| Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
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| 12.01 |
Drugs acting on the ear |
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Please refer to the GMMMG Formulary Chapter 12 for treatment advice. |
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| 12.01.01 |
Astringent preparations |
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Acetic Acid 2% (Earcalm ®)
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Formulary
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Ear Spray
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| 12.01.01 |
Anti-inflammatory preparations |
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Betamethasone drops
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First Choice
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Ear/eye/nose drops
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Hydrocortisone Acetate 1% with Gentamicin 0.3% (Gentisone® HC)
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First Choice
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Ear drops
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Flumetasone 0.02% with Clioquinol 1% (Locorten-Vioform®)
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Formulary
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Ear drops
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Betamethasone 0.1% with Neomycin 0.5% drops (Betnesol N®)
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Formulary
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Ear/eye/nose drops
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Dexamethasone with Antibacterial (Otomize®)
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Formulary
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Ear Spray
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Dexamethasone with Antibacterial (Sofradex®)
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Formulary
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Eye/ear drops
Not on GMMMG formulary
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Hydrocortisone with Antibactrial (Otosporin®)
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Formulary
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Ear drops
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| 12.01.01 |
Anti-infective preparations |
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Flumetasone 0.02% with Clioquinol 1% (Locorten-Vioform®)
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First Choice
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Ear drops
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Clotrimazole (Canesten®)
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Formulary
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1% solution
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Betamethasone 0.1% with Neomycin 0.5% drops (Betnesol N®)
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Formulary
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Ear/eye/nose drops
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Gentamicin (Genticin®)
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Formulary
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Ear/eye drops
Not on GMMMG formulary
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Neomycin Sulphate with corticosteroids (Otosporin®)
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Formulary
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Ear drops
Not on GMMMG formulary
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Trimacinolone, neomycin, gramidicin and nystatin ointment (Otocomb Otic®)
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Formulary
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| 12.01.03 |
Removal of ear wax |
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Olive Oil Ear Drops
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First Choice
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Ear drops
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Sodium Bicarbonate
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Formulary
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Ear drops
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Cerumol®
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Formulary
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Ear drops
Not on GMMMG Formulary
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| 12.02 |
Drugs acting on the nose |
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| 12.02.01 |
Drugs used in nasal allergy |
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| 12.02.01 |
Antihistamines |
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Beclometasone Dipropionate
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First Choice
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Nasal Spray
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Mometasone Furoate (Nasonex®)
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Formulary
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Nasal Spray
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Fluticasone Propionate
(Flixonase® / Nasofan®)
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Formulary
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50mcg/metered dose Nasal Spray
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Betamethasone drops
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Formulary
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Eye/ear/nose drops
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| 12.02.02 |
Topical nasal decongestants |
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Sodium Chloride 0.9% Nose Drops
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Formulary
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Nose drops
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| 12.02.02 |
Sympathomimetics |
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Xylometazoline (Otrivine®)
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First Choice
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Nasal drops
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Ephedrine
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Formulary
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Nasal drops
 Licensed for over 12 years of age only
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| 12.02.02 |
Antimuscarinic |
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Ipratropium Bromide (Rinatec®)
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Formulary
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 UKMI Q&A: Drug induced hypersalivation
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| 12.02.03 |
Nasal preparations for infection |
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| 12.02.03 |
Nasal Staphylococci |
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Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5% (Naseptin®)
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Formulary
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Cream
Contains PEANUT oil
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Mupirocin 2% in White Soft Paraffin (Bactroban Nasal®)
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Formulary
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Nasal ointment
For MRSA eradication only
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| 12.03 |
Drugs acting on the oropharynx |
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| 12.03.01 |
Drugs for oral ulceration and inflammation |
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Benzydamine (Difflam®)
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First Choice
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Mouthwash
Oromucosal Spray
To only be prescribed in paediatrics with consultant approval
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Hydrocortisone (Corlan®)
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Formulary
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Oromucosal tablets
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Benzocaine
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Formulary
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Anaesthetic gel
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Carmellose Sodium (Orabase®)
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Formulary
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Oral paste
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Carmellose Sodium (Orahesive®)
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Formulary
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Powder
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Choline Salicylate (Bonjela® Adult)
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Formulary
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Oral gel
For over 16 years of age only
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Gelclair®
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Formulary
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Sachets
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Lidocaine
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Formulary
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10% mouth spray
5% ointment
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| 12.03.02 |
Oropharyngeal anti-infective drugs |
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| 12.03.02 |
Oropharyngeal Fungal infections |
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Fluconazole
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First Choice
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Capsules
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Nystatin (Nystan®)
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Second Choice
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Oral suspension
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Miconazole (Daktarin®)
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Formulary
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Oral Gel
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MHRA Safety Alert: serious interactions with warfarin
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| 12.03.02 |
Oropharyngeal Viral infections |
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| 12.03.03 |
Lozenges and sprays |
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| 12.03.04 |
Mouthwashes, gargles, and dentifrices |
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Chlorhexidine Gluconate
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First Choice
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Mouthwash
Dental gel
Oral spray
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Hydrogen Peroxide
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Formulary
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Mouthwash
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Sodium Chloride Mouthwash, Compound BP
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Formulary
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Mouthwash
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Tranexamic Acid Mouthwash
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Formulary
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 unlicensed
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| 12.03.05 |
Treatment of dry mouth |
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Glandosane®
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First Choice
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Aerosol spray
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Biotene Oralbalance®
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Formulary
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Saliva replacement gel
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BioXtra®
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Formulary
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Gel
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| 12.03.05 |
Systemic treatment |
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| .... |
| Non Formulary Items |
ACETIC ACID 5% solution in IMS
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Non Formulary
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Aciclovir
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Non Formulary
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Almond Oil
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Non Formulary
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Amphotericin Lozenges (Fungilin®)
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Non Formulary
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Antacid with Oxetacaine
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Non Formulary
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AS saliva Orthana®
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Non Formulary
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Azelastine and fluticasone (Dymista)
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Non Formulary
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Azelastine Hydrochloride (Rhinolast®)
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Non Formulary
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Nasal spray |
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Betamethasone
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Non Formulary
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Soluble tablets |
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Betamethasone Sodium Phosphate 0.1% with Neomycin Sulphate 0.5%
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Non Formulary
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Betamethasone Sodium Phosphate with Antibacterial (Vista-Methasone N®)
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Non Formulary
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DISCONTINUED |
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Budesonide (Rhinocort Aqua®)
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Non Formulary
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Nasal spray |
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Caphosol®
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Non Formulary
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Cetylpyridinium, Chlrocresol, Lidocaine (Anbesol®)
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Non Formulary
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Chloramphenicol
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Non Formulary
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Ear drops
Not on GMMMG Formulary |
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Chlorhexidine Gluconate 0.1% with Chlorobutanol 0.5% (Eludril®)
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Non Formulary
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Chlorhexidine Mouthwash
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Non Formulary
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Docusate Sodium 0.5% (Waxsol®)
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Non Formulary
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Doxycycline
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Non Formulary
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Doxycycline (Periostat®)
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Non Formulary
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Exterol®
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Non Formulary
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Flunisolide (Syntaris®)
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Non Formulary
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Nasal spray |
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Flurbiprofen lozenge
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Non Formulary
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Fluticasone furoate (Avamys®)
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Non Formulary
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Nasal spray
Formulary application rejected Sept 2010 |
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Fluticasone Propionate (Flixonase Nasule®)
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Non Formulary
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Nasal drops |
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Hydrocortisone with Antibacterial (Neo-Cortef®)
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Non Formulary
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DISCONTINUED |
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Lidocaine and Cetylpyridinium (Dentinox® Teething Gel)
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Non Formulary
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Lidocaine and Phenylephrine (Cophenalcaine®)
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Non Formulary
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Luborant®
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Non Formulary
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Miconazole (Loramyc®)
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Non Formulary
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Molcer®
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Non Formulary
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Neomycin Sulphate with corticosteroids (Neo-Cortef®)
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Non Formulary
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DISCONTINUED |
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Otex®
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Non Formulary
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pilocarpine Hydrochloride (Salagen®)
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Non Formulary
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Prednisolone 0.5% with Neomycin 0.5% (Predsol-N®)
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Non Formulary
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DISCONTINUED |
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Prednisolone drops (Predsol®)
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Non Formulary
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Ear/eye drops
Not on GMMMG formulary for use in the ear |
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Salicylates - Salicylic acid (Pyralvex®)
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Non Formulary
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Salinum®
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Non Formulary
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Saliveze®
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Non Formulary
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Salivix®
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Non Formulary
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Sodium Cromoglicate (Rynacrom®)
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Non Formulary
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Nasal spray |
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Sodium Cromoglicate (Vividrin®)
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Non Formulary
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Nasal Spray DISCONTINUED |
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SST
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Non Formulary
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Triamcinolone with Antibacterial (Tri-Adcortyl Otic®)
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Non Formulary
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Triamcinolone Acetonide (Nasacort®)
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Non Formulary
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Nasal spray |
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Triamcinolone Acetonide 0.1% in Adhesive Basis (Adcortyl in Orabase®)
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Non Formulary
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Xerotin(r) (Xerotin®)
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Non Formulary
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
| Status |
Description |
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Drugs designated amber are suitable for shared care arrangements under a shared care protocol.
Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.
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These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products. |
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Not used
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Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care. |
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Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required. |
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Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required. |
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Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient. |
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Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.
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