Recent Updates

COVID-19 updates

For the latest updates and advice on coronavirus (COVID-19), please visit the NHS website.

For a summary of Formulary updates specific to the COVID-19 pandemic, please click here.

For Clinical Referral Guideline (CRG) updates specific to the COVID-19 pandemic, please click here.

May 2023

Drug changes and additions
  • Comirnaty Original/Omicron BA.4-5 variant and Spikevax bivalent Original/Omicron BA.4-5 variant COVID-19 vaccines have been added to the formulary
  • Ketotifen 250micrgrams/ml eye drops 0.4ml unit dose preservative free have been added as a blue (second line) option for seasonal allergic conjunctivitis
  • Following agreement by local specialists the Sativex entry has been revised and updated. The updated entry may support GPs who are asked to prescribe the treatment, by providing clarity on the level of support which is provided by the specialist team
    • The revision identifies prescriber responsibilities; reassures GPs that patients will remain under specialist supervision; and highlights that GPs should refer patients back to the specialist should any changes in the severity of the patient's condition, concomitant medication or if troublesome adverse reactions develop. Sativex does not require any specific ongoing drug safety monitoring by a GP
    • Click here for the formulary entry.
  • Verkazia (ciclosporin) emulsion eye drops 1mg/1ml have been added as an amber (specialist input) option for severe vernal keratoconjunctivitis in children from 4 years of age and adolescents. Prescribe by brand to avoid confusion
    COVID-19 updates
    • Following the announcement of the national protocol programme for the administration of COVID-19 vaccine to children and adolescents (individuals aged 5 to 17 years) and adults (aged 18 and over), the COVID-19 vaccine section has been reviewed and updated to include all listed vaccines in the UK and associated links to national guidance

    March 2023

    Drug changes and additions
    • Dexamfetamine 10mg and 20mg tablets and 5mg/5ml oral solution sugar free have been added as amber (specialist input)
      • Due to its higher acquisition cost, the oral solution sugar free should be reserved for patients who are unable to use tablets
      • Click here for the formulary entry.
    • The Dexcom ONE real time continuous glucose monitoring (rtCGM) system entry has been updated to include the transmitter which is now prescribable on FP10
      • Dexcom ONE is a rtCGM system which requires the patient to attach both a "sensor" and a "transmitter" to themselves. The transmitter snaps into the sensor and sends glucose readings to a smartphone or Dexcom ONE reader. Each sensor lasts for 10 days, and each transmitter lasts for 3 months. Until now, only the sensors were prescribable; the transmitters were supplied directly to patients by Dexcom via pharmacies. For more information, see here
      • Click here for the formulary entry.
    • Luforbec 200/6 pMDI (BDP extrafine 200micrograms / formoterol 6micrograms per dose) has been added for the treatment of asthma in adults
    • Fostair 200/6 pMDI (BDP extrafine 200micrograms / formoterol 6micrograms per dose) has been removed from the formulary due to its high acquisition cost in comparison to Luforbec 200/6 pMDI
      • No new patients should be prescribed Fostair 100/6 pMDI or 200/6 pMDI. For existing patients, continued prescribing is accepted until the next review when the patient should be switched to Fostair NEXThaler or Luforbec pMDI if clinically appropriate
      • The text above is included in the formulary entry, see here
      • Fostair NEXThalers (BDP extrafine / formoterol) 100/6 DPI and 200/6 DPI remain unchanged as formulary options
      • Click here for the formulary entry.
    • Medicine Supply Notification 17 January 2023 - Update (MSN/2023/002U):
      • Insuman Comb 25 cartridge and Insuman Basal cartridge stock have now been exhausted and are no longer available
      • Insuman Comb 25 pre-filled pens, Insuman Basal pre-filled pens, and Insuman Rapid cartridges will be discontinued with stocks being exhausted by June 2023
      • No new patients should be initiated on Insuman Comb 25, Insuman Basal, and Insuman Rapid products
      • All patients should be reviewed and alternative prescribing considered as per the Supporting Information in the Medicine Supply Notification - available alternative insulins are also listed in the formulary
      • Ensure that after switching, patients are counselled on how to use the new device, explain that the dose of insulin remains the same, but adjustments may be needed
      • Click here for the formulary entry.
    • ViATIM (combined hepatitis A and typhoid vaccine) has been removed from the formulary following confirmation that Sanofi has discontinued production. The decision to cease production is not linked to safety issues
      • Production ceased in December 2021; with anticipated stock supplies already exhausted, however last batches have an expiry date of November 2024
      • There is availability of alternative typhoid and hepatitis A vaccines
      • Click here for the formulary entry.
    • The Sanofi Pasteur COVID-19 vaccine, VidPrevtyn Beta, has been authorised by the Medicines and Healthcare products Regulatory Agency (MHRA)
      • The authorisation is for the use of this vaccine in those aged 18 and over, as a heterologous booster dose, given as a single injection
      • The vaccine has been added to the formulary after it was found to meet the UK regulator's standards of safety, quality and effectiveness
      • Click here for the formulary entry.

    February 2023

    Drug changes and additions
    • Melatonin 1mg, 2mg, 3mg, 4mg, and 5mg immediate-release tablets have been added as an amber (specialist input) option. Branded Circadin 2mg modified-release tablets have been removed from the formulary in favour of generic prescribing (melatonin 2mg modified-release tablets), which remain amber (specialist input)
      • Melatonin may be prescribed in primary care only on the advice of a specialist
      • Adaflex brand immediate-release tablets can be crushed and mixed with water directly before administration
      • Other melatonin products are available and in use often for historical reasons. It is considered appropriate for GPs to initiate discussions with patients and carers about changing to a formulary recommended formulation
      • Click here for the formulary entry.
    • Varenicline 500micrograms, 1mg tablets have been declassified. The product has been withdrawn from the market; however, the entry will remain listed while the mandatory NICE Technology Appraisal (TA123) continues to positively recommend varenicline.
    Commissioning policies
    • The routine commissioning of guanfacine hydrochloride 1mg, 2mg, 3mg, and 4mg prolonged-release tablets is accepted in Devon for the management of attention deficit hyperactivity disorder (ADHD) in children and adolescents aged 6 to 17 years, where previous treatment with stimulants AND previous treatment with atomoxetine, is ineffective OR not tolerated OR these treatments are not suitable
    Last updated: 17-05-2023


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