| Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
|
|
| Details... |
| 12.01 |
Drugs acting on the ear |
|
|
| 12.01.01 |
Otitis externa |
|
|
| 12.01.01 |
Astringent preparations |
|
|
Acetic Acid 2% (Earcalm ®)
|
Formulary
|
First line in Acute Otitis Externa, as per antimicrobial guidelines
guidelines
|
|
|
| 12.01.01 |
Anti-inflammatory preparations |
|
|
Flumetasone 0.02% with Clioquinol 1% (Locorten-Vioform®)
|
First Choice
|
|
|
|
Dexamethasone with neomycin and glacial acetic acid (Otomize®)
|
Second Choice
|
|
|
|
Betamethasone 0.1% with Neomycin 0.5% ear drops
|
Formulary
|
|
|
|
Betamethasone ear drops
|
Formulary
|
|
|
|
Hydrocortisone Acetate 1% with Gentamicin 0.3% (Gentisone® HC)
|
Formulary
|
Only with positive culture/sensitivity data
|
|
|
Dexamethasone with Antibacterial (Sofradex®)
|
Formulary
|
|
|
|
| 12.01.01 |
Anti-infective preparations |
|
|
Chloramphenicol ear drops
|
Formulary
|
Only with positive culture/sensitivity data.
|
|
|
Ciprofloxacin 0.3% drops
|
Formulary
|
Off label use of eye drops
Specialist Recommendation
|
|
|
Clotrimazole (Canesten®)
|
Formulary
|
Only with positive culture/sensitivity data.
|
|
|
Gentamicin ear drops (Genticin®)
|
Formulary
|
Only with positive culture/sensitivity data.
|
|
|
| 12.01.01 |
Other aural preparations |
|
|
| 12.01.02 |
Otitis media |
|
|
 |
Please refer to antimicrobial guidelines. |
|
|
|
| 12.01.03 |
Removal of ear wax |
|
|
Cerumol®
|
Formulary
|
|
|
|
Olive Oil Ear Drops
|
Formulary
|
|
|
|
Sodium Bicarbonate 5% ear drops
|
Formulary
|
|
|
|
| 12.02 |
Drugs acting on the nose |
|
|
| 12.02.01 |
Drugs used in nasal allergy |
|
|
Azelastine and fluticasone (Dymista)
|
Formulary
|
Third line option for adults and children over 12 years with moderate to severe allergic rhinitis who have failed to respond to a steroid nasal spray with the addition of an oral antihistamine.
Follow treatment algorithm
|
 BSSE APC: Allergic Rhinitis Treatment Pathway
|
| 12.02.01 |
Antihistamines |
|
|
| 12.02.01 |
Corticosteroids |
|
|
Beclometasone Dipropionate nasal preparations
|
First Choice
|
|
|
|
Mometasone Furoate nasal spray
|
Second Choice
|
|
|
|
Betamethasone Sodium Phosphate nasal preparations
|
Formulary
|
|
|
|
Fluticasone furoate (Avamys®)
|
Formulary
|
previous APC decision reviewed in December 2015.
Approved for use in children and adults.
|
|
|
Fluticasone Propionate (Flixonase Nasule®)
|
Formulary
|
Specialist Recommendations for Nasal Polyps.
|
|
|
| 12.02.01 |
Cromoglicate |
|
|
| 12.02.02 |
Topical nasal decongestants |
|
|
| 12.02.02 |
Sympathomimetics |
|
|
Ephedrine nose drops
|
Formulary
|
Short Term Use Only
|
|
|
Sodium Chloride Nose drops 10ml
|
Formulary
|
|
|
|
Xylometazoline nose drops/spray
|
Formulary
|
Short term use only
|
|
|
| 12.02.02 |
Antimuscarinic |
|
|
| 12.02.03 |
Nasal preparations for infection |
|
|
| 12.02.03 |
Nasal Staphylococci |
|
|
Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5% (Naseptin®)
|
Formulary
|
Contains arachis (peanut) oil, not suitable for patients with allergy to peanuts.
Patients with soya allergy should also avoid Naseptin®
|
|
|
Mupirocin 2% in White Soft Paraffin (Bactroban Nasal®)
|
Formulary
|
Long term disruption to supply until second or third quarter of 2018.
|
UKMi Memo re shortage of supply and alternative agents/ management options
|
Octenidine hydrochloride (Octenisan® md Nasal gel )
|
Formulary
|
Classed as a medical device
Listed in drug tariff- 6ml tube
Added to formulary as alternative to Bactroban® nasal ointment in view of supply issues.
|
|
|
| 12.03 |
Drugs acting on the oropharynx |
|
|
| 12.03.01 |
Drugs for oral ulceration and inflammation |
|
|
Benzydamine 0.15% oral rinse
|
Formulary
|
|
|
|
Benzydamine 0.15% oral spray
|
Formulary
|
|
|
|
Bonjela Junior Dental Gel (Bonjela® Junior)
|
Formulary
|
From 3 months of age
|
|
|
Caphosol®
|
Formulary
|
Oncology and haematology use
|
|
|
Choline Salicylate dental gel
|
Formulary
|
For patients over 16 years
|
|
|
Gelclair®
|
Formulary
|
Oncology and haematology use only
|
|
|
Hydrocortisone 2.5mg buccal tablets
|
Formulary
|
Specialist Recommendation
|
|
|
Lidocaine 10% mouth spray
|
 Restricted
|
Hospital only
|
|
|
Orabase Protective Paste
|
Formulary
|
|
|
|
Orahesive Powder
|
Formulary
|
|
|
|
| 12.03.02 |
Oropharyngeal anti-infective drugs |
|
|
| 12.03.02 |
Oropharyngeal Fungal infections |
|
|
Miconazole oral gel
|
Formulary
|
|
Topical miconazole, including oral gel: reminder of potential for serious interactions with warfarin
|
Nystatin 100,000units/ml suspension
|
Formulary
|
Do not Prescribe as Sugar Free (SF)
|
|
|
| 12.03.02 |
Oropharyngeal Viral infections |
|
|
| 12.03.03 |
Lozenges and sprays |
|
|
| 12.03.04 |
Mouthwashes, gargles, and dentifrices |
|
|
Chlorhexidine gluconate 0.2% mouthwash
|
Formulary
|
|
|
|
Chlorhexidine gluconate 1% dental gel
|
Formulary
|
|
|
|
Hydrogen Peroxide mouthwash BP
|
Formulary
|
|
|
|
| 12.03.05 |
Treatment of dry mouth |
|
|
| 12.03.05 |
Local Treatment |
|
|
Biotene Oralbalance® (Saliva replacement gel)
|
Formulary
|
Approved for
ACBS conditions i.e. patients suffering from xerostomia (dry mouth) as a result of having or having undergone radiotherapy or sicca syndrome.
Palliative Care
Dental practitioners
|
|
|
Saliveze® Oral spray
|
Formulary
|
Approved for
ACBS conditions i.e. patients suffering from xerostomia (dry mouth) as a result of having or having undergone radiotherapy or sicca syndrome.
Palliative Care
Dental practitioners
|
|
|
Salivix® pastilles
|
Formulary
|
Approved for
ACBS conditions i.e. patients suffering from xerostomia (dry mouth) as a result of having or having undergone radiotherapy or sicca syndrome.
Palliative Care
Dental practitioners
only useful in patients who have residual salivary gland function.
|
|
|
| 12.03.05 |
Systemic treatment |
|
|
pilocarpine Hydrochloride tablets (Salagen®)
|
Formulary
|
Licensed for treatment of xerostomia following irradiation for head and neck cancer; dry mouth and dry eyes in Sjögren's syndrome.
Effective only in patients who have residual salivary gland function.
|
|
|
| 12.04 |
Other preparations |
|
|
Bismuth Iodine Paraffin Paste (BIPP ® )
|
Formulary
|
|
|
|
Bismuth Subnitrate and Iodoform Paste for Gauze
|
Formulary
|
|
|
|
Human papilloma virus vaccine (Gardasil® )
|
Formulary
|
For use by ENT Specialists in recurrent respiratory papillomatosis (RRP)
|
|
|
| .... |
| Non Formulary Items |
ACETIC ACID 5% solution in IMS
|
Non Formulary
|
|
|
|
Aciclovir
|
Non Formulary
|
|
|
|
Almond Oil
|
Non Formulary
|
|
|
|
Antacid with Oxetacaine
|
Non Formulary
|
|
|
|
AS saliva Orthana®
|
Non Formulary
|
contains porcine derived gastric mucin |
|
|
Azelastine Hydrochloride (Rhinolast®)
|
Non Formulary
|
|
|
|
Benzocaine
|
Non Formulary
|
|
|
|
Betamethasone Sodium Phosphate 0.1% with Neomycin Sulphate 0.5%
|
Non Formulary
|
|
|
|
BioXtra®
|
Non Formulary
|
|
|
|
Budesonide
|
Non Formulary
|
|
|
|
Budesonide (Rhinocort Aqua®)
|
Non Formulary
|
|
|
|
Cetylpyridinium, Chlrocresol, Lidocaine (Anbesol®)
|
Non Formulary
|
|
|
|
Chlorhexidine & Chlorobutanol (Eludril®)
|
Non Formulary
|
|
|
|
Chlorhexidine mouthwash
|
Non Formulary
|
|
|
|
Docusate Sodium 0.5% (Waxsol®)
|
Non Formulary
|
|
|
|
Doxycycline
|
Non Formulary
|
|
|
|
Doxycycline
|
Non Formulary
|
|
|
|
Doxycycline (Periostat®)
|
Non Formulary
|
|
|
|
Exterol®
|
Non Formulary
|
|
|
|
Flunisolide (Syntaris®)
|
Non Formulary
|
|
|
|
Flurbiprofen lozenge
|
Non Formulary
|
|
|
|
Fluticasone Propionate Aqueous Nasal spray (Flixonase®)
|
Non Formulary
|
|
|
|
Fluticasone Propionate Aqueous Nasal spray (Nasofan®)
|
Non Formulary
|
|
|
|
Glandosane®
|
Non Formulary
|
Should not be prescribed to patients with their own teeth due to acidic pH. |
|
|
Ipratropium Bromide (Rinatec®)
|
Non Formulary
|
|
 UKMI Q&A: Drug induced hypersalivation
|
Lidocaine 5% ointment
|
Non Formulary
|
|
|
|
Lidocaine and Cetylpyridinium (Dentinox® Teething Gel)
|
Non Formulary
|
|
|
|
Lidocaine and Chlorhexidine (Instillagel®)
|
Non Formulary
|
|
|
|
Lidocaine and Phenylephrine (Cophenalcaine®)
|
Non Formulary
|
|
|
|
Luborant®
|
Non Formulary
|
|
|
|
Miconazole (Loramyc®)
|
Non Formulary
|
|
|
|
Molcer®
|
Non Formulary
|
|
|
|
Mouth Swabs
|
Non Formulary
|
|
|
|
Otex®
|
Non Formulary
|
|
|
|
Povidone Iodine (Betadine®)
|
Non Formulary
|
|
|
|
Prednisolone ear drops (Predsol®)
|
Non Formulary
|
|
|
|
Salicylates - Salicylic acid (Pyralvex®)
|
Non Formulary
|
|
|
|
Salinum®
|
Non Formulary
|
|
|
|
Sodium Chloride Mouthwash, Compound, BP
|
Non Formulary
|
|
|
|
Sodium Cromoglicate (Rynacrom®)
|
Non Formulary
|
|
|
|
Sodium Cromoglicate (Vividrin®)
|
Non Formulary
|
|
|
|
SST
|
Non Formulary
|
|
|
|
Thymol
|
Non Formulary
|
|
|
|
Tranexamic Acid Mouthwash
|
Non Formulary
|
|
|
|
Triamcinolone Acetonide (Nasacort®)
|
Non Formulary
|
|
|
|
Xerotin(r) (Xerotin®)
|
Non Formulary
|
|
|
|
| |
Key |
|
|
|
|
Cytotoxic Drug
|
|
|
Controlled Drug
|
|
High Cost Medicine
|
|
Cancer Drugs Fund
|
|
NHS England |
|
Homecare |
|
CCG |
|
Traffic Light Status Information
| Status |
Description |
|
Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications. |
|
Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate, or initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.
Some amber medicines require agreement with the local (internal) medicines committee prior to initiation; others may require a framework to support safe transfer and maintenance of care such as a RICaD or ESCA. The Formulary will be annotated to reflect these requirements. |
|
Medicines for initiation and maintenance prescribing by Specialists only |
|
Non-formulary medicines- medicines not recommended for routine primary care prescribing. |
|
Positive NICE TA and /or awaiting local clarification on place in therapy ; Please contact your Medicines Optimisation team for more information. |
|
|
|
