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Birmingham, Sandwell, Solihull and environs APC Formulary
Maintained by Midlands and Lancashire Commissioning Support Unit
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 Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
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
    Alprostadil cream (Vitaros®)
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    Formulary
    Amber Initiation

    Specialist initiation

    • For patients who would otherwise use alprostadil injection.
     
       
    Alprostadil Intracavernosal injection
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    Formulary
    Amber Recommended
     
       
    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
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    Formulary
    Green
    High Cost Medicine
    • Erectile Dysfunction Only 
    • on demand preparation only
    • SLS criteria still apply
    • quantities in line with HSC guidance
      (max 4 tablets per month)
    • Black for Lower Urinary tract symptoms in Benign Prostatic Hyperplasia
     
    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 Initiation
    • 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
     
       
     ....
     Non Formulary Items
    Alprostadil  (MUSE®)

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    Non Formulary
     
    Avanafil  (Spedra®)

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    Non Formulary
     
    Dapoxetine  (Priligy®)

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    Non Formulary
     
    Papaverine

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    Non Formulary
     
    Sildenafil chewable tablets  (Nipatra®)

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    Non Formulary Discontinued October 2017
     
    Tadalafil

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    Non Formulary
    Black

    Non formulary for:

    - Lower urinary tract symptoms in benign prostatic hyperplasia

     

     
    Tadalafil once daily

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    Non Formulary
    Black
    Link  Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
    Link  NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
    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
     
    Vardenafil  (Levitra®)

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    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

    Prescribing in children

    The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

    The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
      

    Green

    Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

    Amber Initiation

    Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

    Amber Recommended

    Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

    Amber SC

    Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

    Red

    Medicines for initiation and maintenance prescribing by Specialists only.  

    Black

    Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

    Grey

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

    The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

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