Recent Updates

March 2018

Alprostadil urethral sticks 250 microgram, 500 microgram, 1000 microgram (£11.30 = 1 dose) have been added to the formulary here, as an alternative to intracavernosal injection and topical cream.

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.

Ondansetron tablets and oral solution have been reclassified to blue (second line); the formulary entry can be found here.

Rifaximin tablets 550mg (£259.23 = 56 tablets), for the treatment of hepatic encephalopathy has changed from a red hospital only treatment to amber, specialist use. Further guidance on the use of this treatment can be found here.

Shortec® has been accepted as the preferred brand for oxycodone oral solution, both 5mg/5ml and 10mg/1ml. The formulary entry for oxycodone can be found here.

Trimbow® metered dose inhaler (MDI), combination of beclometasone dipropionate 87 micrograms, formoterol fumarate dihydrate 5 micrograms, and glycopyrronium bromide 9 micrograms / delivered dose (£44.50 = 120 dose unit), has been added to the formulary here, for use in moderate to severe COPD in patients who are not adequately treated by a combination of inhaled corticosteroid / long-acting beta2-agonist.

Zeroveen® Cream (£5.89 = 500g) has been added to the formulary here. It is an emollient 2-in-1 moisturising cream and wash containing natural oatmeal, similar in formulation to Aveeno® cream but available at a lower acquisition cost.

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:

Vacuum devices for the management of erectile dysfunction: new guidance has been added to the formulary (here) to support GPs when asked to continue prescribing. Vacuum devices should be initiated by specialists. Once found to be an acceptable option to the patient, the device may then be continued in primary care.

Nausea and vomiting in pregnancy and hyperemesis gravidarum: new guidance has been added to the formulary to support primary care clinicians, and complement the referral guidance. The guidance can be found here.

Management of acute pain, chronic non-malignant pain, management of opioids, management of pain in substance misuse disorders: the aforementioned formulary treatment guidance and associated drug monographs have been updated with support from local specialists and consideration given to the "Opioids Aware" resource hosted by the Faculty of Pain Medicine. The guidance and associated drug monographs can be accessed in Chapter 4. Central Nervous System.

Devon Formulary and Referral User Survey 2017

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.

January 2018

AirFluSal metered dose inhalers (MDI) (combination of fluticasone propionate and salmeterol) 125 micrograms/ 25 micrograms, and 250 micrograms/ 25 micrograms have been added into the formulary, for use in patients aged 18 years and older with asthma. Please see the formulary for further information.

  • Seretide Evohalers 125 microgram/ 25 microgram, and 250 microgram/ 25 microgram have been removed from the formulary.

Ciprofloxacin eye drops 0.3% has been reclassified as blue second line treatment in cases of acute otitis externa and acute otitis media. It is also a suitable preparation in tympanic membrane perforation. These are unlicensed indications. Please see the formulary for further information.

Modafinil has recently had a prescribing guideline agreed between specialist services, NEW Devon CCG, and the Local Medical Committee (LMC) to support the safe prescribing and monitoring in primary care, when the GP is confident to undertake specified roles. This has been added as a note to the drug monograph. Please see the formulary for further information.

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 magnesium preparations. Please see the formulary for further information.

Sodium oxybate oral solution 500mg in 1ml has been reclassified as an amber specialist input preferred treatment for the management of narcolepsy with cataplexy in adults aged 19 years and older, in Western locality only.Please see the formulary for further information.

Management of Hypertension: guidance has been reviewed in line with NICE CG127 and following consultation with specialists; no major updates were required. 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 ttached in the formulary:

November 2017

Soltel aerosol inhalation 25micrograms/ metered inhalation (£19.95 = 120 doses) 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.

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 further information.

Formulary choice oral nutritional supplements: Following consultation with local dietitian specialists in South and West Devon, the choices of formulary oral nutritional supplements have been reviewed. The choices provided have been chosen based on palatability, range of flavours, and cost efficiency. Please see the formulary for further guidance.

Further specialist oral nutritional supplements are available, that are not included in the formulary, but are suitable to be prescribed at a specialist dietitian's request.

 

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