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Nystan® has been removed as the preferred brand of nystatin 100,00 units/ml and generic prescribing is now recommended. The dose has reverted to 1ml four times a day in line with the recently updated BNF and BNFc.
Omeprazole orodispersible tablets have been added into the formulary, only for use in children.
Evolve® HA 0.2% P/F eye drops have been added as a preferred brand of sodium hyaluronate preservative free and Hyabak® and Hylo-forte® have been removed from the formulary.
Glucodrate® oral powder sachets have been added into the formulary only for patients with short bowel syndrome who are unable to tolerate St Mark's Electrolyte Solution.
Sacubitril/ valsartan tablets has been reclassified as amber for use in primary care. Treatment should be initiated by a heart failure consultant. Initial clinical assessment, monitoring and prescribing will remain the responsibility of the specialist heart failure team for at least the first three months. Please see the formulary for further information.
Management of thyroid disorders guidance: This has been added into the formulary. Please refer to the formulary for this guidance.
IBS guidance: The guidance for irritable bowel syndrome in adults has been reviewed and updated. Please see the formulary for up to date guidance.
Spiriva® Handihaler® has been removed from the formulary, leaving Spiriva® Respimat® and Braltus® Zonda® as options for patients requiring tiotropium.
Naloxegol has been reclassified as amber for use in primary care following recommendation from a member of the palliative care team only. In all other indications, naloxegol should be restricted to secondary care use.
PumpCart® Novorapid insulin aspart cartridges - these cartridges are for use in insulin pumps. PumpCart® cartridges have been reclassified as amber to enable continued prescribing by primary care following specialist initiation.
Adult tension headache guidance: This has been added into the formulary. Please refer to the formulary for this guidance.
NICE TA420 Ticagrelor for preventing atherothrombotic events after myocardial infarction was published in December. The TA recommends treatment with ticagrelor for a maximum of 3 years for patients who have had an MI and who are at high risk of a further event after the initial 12 months of ticagrelor 90mg twice daily or other ADP receptor inhibitor treatment (prasugrel or ticlopidine). The formulary advice has been amended to define those patients at high risk, please see the formulary for further information.
Asthma guidance: Both the adult and the paediatric guidance for the management of asthma have been reviewed. Please see the formulary for up to date guidance.
Management of neuropathic pain: These guidance notes have amended to highlight the advice of recording pain scores and assessing the effectiveness of the treatment, with a view of stopping treatments if they are not reducing the pain. There have been no changes in the drug choices. Please see the formulary for the up to date guidance.
Glucomen Aero® ketone test strips have been added to the formulary
Braltus® (tiotropium) inhalation powder capsules (£25.50) have been added into the formulary as a less costly alternative to Spiriva® inhalation powder capsules (£33.50). Spiriva Respimat® (£23.00) solution for inhalation is also a formulary option. Please see the formulary for further information.
Thick and Easy® Clear and Nutilis® Clear have been approved to be added to the formulary. These will be added with some guidance notes on their use, patients should remain on the products recommended and not switched between the two. Also the sachet preparations should not be prescribed as they are significantly more expensive.