REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Adult Joint Formulary
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Decisions 25th November 2014

At the meeting on the 25th November 2014 the following decisions / changes to the formulary were agreed:


New Drug Requests



Magnesium aspartate (Magnaspartate®) (TLS Green)

  • For the treatment of hypomagnesaemia.

Fostair NEXThaler® (Beclometasone and formoterol) (TLS Green)

  • Approved for asthma in > 18 year olds.

Insulin Degludec (TLS Red)

  • Approved for patients with type II diabetes requiring pre-dialysis insulin.  Will be added to the formulary once Directorate approval has been obtained.

Fluticasone and Azelastine span class="black">(TLS Amber specialist recommendation, no SCP)

  • Approved for patients referred to immunology with moderate to severe seasonal and perennial allergic rhinitis in those who otherwise could be considering desensitisation therapy.

Melatonin (TLS Red)

  • Approved for use in the Intensive Care Unit for the prevention of delirium in at risk patients. Local protocol to be developed.


Shared Care Protocols/TLS Change in Status


  • It was noted that the MHRA had issued advice leading to a change in the requirements for monitoring whilst patients are being treated with denosumab. We are currently in discussion with the specialists to update the current SCP for the treatment of osteoporosis.


Other decisions

Duraphat® toothpaste

  • The JFG agreed that the most appropriate clinician to maintain the prescribing of high fluoride toothpastes such as Duraphat® should be a dentist.