This page was printed from the Northern & Eastern Devon Formulary and Referral site at
Please ensure you are using the current version of this document
New European Medicines Agency safety alert issued for ingenol mebutate gel. Healthcare professional letter expected week beginning 27th January 2020.
Fluphenazine decanoate (Modecate) injections have been removed from the formulary following product discontinuation (due to manufacturing and supply problems not any safety issues). Any remaining patients currently prescribed these products should be referred to specialist services for consideration of alternative therapy (DPT have confirmed that referral should be via the assessment teams as normal).
GlucoRx CarePoint Ultra pen needles 4mm/31G have been added to the formulary as green (first line) options. Click here for more information.
Kelhale Aerosol inhalation metered dose inhalers (beclometasone dipropionate [BDP] extrafine) 50micrograms and 100micrograms have been added to the formulary as green (first line) options. BDP inhalers should be prescribed by brand since they are not all interchangeable. Click here for more information.
Latanoprost / timolol single unit dose eye drops (preservative-free) 50micrograms / 5mg/ml have been added to the formulary as an amber (specialist) option. Click here for more information.
One-Alpha capsules 250 nanograms, 500 nanograms, and 1 microgram have been added as the formulary preferred brand for alfacalcidol for vitamin D complementation in severe renal impairment. Click here for more information.
Acute cough guidance review: Following publication of NICE NG120 Cough (acute): antimicrobial prescribing (February 2019), formulary guidance has been revised and updated. Please see the formulary for further guidance.
Chronic Obstructive Pulmonary Disorder (COPD) guidance review: Following publication of updated guidance from both GOLD and NICE in 2019, formulary guidance on the management of COPD has been revised and updated. The review incorporates management of stable COPD and COPD exacerbations and includes new antimicrobial guidance for acute exacerbations. Please see the formulary for further guidance.
The environmental impact of inhalers: New guidance has been produced which highlights the carbon footprint of inhalers, and steps that may be taken to mitigate environmental impact in terms of inhaler device choice, waste and recycling. Please see the formulary for further guidance
Ondansetron in pregnancy: The formulary guidance on ondansetron use for nausea and vomiting in pregnancy has been updated, following a safety recommendation by the European Medicines Agency (EMA). The SPCs for ondansetron products will be updated to indicate that it should not be used during the first trimester of pregnancy, as a review of studies of pregnancy identified a small increase in the risk of orofacial cleft. However, use of ondansetron in pregnancy is still supported by the UK Teratology Information Service and The Royal College of Obstetricians and Gynaecologists. Please see the formulary for further guidance.
Community-acquired Pneumonia (CAP) guidance review: Following publication of NICE NG138 Pneumonia (community-acquired): antimicrobial prescribing (September 2019), formulary guidance was discussed and will be updated soon, further details will be circulated at that time.
Chapter 14. Immunological products and vaccines: The chapter has undergone format changes and information has been consolidated to streamline the accessibility of clinically appropriate guidance and treatment options. Vaccination strengths, doses, and treatment regimens have been removed and replaced with a permanent link to Public Health England's (PHE) 'The Green Book'. Please see the formulary for further guidance.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): The formulary entries for NSAIDs have been reviewed and updated following the recent review of formulary gout guidance and as part of the rolling review programme. Please see the formulary for further guidance.
Partial updates to the following North and East Devon Shared Care guideline have been published:
Shared Care / SMS guidelines are available on the NHS Devon CCG website ( www.devonccg.nhs.uk) or via the above hyperlink, and are also available from the relevant drug entries in the Devon Formulary
Following feedback from the user survey, a new improved search function has been added which allows users to filter search results by Formulary or Referral pages.
Commissioning Policy: The routine commissioning of glycopyrronium bromide oral solution is accepted in Devon for the symptomatic treatment of severe sialorrhoea (chronic pathological drooling) in children and adolescents aged 3 years and older with chronic neurological disorders (see Commissioning Policy for more details)
Commissioning Policy: The routine commissioning of Continuous Glucose Monitors (CGMs) is accepted in Devon for patients with type 1 diabetes mellitus in line with specific criteria (see Commissioning Policy for more details)
Partial updates to the following North and East Devon Shared Care / Specialised Medicines Service (SMS) guidelines have been published:
Updated information includes:
Shared Care / SMS guidelines are available on the NHS Devon CCG website ( www.devonccg.nhs.uk) or via the above hyperlinks. Hyperlinks are also available from the relevant drug entries in the Devon Formulary
New and updated multiple choice quizzes (MCQs) have been added to the formulary. The quizzes are designed to highlight key areas of formulary guidance and to help keep up-to-date with national and local guidance. Click here for more information. The following quizzes are new or have been updated:
Chlamydia trachomatis: Following an update to the Chlamydia trachomatis guideline from the British Association for Sexual Health and HIV (BASHH). Formulary guidance has been reviewed and updated. Please see the formulary for further information.
Psoriasis management: Following updates to NICE Guideline CG153 Psoriasis: assessment and management (September 2017) and British Association of Dermatologists (BAD) Clinical Guideline: Psoriasis (October 2018). Formulary guidance has been revised, expanded and updated. Please see the formulary for further guidance.
Gender dysphoria and transgender prescribing: A summary of the prescribing responsibilities described by NHS England, alongside advice from NHS England for GPs regarding requests by private online medical service providers has been added to the formulary. Please see the formulary for further information.
Following public consultation; NHS England (NHSE) and NHS Clinical Commissioners (NHSCC) published guidance for CCGs on items which should not be routinely prescribed in primary care. Click here for more information. The following items have new guidance attached in the formulary:
Following public consultation; NHS England (NHSE) and NHS Clinical Commissioners (NHSCC) published guidance for CCGs, on conditions for which over the counter (OTC) items should not routinely be prescribed in primary care. Click here for more information.Last updated: 09-12-2019