Formulary updates

May 2019

Commissioning Policy: The routine commissioning of semaglutide is accepted in Devon for patients with type 2 diabetes as described for glucagon-like peptide-1 (GLP-1) mimetics in NICE guideline NG28 (see Commissioning Policy for more details). Semaglutide has been added in the formulary as a green (first line) option in line with the policy. Click here for more information

Commissioning Policy: The routine commissioning of FreeStyle Libre is accepted in Devon for patients with diabetes mellitus in line with specific criteria (see Commissioning Policy for more details). Click here for more information

April 2019

• Cilodex (ciprofloxacin 3mg/ml & dexamethasone 1mg/ml) ear drops, suspension has been added to formulary as a first line option for acute otitis externa (AOE) in adults and children over 1 year of age. Click here for more information.
• Ganciclovir 0.15% eye gel has been added to the formulary as a first line option for acute herpetic keratitis. Click here for more information.
  • Aciclovir 3% eye ointment has been removed from the formulary due to product discontinuation
• DEKAs Plus (liquid, chewable tablets, and softgels) and DEKAs Essential capsules have been added to the formulary as amber (specialist input) options for the dietary management of cystic fibrosis patients. Click here for more information.
• Paravit-CF liquid has been added to the formulary as an amber (specialist input) option for the dietary management of cystic fibrosis in babies and patients with swallowing difficulties. Click here for more information.
• Lyme disease: Formulary guidance has been revised and updated to provide more detail including specific antibiotic recommendations depending on the patient's age and presenting symptoms. Please see the formulary for further guidance.
• Management of gout: Formulary guidance has been revised and updated. Please see the formulary for further guidance.
• Prolongation of the QT interval: New guidance relating to drugs that prolong the QT interval has been developed and added to the cardiovascular chapter. Please see the formulary for further guidance.
• Management of Secondary prevention of stroke and transient ischaemic attack (TIA): has been reviewed following the publication of The Exeter Guidelines for Secondary Prevention of Stroke and Transient Ischaemic Attack in Primary Care, 8th Edition, February 2019. Please see the formulary for further guidance.
• Unipolar depression: NICE and Devon Partnership NHS Trust (DPT) prescribing guidelines have been used to revise and update formulary guidance. Please see the formulary for further guidance.

December 2018

• Cabergoline tablets (500 microgram, 1mg, 2mg) have been added to the formulary as an amber (specialist input) option for the management of hyperprolactinaemic disorders. Click here for more information.
• Cholurso® 250mg tablets have been removed as the preferred brand of ursodeoxycholic acid; generic prescribing is now recommended. Click here for more information.
• Dexamfetamine sulfate tablets 5mg have been added to the formulary as an amber (specialist input) option for the treatment of narcolepsy in adults. Click here for more information.
• Kyleena® 19.5mg (levonorgestrel) intrauterine systemhas been added to formulary as a green (first line) option for contraception in women, licensed for up to 5 years. Click here for more information.
• Emollients: The choice of formulary emollient preparations has been updated with supporting guidance to aid prescribers. Click here for more information.
• Anal irrigation systems: Following the inclusion of the new guidance published in August 2018, a specific list of locally agreed products has been added to the guidance reflecting current local practice. Please see the formulary for further guidance.
• Anal inserts: Guidance has updated and added to the formulary to offer advice and support to GPs, alongside the list of locally agreed products. Please see the formulary for further guidance.

October 2018

• Ulipristal acetate (Esmya) 5mg tablets have been reclassified as red (hospital only) following an EMA safety review. Click here for more information.
• Acute otitis media: Following publication of NICE NG91: Otitis media (acute): antimicrobial prescribing (March 2018) Formulary guidance has been revised and updated. Please see the formulary for further guidance.
• Adult asthma: NICE NG80: Asthma: diagnosis, monitoring and chronic asthma management (November 2017), prompted a review of the current guidance, which is based on recommendations made by the British Throacic Society (BTS) and the Scottish Intercollegiate Guideline Network (SIGN). Formulary guidance continues to follow the recommendations made by BTS/SIGN, with minor changes to offer clarity to existing guidance and relevant product choices. Please see the formulary for further guidance.
• Management of constipation in children: Guidance has been updated to be more clear and concise, including relevant product choices. Please see the formulary for further guidance.
• Management of pain and opioids: Acute and chronic non-malignant painguidance, with consideration to the Opioids Aware resource hosted by the Faculty of Pain Medicine, has been added in the formulary. Please see the formulary for further guidance.
• Commissioning Policy: The routine commissioning of Tresiba® (insulin degludec) is accepted in Devon for the treatment of patients with type 1 diabetes who meet specific criteria (See Commissioning Policy for more information)
• Commissioning Policy: The routine commissioning of Tresiba® (insulin degludec) in Devon for the treatment of type 2 diabetes is unchanged and is not accepted (See Commissioning Policy for more information)
• Commissioning Policy: The routine commissioning of Trelegy® Ellipta® (combination of fluticasone furoate, umeclidinium bromide, and vilanterol trifenatate) is accepted in Devon for maintenance treatment in adult patients with moderate to severe chronic obstructive pulmonary disease (COPD) (See Commissioning Policy for more details)

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