (Parsabiv®) (injection)
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Formulary
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NICE TA448 : Etelcalcetide for treating secondary hyperparathyroidism
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Pamidronate disodium (injection)
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Formulary
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Magnesium Aspartate (Magnaspartate®) (powder)
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Formulary
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Magnesium Glycerophosphate (2mmol capsule)
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Formulary
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unlicensed
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Magnesium Glycerophosphate (Neomag®) (4mmol chewable tab)
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Formulary
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Magnesium oxide (160mg (4mmol) capsule)
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Formulary
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Unlicensed
If compliance problems with magnesium glycerophosphate
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Magnesium sulfate (injection)
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Formulary
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50% (5g in 10ml; 1g in 2ml)
20% (10g in 50ml) unlicensed - For use within maternity at Princess Anne hospital
10% (1g in 10ml)
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09.05.02.01 |
Phosphate supplements |
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Phosphate supplements (Phosphate-Sandoz®) (effervescent tablet)
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Formulary
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Sodium glycerophosphate 21.6% (Glycophos®) (injection)
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Formulary
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unlicensed
First line intravenous choice
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09.05.02.02 |
Phosphate-binding agents |
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Aluminium Hydroxide (Alu-Cap®) (capsule)
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Formulary
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Calcium acetate and magnesium carbonate, heavy (Osvaren®) (tablet)
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Formulary
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For hyperphosphataemia of chronic renal failure in patients undergoing dialysis
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Calcium carbonate (600mg/5ml liquid)
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Formulary
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unlicensed
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Calcium Carbonate (Adcal®) (chewable tablet)
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Formulary
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Sevelamer Carbonate (sachet)
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Formulary
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Only when calcium-containing products not tolerated
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Sevelamer Hydrochloride (Renagel®) (tablet)
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Formulary
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Only when calcium-containing products not tolerated
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Zinc Sulfate (220mg capsule)
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Formulary
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unlicensed
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Zinc Sulfate (Solvazinc®) (effervescent tablet)
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Formulary
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Selenium and vitamins A,C and E (tablet)
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Formulary
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Approved for use at UHS on Intensive Care only
Not a licensed medicine - nutritional supplement.
Not prescribable on FP10
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09.06 |
Vitamins |
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Vitamins A and D (capsule)
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Formulary
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Pyridoxine Hydrochloride (tablet)
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Formulary
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Thiamine (vitamin B1) (tablet)
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Formulary
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NICE CG100: Alcohol-use disorders: diagnosis and management of physical complications
RMOC Position Statement on Oral Vitamin B Supplementation Nov 2019
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Vitamins B and C (Pabrinex®) (injection)
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Formulary
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NICE CG100: Alcohol-use disorders: diagnosis and management of physical complications
NICE CG115: Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence
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09.06.02 |
Oral vitamin B complex preparations |
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Vitamin B compound strong (tablets)
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Restricted
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Restricted use - see RMOC Position Statement for recommendations on prescribing oral vitamin B supplements.
[Note: UHS may prescribe vitamin B compound strong tablets for patients with Wernicke-Korsakoff syndrome - in this case all supplies (total 1 month) will be made by the hospital].
In rare cases when vitamin B complex prescribing is justified, Vitamin B compound strong should be used in preference to vitamin B compound tablets.
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RMOC Position Statement on Oral Vitamin B Supplementation Nov 2019
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Ascorbic Acid (Vitamin C) (tablet/effervescent tablet)
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Formulary
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Effervescent tablet for mouthcare only
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Ascorbic Acid (Vitamin C) (injection)
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Formulary
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09.06.04 |
Vitamin D |
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Calcium and colecalciferol (vitamin D3) (chewable tablet/effervescent tablet/film-coated tablet)
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Formulary
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Chewable tablets first-line. Effervescent and film-coated tablets reserved to aid administration in those unable to take chewable tablets.
Note that different formulations have different amounts of colecalciferol and calcium.
Choose brand with lowest acquisition cost and prescribe by brand name to avoid confusion.
Preferred brands in primary care: Accrete D3 or TheiCal D3
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Colecalciferol (Vitamin D3) (capsules/tablets/oral solution)
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Formulary
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Products that are UK licensed medicines should be prescribed and supplied wherever possible
Local West Hants CCG guidance can be found here
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Alfacalcidol (One-Alpha®) (liquid/capsule)
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Formulary
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Calcitriol (capsule)
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Formulary
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Ergocalciferol (Vitamin D2) (injection)
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Formulary
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Alpha Tocopheryl Acetate (Vitamin E) (capsule/liquid/injection)
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Formulary
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Injection is unlicensed
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Menadiol (tablet)
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Formulary
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Phytomenadione (tablet/injection)
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Formulary
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Tablets are unlicensed
Konakion MM paediatric injection can be given orally
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Phytomenadione (Neokay) (capsules)
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Formulary
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TTO use only
The contents of one capsule should be administered by cutting the narrow tubular tip off and squeezing the liquid contents into the mouth.
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09.06.07 |
Multivitamin preparations |
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DEKAs Essential/DEKAs Plus (capsules, liquid, softgels, chewable tablets)
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Formulary
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Vitamin and mineral supplements for use when recommended by a specialist in patients with cystic fibrosis.
Specialists to ensure preferred formulation and dose is clearly communicated to primary care prescribers.
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Multivitamin (tablet)
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Formulary
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Multivitamin preparations (Abidec®)
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Formulary
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Alternative to Dalivit drops on Neonatal Unit
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Multivitamin preparations (Dalivit®)
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Formulary
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Paravit-CF (liquid, capsules)
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Formulary
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Fat-soluble vitamin supplements for use when recommended by specialist in patients with cystic fibrosis.
Specialists to ensure preferred formulation and dose is clearly communicated to primary care prescribers.
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Paravit-CF Capsules
Paravit-CF Liquid
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09.06.07 |
Vitamin and mineral supplements and adjuncts to synthetic diets |
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Vitamin and mineral supplements (Forceval Junior soluble®) (tablet)
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Formulary
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Vitamin and mineral supplements (Forceval Soluble®) (effervescent tablet)
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Formulary
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For adults with poor swallowing, who are nil by mouth or who require medicine administration through an enteral feeding tube
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Vitamin and mineral supplements (Ketovite®) (tablet & liquid)
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Formulary
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Vitamin and mineral supplements (Sanatogen A-Z Complete®) (tablet)
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Formulary
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09.07 |
Bitters and tonics |
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09.08 |
Metabolic disorders |
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09.08.01 |
Drugs used in metabolic disorders |
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Betaine (tablet)
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Formulary
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unlicensed
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Burosumab (Crysvita®) (injection)
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Formulary

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Specialist use only in accordance with NICE HST8 guidance
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NICE Highly Specialised Technology Guidance (HST8): Burosumab for treating X-linked hypophosphataemia in children and young people
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Inotersen (Tegsedi®) (injection)
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Formulary

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NICE Highly Specialised Technology Guidance (HST9): Inotersen for treating hereditary transthyretin amyloidosis
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Trientine (capsules/tablets)
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Formulary
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Specialist use only. For treatment of Wilson's disease only in accordance with NHS England Clinical Commissioning Policy.
Not routinely stocked at UHS. If required please liaise with divisional lead pharmacist.
[N.B. Available as trientine dihydrochloride 300mg capsules and trientine tetrahydrochloride (Cuprior) 150mg tablets. NHS England confirm that both formulations will be commissioned]
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NHS England Clinical Commissioning Policy: Trientine for Wilson’s disease (all ages)
Summary of Product Characteristics: Trientine dihydrochloride capsules 300mg
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09.08.01 |
Carnitine deficiency |
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Levocarnitine (liquid/injection)
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Formulary
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09.08.01 |
Nephropathic cystinosis |
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Mercaptamine (Cystagon®) (capsules)
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Formulary
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In line with NHSE specialist commissioning criteria
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09.08.01 |
Urea cycle disorders |
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L-Arginine (50% injection)
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Formulary
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Unlicensed
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Sodium Benzoate (injection)
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Formulary
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unlicensed
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Sodium Phenylbutyrate (injection)
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Formulary
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unlicensed
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09.08.02 |
Acute porphyrias |
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Haem Arginate (injection)
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Formulary
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.... |
Non Formulary Items |
Colecalciferol (Vitamin D3) (injection)
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Non Formulary
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Unlicensed
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Compound iron preparations (Ferrograd C®)

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Non Formulary
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Ferrous gluconate (tablets)

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Non Formulary
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Ferrous sulfate (Ironorm®) (oral drops)

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Non Formulary
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Iron Dextran (CosmoFer®)

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Non Formulary
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Lenograstim (Granocyte®)

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Non Formulary
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Methoxy Polyethylene Glycol-Epoetin Beta (Mircera®)

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Non Formulary
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Ocular antioxidant vitamin and mineral supplement (Viteyes 2® Formula) (caps/softgels)

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Non Formulary
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For age-related macular degeneration (AMD). Not recommended for NHS prescribing.
Patients may opt to purchase OTC.
Removed from formulary as recommended by District Prescribing Committee Feb 2018. |
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Ocular antioxidant vitamin and mineral supplements (all brands)
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Non Formulary
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For age-related macular degeneration (AMD). Not recommended for NHS prescribing.
Patients may opt to purchase OTC. |
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Oxymetholone

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Non Formulary
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Riboflavin (vitamin B2) (capsules/tablets/liquid)
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Non Formulary
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Nutritional supplement. Not recommended for NHS prescribing.
Patients may opt to self-purchase. |
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Selenium (tablets/capsules)

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Non Formulary
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not available as licensed medicines - nutritional supplements only
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Selenium (Selenase®) (oral solution)

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Non Formulary
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Each ampoule of 2 ml oral solution contains 100 micrograms selenium in the form of 332 micrograms sodium selenite pentahydrate. Link to SmPC here. |
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Sodium polystyrene sulfonate (Resonium A®) (powder)

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Non Formulary
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Powder for oral or rectal suspension
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Thiamine (vitamin B1) (injection)
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Non Formulary
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Unlicensed. High cost.
Consider Pabrinex as a licensed alternative. |
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Vitamin B compound (tablets)

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Non Formulary
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RMOC Position Statement: In rare cases where there might be a justifiable reason for prescribing vitamin B complex e.g. medically diagnosed deficiency or chronic malabsorption, vitamin B compound strong and not vitamin B compound tablets should be prescribed as they represent better value for money. |
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Traffic Light Status Information
Status |
Description |

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

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Specialist recommended but suitable for continuation in primary care. |

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Specialist initiated but suitable for continuation in primary care. |

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

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

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

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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. |

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Not recommended for use. |
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