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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.01  Expand sub section  Bronchodilators
03.01  Expand sub section  Asthma
03.01  Expand sub section  Chronic obstructive pulmonary disease
03.01  Expand sub section  Croup
03.01.01  Expand sub section  Adrenoceptor agonists to top
03.01.01.01  Expand sub section  Selective Beta2 agonists
Bambuterol tablets (Bambec)
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Formulary
Amber
Specialist initiation for severe brittle asthma/ cystic fibrosis 
   
Salbutamol
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Formulary
Green
  • Inhaler
  • oral preparations
  • Nebules
     
  •    
    Salbutamol IV
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    Formulary
    Green
     
       
    Formoterol
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Salmeterol
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
  • Prescribe by brand to ensure patients receive the device they are used to.
  • Check licensed indication (differences among brands).
  • Be aware of differences in excipients among the different brands.
     
  •    
    Terbutaline Inhaler
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Terbutaline Nebulised
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber
     
       
    03.01.01.01  Expand sub section  Short-acting beta2 agonists
    03.01.01.01  Expand sub section  Long-acting beta2 agonists
    03.01.01.02  Expand sub section  Other adrenoceptor agonists
    03.01.02  Expand sub section  Antimuscarinic bronchodilators to top
    Glycopyrronium (Seebri breezhaler)
    View adult BNF View SPC online View childrens BNF
    First Choice
    Green
  • For COPD only 
  • Aclidinium (Eklira Genuair)
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    Formulary
    Green
  • For COPD only 
  •    
    Ipratropium
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    Formulary
    Green
  • Inhaler
  • Nebules 
  •    
    Tiotropium (Spiriva Respimat)
    View adult BNF View SPC online View childrens BNF
    Formulary Amber Traffic Light For asthma

    Green Traffic Light For COPD 
       
    Umeclidinium (Incruse Ellipta)
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    Formulary
    Green
  • For COPD.
  • Approved on formulary February 2017 
  •    
    03.01.02  Expand sub section  Short Acting Anti-muscarinic Bronchodilators
    03.01.02  Expand sub section  Long Acting Anti-muscarinic Bronchodilators
    03.01.03  Expand sub section  Theophylline
    Aminophylline (Phyllocontin Continus)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Theophylline (Uniphyllin Continus)
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    Formulary
    Green
     
       
    Aminophylline IV
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
    Link  UKMI Q&A: Conversion of IV aminophylline dose to oral aminophylline or theophylline
       
    03.01.04  Expand sub section  Compound bronchodilator preparations
    Aclidinium / formoterol inhaler (Duaklir Genuair)
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    Formulary
    Green
     
       
    Glycopyrronium/ indacaterol inhaler (Ultibro Breezhaler)
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    Formulary
    Green
     
       
    Tiotropium olodaterol (SpioltoRespimat)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Umeclidinium / vilanterol inhaler (Anoro Ellipta)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    03.01.05  Expand sub section  Peak flow meters, inhaler devices and nebulisers to top
    03.01.05  Expand sub section  Peak flow meters
    Low range peak flow meter
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Standard range peak flow meter
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    03.01.05  Expand sub section  Drug delivery devices
    Drug Delivery Device (Haleraid)
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    Formulary
  • Please note this device is not prescribable, but can be obtained on request from community pharmacies but will incur a small cost.  
  •    
    Drug Delivery Devices
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
    All spacer devices 
       
    03.01.05  Expand sub section  Nebuliser Diluent
    Sodium Chloride
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    03.02  Expand sub section  Corticosteroids
    Beclometasone Dipropionate (Clenil Modulite)
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    Formulary
    Green
     
       
    Budesonide
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    Formulary
    Green
  • Dry powder Inhaler
  • Nebulised solution 
  •    
    Fluticasone nebules
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    Formulary
    Green



     
       
    Fluticasone inhalers
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    Formulary For paediatric use ONLY (i.e. up to 18 years of age)

    Green Traffic Light Fluticasone Evohaler 50, Fluticasone Accuhaler 50,100


    Amber Traffic Light Fluticasone Evohaler 125, Fluticasone Accuhaler 250

     

       
    Beclometasone and formoterol (Fostair)
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    Formulary
    Green
  • Alternative to Seretide Evohaler/ Seretide 250 Accuhaler
  • When reviewing/ stepping down, consider switch if appropriate 
  •    
    Beclometasone and formoterol (FostairNEXThaler)
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    Formulary
    Green
     
       
    Budesonide and formoterol (DuoResp Spiromax)
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    Formulary
    Green
  • DuoResp Spiromax 160/4.5 is therapeutically equivalent to Symbicort Turbohaler 200/6

  • DuoResp Spiromax 320/9 is therapeutically equivalent to Symbicort Turbohaler 400/12

  • Should be prescribed by the intended brand to ensure patients receive the device they are used to. 
  •    
    Budesonide and formoterol (Symbicort Turbohaler)
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    Formulary
    Green
  • Should be prescribed by the intended brand to ensure patients receive the device they are used to.

  • For asthma only
    Non-Formulary for COPD 
  •    
    Ciclesonide (Alvesco)
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    Formulary
    Red
  • For specialist in Birmingham Region Severe Asthma Service sites initiation and continuation only. 
  •    
    Fluticasone and formoterol (Flutiform)
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    Formulary
    Green
  • Alternative to Seretide Evohaler/ Seretide 250 Accuhaler
  • When reviewing/stepping down, consider switch if appropriate 
  •    
    Fluticasone and salmeterol (Seretide)
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    Formulary
    Green
    For paediatric use ONLY (i.e. up to 18 years of age)
  • Seretide Evohalers
  • Seretide Accuhalers

  • Should be prescribed by the intended brand to ensure patients are maintained on the formulation they are used to.
  • When reviewing patients on Seretide 250 Accuhaler,consider switch to Fostair or Flutiform if appropriate.  
  •    
    Fluticasone and salmeterol (Sirdupla)
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    Formulary
    Green
    For existing patients only, no new prescribing.

  • Sirdupla is bioequivalent to Seretide Evohaler.

  • Contains alcohol: patients who object to alcohol may not be suitable for this product. It should not be switched to without consultation.

  • Should be prescribed by the intended brand to ensure patients are maintained on the formulation they are used to. 
  •    
    Fluticasone furoate & vilanterol (Relvar Ellipta)
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    Formulary
    Green
  • For COPD- 92mcg/22mcg
  • For asthma- both strengths 
  •    
    03.02.01  Expand sub section  Inhaled Corticosteroids to top
    03.02.02  Expand sub section  Combination products (ICS+LABA) for asthma
    03.02.02  Expand sub section  Low dose
    03.02.02  Expand sub section  Moderate dose
    03.02.02  Expand sub section  High dose
    03.02.03  Expand sub section  Combination products (ICS+LABA) for COPD to top
    Beclometasone/formoterol/glycopyrronium (Trimbow)
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    Formulary
    Green

    COPD Appendix 4 - Criteria for triple therapy and for triple inhaler use in COPD

     

     
       
    Fluticasone/vilanterol/umeclidinium (Trelegy Ellipta)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green

    COPD Appendix 4 : Criteria for triple therapy and for triple inhaler use in COPD

     

     
       
    03.03  Expand sub section  Cromoglicate, related therapy and leukotriene receptor antagonists
    03.03.01  Expand sub section  Cromoglicate and related therapy
    03.03.01  Expand sub section  Related therapy
    03.03.02  Expand sub section  Leukotriene receptor antagonists
    Montelukast
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    Formulary
    Green
     
       
    Zafirlukast
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    Formulary
    Green
  • Accolate brand to be discontinued in March 2018 
  •    
    03.03.03  Expand sub section  Phosphodiesterase type-4 inhibitors to top
    RoflumilastBlack Triangle (Daxas)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber
    CCG

    In line with NICE
    Specialist initiation- transfer of prescribing supported by RICaD

    RICaD: Roflumilast for treating COPD

     
    Link  NICE TA461: Roflumilast for treating chronic obstructive pulmonary disease
       
    03.04  Expand sub section  Antihistamines, hyposensitisation, and allergic emergencies
    03.04.01  Expand sub section  Antihistamines
    03.04.01  Expand sub section  Non-sedating antihistamines
    Loratadine
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Cetirizine
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    Formulary
    Green
     
       
    Fexofenadine
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    Formulary
    Green
    High Cost Medicine
    Second Line
     
       
    03.04.01  Expand sub section  Sedating antihistamines
    Chlorphenamine
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    Formulary
    Green
  • Tablets
  • Syrup 
  •    
    Hydroxyzine
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    Formulary
    Green
  • Tablets
  • Syrup 
  •    
    Promethazine
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    Formulary
    Green
     
       
    Alimemazine
    (Trimeprazine)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber
    Second line- in children as per guidance 
       
    03.04.02  Expand sub section  Allergen Immunotherapy to top
    Grass pollen extract (Grazax)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber
  • Supported by RICaD
    RICaD: Grazax 
  •    
    Bee and Wasp Allergen Extracts (Pharmalgen)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
       
    Grass and Tree Pollen Extract (Pollinex)
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    Formulary
    Red
     
       
    Reslizumab (Cinqaero)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
  • For specialist use only in line with NICE
  • NHS England is the responsible commissioner for use in Asthma 
  • Link  NICE TA479: Reslizumab for treating severe eosinophilic asthma
       
    03.04.02  Expand sub section  Omalizumab
    Omalizumab (Xolair)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
  • For specialist use only in line with NICE guidance below
  • NHS England is the responsible commissioner for use in Asthma
  • Clinical Commissioning Groups are the responsible commissioners for use in urticaria 
  • Link  NICE TA278: Asthma (severe, persistent, patients aged 6+, adults) - omalizumab (rev TA133, TA201)
    Link  NICE TA339: Previously treated chronic spontaneous urticaria- omalizumab
       
    03.04.03  Expand sub section  Allergic emergencies
    03.04.03  Expand sub section  Anaphylaxis
    Adrenaline / epinephrine (EpiPen)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Adrenaline / Epinephrine (Jext)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    03.04.03  Expand sub section  Angioedema
    C1 Esterase Inhibitor (Berinert)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital only- NHSE commissioned 
       
    C1 esterase inhibitor (Cinryze )
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital only- NHSE Commissioned 
       
    Conestat Alfa (Ruconest)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital Only- NHSE commissioned 
       
    Icatibant (Firazyr)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital Only- NHSE commissioned 
       
    03.04.03  Expand sub section  Intramuscular adrenaline (epinephrine) to top
    03.04.03  Expand sub section  Intravenous adrenaline (epinephrine)
    03.04.03  Expand sub section  Self-administration of adrenaline (epinephrine)
    03.05  Expand sub section  Respiratory stimulants and pulmonary surfactants
    03.05.01  Expand sub section  Respiratory stimulants
    Caffeine citrate
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    unlicensedunlicensed 
       
    Doxapram (Dopram)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital only 
       
    03.05.02  Expand sub section  Pulmonary surfactants to top
    Poractant Alfa (Curosurf)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital only 
       
    03.06  Expand sub section  Oxygen
    Oxygen
    View adult BNF View SPC online View childrens BNF
    Formulary Green Traffic Light Short term use in palliative care

    Amber Traffic Light Long term use- requires specialist assessment


     
       
    03.06  Expand sub section  Long-term oxygen therapy
    03.06  Expand sub section  Short burst oxygen therpary
    03.06  Expand sub section  Ambulatory oxygen therapy
    03.06  Expand sub section  Oxygen therapy equipment to top
    03.06  Expand sub section  Arrangements for supplying oxygen
    03.07  Expand sub section  Mucolytics
    Carbocisteine
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Acetylcysteine
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital Only
  • Tablets
  • Sachets- available as 200mg powder for oral solution- licensed product. 
  •    
    Erdosteine
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
     
       
    Mannitol inhalation (Bronchitol )
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital only 
    Link  TA266 Mannitol dry powder for inhalation for treating cystic fibrosis
       
    N-Acetylcysteine nebulised
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Hospital only 
       
    03.07  Expand sub section  Dornase alfa
    Dornase Alfa (Pulmozyme)
    View adult BNF View SPC online View childrens BNF
    Formulary Commissioned by NHS England for Cystic Fibrosis only

    Red Traffic Light New patients


    Amber Traffic Light For existing patients (initiated pre April 2013)



     

       
    03.07  Expand sub section  Hypertonic Sodium Chloride
    Hypertonic sodium chloride 7% (Resp-Ease)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
  • Accepted onto formulary December 2016- to replace Nebusal brand. 
  •    
    Sodium chloride 0.9%
    (Nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green

     
       
    03.08  Expand sub section  Aromatic inhalations to top
    Menthol and Eucalyptus Inhalation BP 1980
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    03.09  Expand sub section  Cough preparations
    03.09.01  Expand sub section  Cough suppressants
    Pholcodine Linctus, BP
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    03.09.01  Expand sub section  Palliative care
    Controlled Drug Methadone Hydrochloride (Methadone Linctus)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber
    Palliative care only 
       
    03.09.02  Expand sub section  Expectorant and demulcent cough preparations
    Simple Linctus, BP
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    Formulary
    Green
     
       
    Simple Linctus, Paediatric BP
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    03.10  Expand sub section  Systemic nasal decongestants to top
    Pseudoephedrine Hydrochloride
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    03.11  Expand sub section  Antifibrotics
    Nintedanib (OfevRestricted Item View adult BNF View SPC online View childrens BNF Restricted Drug Restricted
    Red
  • Hospital only- NHSE commissioned
  • In line with NICE and available from day 91 following publication of TA.
     
  • Link  NICE TA379: Nintedanib for treating idiopathic pulmonary fibrosis
       
    Pirfenidone (Esbriet)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    NHS England

    Hospital only - NHSE commissioned

     
    Link  NICE TA504: Pirfenidone for treating idiopathic pulmonary fibrosis
       
    03.12  Expand sub section  Other drugs for Interstitial lung disease (idiopathic pulmonary fibrosis)
     note 
    Azathioprine
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber
  • in conjunction with prednisolone (plain tablets, not EC)
  • Supported by ESCA , see link below. 
  • Link  ESCA: Azathioprine in conjunction with prednisolone in ILD.
       
    Methotrexate tablets
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber
  • Supported by ESCA , see link below.  
  • Link  ESCA: Methotrexate tablets in ILD.
       
    Prednisolone tablets
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber
  • Plain tablets (not enteric coated)  
  •    
    03.13  Expand sub section  Nebulised antibiotics for cystic fibrosis
     note 
    Amoxicillin
    (nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Hospital only 
       
    Amphotericin (Fungizone)
    (nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Hospital only 
       
    Ceftazidime
    (nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Hospital only 
       
    Cefuroxime
    (nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Hospital only 
       
    Colistimethate sodium  (Colistin sulfomethate sodium nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary Commissioned by NHS England for Cystic Fibrosis only

    Red Traffic Light New patients

    Amber Traffic Light Existing patients (initiated prior to April 2013) 
       
    Gentamicin
    (nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Hospital only 
       
    Meropenem
    (nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Hospital only 
       
    Tobramycin
    (nebulised)
    View adult BNF View SPC online View childrens BNF
    Formulary Commissioned by NHS England for Cystic Fibrosis only.

    Red Traffic Light  New patients

    Amber Traffic Light  Existing patients (initiated prior to April 2013) 
       
     ....
     Non Formulary Items
    Acrivastine

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Adrenaline / Epinephrine  (Anapen)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Adrenaline / Epinephrine  (Minijet Adrenaline 1 in 1000)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Adrenaline / Epinephrine  (Minijet Adrenaline 1 in 10000)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Ammonia and Ipecacuanha Mixture BP

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Beclometasone  (Qvar)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
    For existing patients only
     
    Benzoin Compound Tincture  (Friars Balsam)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
    Update following APC
     
    Beractant  (Survanta)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Bilastine  (Ilaxten)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Budesonide  (Novolizer®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Budesonide and formoterol  (Symbicort pMDI)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
  • Not approved on formulary for COPD in February 2017
  • Should be prescribed by the intended brand to ensure patients receive the device they are used to.



  •  
    Clemastine  (Tevegil)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Codeine Linctus BP

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Codeine Linctus, Paediatric BP

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Controlled Drug  Codeine Phosphate

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Cyproheptadine  (Periactin)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Desloratadine  (Neoclarityn)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Dextromethorphan / quinidine  (Nuedexta)

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

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Ephedrine Hydrochloride

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

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Flo-Tone MDI

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Fluticasone and salmeterol  (Seretide 500 Accuhaler)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
  • Removed from formulary for COPD in February 2017
  • Should be prescribed by the intended brand to ensure patients are maintained on the formulation they are used to.
  •  
    Fluticasone and salmeterol DPI  (AirFluSal Forspiro )

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
  • Therapeutically equivalent to Seretide 500 Accuhaler

  • Removed from formulary February 2017
  •  
    Hypertonic sodium chloride  (MucoClear3%)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Hypertonic sodium chloride  (MucoClear6%)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Hypertonic sodium chloride 7%  (Nebusal)

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    Non Formulary
    Black
  • Replaced in December 2016 by Resp-Ease
  •  
    Indacaterol  (Onbrez Breezhaler)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Ipratropium bromide with salbutamol  (Combivent)

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    Non Formulary
     
    Ivacaftor

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    Non Formulary
     
    Karvol

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    Non Formulary
     
    Ketotifen  (Zaditen®)

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    Non Formulary
     
    Levocetirizine  (Xyzal)

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    Non Formulary
    Black
     
    Mecysteine Hydrochloride  (Visclair)

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    Non Formulary
     
    Mizolastine  (Mizollen®)

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    Non Formulary
     
    Mometasone Furoate  (Asmanex)

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    Non Formulary
     
    Controlled Drug  Morphine Hydrochloride

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    Non Formulary
    Black
     
    Nedocromil  (Tilade® CFC-free inhaler)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Olodaterol  (Striverdi Respimat)

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    Non Formulary
     
    Orciprenaline Sulphate  (Alupent®)

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    Non Formulary
     
    Pholcodine  (Galenphol®)

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    Non Formulary
     
    Pholcodine Linctus, Strong, BP

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    Non Formulary
     
    Rupatadine

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    Non Formulary
     
    Salmeterol  (Serevent Accuhaler)

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    Non Formulary
    Black
  • Removed from formulary for COPD February 2017
  •  
    Sodium Cromoglicate

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    Non Formulary
     
    Sodium Cromoglicate  (Comogen Easi-Breathe®)

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    Non Formulary
     
    Sodium Cromoglicate  (Intal®)

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    Non Formulary
     
    Theophylline  (Nuelin SA)

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    Non Formulary
     
    Theophylline  (Slo-Phyllin)

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    Non Formulary
     
    Tiotropium  (Braltus)
    (dry powder inhaler)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Tiotropium  (Spiriva Handihaler)

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    Non Formulary
    Black
    Removed from formulary for COPD February 2017
     
      
    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
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Green

    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.  

    Amber

    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.   

    Red

    Medicines for initiation and maintenance prescribing by Specialists only  

    Black

    Non-formulary medicines- medicines not recommended for routine primary care prescribing.  

    Grey

    Positive NICE TA and /or awaiting local clarification on place in therapy ; Please contact your Medicines Optimisation team for more information.  

    netFormulary