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BNSSG Adult Joint Formulary
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Decisions 21st March 2023

New Drug Requests

Approved

Ivermectin (oral) (TLS Red)

  • For treatment resistant scabies, specialist use only, not for children under 15kg.

Hydrocortisone sodium phosphate 3.35mg/mL eye drops (Softacort) (TLS Red)

  • For short-term treatment of mild non-infectious allergic or inflammatory conjunctival diseases for patients who are at increased risk of raised intraocular pressure and who require a preservative-free option.

 

Shared Care Protocols

Nil 

 

Traffic Light Status Change Requests

  • Cenobamate to be changed from TLS Red to TLS Amber Specialist Initiated. 

  • Insuman Basal to be changed from TLS Green to TLS Blue for existing patients only

  • Insuman Comb 25 to be changed from TLS Green to TLS Blue for existing patients only

  • Humulin M3 to be changed from TLS Blue to TLS Green

  • Insuman Rapid to be changed from TLS Green to TLS Blue for existing patients only

  • Humulin S to be changed from TLS Blue to TLS Green

  • Entacapone and entacapone in combination with levodopa and carbidopa to be changed from Amber 1 month to Amber Specialist Recommended.

  • Dabigatran and edoxaban for treatment and prevention of recurrent DVT and PE to be changed from Amber 1 month to Green. 

  • Oral amiodarone to be changed from TLS Green to TLS Amber and for there to be further review as part of the cardiodlogy chapter review. 

  • Betamethasone soluble tablets, dexamethasone soluble tablets (oral rinse) and fluocinolone acetonide 0.025% gel (Synalar®) (oral) to be changed from TLS Amber 1 month to TLS Amber Specialist Recommended.

  • Ferric Maltol to be changed from Amber 1 month to Amber Specialist Initiated. 

  • Midodrine for orthostatic hypotension to be changed from Amber 1 month to Amber Specialist Initiated. 

  • Pramipexole for PD to be changed from Amber 1 month to Amber Specialist Initiated. 

  • Pregabalin for seizures to be changed from Amber 1 month to Amber Specialist Initiated.

  • Rasagiline for PD to be changed from Amber 1 month to Amber Specialist Initiated. 

  • Ropinirole for PD to be changed from Amber 1 month to Amber Specialist Initiated. 

  • Cabergoline for PD to be changed from Amber 3 months to Amber Specialist Initiated (existing patients only).  

Gastroenterology Chapter Review Decisions

  • Famotidine and nizatidine to be changed from TLS Amber no SCP to TLS Green when a PPI is not appropriate or unless specialist recommended.

  • Bismuth chelate (for treatment of H Pylori eradication) to change from TLS Blue to TLS Amber Specialist Recommended.

  • Lansoprazole to be changed from TLS Blue to TLS Green

  • Eluxadoline to be removed from the formulary as this has been discontinued.

  • Ranitidine to be removed from the formulary as this has been withdrawn from the market. 

  • Pancrex to be changed to Pancrex V to reflect brand name change.

  • Colestipol to be removed as this has been discontinued.

 

Other Formulary Decisions

  • Changes to Amber Traffic Light categories and definitions were agreed:

    - Amber 3 month and 1 month - no change

    - Amber No SCP renamed as Amber Specialist Recommended

    - New category - Amber Specialist Initiated.  

  • Changes to the New Drug Request Application paperwork were agreed including removal of short forms. A single New Drug Request form to be used going forward. 

  • Insuman insulins are being discontinued. These will be removed from the Joint Formulary when supplies are exhausted. 

  • Isotretinoin to be changed from TLS Red 'hospital consultant only' to TLS Red 'restricted to dermatology specialist teams only'.

  • Removal of SCP and separate entry for exenatide in combination with insulin. TLS of exenatide with/without insulin to be blue. 

  • Removal of alfacalcidol and rotigotine prescribing guidance, sulfasalazine monitoring guidance, naltrexone agreement forms and Collistin trial information as no longer required.

  • Confirmation that the TLS of haloperidol injection in chapter 4.2 is TLS Amber 1 month - SCP to be developed. 

  • Confirmation that the TLS of namlefene in Bristol is TLS Amber Specialist Recommended.

  • Confirmation that the TLS of goserelin (Zoladex) for breast cancer is TLS Amber 3 months.

  • Confirmation that the TLS of carbamazepine for bipolar disorder and mania should be Amber Specialist Initiated