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. The NHS Devon Medicines Optimisation Team have produced a COVID-19 Information and Guidance page, which features a frequently asked questions section, please click here.
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
January 2023
Drug changes and additions
- EVRA (ethinylestradiol/norelgestomin) 33.9micrograms/203micrograms/24hr transdermal patches have been added as a blue (second line) option for contraception in women aged 18 to 45 years.
- SyreniRing (ethinylestradiol/etonogestrel) 15micrograms/120micrograms/24hr vaginal delivery system has been added as a blue (second line) option for contraception in women aged 18 to 40 years.
Revised sections
- The Stoma Care section has been updated following a comprehensive review involving Stoma Care Nurse Specialists, with representation from each of the three NHS Trusts across Devon. This section has been updated to create cohesive Devon-wide stoma care recommendations, enabling consistent prescribing whilst providing guidance to support GPs and other prescribers.
Commissioning policies
- The routine commissioning of nefopam is not accepted in Devon for the management of chronic pain.
- The routine commissioning of Otigo (phenazone with lidocaine) ear drops is not accepted in Devon for the treatment of acute otitis media pain.
Last updated: 08-03-2023
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