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FreeStyle Libre interstitial glucose monitor has been added into the formulary for patients with type 1 diabetes mellitus who meet specific initiation and continuation criteria, following a commissioning decision from the Clinical Policy Committee. This device should be initiated by specialist endocrinologists only. Please see the formulary for further information.
We would like to thank everyone who has taken part in the Devon Formulary and Referral user survey; the survey is now closed. Your responses will be analysed and the findings published, enabling the team to improve user experience and satisfaction, and inform the future direction of the formulary.
Activon® Tube 100% Medical Grade Manuka Honey (£2.05 = 25g) has been added into the formulary as the preferred choice of honey-based topical application. Please see the formulary for further information. Medihoney 20g and 50g tubes have been removed from the formulary
ActivHeal® Silicone Foam Border Dressings have been added into the formulary as the preferred choice of silicone foam dressings. Please see the formulary for further information. Biatain Silicone Dressings have been removed from the formulary.
Sinemet tablets (62.5mg, 110mg, 275mg), Sinemet Plus tablets (125mg), Half Sinemet CR tablets (125mg), and Sinemet CR tablets (250mg) have all been removed as preferred brands from the formulary. Generic prescribing of co-careldopa is now recommended. See 4.9.1 Dopaminergic drugs used in Parkinson's disease
Neomag® 4mmol chewable tablets (£22.77 = 50 tablets) has been added into the formulary as a licensed preparation of magnesium glycerophosphate, for patients who cannot tolerate high sugar content in other formulary oral magnesium preparations. Please see the formulary for further information.
Sodium oxybate for narcolepsy with cataplexy has been reclassified from secondary care only to amber (specialist input) when used in line with the NEW Devon CCG Specialised Medicines Service prescribing guideline (funded from 1st January 2018). Please see the formulary for more information.
A NEW Devon CCG Specialised Medicines Service prescribing guideline (funded from 1st January 2018) is now available for the use of modafinil for excessive sleepiness associated with narcolepsy with or without cataplexy. The formulary entry has been updated accordingly.
Nausea and vomiting in pregnancy and hyperemesis gravidarum: new guidance in line with the Royal College of Obstetricians and Gynaecologists and NICE CKS has been added into the formulary. Please refer to the formulary for this new guidance.
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.