Recent Updates

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.

September 2017

Spiolto Respimat(combination of tiotropium and olodaterol) 2.5micrograms/ 2.5micrograms solution for inhalation has been added into the formulary for the management of chronic obstructive pulmonary disease (COPD), following a commissioning decision form the Clinical Policy Committee. Please see the formulary for further information. It should be noted that the MHRA Drug Safety Update (February 2015) applies to SpioltoRespimat as tiotropium is delivered via Respimat or HandiHaler.

Monuril sachets 3g have been added into the formulary as the preferred brand of fosfomycin, for the treatment of uncomplicated urinary tract infection (UTI) in adults if first line options are unsuitable. Please see the formulary for further information.

Levetiracetam granules sugar free sachets 250mg, 500mg, and 1g, have been added into the formulary for use in paediatric patients who cannot take the tablets, and cannot tolerate the oral solution. Please see the formulary for further information.

Enoxaparin sodium prefilled syringes for injection have been updated with the latest strength expressions, after a letter was sent to healthcare professionals to highlight an inclusion of international units (IU) of anti-Xa activity. One mg of enoxaparin sodium is equivalent to 100 IU anti-Xa activity. Please see the formulary for further information.

Alzain has been removed from the formulary as the preferred brand of pregabalin. Generic prescribing is now recommended. Please see the formulary for further information. Please see the formulary for further information.

Antimicrobials and infections: The infections chapter of the formulary has been updated in line with Public Health England: Management of infection guidance for primary care for consultation and local adaptation (May 2017), and local microbiologist specialists. Please see the formulary for up to date guidance. Pivmecillinam tablets 200mg and Fosfomycin (Monuril) sachets 3g have been reclassified as blue second line treatment of uncomplicated UTI in adults if first line options are unsuitable, following advice and recommendation from local microbiologist specialists. Please see the formulary for further information.

Compression hosiery and garments: Following consultation with local tissue viability specialist nurses, this guidance has been reviewed and refreshed to provide unified care across settings, to encourage patient concordance by offering a vast choice of hosiery suitable for patient needs and lower limb conditions. Please see the formulary for up to date guidance.

Management of low back pain and sciatica: This has been added into the formulary. Please refer to the formulary for this guidance

 

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