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 Formulary Chapter 9: Nutrition and blood - Full Chapter
09.01  Anaemias and some other blood disorders
09.01.01  Iron-deficiency anaemias
 note 

Iron (oral)

Warning – Iron tablets may be attractive to children and patients should be warned to store their iron tablets carefully to avoid accidental iron poisoning.

Notes:  

  • Patients should be advised to continue taking iron for 3 months after recovery of haemoglobin to allow replenishment of iron stores.
  • Maximum absorption of iron occurs with TDS dosing. Once or twice a day dosing of iron preparations may be effective for prophylaxis or mild iron deficiency.
  • Modified release preparations have not been included because they are likely to carry the iron past the first part of the duodenum into an area of the gut where conditions for iron absorption are poor. The low incidence of side effects may well be because of the small amounts of iron available under these conditions. The BNF recommends that these preparations have no therapeutic advantage and should not be used.
  • Pregaday®has not been included. It contains 350 microgram of folic acid, less than the 400 micrograms recommended for the prevention of neural tube defects in women planning a pregnancy and is inadequate for the treatment of megaloblastic anaemia.
  • A low Hb in pregnancy does not mean anaemia and iron should only be prescribed if the MCV and ferritin are low. 
09.01.01.01  Oral iron
Ferric maltol (Feraccru®)
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Formulary
Red

Capsules 30mg

Notes:

  • Second line for iron deficiency anaemia in adult with mild to moderate IBD who have failed 2 oral ferrous products.
  • To be considered prior to administration of IV options.
  • Usual duration - 12 weeks.
 
   
Ferrous Fumarate
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Formulary
Green
  • Tablets 210mg (equivalent to 68mg ferrous iron per tablet) 
  • Syrup 140mg/5mL (equivalent to 45mg ferrous iron per 5mL)
 
   
Ferrous Sulfate
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Formulary
Green

Tablets 200mg (equivalent to 65mg ferrous iron per tablet)

Note:

Iron preparations differ in their iron content. As gastro-intestinal side effects are related to the iron content there is a lower incidence of side effects with preparations containing less iron.

 
   
Polysaccharide Iron Complex (Niferex®)
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Formulary
Amber 1

Elixir (equivalent to approx 500 micrograms of ferrous iron per drop) 30ml dropper bottle

Notes:

Under part XVIIIB of Drug Tariff, Niferex can only be prescribed on FP10s to infants born prematurely for prophylaxis of iron deficiency

Such prescriptions must be endorsed SLS

 
   
Sodium Feredetate (Sytron®)
Formulary
Green

ElixirSF 190mg in 5mL (equivalent to 27.5mg of ferrous iron per 5mL)

Note:  Sodium feredetate is included as the liquid form of iron. 

 
   
09.01.01.01  Iron and folic acid
09.01.01.01  Compound iron preparations to top
09.01.01.02  Parenteral iron
 note 

Iron (Parenteral)

Important Safety Information

MHRA/CHM advice: Serious hypersensitivity reactions with intravenous iron (August 2013)

Serious hypersensitivity reactions, including life-threatening and fatal anaphylactic reactions, have been reported in patients receiving intravenous iron. These reactions can occur even when a previous administration has been tolerated (including a negative test dose). Test doses are no longer recommended and caution is needed with every dose of intravenous iron.

Intravenous iron products should only be administered when appropriately trained staff and resuscitation facilities are immediately available; patients should be closely monitored for signs of hypersensitivity during and for at least 30 minutes after every administration. In the event of a hypersensitivity reaction, treatment should be stopped immediately and appropriate management initiated.

The risk of hypersensitivity is increased in patients with known allergies, immune or inflammatory conditions, or those with a history of severe asthma, eczema, or other atopic allergy; in these patients, intravenous iron should only be used if the benefits outweigh the risks.

Intravenous iron should be avoided in the first trimester of pregnancy and used in the second or third trimesters only if the benefit outweighs the potential risks for both mother and fetus.

Ferric Carboxymaltose (Ferinject®)
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Formulary
Red

Injection 50mg/mL

 
Link  Drug Safety Update : Intravenous iron and serious hypersensitivity reactions: strengthened recommendations
   
Iron Dextran (CosmoFer®)
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Formulary
Red

Injection 50mg/mL

 
Link  Drug Safety Update: Intravenous iron and serious hypersensitivity reactions: strengthened recommendations
Link  UKMI Q&A: How do I use Cosmofer (iron dextran) total dose infusion for correction of iron deficiency anaemia
   
Iron Sucrose (Venofer®)
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Formulary
Red

Injection 20mg/ml

 
Link  Drug Safety Update : Intravenous iron and serious hypersensitivity reactions: strengthened recommendations
   
09.01.02  Drugs used in megaloblastic anaemias
Folic Acid
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Formulary
Green
  • Tablets 5mg
  • Tablets 400 microgram  
  • SyrupSF2.5mg in 5mL
  • SyrupSF 400 microgram in 5mL 
  • Folic Acid – injection 15mg/mL  U  

Care should be taken in giving folic acid on its own for megaloblastic anaemia. Patients given folic acid alone must have a proven high/normal B12 level before folic acid is started or else both must be given jointly until the level has back, if there is an urgent need to start treatment.

A ferritin level should also be done before treatment is given and one month after starting in case there is an occult iron deficiency which may become evident afetr B12 and folate replacement.

Neural tube defects (prevention in preganancy)

Periconceptional Folic Acid and Food Fortification in the Prevention of Neural Tube Defects (SAC Opinion Paper 4)

Recommendations of an expert advisory group of the Department of Health include the advice that:

  • To prevent recurrence of neural tube defect (in a child of a man or woman with spina bifida, or if there is a history of neural tube defect in a previous child). Women who wish to become pregnant (or who are at risk of becoming pregnant) should be advised to take folic acid supplements at a dose of 5mg daily (reduced to 4mg daily if a suitable preparation becomes available). Supplementation should continue until the twelfth week of pregnancy. Women receiving antiepileptic therapy need individual counselling by their doctor before starting folic acid.
  • To prevent first occurrence of neural tube defect women who are planning a pregnancy should be advised to take folic acid as a medicinal or food supplement at a dose of 400 micrograms daily before conception and during the first 12 weeks of pregnancy. Women who have not been supplementing and who suspect they are pregnant should start at once and continue until the twelfth week of pregnancy.
  • There is no justification for prescribing multiple-ingredient vitamin preparations containing vitamin B12 or folic acid.
 
   
Hydroxocobalamin
(Vitamin B12)
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Formulary
Green

Injection 1mg/mL 

 
   
Cyanocobalamin
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Restricted Drug Restricted
Green

Tablets 50 micrograms

Notes:

Tablets for dietary deficiency are selfcare.

Hydroxocobalamin has completely replaced cyanocobalamin as the form of vitamin B12 of choice for therapy; it is retained in the body longer than cyanocobalamin and thus for maintenance therapy can be given at intervals of up to 3 months.

Neo-Cytamen® injection is blacklisted and prescriptions must be written for generic hydroxocobalamin to be allowable on FP10 prescription.

Folinic acid tablets (calcium folinate), used to counteract the folate-antagonistic action of methotrexate.

 
   
09.01.03  Drugs used in hypoplastic, haemolytic, and renal anaemias
 note 

NICE recommendations:

Use as per NICE TA 142: Epoetin alfa, beta and darbepoetin alfa for cancer treatment-induced anaemia (May 2008)

Use as per NICE TA 323: Erythropoiesis stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy (including review of TA 142) (November 2014)

09.01.03  Erythropoietin
Epoetin alfa (Eprex®)
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Formulary
Red
High Cost Medicine
Homecare
  • Eprex® Injection, prefilled syringes - 1000, 2000, 3000, 4000, 5000, 6000, 8000, 10 000, 20 000, 30 000, 40 000 units
  • Eprex® [Amber 3] - Eprex can be prescribed by GPs after consultant initiation and stabilisation. However, renal patients remain under hospital prescribing and Eprex should NOT be prescribed by their GP.
 
Link  NICE NG8: Anaemia in chronic kidney disease
Link  NICE TA323: Erythropoiesis‑stimulating agents during chemotherapy
   
Darbepoetin Alfa (Aranesp®)
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Formulary
Amber 3
High Cost Medicine
Homecare
  • Aranesp® Injection, prefilled syringes - 10, 20, 30, 40, 50, 60, 80, 100, 130, 150, 300, 500 micrograms
  • Aranesp® Injection, SureClick prefilled disposable pens 20, 40, 60, 80, 100, 150, 300, 500 micrograms 
 
Link  NICE NG8: Anaemia in chronic kidney disease
Link  NICE TA323: Erythropoiesis‑stimulating agents during chemotherapy
   
Epoetin beta (NeoRecormon®)
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Formulary
Red
High Cost Medicine

NeoRecormon® Injection, prefilled syringes – 500, 2000, 3000, 4000, 5000, 6000, 10,000, 20,000, 30,000 units 

 
Link  MHRA: epoetin beta may increase risk of retinopathy in preterm infants
Link  NICE NG8: Anaemia in chronic kidney disease
Link  NICE TA323: Erythropoiesis‑stimulating agents during chemotherapy
   
09.01.03  Iron overload to top
Desferrioxamine Mesilate
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Formulary
Red
High Cost Medicine
Homecare

Injection, powder for reconstitution, 500mg vial

 
   
09.01.04  Drugs used in autoimmune thrombocytopenic purpura
Anagrelide
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Formulary
Red

Capsules 500 micrograms 

 
   
Eltrombopag (Revolade®)
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Formulary
Red
High Cost Medicine

Tablets 25mg, 50mg

Advice for healthcare professionals:


• Eltrombopag is highly coloured (reddish-brown) and can cause serum discolouration and interference with the test results of creatinine and bilirubin.


• Be aware that interference with bilirubin (falsely low/normal results) and creatinine (falsely high/normal results) may occur in patients taking eltrombopag.


• If bilirubin and/or creatinine laboratory results are inconsistent with clinical observations, request re-testing using another method to determine the validity of the result.


• The laboratory may consider susceptibility to serum discolouration and other factors that may be relevant when selecting an alternative test method.


• Report suspected adverse drug reactions, including any harm that
occurs from a medicine interfering with laboratory test results, to the Yellow Card Scheme.

 
Link  MHRA: eltrombopag interference with creatinine and bilirubin tests
Link  NICE TAG 293: Eltrombopag for treating chronic ITP
   
Lusutrombopag
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Formulary
Red
High Cost Medicine

3mg tablets

 
Link  NICE TA617: Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
   
Romiplostim (Nplate®)
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Formulary
Red
High Cost Medicine

Injection, powder for reconstitution 250 microgram vial 

 
Link  NICE TA221: Thrombocytopenic purpura - romiplostim
   
09.01.05  G6PD deficiency
09.01.06  Drugs used in neutropenia
Filgrastim (Neupogen®)
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Formulary
Red
High Cost Medicine

Injection 30 million units (300 micrograms) in 1mL vial or pre-filled syringe

 
   
Filgrastim (Zarzio®, Accofil®)
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Formulary
Red
  • Injection 30 million units (300 micrograms) in 0.5mL pre-filled syringe
  • Injection 48 million units (480 micrograms) in 0.5mL pre-filled syringe
 
   
Lenograstim (Granocyte®)
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Formulary
Red
High Cost Medicine
  • Pre-filled syringe 13.4 million units (105 micrograms)
  • Pre-filled syringe 33.6 million units (263 micrograms)  
 
   
Pegfilgrastim (Neulasta®)
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Formulary
Red
High Cost Medicine

Injection 6mg / 0.6ml solution for injection in pre-filled syringe

 
   
09.01.07  Drugs used to mobilise stem cells
09.02  Fluids and electrolytes to top
 note 

Pre-mixed Infusion solutions

  • Pre-mixed infusion solutions should be used when possible.
  • Medical errors involving Sterile Potassium Chloride Concentrate (20mmol/10ml {15%}) can be potentially fatal.
  • The use of Sterile Potassium Chloride Concentrate (20mmol/10ml {15%}) is restricted to use in areas that require potassium-containing fluids not available as pre-mixed solutions.

  

Recommended: Pre-mixed infusion solutions

Base fluid

Volume

Potassium content

per bag

Potassium chloride

content

Sodium chloride 0.9%

1000ml

20mmol

0.15%

Sodium chloride 0.9%

1000ml

40mmol

0.30%

Glucose 5%

1000ml

20mmol

0.15%

Glucose 5%

1000ml

40mmol

0.30%

Glucose 4% & Sodium chloride 0.18%

1000ml

20mmol

0.15%

Glucose 4% & Sodium chloride 0.18%

1000ml

40mmol

0.30%

Glucose 10%*

500ml

10mmol

0.15%

*Unlicensed product.

  • Other pre-mixed solutions are expected to become available. Please check the current position with Pharmacy.

 

Specific indication:

Sterile Potassium Chloride Concentrate (20mmol/10ml {15%})

  • Restricted to Critical Care areas

Potassium Chloride prefilled syringe (50mmol/50ml {7.5%})

  • Restricted to Critical Care areas

Potassium Acid Phosphate Sterile Solution for injection {13.6%}

  • Restricted to Critical Care areas
09.02.01  Oral preparations for fluid and electrolyte imbalance
09.02.01.01  Oral potassium
Potassium Chloride (Kay-Cee-L®)
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Formulary
Green

Syrup SF containing 1mmol potassium per ml

 
   
Potassium Chloride (Sando-K®)
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Formulary
Green

Effervescent tablets each containing 12mmol potassium

 
   
Potassium Chloride (Slow-K®)
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Formulary
Green

Modified release tablets each containing 8mmol potassium

Notes:

  • Potassium supplementation is indicated for proven hypokalaemia.
  • Potassium salts are preferably given as the effervescent tablets or liquid preparation, rather than the modified release tablets. Slow-K® tablets only contain 8mmol potassium per tablet and are associated with oesophageal ulceration.
 
   
09.02.01.01  Potassium removal
Polystyrene Sulphonate Resins (Calcium Resonium®)
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Formulary
Amber 2
  • Powder calcium polystyrene sulphonate.  
  • Enema 30g in 100mL U 

Note:

Calcium Resonium or Resonium A can be taken orally mixed in water (not fruit squash or other potassium containing fluids), or as a paste. It may also be administered rectally (contact your pharmacist for formulation details).

 
   
Polystyrene Sulphonate Resins (Resonium A®)
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Formulary
Amber 2

Powder sodium polystyrene sulphonate.

Note:

Calcium Resonium or Resonium A can be taken orally mixed in water (not fruit squash or other potassium containing fluids), or as a paste. It may also be administered rectally (contact your pharmacist for formulation details).

 
   
09.02.01.02  Oral sodium and water
Sodium Chloride (Slow Sodium®)
Formulary
Amber 3

Modified release tablets containing 600mg sodium chloride (equivalent to 10mmol Sodium)

 
   
Sodium Chloride 30% oral solution
Unlicensed Drug Unlicensed
Red

Sodium Chloride 30% oral solution

 
   
09.02.01.02  Oral rehydration therapy (ORT) to top
 note 

Oral rehydration salts:

  Na+ K+ Cl- Glucose Other
Dioralyte® - 5 sachets reconstituted with 1 litre of water  60 mmol 20 mmol 60 mmol  90 mmol 10 mmol citrate 
Dioralyte® Relief - 5 sachets reconstituted with 1 litre of water  60 mmol 20 mmol 50 mmol 30g Rice starch 10 mmol citrate
Electrolade® - 5 sachets reconstituted with 1 litre of water  50 mmol 20 mmol 40 mmol 111 mmol 30 mmol HCO3-
WHO formulation - 1 litre (Unlicensed) 90 mmol 20 mmol 80 mmol 111 mmol 10 mmol citrate


Notes:

  • WHO formulation (St Marks solution) is an unlicensed preparation and not commonly used in the UK.
  • It is usually for short bowel patients requiring oral rehydration.
Oral Rehydration Salts
Formulary
Green
 
   
09.02.01.03  Oral bicarbonate
Sodium Bicarbonate
Formulary
  • Capsules, 500mg
  • Infusion 1.26%, 2.74%, 8.4%
  • Injection 8.4%
 
   
09.02.02  Parenteral preparations for fluid and electrolyte imbalance
09.02.02.01  Electrolytes and water
09.02.02.01  Intravenous sodium
Sodium Chloride and Glucose Intravenous Infusion
Formulary
Green
  • Sodium chloride 0.18% and glucose 4% intravenous infusion
  • Sodium chloride 0.45% and glucose 5% intravenous infusion
  • Sodium chloride 0.45% and glucose 2.5% intravenous infusion
  • Sodium lactate intravenous infusion compound (Hartmann's solution)
 
Link  NPSA Patient Safety Alert: Reducing the risk of hyponatraemia when administering intravenous infusions to children
   
Sodium Chloride Intravenous
Formulary
Green
  • 0.45%, 0.9%, 1.8% for injection / infusion
  • 0.9% available as 5mL, 10mL, 20mL ampoules
  • 50mL vials  
 
   
09.02.02.01  Intravenous glucose to top
Glucose Infusion
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Formulary
Green
  • 5% infusion, 500ml, 1 litre bags
  • 10% infusion, 500ml and 1 litre bags
  • 20% infusion, 100ml and 500ml bags
 
   
09.02.02.01  Intravenous potassium
Potassium Chloride Injections
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Formulary
Red

Sterile Potassium Chloride Concentrate (20mmol/10ml {15%})

  • Restricted to Critical Care areas

Potassium Chloride prefilled syringe (50mmol/50ml {7.5%})

  • Restricted to Critical Care areas

Potassium Acid Phosphate Sterile Solution for injection {13.6%}

  • Restricted to Critical Care areas
 
   
09.02.02.01  Bicarbonate and lactate
09.02.02.01  Water
09.02.02.02  Plasma and plasma substitutes
09.02.02.02  Plasma substitutes to top
Gelatin (Gelofusine®, Isoplex®)
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Formulary
Red

40g per 1ml (4%)

 
   
09.03  Intravenous nutrition
 note 

Proprietary infusion fluids for parenteral feeding

Note:  

  • Parenteral nutrition is a PbR excluded medicine.
  • Treatment beyond the first 14 days will require approval from the exceptional circumstances committee.
  • GPs should not be asked to prescribe TPN or any component of it. 
Intralipid® 10%
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Formulary
Red

500mL

 
   
Intralipid® 20%
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Formulary
Red

500mL

 
   
Kabiven 11g N (Manipulated) 2073mL
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Formulary
Red

Central PN

 
   
Kabiven 14g N (Manipulated) 2586mL
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Formulary
Red

Central PN

 
   
Kabiven 7g N (Manipulated) 1940mL
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Formulary
Red

Peripheral or Central PN

 
   
Parenteral Nutrition (TPN or PN)
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Formulary
Red

Contact the Pharmacy Depertment

 
   
Plasma-Lyte® 148 (water)
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Formulary
Red

Solution for Infusion, pH 7.4, 1000mL

 
   
Vamin® 14 (electrolyte-free)
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Formulary
Red

1000 mL 

 
   
09.03  Supplementary preparations
Addiphos® solution
(Supplementary preparation)
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Formulary
Red

20 mL vial

 
   
Glucose Oral 30%
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Unlicensed Drug Unlicensed
Red

Glucose 30% Oral Solution

 
   
09.04  Oral nutrition
09.04.01  Foods for special diets
09.04.02  Enteral nutrition to top
 note 

Enteral Feeds (non-disease specific), Nutritional supplements (non-disease specific), Specialised formulas and Feed supplements

Due to separate contractual arrangements in place for the supply of products to the hospital, the designated categories do not apply to prescribing for inpatients at the hospital.

The choice of product from the list for use only within the hospital remains the clinical decision/recommendation of the hospital dietitians.

Please refer to our Complete Adult Oral Nutritional Supplements Formulary (updated 2020).

 

Initiating Oral Nutritional Supplements (ONS) in Primary Care

Food First advice should be trialled for 2- 4 weeks. If goals are not achieved, consider prescribing ONS twice daily, supported by a planned review process.

The other criteria that should be fulfilled before an ONS is prescribed, as discussed in the NICE guideline CG 32, are essentially that:

  • Patient’s MUST score is appropriate
  • Patient’s condition is ACBS approved

ONS are only available on FP10 prescriptions for specific indications as agreed by the Advisory Committee on Borderline Substances (ACBS).

 

Standard ACBS Indications: Disease-related malnutrition, intractable malabsorption, pre-operative preparation of patients who are undernourished, dysphagia, proven inflammatory bowel disease, following total gastrectomy, short bowel syndrome, bowel fistula.

 

Useful sources of information:

 

Infant Formulae

 

Feed additives

Feed thickeners and pre-thickened drinks

Resources to support safer modification of food and drink 27 June 2018

Products

Instant Carobel powder (Cow & Gate Ltd)

Nutilis® Clear (Nutricia Ltd) - subject to robost implementation plan 

 

Nutrition in special diets

Coeliac disease

Milton Keynes CCG does not routinely fund gluten free foods on prescription for coeliac disease and dermatitis herpetiformis.


If a clinician considers that a patient’s specific circumstances mean that they could be at risk of dietary neglect then they can request that their case is considered by MKCCG.


You will need to complete this Gluten Free Foods Proforma and include as much information as possible so that the case can be fully reviewed by the team.

If a patient is approved for NHS prescriptions, the only products that can be prescribed are bread and flour mixes as listed in the Drug Tariff.

 

Phenyketonuria (PKU), Maple Syrup Urine Disease (MSUD) and other low protein diets

Patients with a diagnosis of PKU, MSUD or other diagnoses requiring a low protein diet who are prescribed low protein products that are also gluten free must remain on such products.

09.05  Minerals
09.05.01  Calcium and magnesium
09.05.01.01  Calcium supplements
 note 

Notes:

  • Patients should be encouraged to increase their dietary intake of calcium.
  • Calcium supplements are usually only required where dietary calcium intake is deficient. Patients with coeliac disease are at increased risk of osteoporosis due to malabsorption of calcium, weight loss and low BMI. With a good response to a gluten free diet, bone mineral density increases. However, many coeliacs require supplementary calcium. (see section 9.6.4)
  • Approximately 700mg of calcium is required per day. In osteoporosis, double the recommended daily amount reduces the risk of bone loss. For specific advice on the use of calcium in treatment and prophylaxis of osteoporosis see chapter 6 section 6.6 ‘Drugs affecting bone metabolism’.
  • Calcium Sandoz® syrup is included where a liquid form of calcium is required.
  • Calcium and vitamin D products are included in Section 9.6.4.
Calcium Chloride
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Formulary
Red

Min-I-jet 10mL 

 

Shortage of supply (23/03/2020) - Calcium chloride 10% pre-filled syringes:

Calcium chloride pre-filled syringes 10% (6.8 mmol in 10 ml) are licensed for use in cardio-pulmonary resuscitation, as well as the treatment of hypocalcaemia and calcium deficiency states. 

The 10 ml pre-filled syringe of calcium chloride 10% is the preparation listed in the Resus Council list of drugs for intravenous use for cardiac- and peri-arrest. In cardiac arrest caused by hyperkalaemia, hypocalcaemia, or overdose of calcium channel-blocking drugs, an initial dose of 10 ml of 10% calcium chloride (6.8 mmol Ca2+) is recommended, which may be repeated if necessary.

Calcium chloride 10% pre filled syringes are out of stock, we do not currently have a clear date for resolution.

Alternative agents and management options

Calcium gluconate injection is an alternative to calcium chloride. In order to manage this shortage, some of the cardiac arrest boxes will contain calcium gluconate ampoules instead of calcium chloride pre-filled syringes.

It is important to note that there is a difference in calcium content:

10 ml of 10% calcium chloride pre-filled syringes contains 6.8 mmol calcium whereas 10 ml of 10% calcium gluconate contains 2.26 mmol calcium.

The Resus Council mentions use of calcium gluconate as an alternative, highlighting difference in calcium content, you would need to administer 30mls of calcium gluconate to achieve 6.78 mmol calcium and during CPR, if required, it should be given as a rapid bolus injection followed by a 0.9% sodium chloride flush.

Administration

Calcium gluconate can be given as a slow IV injection in an emergency (e.g. severe acute hypocalcaemia, cardiac resuscitation, hypocalcaemic tetany). Give each 10mL of undiluted injection over at least 5 minutes, while monitoring plasma-calcium and ECG. (Resus Council advises can be given as rapid bolus injection during CPR).

Safety:

Calcium gluconate undiluted has a high osmolarity and may cause venous irritation and tissue damage in cases of extravasation.

There may be certain patients, for example in critical care and those with severe liver impairment, for whom the increased volume of gluconate or the time taken to infuse this additional volume may be problematic, and any remaining stock of chloride may need to be prioritised for this group.

 

 

 
   
Calcium Gluconate
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Formulary
Red

10mL ampoule 

 
   
Sandocal-1000®
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Formulary
Green

Effervescent tablets containing 1000mg calcium (25mmol)

Note:  Approved for the short term treatment of hypocalcaemia post thyroidectomy.

 
   
09.05.01.02  Hypercalcaemia and hypercalciuria
Cinacalcet (Mimpara®)
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Formulary
Red
High Cost Medicine
Homecare

Tablets 30mg, 60mg, 90mg

Notes:  GP can continue to prescribe for patients already stabilised on it.

 
Link  NICE TA117: Hyperparathyroidism - cinacalcet
   
Etelcalcetide (Parsabiv®)
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Formulary
Red

Solution for injection; 2.5mg, 5mg, 10mg in vial

 
Link  NICE TA448: Etelcalcetide for secondary hyperparathyroidism
   
09.05.01.03  Magnesium to top
Magnesium Aspartate (Magnaspartate®)
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Formulary
Amber 1

Magnaspartate® Powder in Sachets containing magnesium (as aspartate dihydrate) 243mg (10mmol) per 6.5g peach/apricot flavoured powder in sachet for oral solution

 
   
Magnesium Glycerophosphate
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Formulary
Amber 1

Neomag® Chewable Tablets containing 97mg (4mmol) magnesium per tablet

 
Link  NICE: Evidence Summary: Magnesium glycerophosphate
   
Magnesium Sulphate
Formulary
Red

Injection 50% (approximately 2 mmol magnesium per mL) 10mL amps

Note:

  • Magnesium deficiency is rare.
  • Magnesium sulfate may be used to treat pre-eclamptic arrhythmias. 
 
Link  UKMI Q&A: Can magnesium sulphate be given subcutaneously?
Link  UKMI Q&A: Magnesium sulphate injection: converting between mM, mg and % w/v.
   
Magnesium Glycerophosphate
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Unlicensed Drug Unlicensed
Amber 1

Liquid containing 10 mmol in 10ml

 
Link  NICE: Evidence Summary: Magnesium glycerophosphate
   
09.05.02  Phosphorus
09.05.02.01  Phosphate supplements
Phosphate - Sandoz (Phosphate-Sandoz®)
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Formulary
Amber 1
Effervescent tablets containing the equivalent of 16.1mmol phosphate
 
   
Phosphate Polyfusor®
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Formulary
Red

0.1mmol phosphate per ml infusion

 
   
Phosphate Mixture
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Unlicensed Drug Unlicensed
Red

Mixture 100ml, containing the equivalent of 527 mmol phosphate/litre

 
   
09.05.02.02  Phosphate-binding agents
Lanthanum (Fosrenol ®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
  • Fosrenol® chewable tablets lanthanum carbonate hydrate 500mg
  • Fosrenol® chewable tablets lanthanum carbonate hydrate 750mg
  • Fosrenol® chewable tablets lanthanum carbonate hydrate 1g
  • Fosrenol® powder lanthanum carbonate hydrate 750mg
  • Fosrenol® powder lanthanum carbonate hydrate 1g

Note:

  • For use by the Renal Team only.
  • Renagel and Lanthanum are available for third line management of hyperphosphataemia in dialysis patients with serum phosphate levels that are not controlled, or where aluminium and calcium salts are inappropriate.
 
   
Sevelamer Carbonate
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Formulary
Red
High Cost Medicine
  • Renvela® tablets sevelamer carbonate 800mg
  • Renvela® sachets sevelamer carbonate 2.4g - for use via enteral feeding tubes when sevelamer is indicated.

Note:

  • For use by the Renal Team only.
  • Hospital use only for new patients.
 
   
Sevelamer Hydrochloride  (Renagel®)
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Formulary
Red
High Cost Medicine

Renagel® tablets 800mg 

Note:

  • For use by the Renal Team only.
  • Hospital use only for new patients.
 
   
09.05.03  Fluoride
09.05.04  Zinc to top
Zinc Sulphate (Solvazinc®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Solvazinc® Zinc sulphate 125mg (equivalent to 45mg Zn) effervescent tablets

 
   
09.05.05  Selenium
09.06  Vitamins
09.06.01  Vitamin A
VITAMIN A (RETINYL PALMITATE) Injection 100,000 units in 2 mL (VITAMINE A NEPALM)
Formulary
Red

Injection 100,000 units in 2ml

 
   
09.06.02  Vitamin B group
Pyridoxine Hydrochloride
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • Tablets 10mg, 20mg, 50mg
  • Injection 50mg in 2mL  (Unlicensed)   
 
   
Thiamine
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • Tablets 50mg, 100mg
  • Injection 250mg in 5mL  (Unlicensed)    
 
Link  NICE: Alcohol dependence - diagnosis, assessment and management
Link  NICE: Management of alcohol-related physical complications
   
Thiamine (Pabrinex®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
  • Injection I/M High potency
  • Injection I/V High potency
 
Link  NICE: Alcohol dependence - diagnosis, assessment and management
Link  NICE: Management of alcohol-related physical complications
   
Riboflavin
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Restricted Drug Restricted
Red Red

Capsules 400mg

Note:  Self-care product - Advise patients to buy over the counter.

 
   
09.06.02  Oral vitamin B complex preparations to top
Vitamin B Tablets (Compound)
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Formulary
Green

Tablets    

 
   
Vitamin B Tablets, Compound Strong
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Formulary
Green

Tablets 

 
   
09.06.02  Other compounds
09.06.03  Vitamin C
Ascorbic Acid (Vitamin C)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted

Tablets 50mg, 100mg, 500mg

Notes:

  • Should not be prescribed in Primary Care or at Discharge.
  • Advise patient to purchase, unless prescription is for long-term regular use.
  • Deficiency is rare and ascorbic acid is not recommended.
  • In iron deficiency states ascorbic acid may increase gastro-intestinal iron absorption but its role in clinical practice is not established.
 
   
09.06.04  Vitamin D
 note 

In line with guidance from the Royal College of Obstetricians and Gynaecologists, MKPAG recommends a treatnment does of Fultium D3 20,000 IU per week for 4 to 6 weeks, followed by a maintenance dose of Invita D3800 IU daily.

The maintenance therapy should be continued throughout pregnancy.

 

Also in line with this guidance, treatment doses should not be given in the first trimester.

 

For supplementation in pregnancy, MKPAG recommends either Healthy Start viatmins if the woman is eligible or self purchase over-the-counter. These products should not be recommended or supplied as prescribed medicines.

Alfacalcidol (One-Alpha®)
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Formulary
Amber 2
  • Capsules 250 nanograms, 500 nanograms, 1 microgram
  • Oral drops 2 microgram in 1mL
  • Injection 2 micrograms 1mL (1mL ampoules)
 
   
Calcitriol
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Formulary
Amber 2
  • Capsules 250 nanograms, 500 nanograms
  • Injection 1 microgram in 1mL, 2 micrograms in 1mL 
 
   
Colecalciferol 2,400 units/ml drops (Invita D3® oral drops)
View adult BNF View SPC online View childrens BNF
Formulary
Green
  • 800 unit capsules containing colecalciferol 
  • 5,600 unit capsules containing colecalciferol (This strength allows weekly dosing)
  • 50,000 unit capsules containing colecalciferol 
  • 25,000 units/mL oral solution 
  • 50,000 units/mL oral solution 
  • 2,400 units/mL oral drops, solution

Note:  May be mixed with a small amount of cold or lukewarm food immediately before administration.

 
   
Colecalciferol 20,000 unit capsules (Fultium D3®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Capsules containing 20,000 unit (= 500 micrograms Vitamin D)

 
   
Colecalciferol 4000 units (Desunin®)
(Tablets)
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Formulary
Green

Tablet 800 unit

 
   
Ergocalciferol
(Injection)
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Formulary
Red

Injection 300,000 units in 1mL

 
   
Colecalciferol 3,000 units per ml liquid
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Unlicensed Drug Unlicensed
Red

Liquid 3,000 units in 1mL

 
   
09.06.05  Vitamin E
Alpha Tocopheryl Acetate
(Vitamin E)
View adult BNF View SPC online View childrens BNF
Formulary
Amber 3

Suspension 500mg in 5ml

 
Link  UKMI Q&A: Oral treatments for treating Peyronie’s disease
Link  UKMI Q&A: Vitamin E for ME review
   
09.06.06  Vitamin K to top
 note 

Local Guideline:

Vitamin K Prophylaxis in Newborn Babies

Menadiol Sodium Phosphate
View adult BNF View SPC online View childrens BNF
Formulary
Amber 1

Tablets 10mg

Menadiol sodium phosphate is water-soluble and is included for use where patients have fat malabsorption syndromes.

 
Link  National guidance on vitamin K in obstetric cholestasis: UKMI Q+A
   
Phytomenadione (Konakion® MM Paediatric)
View adult BNF View SPC online View childrens BNF
Formulary
Amber 1

Injection (Konakion® MM Paediatric) 2mg in 0.2mL 

  • [May be administered by mouth, intramuscular injection or intravenous injection]. See local guideline above.
  • Injection (Konakion MM) 10mg in 1ml. Not for intramuscular administration.

Notes:

  • Vitamin K in the newborn – The recommendation of the Chief Medical Officer and the Chief Nursing Officer is that all newborn babies should receive vitamin K to prevent vitamin K deficiency bleeding (previously termed haemorrhagic disease of the newborn).
  • For preterm neonates, see BNF for Children.
 
Link  UKMI Q&A: Guidance on the use of vitamin K for obstetric cholestasis
   
09.06.07  Multivitamin preparations
Multivitamin preparations (Abidec®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber 1

Oral drops

 
Link  Abidec and peanut allergy (UKMi Q&A)
   
Multivitamin preparations (Dalivit®)
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Formulary
Amber 1

Oral drops

 
   
Multivitamin eye supplements
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Restricted Drug Restricted
Red Red

All formulations are Non-formulary - for self care only.

 
   
09.06.07  Vitamin and mineral supplements and adjuncts to synthetic diets
 note 

Vitamin capsules BPC

Notes:

  • Should not be prescribed in Primary Care or at Discharge.
  • Advise patient to purchase, unless prescription is for long-term regular use.

 

Vitamin tablets

(with calcium and iodine) for nursing mothers

Tablets vitamin A 8mg, ascorbic acid 60mg, ergocalciferol 400 units, calcium hydrogen phosphate 190mg, potassium iodide 130 micrograms, ascorbic acid 60mg

Notes: 

  • Should not be prescribed in Primary Care or at Discharge.
  • Advise patient to purchase, unless prescription is for long-term regular use.
  • Women who are (or may become) pregnant are advised not to take this supplement except on the advice of a doctor or antenatal clinic.
Vitamin and mineral supplements (Ketovite®)
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Formulary
Amber 1
  • Tablets
  • Liquid

Note:  Ketovite tabs (taken three times a day) and liquid (5ml daily in addition to the tablets) are included for use in disorders of carbohydrate or amino acid metabolism.

 
   
Multivitamin
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Restricted Drug Restricted

Capsules BPC

Notes:

  • Should not be prescribed in Primary Care or at Discharge.
  • Advise patient to purchase, unless prescription is for long-term regular use.
 
   
Vitamin and mineral supplements (Forceval®)
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Restricted Drug Restricted
Amber 1

Capsules

Notes:

  • Forceval contains vitamins and minerals and must be recommended by a dietitian/gastroenterologist stating the indication and duration of therapy.
  • On hospital discharge, patients will receive 2 weeks' supply as part of their TTOs and GPs should not continue the prescription, unless they receive a letter from the dietitian/specialist to continue therapy stating an indication and duration of therapy.
 
   
09.07  Bitters and tonics
09.08  Metabolic disorders
09.08.01  Drugs used in metabolic disorders to top
09.08.01  Wilsons disease
Penicillamine
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Formulary
Red

Tablet 125mg 

 
   
Trientine
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Formulary
Red
NHS England
BlueTeq

Capsule 250mg, 300mg

 
Link  Clinical Commissioning Policy: Trientine for Wilson disease (all ages)
   
09.08.01  Carnitine deficiency
Levocarnitine (Carnitor®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
  • Oral liquid 100mg per 1ml = 1g/10ml, 10% solution
  • Oral liquid 300mg per 1ml = 1.5g/5ml, 30% Paediatric solution
  • Injection 200mg per 1ml = 1g in 5ml soultion
 
   
09.08.01  Fabry's disease
09.08.01  Gaucher's disease
09.08.01  Mucopolysaccharidosis I to top
09.08.01  Pompe disease
09.08.01  Nephropathic cystinosis
Mercaptamine (Cystagon®)
View adult BNF View SPC online View childrens BNF
Formulary
High Cost Medicine

Tablets 50mg

 
   
09.08.01  Urea cycle disorders
09.08.02  Acute porphyrias
Haem Arginate (Normosang®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Normosang® solution for infusion 25mg/ml

Note:

  • Many drugs can precipitate porphyria crisis. The BNF contains some guidance but please refer to Haematologists or the Medicines Information Centre at Milton Keynes Hospital for advice on prescribing for patients with acute porphyria.
  • Haemarginate (Normosang®) is kept in the Pharmacy Emergency Cupboard fridge for the treatment of acute porphyric crisis under the supervision of a Consultant Haematologist.
 
Link  UKMI Q&A: Use of haem arginate (human hemin) in acute porphyria
Link  BIMDG (British Inherited Metabolic Disease Group) protocol: Adult emergency management of acute porphyria
Link  BIPNET (British and Irish Porphyria Network) Clinical Guidelines
   
09.08.02  Drugs unsafe for use in acute porphyrias to top
 ....
 Non Formulary Items
Colecalciferol with calcium phosphate  (Calfovit D3®)

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Non Formulary
 
Agalsidase Alfa and Beta  (Fabrazyme®)

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Non Formulary
High Cost Medicine
 
Agalsidase Alfa and Beta  (Replagal®)

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Non Formulary
High Cost Medicine
 
Albumin Solution
(Isotonic solutions)

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Non Formulary
 
Alglucosidase Alfa  (Myozyme®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Alpha Tocopherol  (Vedrop®)

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Non Formulary

Suspension 500mg in 5ml

 
Aluminium Hydroxide  (Alu-Cap®)

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Non Formulary
 
Antithymocyte Immunoglobulin (Equine)

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Non Formulary
High Cost Medicine
 
Arginine

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Non Formulary
 
Asfotase alfa  (Strensiq®)

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Non Formulary
High Cost Medicine
Link  NICE HST6: Asfotase alfa for treating paediatric-onset hypophosphatasia
 
Babiven start up

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Non Formulary
 
Betaine
(Homocystinuria)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Biotin

View adult BNF View childrens BNF
Non Formulary
 
Bisphosphonates

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Bitters and tonics
(Gentian mixture alkaline BP)

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Non Formulary
 
Bitters and tonics  (Effico®)

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Non Formulary
 
Bitters and tonics  (Labiton®)

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Non Formulary
 
Bitters and tonics  (Metatone®)

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Non Formulary
 
Cacit®
(Calcium carbonate)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Calcichew®
(Calcium carbonate)

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Non Formulary
 
Calcitriol  (Calcijex®)

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Non Formulary
 
Calcitriol  (Rocaltrol®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Calcium Acetate  (Phosex®)

Non Formulary
 
Calcium acetate  (PhosLo®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Calcium Acetate  (Renacet®)

Non Formulary
 
Calcium and Ergocalciferol

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Non Formulary
 
Calcium Carbonate  (Calcichew®)

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Non Formulary
 
Calcium Carbonate with Colecalciferol

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Non Formulary
 
Calcium Salts

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Non Formulary
 
Calcium Salts
(Calcium lactate)

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Non Formulary
 
Calcium Salts

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Non Formulary
 
Calcium Syrup  (Alliance Pharma)

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Non Formulary
 
Calcium-Sandoz®

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Non Formulary
 
Carglumic Acid  (Carbaglu®)

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Non Formulary
High Cost Medicine
 
Chenodeoxycholic acid

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Non Formulary
Red Red
High Cost Medicine

This product must not be prescribed. Please contact Pharmacy for advice.

 
Chenodeoxycholic acid  (Leadiant biosciences)

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Non Formulary
Red Red
High Cost Medicine

This product must not be prescribed. Please contact Pharmacy for advice.

 
Colecalciferol

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Non Formulary
 
Colecalciferol
(With alendronic acid )

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Non Formulary
 
Colecalciferol 1,000 units  (Sunvit D3®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Colecalciferol 10,000units/ml drops  (Thorens®)

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Non Formulary
 
Colecalciferol and Calcium Carbonate

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Colestilan  (BindRen®)

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Non Formulary
High Cost Medicine
 
Compound iron preparations  (Ferrograd C®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Compound iron preparations  (Givitol®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Compound Sodium Lactate Intravenous Infusion
(Known as hartmanns solution)

Non Formulary
 
Deferiprone  (Ferriprox®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Desferrioxamine Mesilate  (Desferal®)

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Non Formulary
 
Dextran 40®

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Non Formulary
 
Dextran 70  (RescueFlow®)

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Non Formulary
 
Dextran 70®

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Non Formulary
 
Dihydrotachysterol  (AT 10®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Eculizumab

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Non Formulary
High Cost Medicine
Homecare
Link  NICE HST1: Eculizumab for atypical haemolytic uraemic syndrome
Link  Commissioning Policy: Eculizumab in the treatment of recurrence of C3 glomerulopathy post-kidney transplant (all ages)
Link  Commissioning Policy: Eculizumab is NOT routinely commissioned to prevent recurrence of C3 glomerulopathy post kidney transplant
Link  NICE evidence summary: eculizumab for prevention of C3 glomerulopathy post-transplant
 
Eliglustat  (Cerdelga®)

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Non Formulary
High Cost Medicine
Link  NICE HST5- Eliglustat for treating type 1 Gaucher disease
 
Elosulfase alfa  (Vimizim® )

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Non Formulary
High Cost Medicine
Link  NICE HST2: Elosulfase alfa for treating mucopolysaccharidosis type IVa
 
Ergocalciferol
(Oral)

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Non Formulary
 
Etherified Starch
(Hetastarch)

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Non Formulary
 
Etherified Starch
(Pentastarch)

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Non Formulary
 
Etherified Starch  (HAES-steril®)

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Non Formulary
 
Etherified Starch  (Hemohes®)

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Non Formulary
 
Etherified Starch  (Infukoll®)

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Non Formulary
 
Ferric citrate coordination complex  (Fexeric®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ferrous Fumarate  (Fersaday®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ferrous Fumarate  (Fersamal® Syrup)

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Non Formulary
 
Ferrous Fumarate  (Galfer®)

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Non Formulary
 
Ferrous Gluconate

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Non Formulary
 
Ferrous Sulphate  (Ferrograd®)

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Non Formulary
 
Ferrous Sulphate  (Ironorm® drops)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ferumoxytol Injection  (Rienso ®)

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Non Formulary
Link  MHRA: Serious hypersensitivity reactions—contraindicated if any drug allergy (Sept 14)
 
Filgrastim  (Nivestim®)

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Non Formulary
High Cost Medicine
Link  NICE KTT15: Biosimilar medicines
 
Filgrastim  (Ratiograstim®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fluoride

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Non Formulary
Link  Avoiding tooth decay - Self-care information (Notts APC)
 
Galsulfase  (Naglazyme®)

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Non Formulary
Link  Summary of Product Characteristics: 2011
 
Gelatin  (Gelaspan®)

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Non Formulary
 
Gelatin  (Geloplasma®)

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Non Formulary
 
Gelatin  (Haemaccel®)

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Non Formulary
 
Gelatin  (Volplex®)

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Non Formulary
 
Glucodrate®

Non Formulary
 
Glycerol phenylbutyrate  (Ravicti®)

View adult BNF View SPC online View childrens BNF
Non Formulary
NHS England
 
Human Albumin Solution

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cytotoxic Drug  Hydroxycarbamide  (Siklos®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Hypertonic Solution  (HyperHAES®)

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Non Formulary
 
Imiglucerase  (Cerezyme®)

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Non Formulary
High Cost Medicine
 
Iron and Folic Acid  (Ferrograd Folic®)

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Non Formulary
 
Iron and Folic Acid  (Pregaday®)

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Non Formulary
 
Iron and Folic Acide  (Fefol®)

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Non Formulary
 
Iron and Folic Acide  (Galfer FA®)

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Non Formulary
 
Iron Isomaltoside  (Monofer®)

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Non Formulary
Link  Ideal body weight calculator
 
Iron(III) Isomaltoside  (Diafer®)

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Non Formulary
 
Laronidase  (Aldurazyme®)

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Non Formulary
High Cost Medicine
 
Magnesium Chelate

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Magnesium citrate

View adult BNF View childrens BNF
Non Formulary
 
Magnesium Hydroxide Mixture BP

Non Formulary
 
Mercaptamine (cysteamine) eye drops

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Methoxy Polyethylene Glycol-Epoetin Beta  (Mircera®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Migalastat  (Galafold®)

Non Formulary
High Cost Medicine
Link  NICE HST4: Migalastat for treating Fabry disease
 
Miglustat  (Zavesca®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Multivitamin supplement  (DEKAs® )

Non Formulary
 
Multivitamin supplement  (Paravit-CF®)

Non Formulary
 
Mutivitamin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nicotinamide

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nitisinone

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nutryelt®

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Other Compounds  (Potaba®)

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Non Formulary
Link  UKMI Q&A: Oral treatments for treating Peyronie’s disease
 
Oxymetholone

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Non Formulary
Link  Patient Information Leaflet
 
Paricalcitol  (Zemplar®)

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Non Formulary
 
Patiromer calcium  (Veltassa®)

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Non Formulary

Note:

 

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/c0299-acute-kidney-injury-in-covid-outside-the-icu-version-v1-1.pdf

 
Phytomenadione
(capsules)

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Non Formulary
 
Phytomenadione  (Konakion® MM)

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Non Formulary
 
Phytomenadione  (Vitacon®)

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Non Formulary
 
Plasma-lyte 148 with Glucose 5%

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Non Formulary
 
Plerixafor  (Mozobil®)

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Non Formulary
High Cost Medicine
 
Potasium Chloride  (Klofer®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Potassium Bicarbonate
(Potassium effervescent tablets)

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Non Formulary
 
Potassium Chloride 50mmol in 50mL Sodium Chloride 0.9% prefilled syringe

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Non Formulary
 
Potassium Chloride and Glucose Intravenous Infusion

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Non Formulary
 
Potassium Chloride and Sodium Chloride Intravenous Infusion

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Non Formulary
 
Potassium Chloride Concentrate (Sterile)

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Non Formulary
 
Potassium Chloride, Sodium Chloride and Glucose Intravenous Infusion

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Non Formulary
 
Potassium dihydrogen phosphate
(Potassium acid phosphate)

Non Formulary
 
Preparations  (Forceval Protein Powder®)

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Non Formulary
 
Ringer's Solution for Injection

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Non Formulary
 
Sapropterin Dihydrochloride  (Kuvan®)

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Non Formulary
High Cost Medicine
Link  Clinical Commissioning Policy: Sapropterin (Kuvan®) For Phenylketonuria: Use in Pregnancy
Link  Clinical Commissioning Policy: Sapropterin for Phenylketonuria (all ages)- NB not routinely commissioned
 
Sebelipase alfa  (Kanuma®)

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Non Formulary
 
Selenium  (Selenase®)

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Non Formulary
 
Sodium Benzoate

Non Formulary
 
Sodium Bicarbonate
(injection)

Non Formulary
Link  Guidance on administration of IV sodium bicarbonate in AKI
 
Sodium Bicarbonate  (Min-I-Jet® Sodium Bicarbonate)

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Non Formulary
 
Sodium Dichloroacetate

Non Formulary
 
Sodium Phenylbutyrate

Non Formulary
 
Sodium zirconium cyclosilicate  (Lokelma®)

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Non Formulary
Link  NICE TA599: Sodium zirconium cyclosilicate for treating hyperkalaemia
 
Sucroferric oxyhydroxide  (Velphoro®)

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Non Formulary
 
Tetrastarch  (Tetraspan®)

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Non Formulary
 
Tetrastarch  (Venofundin®)

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Non Formulary
 
Tetrastarch  (Volulyte®)

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Non Formulary
Link  MHRA: Hydroxyethyl starch - Advice for healthcare professionals Dec 14
Link  MHRA: Drug alert and recall
Link  MHRA: Hydroxyethyl starch - suspension of licences (June 2013)
 
Tetrastarch  (Voluven®)

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Non Formulary
 
Trisodium Edetate  (Limclair®)

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Non Formulary
 
Ubidecarenone

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  DTB review of co-enzyme Q10 for statin related myopathy
 
Vitamin B complex preparations  (Vigranon B®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Vitamins A and D
(Halibut-liver oil)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Vitamins A and D

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Vitamins A and D  (Halycitrol®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Vitamins A C and D
(Healthy start children’s vitamin drops)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  Healthy Start scheme
 
Vitamins C, D and folic acid
(Healthy start vitamins for women)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  Healthy Start vitamins: Info for healthcare professionals
 
Water for Injection

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Zinc Acetate  (Wilzin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Routine prescribing within licensed indication  

Amber 1

Specialist recommendation followed by GP initiation and continuation  

Amber 2

Specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation   

Amber 3

Specialist initiation and stabilisation followed by GP continuation  

Amber SCG

Specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline  

Red

Hospital or specialist prescribing only  

Red Red

These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.  

netFormulary