REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Adult Joint Formulary
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Decisions 26th July 2022

At the meeting on the 26th July, the following decisions were agreed


New Drug Requests 


Ropivacaine (TLS Red)

  • For top up of epidural anaesthesia for instrumental or caesarean delivery

Misoprostol (TLS Red)

  • For induction of labour, including patients with intrauterine foetal death

Insulin Lispro (Lyumjev) (TLS Amber no SCP)

  • For diabetic patients with postprandial hyperglycaemia not controlled by first line options

Tirbanibulin ointment (TLS Blue)

  • For solar keratosis in line with licensed indications

Trimbow Nexthaler (TLS Green)

  • For adult patients with moderate to severe chronic obstructive pulmonary disease (COPD)

Insulin Lispro (Admelog) (TLS Green)

  • For new patients

Isophane Insulin (Insuman Basal) (TLS Green)

  • For diabetes mellitus

Insulin human (Actrapid) (TLS Green)

  • Type 1 diabetes

Traffic light status Changes

  • Linaclotide from TLS Amber 1 month to TLS Amber no SCP

  • Potassium Permanganate 400mg tablets from TLS Green to TLS Blue. On 5th April 2022 a National Patient Safety Alert was issued on the risk of inadvertent oral administration of potassium permanganate. Please refer to the NPSA alert for more information’.

  • Following Diabetes Chapter Review Work:
    Saxagliptin from TLS Green to TLS Blue

    Dulaglutide from TLS Blue to TLS Green (weekly use)

    Semaglutide (injectable) from TLS Blue to TLS Green (weekly use)

    Lixisenatide TLS Green to TLS Blue for current patients only (daily use)

    SGLT2i's: Canagliflozin, Dapagliflozin, Empagliflozin and Ertugliflozin- For diabetes indications from TLS Blue to TLS Green

    Insulin glargine (Abasaglar) TLS Green to TLS Blue

    Insulin glargine (Semglee) TLS Blue to TLS Green

  • Imvaggis TLS Green to TLS Blue- in line with menopause guideline review

Other Formulary Decisions:

  • Cilodex brand of ear drops has been discontinued, but a generic formulation of ciprofloxacin and dexamethasone remains available

  • Anidulafungin - to be re-instated on the formulary as TLS Red