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REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Adult Joint Formulary
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Decisions 17th October 2023

New Drug Requests: 


Droperidol (TLS Red)

  • management of acute behavioural disturbance in the Emergency Department. Alternative to ketamine. 

Bijuve® (1mg estradiol / 100mg micronised progesterone) (TLS Green)

  • HRT for postmenopausal women
  • Second line treatment option and alternative to Femoston-Conti where first line options have not been tolerated / are not suitable. 

Aklief® (trifarotene cream 50micrograms/g) (TLS Green)

  • treatment of acne 


Other decisions and discussions:

SCP Review Work:

  • Oral testosterone for male hypogonadism to be removed from the formulary as no longer used.
  • Danazol for hereditary angiodema - change TLS to Amber Specialist Initiated. 
  • Rivaroxaban with anti-platelets in line with NICE TA 335 and TA 607 - change TLS to Amber Specialist Recommended and remove SCPs once a guideline to support use of concomitant DOAC and anti-platelets is developed.

ADHD medicines shortage discussed.  

Adex gel emollient - not approved for treatment of eczema, psoriasis and dermatitis.

Doublebase Once emollient - not approved for treatment of eczema, psoriasis and dermatitis.