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 Formulary Chapter 5: Infections - Full Chapter
Notes:
This chapter of the formulary is not an antibiotic prescribing guide and is not intended to guide treatment choice.

Please refer to the relevant Pennine Acute policies (e.g. the Antibiotic Policy for Adult Patients, or Antibiotic Guidelines for Paediatrics) when making treatment choices.
 Details...
05.03  Expand sub section  Antiviral drugs
05.03.01  Expand sub section  HIV infection
05.03.01  Expand sub section  Nucleoside reverse transcriptase inhibitors
Abacavir (Ziagen®)
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Formulary
Red
 
   
Emtricitabine (Emtriva®)
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Formulary
Red
 
   
Lamivudine
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Formulary
Red
Tablets
Oral Solution 
   
Tenofovir Disproxil (Viread®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE CG165: Hepatitis B (chronic) - incorporates TA173
Link  NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
   
Zidovudine (Retrovir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Capsules
Oral Solution
Injection 
Link  PAHT: HIV in Pregnancy
   
Abacavir and Lamivudine (Kivexa®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
   
Abacavir and Lamivudine and Zidovudine (Trizivir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Emtricitabine 200mg, Rilpivirine 25mg and Tenofovir 245mg (Eviplera®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Tenofovir 245mg, Efavirenz 600mg and Emtricitabine 200mg (Atripla®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Tenofovir alafenamide and Emtricitabine (Descovy®)
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Formulary
Red
Restricted ItemRequires MDT discussion with ID team
 
   
Tenofovir alafenamide, Emtricitabine and Rilpivirine (Odefsey®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablet

Restricted ItemRequires MDT discussion with ID team 
   
Tenofovir alafenamide, Emtricitabine, Elvitegravir and Cobicistat (Genvoya®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablet

Restricted ItemRequires MDT discussion with ID team 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
   
Tenofovir and Emtricitabine (Truvada®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE Evidence Summary: Pre-exposure prophylaxis of HIV in adults at high risk: Truvada
   
Tenofovir, cobicistat, elvitegravir & emtricitabine (Stribild®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets

Restricted Item Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
Link  NHS England Commissioning Policy
   
Zidovudine and Lamivudine (Combivir®)
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Formulary
Red
 
   
Didanosine (Videx®)
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Formulary
Red
Tablets
Capsules

Restricted Item Only for patients already established on this treatment.  
   
Stavudine (Zerit®)
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Formulary
Red
Capsules
Oral Solution

Restricted Item Only for patients already established on this treatment 
   
05.03.01  Expand sub section  Protease inhibitors
Atazanavir (Reyataz®)
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Formulary
Red
 
   
Atazanavir and Cobicistat (Evotaz®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
   
Darunavir (Prezista®)
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Formulary
Red
 
   
Darunavir and Cobicistat (Rezolsta®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
   
Fosamprenavir (Telzir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Lopinavir and Ritonavir (Kaletra®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  MHRA Safety Alert: interaction with levothyroxine
Link  MHRA Safety Alert: Ritonavir coadministration with a corticosteroid
   
Ritonavir (Norvir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  MHRA Safety Alert: interaction with levothyroxine
Link  MHRA Safety Alert: Ritonavir coadministration with a corticosteroid
   
Tipranavir (Aptivus®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
05.03.01  Expand sub section  Non-nucleoside reverse transcriptase inhibitors to top
Rilpivirine hydrochloride (Edurant®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Efavirenz (Sustiva®)
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Formulary
Red
 
   
Etravirine (Intelence®)
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Formulary
Red
 
   
Nevirapine (Viramune®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
05.03.01  Expand sub section  Other antiretrovirals
Enfuvirtide (Fuzeon®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Maraviroc
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Raltegravir (Isentress ®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Dolutegravir (Tivicay ®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
   
Dolutegravir and Abacavir and Lamivudine (Triumeq ®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
05.03.01  Expand sub section  Pharmacokinetic enhancers of antiretrovirals
Cobicistat (Tybost®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
Link  NHS England Commissioning Policy: cobicistat as a booster in treatment of HIV positive patients
   
05.03.02  Expand sub section  Herpesvirus infections
05.03.02.01  Expand sub section  Herpes simplex and varicella-zoster infection
Aciclovir
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Suspension
Intravenous Infusion 
   
Valaciclovir (Valtrex®)
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Formulary Tablets

Restricted Item Can only be prescribed on advice of ID physician or virologist 
   
05.03.02.02  Expand sub section  Cytomegalovirus infection to top
Cidofovir (Vistide®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Foscarnet Sodium (Foscavir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary  
   
Ganciclovir (Cymevene®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red



Prepared by pharmacy aseptics during working hours. Liaise with pharmacy.  
   
Valganciclovir (Valcyte®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
05.03.03  Expand sub section  Viral hepatitis
05.03.03.01  Expand sub section  Chronic hepatitis B
Peginterferon Alfa
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Red
Injection 
Adefovir Dipivoxil (Hepsera®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE CG165: Hepatitis B (chronic) - incorporates TA96
Link  NICE TA96: Hepatitis B (chronic) - adefovir dipivoxil and pegylated interferon alpha-2a
   
Entecavir (Baraclude®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE CG165: Hepatitis B (incorporates TA153)
Link  NICE TA153: Hepatitis B (chronic) - etecavir
   
Tenofovir Disoproxil (Viread®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE CG165: Hepatitis B (chronic) - incorporates TA173
Link  NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
   
Lamivudine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets
Oral Solution 
   
05.03.03.02  Expand sub section  Chronic hepatitis C
Peginterferon Alfa
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Injection 
Link  NICE TA106: Peginterferon alfa and ribavirin for the treatment of mild chronic hepatitis C
Link  NICE TA200: Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C
Link  NICE TA300: Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people
   
Ribavirin (Copegus®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
Link  NICE TA106: Hepatitis C - peginterferon alfa and ribavirin
Link  NICE TA200: Hepatitis C - peginterferon alfa and ribavirin
Link  NICE TA75: Hepatitis C - pegylated interferons, ribavirin and alfa interferon
   
Daclatasvir (Daklinza®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
Link  MHRA Safety Alert: Risk of severe bradycardia or heart block when taken with amiodarone
   
Dasabuvir (Exviera®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
   
Elbasvir/Grazoprevir (Zepatier® 50mg/100mg)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item Requires MDT discussion with ID team 
Link  NICE TA413: Elbasvir–grazoprevir for treating chronic hepatitis C
   
Ledipasvir/Sofosbuvir (Harvoni® 90mg/400mg)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
Link  MHRA Safety Alert: Risk of severe bradycardia or heart block when taken with amiodarone
   
Ombitasvir/Paritaprevir/Ritonavir (Viekirax® 12.5mg/75mg/50mg)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  MHRA Safety Alert: interaction with levothyroxine
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
Link  MHRA Safety Alert: Ritonavir coadministration with a corticosteroid
   
Sofosbuvir (Sovaldi®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets
Restricted Item  Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
Link  MHRA Safety Alert: Risk of severe bradycardia or heart block when taken with amiodarone
Link  NICE TA330: Sofosbuvir for treating chronic hepatitis C
   
Sofosbuvir / Velpatasvir (Epclusa®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets
Restricted Item  Requires MDT discussion with ID team 
Link  NICE TA430: Sofosbuvir–velpatasvir for treating chronic hepatitis C
   
Sofosbuvir / Velpatasvir / Voxilaprevir (Vosevi®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  NICE TA507: Sofosbuvir–velpatasvir–voxilaprevir for treating chronic hepatitis C
   
Simeprevir (Olysio®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine

Requires MDT discussion with ID team


For resistant cases only

 
Link  MHRA Safety Alert: Risk of severe bradycardia or heart block when taken with amiodarone
Link  NICE TA331: Simeprevir in combination with peginterferon alfa and ribavirin for treating genotypes 1 and 4 chronic hepatitis C
   
05.03.04  Expand sub section  Influenza
Oseltamivir (Tamiflu®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Oral Suspension 
Link  UKMI Q&A: Can mothers breastfeed after taking oseltamivir and zanamivir
Link  UKMI Q&A: Can oseltamivir be used in adult patients with renal impairment?
   
Zanamivir inhalation (Relenza®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Dry powder for inhalation 
Link  UKMI Q&A: Can mothers breastfeed after taking oseltamivir and zanamivir
   
05.03.05  Expand sub section  Respiratory syncytial virus to top
Palivizumab (Synagis®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Injection 
Link  PAT: Guideline for the use of Palivizumab (Synagis)
   
 ....
 Non Formulary Items
Aciclovir  (Zovirax®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aciclovir lauriad  (Sitavig)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Amprenavir  (Agenerase®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Boceprevir  (Victrelis®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
High Cost Medicine
Link  NICE TA253: Boceprevir for the treatment of genotype 1 chronic hepatitis C
 
Famciclovir  (Famvir®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
 
Indinavir  (Crixivan®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Inosine Pranobex  (Imunovir®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nelfinavir  (Viracept®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ribavirin  (Rebetol®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
 
Ribavirin  (Virazole®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
 
Saquinavir  (Invirase®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
 
Telaprevir  (Incivo®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
High Cost Medicine
Link  NICE TA252:Telaprevir for the treatment of genotype 1 chronic hepatitis C
 
Zanamivir Injection

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

Amber

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.   

Black

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.  

Green

Not used   

Green 1

Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

Green 2

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.  

Green 3

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.  

Grey

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.   

Red

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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