REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Paediatric Joint Formulary
Home > Formulary : Paediatric > Recent Decisions > 2024 >

Tuesday 6th February

New Drug Requests: 

Phenazone / lidocaine hydrochloride (Otigo) ear drops solution (TLS blue) as a second line option if oral analgesia is insufficient for local symptomatic treatment and relief of pain in acute congestive otitis media only if an immediate oral antibiotic prescription is not given, and there is no eardrum perforation or otorrhoea.

Dexmedetomidine (TLS Red) as a second line option for sedative premedication before general anaesthesia. 


Shared Care Protocols

  • Valproate - combined adult and paediatric SCP approved

  • Clobazam - updated SCP approved

  • Guanfacine - new SCP approved


Traffic light status changes

  • Ivermectin (oral) for treatment resistant classical scabies - change to TLS blue. For outbreaks and crusted / Norwegian scabies, TLS remains red. 

  • Novorapid - change TLS to blue


Contraception chapter review changes

  • Add Bimizza brand ethinylestradiol 20 mcg/ desogestrel 150mcg as TLS Green

  • Remove Loestrin 20 from paediatric formulary as product is discontinued

  • Add Cilique and Lizinna brand ethinylestradiol 35mcg / norgestimate 250 mcg as TLS Blue

  • Remove Cilest brand as discontinued

  • Add Brevinor brand ethinylestradiol 35 mcg / norethisterone 500mcg as TLS Green

  • Add Norimin brand ethinylestradiol 35 mcg / norethisterone 1000mcg as TLS Green

  • Add Microgynon ED ethinylestradiol 30 mcg / levonorgestrel 150 mcg as TLS blue

  • Remove Trinovum from paediatric formulary as this is discontinued

  • Cerelle change from TLS green to blue due to lower price brand Zelleta.

  • Add Zelleta brand desogestrel 75mcg as TLS Green


Gastroenterology Chapter Review Changes

  • Add bisacodyl to chapter 1.2 Bowel cleansing page

  • Ranitidine - remove from formulary as no longer available

  • Chapter 1.8 obesity - move to endocrine chapter

  • Diltiazem 2% cream/ointment - change to TLS Amber Specialist Recommended

  • Creon and Pancrex Change to TLS Amber Specialist Initiated

  • Add Creon micro formulation

  • Add Anusol HC to formulary as TLS Green, restricted to patients who are 12+

  • Most cost-effective aminosalicylate preparation should be considered when initiating treatment. 

  • Under Chapter 1.7, add link to  chapter 9.10 vitamin deficiency page.


Other decisions and discussions:

  • Removal of discontinued products agreed:

    • betamethasone 0.1% eye ointment

    • polymyxin B sulphate eye ointment (Polyfax®)

    • polymixin B sulphate / Bacitracin zinc ointment (Polyfax®)

  • Sodium valproate - agreed migraine and neuropathic pain indications can be removed for new patients.  Patients currently prescribed valproate for migraine or neuropathic pain may continue without change until they and their NHS clinician consider it appropriate to stop. The specialist team must review use of valproate at the next routine review to explore alternative treatment options. Valproate should not be stopped without agreement from the specialist team.

  • Clobazam - 10mg/5ml is the recommended strength for use in BNSSG