| Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
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| 07.01 |
Drugs used in obstetrics |
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| 07.01.01 |
Prostaglandins and oxytocics |
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Dinoprostone
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First Choice
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Pessaries (Propess®)
Vaginal Tablets (Prostin E2®)
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Carboprost (Hemabate®)
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Formulary
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Injection
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Ergometrine Maleate
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Formulary
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Injection
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Ergometrine Maleate and Oxytocin (Syntometrine®)
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Formulary
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Injection
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Oxytocin (Syntocinon®)
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Formulary
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Injection
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Gemeprost
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Formulary
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Pessaries
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Misoprostol
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Formulary
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Tablets (for oral or vaginal administration)
 Unlicensed indication
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 PAT Guideline: Termination of Pregnancy for Fetal Anomaly
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| 07.01.01.01 |
Drugs affecting the ductus arteriosus |
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| 07.01.01.01 |
Maintenance of patency |
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| 07.01.01.01 |
Closure of ductus arteriosus |
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Ibuprofen (Pedea®)
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Formulary
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Intravenous solution
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Indometacin
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Formulary
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Injection
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Mifepristone (Mifegyne®)
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Formulary
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Tablets
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PAT Guideline: Termination of Pregnancy for Fetal Anomaly
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| 07.01.03 |
Myometrial relaxants |
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Nifedipine
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First Choice
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Capsules
Unlicensed indication
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Indometacin
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Second Choice
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Suppositories
Capsules
Unlicensed indication
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Atosiban (Tractocile®)
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 Restricted
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Not to be initiated at Pennine Acute Trust
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Salbutamol
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Formulary
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Injection
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Terbutaline
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Formulary
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Injection
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| 07.02 |
Treatment of vaginal and vulval conditions |
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| 07.02.01 |
Preparations for vaginal and vulval changes |
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| 07.02.01 |
Topical HRT |
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Oestrogens, Topical (Gynest®)
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Formulary
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0.01% intravaginal cream
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Oestrogens, Topical (Vagifem®)
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Formulary
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Vaginal tablets
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| 07.02.01 |
Non-hormonal preparations |
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| 07.02.02 |
Vaginal and vulval infections |
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| 07.02.02 |
Fungal infections |
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Clotrimazole
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First Choice
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Cream
Pessary
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Fluconazole
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First Choice
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Capsule
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Econazole
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Formulary
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Cream
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Ketoconazole 2%
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Formulary
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Cream
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Miconazole
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Formulary
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Cream
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MHRA Safety Alert: serious interactions with warfarin
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| 07.02.02 |
Other vaginal infections |
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Metronidazole
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First Choice
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Vaginal gel
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Clindamycin
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Second Choice
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Cream
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| 07.03 |
Contraceptives |
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| 07.03.01 |
Combined hormonal contraceptives |
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Loestrin 20® (Ethinylestradiol 20 mcg / norethisterone 1mg)
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First Choice
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Low strength preparation
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Microgynon 30® or Levest® (Ethinylestradiol 30mcg / levonorgestrel 150mcg)
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First Choice
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Standard strength preparation
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Norimin® (Ethinylestradiol 35 mcg / noresthisterone 1mg)
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First Choice
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Standard strength preparation
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Ovysmen® (Ethinylestradiol 35 mcg / noresthisterone 500mcg)
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First Choice
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Standard strength preparation
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Microgynon 30 ED® (Ethinylestradiol 30 mcg / levonorgestrel 150 mcg)
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First Choice
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Standard strength, everyday preparation
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Logynon® (Ethinylestradiol / levonorgestrel phased pill)
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First Choice
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Tri-phasic preparation
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Cilest® (Ethinylestradiol 35 mcg / norgestimate 250 mcg)
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Second Choice
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Standard strength preparation
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TriNovum® (Ethinylestradiol / norethisterone phased pill)
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Second Choice
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Tri-phasic preparation
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NuvaRing® (Ethinylestradiol / etonogestrel)
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Formulary
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Low strength vaginal ring
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| 07.03.02 |
Progestogen-only contraceptives |
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Noriday® (Norethisterone 350mcg)
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First Choice
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Norgeston® (Levonorgestrel 30mcg)
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Formulary
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Micronor® (Norethisterone 350mcg)
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Formulary
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Zelleta® (Desogestrel 75mcg)
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Formulary
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Tablets
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| 07.03.02.01 |
Oral progestogen-only contraceptives |
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| 07.03.02.02 |
Parenteral progestogen-only contraceptives |
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Etonorgestrel (Nexplanon®)
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Formulary
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Implant
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Medroxyprogesterone Acetate (Depo-Provera®)
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Formulary
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12-weekly IM injection
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| 07.03.02.03 |
Intra-uterine progestogen-only contraceptive |
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Intra-uterine Progestogen Only System (Mirena®)
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Formulary
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| 07.03.03 |
Spermicidal contraceptives |
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| 07.03.04 |
Contraceptive devices |
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| 07.03.04 |
Intra-uterine devices |
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Intra-uterine Contraceptive Devices (TT 380 Slimline®)
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Formulary
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| 07.03.04 |
Other contraceptive devices |
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| 07.03.05 |
Emergency Contraception |
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| 07.03.05 |
Hormonal methods |
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Levonorgestrel (Levonelle® 1500)
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First Choice
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MHRA Safety Update: Interaction with hepatic enzyme inducers
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Ulipristal (EllaOne®)
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Formulary
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| 07.03.05 |
Intra-uterine device |
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| 07.04 |
Drugs for genito-urinary disorders |
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| 07.04.01 |
Drugs for urinary retention |
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| 07.04.01 |
Alpha-blockers |
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Tamsulosin
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First Choice
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Capsules
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Alfuzosin
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Formulary
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M/R tablets
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Doxazosin
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Formulary
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Tablets
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UKMI Q&A: How should conversion between doxazosin formulations be carried out?
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| 07.04.01 |
Parasympathomimetics |
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| 07.04.02 |
Drugs for urinary frequency, enuresis, and incontinence |
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GMMMG Guidance: Treatment of Overactive Bladder in Women
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| 07.04.02 |
Urinary incontinence |
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Oxybutynin
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First Choice
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Tablets
M/R tablets
Patches ( only when the oral route is not tolerated)
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Tolterodine
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First Choice
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Tablets
M/R capsules
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Trospium
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Second Choice
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Tablets
M/R capsules
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Mirabegron
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Third Choice
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M/R tablets
Only recommended if antimuscarinic drugs are contraindicated, clinically ineffective or have unacceptable side effects.
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MHRA Safety Alert: Risk of severe hypertension and associated cerebrovascular and cardiac events
NICE TA290: Mirabegron for overactive bladder
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Solifenacin
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Third Choice
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Tablets
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Fesoterodine
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Third Choice
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M/R Tablets
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Duloxetine (Yentreve®)
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Formulary
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Capsules
For stress incontinence only
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| 07.04.02 |
Nocturnal enuresis |
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Imipramine
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Formulary
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Tablets
Oral solution
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| 07.04.03 |
Drugs used in urological pain |
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| 07.04.03 |
Alkalinisation of urine |
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Potassium Citrate Mixture BP
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Formulary
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Oral solution
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Sodium Bicarbonate
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Formulary
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Capsules
Tablets
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| 07.04.03 |
Acidification of urine |
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| 07.04.03 |
Other preparations for urinary disorders |
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| 07.04.04 |
Bladder instillations and urological surgery |
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| 07.04.04 |
Urological surgery |
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Glycine 1.5%
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Formulary
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Bladder irrigation solution
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| 07.04.04 |
Maintenance of indwelling urinary catheters |
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Catheter Patency Solutions (Sodium Chloride 0.9% Uro-Tainer®)
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Formulary
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Catheter Patency Solutions (Solution R Uro-Tainer®)
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Formulary
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| 07.04.04 |
Bladder carcinoma |
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BCG (Bacillus Calmette-Guerin)
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Formulary
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Bladder instillation
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Doxorubicin
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Formulary
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Bladder instillation
Liaise with Pharmacy Aseptics for preparation of this product
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Epirubicin
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Formulary
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Bladder instillation
Liaise with Pharmacy Aseptics for preparation of this product
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Mitomycin
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Formulary
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Bladder instillation
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| 07.04.04 |
Interstitial cystitis |
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Dimethyl Sulfoxide 50% (Rimso-50®)
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Formulary
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Bladder instillation
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| 07.04.05 |
Drugs for erectile dysfunction |
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| 07.04.05 |
Alprostadil |
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Alprostadil
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Formulary
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Caverject® intracavernosal injection
MUSE® urethral application
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| 07.04.05 |
Phosphodiesterase type 5 inhibitors |
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Sildenafil
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Formulary
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Tablets
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| 07.04.06 |
Drugs for premature ejaculation |
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| .... |
| Non Formulary Items |
Alprostadil (Prostin VR®)
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Non Formulary
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Alprostadil (Viridal® Duo)
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Non Formulary
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Anethol, Borneol, Camphene, Cineole, Fenchone, Pinene (Rowatinex®)
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Non Formulary
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Avanafil (Stendra®)
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Non Formulary
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Bethanechol Chloride (Myotonine®)
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Non Formulary
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Carbetocin (Pabel®)
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Non Formulary
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Combined Hormonal Contraceptives (BiNovum®)
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Non Formulary
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Combined Hormonal Contraceptives (Evra)
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Non Formulary
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Combined Hormonal Contraceptives (Femodene® ED)
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Non Formulary
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Combined Hormonal Contraceptives (Loestrin 30®)
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Non Formulary
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Combined Hormonal Contraceptives (Logynon ED®)
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Non Formulary
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Combined Hormonal Contraceptives (Minulet®)
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Non Formulary
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Combined Hormonal Contraceptives (Norinyl-1®)
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Non Formulary
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Combined Hormonal Contraceptives (Qlaira®)
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Non Formulary
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Combined Hormonal Contraceptives (Synphase®)
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Non Formulary
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Combined Hormonal Contraceptives (Triadene®)
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Non Formulary
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Combined Hormonal Contraceptives (Tri-minulet®)
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Non Formulary
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Combined Hormonal Contraceptives (Trinordiol®)
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Non Formulary
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Dapoxetine (Priligy®)
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Non Formulary
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Darifenacin (Emselex®)
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Non Formulary
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Distigmine Bromide (Ubretid®)
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Non Formulary
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Dutasteride and Tamsulosin (Combodart®)
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Non Formulary
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Ethinylestradiol 20mcg / desogestrel 150mcg (Gedarel®, Mercilon®)
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Non Formulary
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Ethinylestradiol 20mcg / gestodene 75 mcg (Millinette®, Femodette®)
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Non Formulary
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Ethinylestradiol 30 mcg / drospirenone 3 mg (Yasmin®)
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Non Formulary
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Ethinylestradiol 30 mcg / levonorgestrel 150 mcg (Ovranette®)
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Non Formulary
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Ethinylestradiol 30mcg / desogestrel 150mcg (Gedarel®, Marvelon®)
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Non Formulary
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Ethinylestradiol 30mcg / gestodene 75 mcg (Millinette®, Femodene®)
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Non Formulary
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Fenticonazole (Gynoxin®)
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Non Formulary
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Flavoxate
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Non Formulary
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Indoramin (Doralese®)
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Non Formulary
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Intra-uterine Contraceptive Devices (Flexi-T® + 300)
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Non Formulary
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Intra-uterine Contraceptive Devices (Flexi-T® 300)
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Non Formulary
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Intra-uterine Contraceptive Devices (GyneFix®)
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Non Formulary
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Intra-uterine Contraceptive Devices (Load® 375)
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Non Formulary
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Intra-uterine Contraceptive Devices (Nova-T® 360)
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Non Formulary
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Intra-uterine Contraceptive Devices (T-Safe® CU 380 A)
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Non Formulary
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Intra-uterine Contraceptive Devices (UT 380 Short®)
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Non Formulary
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Intra-uterine Contraceptive Devices (UT 380 Standard®)
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Non Formulary
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Lactic acid (Balance Activ Rx®)
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Non Formulary
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Medroxyprogesterone acetate (Sayana Press®)
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Non Formulary
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nomegestrol acetate and beta estradiol (Zoely®)
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Non Formulary
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Norethisterone enantate (Noristerat®)
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Non Formulary
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Oestrogens, Topical (Estring®)
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Non Formulary
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Oestrogens, Topical (Ovestin®)
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Non Formulary
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Oral Progestogen Only Contraceptives (Cerazette®, Cerelle®)
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Non Formulary
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Oral Progestogen-Only Contraceptives (Femulen®)
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Non Formulary
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Prazosin
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Non Formulary
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Propantheline
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Non Formulary
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Propiverine
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Non Formulary
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Replens MD®
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Non Formulary
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Ritodrine (Yutopar®)
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Non Formulary
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Spremicidal Contraceptives (Ortho-Creme®)
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Non Formulary
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Spremicidal Contraceptives (Orthoforms®)
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Non Formulary
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Tadalafil (Cialis®)
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Non Formulary
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Terazosin
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Non Formulary
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Vardenafil (Levitra®)
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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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