Birmingham, Sandwell, Solihull and environs APC Formulary Formulary


	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

Drugs for erectile dysfunction

Vacuum pumps

Formulary

Available in line with SLS criteria

If use not in line with SLS criteria

Use device with lowest acquisition cost

07.04.05

Alprostadil

Alprostadil cream (Vitaros^®)

Formulary

Specialist initiation

For patients who would otherwise use alprostadil injection.

Alprostadil Intracavernosal injection

Formulary

07.04.05

Phosphodiesterase type 5 inhibitors

Sildenafil tablets GENERIC

First Choice

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

Formulary

Erectile Dysfunction Only
on demand preparation only
SLS criteria still apply
quantities in line with HSC guidance
(max 4 tablets per month)
for Lower Urinary tract symptoms in Benign Prostatic Hyperplasia

NICE TA273: Hyperplasia (benign prostatic) - tadalafil (terminated appraisal) (TA273)

07.04.05

Papaverine and phentolamine

Aviptadil 25mcg / Phentolamine 2mg (Invicorp^®)
(intracavernosal injection)

Formulary

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^®)

Non Formulary

Avanafil (Spedra^®)

Non Formulary

Dapoxetine (Priligy^®)

Non Formulary

Papaverine

Non Formulary

Sildenafil chewable tablets (Nipatra^®)

Non Formulary

Discontinued October 2017

Tadalafil

Non Formulary

Non formulary for:

- Lower urinary tract symptoms in benign prostatic hyperplasia

Tadalafil once daily

Non Formulary

Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care

NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs

Patient Information Leaflet

UKMI Q&A: Evidence for the use of regular, rather than on-demand dosing of phosphodiesterase-5 inhibitors after radical prostatectomy

Vardenafil (Levitra^®)

Non Formulary

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	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.
	Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.
	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 Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.
	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.
	Medicines for initiation and maintenance prescribing by Specialists only.
	Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.
	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.