netFormulary Birmingham, Sandwell, Solihull and environs APC Formulary NHS
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 Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
07.01  Expand sub section  Drugs used in obstetrics
07.01.01  Expand sub section  Prostaglandins and oxytocics
Ergometrine Maleate and Oxytocin (Syntometrine®)
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Formulary
Red
 
   
Carboprost
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Formulary
Red
 
   
Dinoprostone
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Formulary
Red
 
   
Ergometrine Maleate
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Formulary
Red
 
   
Oxytocin
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Formulary
Red
 
   
Gemeprost
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Formulary
Red
 
   
Misoprostol
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Unlicensed Drug Unlicensed
Red
  • oral
  • PV 
  •    
    07.01.01.01  Expand sub section  Drugs affecting the ductus arteriosus
    07.01.01.01  Expand sub section  Maintenance of patency
    Alprostadil (Prostin VR®)
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    Formulary
    Red
     
       
    Dinoprostone (Prostin E2®)
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    Formulary
    Red
     
       
    07.01.01.01  Expand sub section  Closure of ductus arteriosus to top
    Ibuprofen (Pedea® injection)
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    Formulary
    Red
     
       
    Indometacin (Indocid PDA®)
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    Formulary
    Red
     
       
    07.01.02  Expand sub section  Mifepristone
    Mifepristone (Mifegyne®)
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    Formulary
    Red
     
       
    07.01.03  Expand sub section  Myometrial relaxants
    Atosiban (Tractocile®)
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    Formulary
    Red
     
       
    Salbutamol
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    Formulary
    Red
     
       
    Terbutaline
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    Formulary
    Red
     
       
    Nifedipine
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    Unlicensed Drug Unlicensed
    Red
     
       
    07.02  Expand sub section  Treatment of vaginal and vulval conditions
    07.02.01  Expand sub section  Preparations for vaginal and vulval changes
    07.02.01  Expand sub section  Topical HRT to top
    Oestrogens, Topical (Estring®)
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    Formulary
    Green
     
       
    Oestrogens, Topical (Gynest®)
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    Formulary
    Green
     
       
    Oestrogens, Topical (Ovestin®)
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    Formulary
    Green
     
       
    Oestrogens, Topical (Vagifem®)
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    Formulary
    Green
     
       
    07.02.01  Expand sub section  Non-hormonal preparations
    07.02.02  Expand sub section  Vaginal and vulval infections
    07.02.02  Expand sub section  Fungal infections
    Clotrimazole
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    Formulary
    Green
  • All formulations  
  •    
    Fluconazole 150mg oral capsule
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    Formulary
    Green
     
    Link  UKMI Q&A: Can oral fluconazole be used with breastfeeding?
       
    Miconazole (Gyno-Daktarin®)
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    Formulary
    Green
  • 2% intravaginal cream
  • 1.2g ovule (vaginal capsule) 
  •    
    Econazole pessaries (Gyno-Pevaryl®)
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    Formulary
    Red
     
       
    07.02.02  Expand sub section  Other vaginal infections
    Clindamycin (Dalacin®)
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    Formulary
    Green
  • 2% cream 
  •    
    Metronidazole (Zidoval®)
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    Formulary
    Green
  • 0.75% vaginal gel 
  •    
    07.03  Expand sub section  Contraceptives to top
    07.03.01  Expand sub section  Combined hormonal contraceptives
    Ethinylestradiol 20mcg / desogestrel 150mcg (Gedarel®20/150/ Lestramyl®20/150)
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    Formulary
    Green
  • Monophasic low strength (21-day preparation)  
  •    
    Ethinylestradiol 20mcg / gestodene 75 mcg (Millinette®20/75)
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    Formulary
    Green
  • Monophasic low strength (21-day preparation)  
  •    
    Ethinylestradiol 20 mcg / norethisterone 1mg (Loestrin 20®)
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    Formulary
    Amber
  • Monophasic low strength (21-day preparation)
  • For pubertal induction in adolescent patient or premature ovarian failure ONLY 
  •    
    Ethinylestradiol 30 mcg / drospirenone 3 mg
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    Formulary
    Green
  • Monophasic standard strength (21-day preparation)

    Brands approved by APC:
  • Yacella ®
  • Acondro ®
  • Dretine ® 
  •    
    Ethinylestradiol 30mcg / desogestrel 150mcg (Gedarel®30/150, Lestramyl®30/150)
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    Formulary
    Green
  • Monophasic standard strength (21-day preparation) 
  •    
    Ethinylestradiol 30mcg / gestodene 75 mcg (Millinette®30/75)
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    Formulary
    Green
  • Monophasic standard strength (21-day preparation) 
  •    
    Ethinylestradiol 30mcg / levonorgestrel 150mcg
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    Formulary
    Green
  • Monophasic standard strength (21-day preparation)
  • Rigevidon®
  • Levest®
     
  •    
    Ethinylestradiol 30mcg / levonorgestrel 150mcg (Microgynon 30 ED ®)
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    Formulary
    Green
  • Monophasic standard strength (28-day ‘Every day’ preparation) 
  •    
    Ethinylestradiol 35 mcg / noresthisterone 500mcg (Brevinor®)
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    Formulary
    Green
  • Monophasic standard strength (21-day preparation)  
  •    
    Ethinylestradiol 35 mcg / norgestimate 250 mcg (Lizinna®)
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    Formulary
    Green
  • Monophasic standard strength (21-day preparation)  
  •    
    Ethinylestradiol/ Norethisterone  (Synphase®)
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    Formulary
    Green
  • Phasic 21-day preparation
  • Added to formulary May 2017 as alternative to Trinovum which was discontinued in 2016.  
  •    
    Mestranol 50mcg/norethisterone 1mg (Norinyl-1®)
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    Formulary
    Amber
  • Monophasic standard strength (21-day preparation)
  • For patients who need high oestrogen
  • For patients on anticonvulsant treatment 
  •    
    Ethinylestradiol / levonorgestrel phased pill (TriRegol®)
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    Formulary
    Green
  • Phasic standard strength (21-day preparation)  
  •    
    Estradiol/dienogest (Qlaira®)
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    Formulary
    Amber
  • Phasic (28-day ‘Every day’ preparation)
  • For Synphase failure 
  •    
    Combined Hormonal Contraceptive Patches (Evra®)
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    Formulary
    Amber
  • For patients with poor compliance or absorption problems 
  •    
    07.03.02  Expand sub section  Progestogen-only contraceptives
    07.03.02.01  Expand sub section  Oral progestogen-only contraceptives
    Desogestrel 75mcg
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    Formulary
    Green
  • Prescribe generically
     
  •    
    Levonorgestrel 30mcg (Norgeston®)
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    Formulary
    Green
     
       
    Norethisterone (Noriday®)
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    Formulary
    Green
  • Alternative to discontinued Micronor® 
  •    
    07.03.02.02  Expand sub section  Parenteral progestogen-only contraceptives
    Etonorgestrel 68mg implant (Nexplanon®)
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    Formulary
    Green
     
       
    Medroxyprogesterone Acetate (Depo-Provera®)
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    Formulary
    Green
     
       
    Medroxyprogesterone acetate (Sayana Press®)
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    Formulary
    Green
  • Suitable for self-injection in patients who have had appropriate training 
  •    
    07.03.02.03  Expand sub section  Intra-uterine progestogen-only contraceptive to top
    Intra-uterine Progestogen Only System (Jaydess®)
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    Formulary
    Green
  • GP will not prescribe for supply. Only prescribe if fitting.
  • Effective for 3 years 
  •    
    Intra-uterine Progestogen Only System (Mirena®)
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    Formulary
    Green
  • GP will not prescribe for supply. Only prescribe if fitting.
  • Effective for 5 years 
  •    
    07.03.03  Expand sub section  Spermicidal contraceptives
    Spermicidal Contraceptives (Gygel®2%)
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    Formulary
    Green
     
       
    07.03.04  Expand sub section  Contraceptive devices
    07.03.04  Expand sub section  Intra-uterine devices
    Intra-uterine Contraceptive Devices (Mini TT ®380 Slimline)
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    Formulary
    Green
     
       
    Intra-uterine Contraceptive Devices (Nova-T® 380)
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    Formulary
    Green
     
       
    Intra-uterine Contraceptive Devices (T-Safe® CU 380 A QuickLoad)
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    Formulary
    Green
     
       
    07.03.04  Expand sub section  Other contraceptive devices
    Arcing spring diaphragm
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    Formulary
    Green
  • Sizes 60-95mm (rising in 5mm) 
  •    
    Flat spring diaphragm
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    Formulary
    Green
  • Sizes 55-95mm (rising in 5mm) 
  •    
    07.03.05  Expand sub section  Emergency Contraception to top
    07.03.05  Expand sub section  Hormonal methods
    Levonogrestrel (Levonelle® 1500)
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    Formulary
    Green
     
       
    Ulipristal (EllaOne®)
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    Formulary
    Green
     
       
    07.03.05  Expand sub section  Intra-uterine device
    Copper Intra-uterine devices
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    Formulary
    Green
  • Various 
  •    
    07.04  Expand sub section  Drugs for genito-urinary disorders
    07.04.01  Expand sub section  Drugs for urinary retention
    07.04.01  Expand sub section  Alpha-blockers to top
    Alfuzosin Hydrochloride
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    Formulary
    Green
  • tablets
  • M/R tablets 
  •    
    Doxazosin tablets
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    Formulary
    Green

    Plain tablets only

    Black Modified release tablets are non formulary.

     
    Link  UKMI Q&A: How should conversion between doxazosin formulations be carried out?
       
    Tamsulosin M/R capsules
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    Formulary
    Green
     
       
    07.04.01  Expand sub section  Parasympathomimetics
    Bethanechol Chloride (Myotonine®)
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    Formulary
    Red
     
       
    07.04.02  Expand sub section  Drugs for urinary frequency, enuresis, and incontinence
    07.04.02  Expand sub section  Urinary incontinence
    Oxybutynin (immediate release tablets)
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    First Choice
    Green
  • 2.5mg and 5mg tablets only

  • 3mg tablets are non-formulary 
  • Oxybutynin (Modified release tablets)
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    Formulary
    Green
    High Cost Medicine
     
       
    Oxybutynin Hydrochloride patch (Kentera®)
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    Formulary
    Amber
  • for patients who cannot tolerate oral agents 
  •    
    Tolterodine tablets
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    Formulary
    Green
     
       
    Tolterodine modified -release capsules
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    Formulary
    Green
    High Cost Medicine
     
       
    Trospium
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    Formulary
    Green
  • for patients over 65 years of age 
  •    
    Trospium (Regurin® XL )
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    Formulary
    Green
  • for patients over 65 years of age 
  •    
    Mirabegron (Betmiga®)
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    Formulary
    Green
  • for patients not tolerating/ with contra-indications to antimuscarinics
  • in line with NICE 
  • Link  MHRA alert (Oct 2015): Mirabegron (Betmiga▼): risk of severe hypertension and associated cerebrovascular and cardiac events
    Link  NICE TA290: Mirabegron for overactive bladder
       
    Solifenacin (Vesicare®)
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    Formulary
    Amber
    High Cost Medicine
  • place in therapy is after agents that have effectiveness at lower costs 
  •    
    Duloxetine (Yentreve®)
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    Formulary
    Red
     
       
    07.04.02  Expand sub section  Nocturnal enuresis
    07.04.03  Expand sub section  Drugs used in urological pain to top
    07.04.03  Expand sub section  Alkalinisation of urine
    Potassium Citrate
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    Formulary
    Green
     
       
    Sodium Bicarbonate
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    Formulary
    Green
     
       
    07.04.03  Expand sub section  Acidification of urine
    07.04.03  Expand sub section  Other preparations for urinary disorders
    07.04.04  Expand sub section  Bladder instillations and urological surgery
    DIMETHYL SULPHOXIDE Bladder Instillation 50%
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    Formulary
    Red
    Hospital only 
       
    Sodium Citrate
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    Formulary
    Red
    Hospital only 
       
    07.04.04  Expand sub section  Urological surgery to top
    Glycine
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    Formulary
    Red
    Hospital only 
       
    07.04.04  Expand sub section  Maintenance of indwelling urinary catheters
    Sodium Chloride 0.9%  (Catheter Patency Solutions)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    07.04.04  Expand sub section  Bladder carcinoma
    07.04.04  Expand sub section  Interstitial cystitis
    07.04.05  Expand sub section  Drugs for erectile dysfunction
    Vacuum pumps
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    Formulary Green Traffic Light  Available in line with SLS criteria


    Red Traffic Light  If use not in line with SLS criteria

  • Use device with lowest acquisition cost 
  •    
    07.04.05  Expand sub section  Alprostadil to top
    Alprostadil cream (Vitaros®)
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    Formulary
    Amber
    Specialist initiation
  • For patients who would otherwise use alprostadil injection. 
  •    
    Alprostadil Intracavernosal injection
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    Formulary
    Amber
     
       
    07.04.05  Expand sub section  Phosphodiesterase type 5 inhibitors
    Sildenafil tablets GENERIC
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    First Choice
    Green
  • no restrictions on quantity to be supplied to ensure adequate trial of treatment
  • SLS criteria no longer apply


    For use in digital ulceration, see chapter 10 
  • Tadalafil tablets 10mg, 20mg ONLY (Cialis®)
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    Formulary
    Green
    High Cost Medicine
  • on demand preparation only
  • SLS criteria still apply
  • quantities in line with HSC guidance
    (max 4 tablets per month)  
  • Link  NICE TA273: Hyperplasia (benign prostatic) - tadalafil (terminated appraisal) (TA273)
       
    07.04.05  Expand sub section  Papaverine and phentolamine
    Aviptadil 25mcg / Phentolamine 2mg  (Invicorp®)
    (intracavernosal injection)
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    Formulary
    Amber
  • Approved on formulary December 2017
  • Specialist initiation.
  • 3rd line after oral PDE-5 inhibitors failed and patient not responding to or intolerant of alprostadil.
  • To be reviewed within 12 months to assess alprostadil supply issues and patent expiry 
  •    
    07.04.06  Expand sub section  Drugs for premature ejaculation
    07.04.06  Expand sub section  Dapoxetine
    07.05.01  Expand sub section  For ovulation induction to top
     ....
     Non Formulary Items
    Alprostadil  (MUSE®)

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    Non Formulary
     
    Anethol, Borneol, Camphene, Cineole, Fenchone, Pinene  (Rowatinex®)

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    Non Formulary
     
    Ascorbic Acid

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    Non Formulary
     
    Avanafil  (Spedra®)

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    Non Formulary
     
    Carbetocin  (Pabel®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Combined Hormonal Contraceptives  (BiNovum®)

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    Non Formulary Discontinued June 2016
     
    Combined Hormonal Contraceptives  (Femodene® ED)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Combined Hormonal Contraceptives  (Loestrin 30®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Combined Hormonal Contraceptives  (Logynon ED®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Combined Hormonal Contraceptives  (Minulet®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Combined Hormonal Contraceptives  (NuvaRing®)

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    Non Formulary
     
    Combined Hormonal Contraceptives  (Triadene®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Combined Hormonal Contraceptives  (Tri-minulet®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Combined Hormonal Contraceptives  (Trinordiol®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Dapoxetine  (Priligy®)

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    Non Formulary
     
    Darifenacin  (Emselex®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Distigmine Bromide  (Ubretid®)

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    Non Formulary
    Black
     
    Dutasteride and Tamsulosin  (Combodart®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Econazole cream  (Gyno-Pevaryl®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Ethinylestradiol 30 mcg / levonorgestrel 150 mcg  (Ovranette®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Ethinylestradiol 35 mcg / noresthisterone 1mg  (Norimin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    ethinylestradiol/norethisterone  (TriNovum®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
  • Phasic standard strength (21-day preparation)

  • Discontinued 2016
  •  
    Fenticonazole  (Gynoxin®)

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    Non Formulary
     
    Fesoterodine  (Toviaz®)

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    Non Formulary
     
    Flavoxate  (Urispas 200®)

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    Non Formulary
     
    Imipramine

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    Non Formulary
     
    Indoramin  (Doralese®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Ketoconazole 2%  (Nizoral®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Lactic acid  (Balance Activ Rx®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Lactic Acid  (Relactagel®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    nomegestrol acetate and beta estradiol  (Zoely®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Norethisterone  (Micronor®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary Discontinued
     
    Norethisterone enantate  (Noristerat®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Nystatin pessaries

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
     
    Oxybutynin Intra-vesical

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    Non Formulary
     
    Papaverine

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    Non Formulary
     
    Prazosin

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    Non Formulary
     
    Preparations for other Vaginal Infections  (Betadine®)

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

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    Non Formulary
     
    Propiverine  (Detrunorm®)

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    Non Formulary
     
    Replens MD®

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Ritodrine  (Yutopar®)

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    Non Formulary
     
    Sildenafil chewable tablets  (Nipatra®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary Discontinued October 2017
     
    Solifenacin and Tamsulosin  (Vesomni®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Tadalafil once daily

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
  • In line with NHS England's Guidance for CCGs: Items which should not routinely be prescribed in primary care (Dec 2017)

    Click here to access guidance
  • Link  Patient Information Leaflet
    Link  UKMI Q&A: Evidence for the use of regular, rather than on-demand dosing of phosphodiesterase-5 inhibitors after radical prostatectomy
     
    Terazosin

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Terazosin  (Hytrin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Vardenafil  (Levitra®)

    View adult BNF View SPC online View childrens BNF
    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
    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