Formulary updates

Devon Formulary and Referral User Survey 2017

We would like to invite you to take part in the Devon formulary and referral user survey. This should take no more than about 10 minutes of your time.

The survey can be accessed by clicking on the following link:

https://www.surveymonkey.co.uk/r/M35LJ5V

The survey is being conducted to enable the team to understand and improve user experience and satisfaction. Your feedback is essential to inform the future direction of the formulary.

Feedback and suggestions via the survey are welcomed, particularly around the relevance, complexity and quantity of content; site navigation and searching; and the "traffic light" drug classification system.

We would like to thank you in advance for your participation and to assure confidentiality of all responses.

The deadline for responses is Monday 18th December 2017

October 2017

Buccolam® oromucosal solution 5mg/ml prefilled oral syringes 2.5mg, 5mg, 7.5mg, 10mg (£22.88 = 10mg prefilled oral syringe) have been highlighted as the preferred brand of buccal midazolam. Epistatus® 10mg/ml oromucosal solution has been removed from the formulary.

For patients currently established on Epistatus® brand (10mg/ml), continued ( non-formulary) prescribing is accepted, however there should be no new initiations without careful clinical consideration Please note the different strengths of these two products. The brand should not be changed without the full involvement of specialist and patient/carer. Please see the formulary for specific notes related to the prescribing of buccal midazolam.

AirFluSal® Forspiro® (combination of fluticasone and salmeterol) 500 microgram/ 50 microgram dry powder for inhalation (£32.74 = 60 doses) has been added into the formulary for use in patients aged 18 years and older with severe asthma, and COPD. Seretide® Accuhaler® 500 microgram/ 50 microgram has been removed from the formulary.

AirFluSal® metered dose inhalers (MDI) (combination of fluticasone and salmeterol) 125 microgram/ 25 microgram have been added into the formulary, for use in patients aged 18 years and older with asthma. AirFluSal® metered dose inhaler is not licensed for COPD. Seretide® Evohaler® 125 microgram/ 25 microgram, and 250 microgram/ 25 microgram have been removed from the formulary. Sirdupla® 125 microgram/ 25 microgram, and 250 microgram/ 25 microgram have been removed from the formulary. Please see the formulary for more information.

Ondansetron tablets 4mg, 8mg, and oral solutionSF 4mg/5ml have been reclassified from hospital only to blue (second line). Ondansetron injection 2mg/ml remains hospital only use. Please see the formulary for more information.

Budenofalk® (budesonide) 2mg/dose rectal foam (£57.11 = 14 application canister) has been added into the formulary, as a second line alternative to Hydrocortisone foam enemas, for use in patients with ulcerative colitis. Prednisolone rectal foam 20mg/application has been removed from the formulary. Please see the formulary for more information.

Clexane® has been added as the preferred brand of enoxaparin injections, as recommended by North Devon Healthcare NHS Trust and Royal Devon and Exeter NHS Foundation Trust. Clexane® should be prescribed by brand to prevent confusion and to ensure continuity of supply for patients. Please see the formulary for more information.

Rivaroxaban 2.5mg tablets (£50.40 = 56 tablets) has been reclassified as amber specialist use; it is included for use in patients who have had an acute coronary syndrome with elevated cardiac biomarkers, in line with NICE TA335. Please see the formulary for more information.

Management of low back pain and sciatica: guidance in line with NICE NG59 has been added into the formulary. Please refer to the formulary for this new guidance.

Management of chronic obstructive pulmonary disease (COPD): Category D: many symptoms with high risk of exacerbations, has been updated following consultation with specialists to include an additional treatment option of long-acting β2 agonist (LABA) plus inhaled corticosteroid (ICS), for patients who exhibit features suggestive of asthma/COPD overlap syndrome. Please see the formulary for up to date guidance.

August 2017

Fiasp® insulin aspart 100 units per 1ml, 10ml vials, 3ml cartridges, and 3ml FlexTouch® prefilled devices have been added into the formulary for use in patients aged 18 years and over. Please see the formulary for further information.

Carbocisteine oral liquid 250mg/5ml has been removed from the formulary. Carbocisteine sachets 750mg/10ml sugar free oral solution remains in the formulary. Please see the formulary for more information.

Catheter patency (maintenance) solutions: The guidance has been refreshed to offer clarity on when solutions may be recommended, and provide guidance towards more cost-efficient product usage. OptiFlo® S, OptiFlo® G, and OptiFlo® R saline catheter patency solutions have been removed from the formulary. Please see the formulary for up to date guidance and further information.

Emergency contraception: The guidance for emergency contraception has been reviewed and updated, following new advice from The Faculty of Sexual and Reproductive Healthcare (FSRH) Please see the formulary for up to date guidance. Ulipristal acetate tablets 30mg has been reclassified as green first line preferred treatment of emergency contraception, and Levonorgestrel tablets 1.5mg has been reclassified as blue second line treatment, following the update. Please see the formulary for further information.

Management of epilepsy: The guidance has been refreshed and expanded to emphasise MHRA Drug Safety Updates. Please see the formulary for up to date guidance and further information.

July 2017

Lyrica® has been removed as the preferred brand of pregabalin, generic prescribing is now recommended. Please see the formulary for further information.

Soltel® aerosol inhalation 25micrograms/ metered inhalation has been added into the formulary as the preferred brand of salmeterol inhaler. Soltel® is contraindicated in patients who have peanut and soya allergies. Please see the formulary for further information.

Lecicarbon A suppositories have been added into the formulary for the management of chronic constipation, following a commissioning decision from the Clinical Policy Committee. Please see the formulary for further information.

Ralvo® medicated plasters 700mg have been added as a preferred brand of lidocaine plasters, for the treatment of post-herpetic neuralgia, and should only be used following initiation by the Pain Clinic. Please see the formulary for further information.

Sodium oxybate oral solution 500mg in 1ml has been added into the formulary for the management of narcolepsy with cataplexy in adults aged 19 years and older, in line with specific criteria, following a commissioning decision from the Clinical Policy Committee. Please see the formulary for further information.

 

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