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A to Z by Drug Name

Recent MHRA Drug Safety Updates

NICE Guidance


Gastro-intestinal system

Cardiovascular system

Respiratory system

Central nervous system

Infections

Endocrine system

Obstetrics, gynaecology, and urinary-tract disorders

Malignant disease and immunosuppression

Nutrition and blood

Musculoskeletal and joint diseases

Eye

Ear, nose, and oropharynx

Skin

Immunological products and vaccines

Anaesthesia

Miscellaneous
   Welcome to the Medicines Formulary

Introduction

Welcome to the ASPH Foundation Trust Medicines Formulary. The formulary comprises a list of medicines which have been approved by the Drugs and Therapeutics Committee (DTC) for prescribing within the Trust.

The purpose of the formulary is to ensure evidence-based and cost-effective prescribing and provide information relating to drug use. All prescribing from within the Trust (i.e. in-patient, out-patient and FP10 prescribing) must comply with the formulary. Advice given to GPs with regard to drug treatment options must also be in line with Trust formulary recommendations. This will be monitored on an ongoing basis.

Drugs are arranged in sections corresponding to those in the British National Formulary (BNF):
  1. Gastro-intestinal system
  2. Cardiovascular system
  3. Respiratory system
  4. Central nervous system
  5. Infections
  6. Endocrine system
  7. Obstetrics, gynaecology, and urinary-tract disorders
  8. Malignant disease and immunosuppression
  1. Nutrition and blood
  2. Musculoskeletal and joint diseases
  3. Eye
  4. Ear, nose, and oropharynx
  5. Skin
  6. Immunological products and vaccines
  7. Anaesthesia
  8. Miscellaneous
  9. X-Ray Contrast Media
  10. Emergency Treatment After Poisoning
Individual drug entries may be located by accessing the appropriate section and holding down the "Control" and "F" buttons on the computer keyboard to bring up a search box. Alternatively the A-Z index may be used. Some drugs appear in more than one section.


Operation of the Formulary

Drugs listed are available for general prescribing unless specific restrictions are indicated.

Drugs which are not listed in the formulary will be obtained only in the following circumstances:


Patients receiving a non-formulary drug on admission

Treatment with a non-formulary drug may be continued in this case. Patients' own supplies should always be used before requesting a supply from pharmacy and it should be borne in mind that there may be a delay in obtaining a non-formulary drug. An appropriate alternative should be considered in situations where treatment may otherwise be interrupted.

An admission to hospital represents an opportunity to review a patient's existing drug therapy and, if appropriate, treatment may be changed to a drug that is on the Trust formulary.


Drugs required for a specific patient in exceptional circumstances

Any drug which is not on the Trust formulary and which is required before the date of the next DTC meeting may be requested using the Drugs and Therapeutics Committee procedure for Urgent/Compassionate use.

Such an application will be considered for "one-off" occasions of drug use. A full application must be made for drugs which are required for addition to the formulary (see below).


Additions to the Formulary

The addition of new drugs to the formulary, and consequently to pharmacy stock, will be made only with the agreement of the Drugs and Therapeutics Committee. In order to request an addition to the formulary, a DTC request form must be completed in full and supporting evidence attached.

DTC applications must be received in pharmacy at least 2 weeks before the date of a DTC meeting in order for the item to be included in the agenda. DTC meetings are held every 2 months.


Drug Supply and Expenditure

Patients' own medicines should be obtained and used before any drug is requested from pharmacy.

The Trust and local PCTs have agreed that a medicines supply of 2 - 4 weeks should be prescribed on out-patient and discharge prescriptions.

It should be noted that items prescribed on FP10(HP) forms and dispensed in a community pharmacy are charged to the Trust. Therefore the rules with regard to Trust formulary prescribing and length of treatment must be followed. Prescriptions should be issued from out-patient clinics only when drug treatment is required to start immediately. In all other circumstances treatment recommendations should be communicated to the patient's GP using the out-patient clinic communication form. Patients should be encouraged to keep up to date with their usual medication supplies and informed that these may not be supplied from out-patient clinics.

A breakdown of drug expenditure (including FP10 expenditure) is regularly reported to each Division. Non-formulary and other inappropriate prescribing will be identified and reported to the Divisional leads.


Further Information

Clinical and pharmaceutical information provided within the formulary is intended as a guide only. Always check relevant information sources before prescribing or administering any drug.

For enquiries relating to the content of the Trust formulary or regarding High Cost Drugs please contact Steven Rees, Pharmacy IT Systems Manager.

For enquiries relating to DTC applications or other general prescribing issues please contact Baljinder Ahitan, Deputy Clinical Services Manager (and Secretary to the Drugs and Therapeutics Committee).


Surrey Prescribing Advisory Database ('PAD')

The PAD has recently been relaunched- it is an innovative resource which can be accessed by healthcare professionals in primary and secondary care and by patients. The PAD provides guidance and key information on medicines use within Surrey. You can search by medicine, condition or NICE technology appraisal. Information available on the PAD includes:
  • Recommendations, decisions, policy statements and submission papers from our Prescribing Clinical Network and Medicines Commissioning Group
  • Links to associated NICE Technology Appraisals
  • Relevant drug / safety alerts issued by the NPSA, EMEA and the MHRA
  • Local Policies, procedures, protocols and guidelines relating to the use of medicines
  • Materials used in the course of optimising medicines use e.g. audit tools, letter templates

Each drug entry on the PAD has been assigned a Traffic Light Status which is a locally agreed colour-coded guidance system on the use of medicines across the interface between primary and secondary care. It provides a framework for defining where clinical and therefore prescribing responsibility should lie. The system is only advisory but is intended to clarify expectations of prescribing responsibility.

The PAD is maintained by members of the NHS Surrey Medicines Management Teams who provide services to the local Clinical Commissioning Groups. The PAD is accessible to all on http://pad.res360.net/.