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Anti-infective
Anti-infective / Amoebic infection
  mepacrine hydrochloride On Formulary
Mepacrine Hydrochloride

On microbiology advice only
  metronidazole On Formulary
Intravenous Metronidazole

Hospital only medicine
Cystic Fibrosis Drug Doses

see attached
MicroGuide App

For how to access MicroGuide App follow the link
  Oral suspension
Metronidazole (Non-proprietary) On Formulary
  Infusion
Metronidazole (Non-proprietary)
  Suppository
Flagyl (Sanofi)
  Vaginal gel
Zidoval (Viatris UK Healthcare Ltd)
  Oral tablet
Metronidazole (Non-proprietary)
Flagyl (Sanofi)
  Cutaneous cream
Rozex (Galderma (UK) Ltd)
  Cutaneous gel
Metronidazole (Non-proprietary)
Acea (Ferndale Pharmaceuticals Ltd)
Anabact (Cambridge Healthcare Supplies Ltd)
Metrogel (Galderma (UK) Ltd)
Metrosa (Beaumont Pharma Ltd)
Rozex (Galderma (UK) Ltd)
Anti-infective / Bacterial infection
  CEFAZOLIN Hospital Only
Cefazolin

Proposed patient selection criteria:
Complicated MSSA bloodstream infection in haemodialysis patients.

  1. Persistent positive blood cultures after 48-72 hours appropriate antibiotic treatment
  2. Persistent fever >72 hours into appropriate antibiotic treatment
  3. Evidence of endocarditis / septic thrombophlebitis
  4. Evidence of bone infection
  5. Skin / soft tissue infection (e.g. diabetic foot)

On advice from microbiology only

Dose : 2g three times a week for 6 weeks

  Faecal microbiota transplant material Hospital Only
  amikacin On Formulary
November 2023-​​Liposomal Amikacin sulphate​ (​​Arikayce​) -​​ NTM-PD caused by MAC​

​​Liposomal Amikacin sulphate​ (​​Arikayce​) Approved at NEL FPG for​​ non-tuberculous mycobacterial pulmonary disease (NTM-PD) caused by Mycobacterium avium complex (MAC)​ for adults and post pubescent children. 

​​590mg nebuliser dispersion vials​ 

Commissioning Policy NHSE  221007P
Cystic Fibrosis Drug Doses

Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)

Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Urinary Tract Infection in renal transplant patients

Rapid Desensitisation Protocol

Antibiotic line lock Guideline - adults

AMIKACIN

HOSPITAL ONLY

Amikacin Injection Shortage Information Dec 2019

To Summarise

 

  • To use Gentamicin as first line  as per memo attached  i.e. if a patient is Septic AND there has not been recent (within past 6 months) isolation of ESBL or gentamicin resistant organisms, use gentamicin (dosing as per MicroGuide). Procurement team are looking into ordering more gentamicin across sites. The ward pharmacists should ensure that there is enough gentamicin on their wards or add to stock lists if appropriate. Note: Amikacin is used as first line in CF patients, if you have any concerns with respiratory patients please contact lead respiratory pharmacist.   

 

  • All ward pharmacists need to review all amikacin prescriptions and ensure that gentamicin cannot be used. If amikacin is still required then the minimum quantity should be dispensed.

 

  • Licensed UK product of amikacin 100mg in 2mL is being ring-fenced for neonates and also EDR cupboards at SBH, NUH AND WXH. All ward pharmacists need to  return any unused licensed amikacin especially the 100mg in 2mL.

 

  • Unlicensed Italian Amikacin 500mg in 2mL has been approved and reserved for adult patients and paediatric patients only. Please follow the instructions in the updated memo attached.  

Please note for all unlicensed products the unlicensed policy must be followed: upon receiving,  dispensing and administration for patients the batch number and expiry date must be recorded.
  Solution for injection
Amikacin (Non-proprietary) On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)

Rapid Desensitisation Protocol

Antibiotic line lock Guideline - adults

Cystic Fibrosis Drug Doses

Amikin (Vianex S.A.)
Cystic Fibrosis Drug Doses

  Nebuliser dispersion
Arikayce (Insmed Ltd)
  amoxicillin On Formulary
Splenectomy Letter

Please see microguide for the splenectomy guideline on non surgical prophylaxis.
Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)

Dental Hospital antibiotic guidance

Please see Microguide (App)

Cystic Fibrosis Drug Doses

PRESCRIBING IN PENICILLIN ALLERGY

Intravenous amoxicillin

Hospital only medicine
  Oral suspension
Amoxicillin (Non-proprietary) On Formulary
Dental Hospital antibiotic guidance

Please see Microguide (App)
Cystic Fibrosis Drug Doses

see attached

 
  Powder for solution for injection
Amoxicillin (Non-proprietary) On Formulary
Dental Hospital antibiotic guidance

Please see Microguide (App)
Cystic Fibrosis Drug Doses

see attached

 
  Oral capsule
Amoxicillin (Non-proprietary)
  Powder for oral suspension
Amoxicillin (Non-proprietary)
  ampicillin On Formulary
Cystic Fibrosis Drug Doses

PRESCRIBING IN PENICILLIN ALLERGY

  Oral suspension
Ampicillin (Non-proprietary) On Formulary
Cystic Fibrosis Drug Doses

see attached
  Powder for solution for injection
Ampicillin (Non-proprietary) On Formulary
Cystic Fibrosis Drug Doses

see attached
  Oral capsule
Ampicillin (Non-proprietary)
  azithromycin On Formulary
Cystic Fibrosis Drug Doses

see attached
Intravenous Azithromycin

Hospital only medicine
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)
Syphilis guidance

see attached
  Oral suspension
Azithromycin (Non-proprietary) On Formulary
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)
Cystic Fibrosis Drug Doses

see attached
Zithromax (Pfizer Ltd) On Formulary
Syphilis guidance

see attached
Cystic Fibrosis Drug Doses

see attached
  Powder for solution for infusion
Azithromycin (Non-proprietary)
Zedbac (Aspire Pharma Ltd)
  Eye drops
Azyter (Thea Pharmaceuticals Ltd) On Formulary
  Oral tablet
Azithromycin (Non-proprietary)
  Oral capsule
Azithromycin (Non-proprietary)
Zithromax (Pfizer Ltd)
  aztreonam Hospital Only
MICROGUIDE APP

For how to access to Microguide app open poster below or follow link

   
Aztreonam

On Microbiology advice only
Cystic Fibrosis Drug Doses

PRESCRIBING IN PENICILLIN ALLERGY

see attached
  Powder for solution for injection
Azactam (Bristol-Myers Squibb Pharmaceuticals Ltd) On Formulary
  Powder and solvent for nebuliser solution
Cayston (Gilead Sciences Ltd)
  benzathine benzylpenicillin
  Powder and solvent for suspension for injection
Benzathine benzylpenicillin (Non-proprietary)
  benzylpenicillin sodium On Formulary
PRESCRIBING IN PENICILLIN ALLERGY

  Powder for solution for injection
Benzylpenicillin sodium (Non-proprietary) On Formulary
  cefaclor Off Formulary
  Modified-release tablet
Distaclor MR (Flynn Pharma Ltd)
  Oral suspension
Distaclor (Flynn Pharma Ltd)
  Oral capsule
Distaclor (Flynn Pharma Ltd)
  cefadroxil Off Formulary
  Oral capsule
Cefadroxil (Non-proprietary)
  cefalexin On Formulary
Cefalexin

For guideline refer to genito-urinary body system on MicroGuide.
Cystic Fibrosis Drug Doses

  Oral suspension
Cefalexin (Non-proprietary) On Formulary
Cystic Fibrosis Drug Doses

see attached
  Oral tablet
Cefalexin (Non-proprietary)
  Oral capsule
Cefalexin (Non-proprietary)
  cefazolin
  Powder for solution for injection
Cefazolin (Non-proprietary)
  cefepime
  Powder for solution for injection
Renapime (Renascience Pharma Ltd)
  cefepime with enmetazobactam
  Powder for solution for infusion
Cefepime with enmetazobactam (Non-proprietary)
  cefiderocol Hospital Only
Cefiderocol powder concentrate (June 2021)

Approved for the treatment of Carbapenemase-producing organism confirmed inections, for which other antibiotic options are unsuitable due to allergy, adverse effects or resistance. Hospital ONLY 

 

 
  Powder for solution for infusion
Fetcroja (Shionogi BV)
  cefixime Hospital Only
Cystic Fibrosis Drug Doses

  Oral tablet
Suprax (Advanz Pharma)
  cefotaxime On Formulary
Cystic Fibrosis Drug Doses

  Powder for solution for injection
Cefotaxime (Non-proprietary) On Formulary
Cystic Fibrosis Drug Doses

  cefoxitin
  Powder for solution for injection
Cefoxitin (Non-proprietary)
Renoxitin (Renascience Pharma Ltd)
  cefradine Off Formulary
  Oral capsule
Cefradine (Non-proprietary)
  ceftaroline fosamil On Formulary
Ceftaroline fosamil

Hospital only medicine

On microbiology advice only
  Powder for solution for infusion
Zinforo (Pfizer Ltd)
  ceftazidime On Formulary
Cystic Fibrosis Drug Doses

Ceftazidime

Hospital only medicine
  Powder for solution for injection
Ceftazidime (Non-proprietary) On Formulary
Cystic Fibrosis Drug Doses

Fortum (Sandoz Ltd)
Cystic Fibrosis Drug Doses

  ceftazidime with avibactam On Formulary
Ceftazidime with avibactam

On microbiology advice only

Hospital only medicine
  Powder for solution for infusion
Zavicefta (Pfizer Ltd)
  ceftobiprole Off Formulary
  Powder for solution for infusion
Zevtera (Advanz Pharma)
  ceftolozane with tazobactam On Formulary
Ceftolozane with tazobactam

On microbiology advice only.

Hospital only medicine.
  Powder for solution for infusion
Zerbaxa (Merck Sharp & Dohme (UK) Ltd) Hospital Only
  ceftriaxone On Formulary
RLH Adult ENT A&E guidelines 2015

Cystic Fibrosis Drug Doses

Treatment guidelines

Refer to MicroGuide
Ceftriaxone

Hospital only medicine
  Powder for solution for injection
Ceftriaxone (Non-proprietary) On Formulary
RLH Adult ENT A&E guidelines 2015

Cystic Fibrosis Drug Doses

Rocephin (Roche Products Ltd) On Formulary
Cystic Fibrosis Drug Doses

  cefuroxime On Formulary
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)

Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)

Antibiotic Prophylaxis in GI Surgery

Please see Microguide (App)

Cystic Fibrosis Drug Doses

INJECTABLE CEFUROXIME

 HOSPITAL ONLY medicine
  Oral suspension
Zinnat (Sandoz Ltd) On Formulary
Cystic Fibrosis Drug Doses

see attached
  Powder for solution for injection
Cefuroxime (Non-proprietary)
Aprokam (Thea Pharmaceuticals Ltd) Hospital Only
Ximaract (Bausch & Lomb UK Ltd)
Zinacef (Sandoz Ltd)
  Oral tablet
Cefuroxime (Non-proprietary)
Zinnat (Sandoz Ltd)
  chloramphenicol On Formulary
Cystic Fibrosis Drug Doses

see attached
Chloramphenicol

For treatment guidelines refer to MicroGuide
CHLORAMPHENICOL

INJECTION IS HOSPITAL ONLY medicine.
 
  Powder for solution for injection
Chloramphenicol (Non-proprietary) On Formulary
  Ear drops
Chloramphenicol (Non-proprietary)
  Eye drops
Chloramphenicol (Non-proprietary)
Eykappo (Aspire Pharma Ltd)
  Eye ointment
Chloramphenicol (Non-proprietary)
  Oral capsule
Chloramphenicol (Non-proprietary)
  ciprofloxacin On Formulary
Bone and joint treatment

Refer to Bone and Joint section of body systems on MicroGuide
RLH Adult ENT A&E guidelines 2015

Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)
Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)
Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)
Antibiotic line lock Guideline - adults

see attached
Cystic Fibrosis Drug Doses

see attached
Intravenous ciprofloxacin

Hospital only medicine.
Fluoroquinolone antibiotics

March 2019 Drug safety update
  Oral suspension
Ciproxin (Bayer Plc) On Formulary
Treatment of prosthetic joint infections

see attached
Cystic Fibrosis Drug Doses

see attached
  Infusion
Ciprofloxacin (Non-proprietary) On Formulary
Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)
RLH Adult ENT A&E guidelines 2015

see attached
Antibiotic line lock Guideline - adults

see attached
Treatment of prosthetic joint infections

see attached
Cystic Fibrosis Drug Doses

see attached
Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)
  Solution for infusion
Ciprofloxacin (Non-proprietary) Hospital Only
Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)
RLH Adult ENT A&E guidelines 2015

see attached
Antibiotic line lock Guideline - adults

see attached
Treatment of prosthetic joint infections

see attached
Cystic Fibrosis Drug Doses

see attached
Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)
  Ear drops
Cetraxal (Aspire Pharma Ltd)
  Eye drops
Ciloxan (Novartis Pharmaceuticals UK Ltd)
  Oral tablet
Ciprofloxacin (Non-proprietary)
  clarithromycin On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Splenectomy Letter

Please see microguide for the splenectomy guideline on non surgical prophylaxis.
Dental Hospital antibiotic guidance

Please see Microguide (App)

Cystic Fibrosis Drug Doses

Intravenous clarithromycin

Hospital only medicine
  Modified-release tablet
Xetinin XL (Morningside Healthcare Ltd) On Formulary
  Oral suspension
Clarithromycin (Non-proprietary) On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
Cystic Fibrosis Drug Doses

see attached
  Powder for solution for infusion
Clarithromycin (Non-proprietary)
Klaricid (Viatris UK Healthcare Ltd)
  Oral tablet
Clarithromycin (Non-proprietary)
  clindamycin On Formulary
Antibiotic prophylaxis in trauma and orthopaedic surgery

Please see Microguide (App)
Cystic Fibrosis Drug Doses

see attached
Antibiotic prophylaxis in Urology

Please see Microguide (App)
MICROGUIDE APP

For how to access to Microguide app open poster below or follow link

   
Injectable Clindamycin

Hospital only medicine
  Solution for injection
Clindamycin (Non-proprietary) On Formulary
Cystic Fibrosis Drug Doses

see attached
Malaria SOP for Barts Health

For the treatment of falciparum and non-falciparum Malaria
Dalacin C (Pfizer Ltd) On Formulary
Cystic Fibrosis Drug Doses

see attached
  Cutaneous emulsion
Dalacin T (Pfizer Ltd)
  Oral capsule
Clindamycin (Non-proprietary)
Dalacin C (Pfizer Ltd)
  Cutaneous gel
Zindaclin (Canute Pharma Ltd)
  Vaginal cream
Dalacin (Pfizer Ltd)
  co-amoxiclav On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)

Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)

Antibiotic prophylaxis Head and Neck 2014

Please see Microguide (App)

Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)

Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)

Antibiotic prophylaxis in trauma and orthopaedic surgery

Please see Microguide (App)

Cystic Fibrosis Drug Doses

PRESCRIBING IN PENICILLIN ALLERGY

MicroGuide App

How to access MicroGuide app
Injectable co-amoxiclav

Hospital only medicine
  Oral suspension
Co-amoxiclav (Non-proprietary)
Augmentin (GlaxoSmithKline UK Ltd)
Augmentin-Duo (GlaxoSmithKline UK Ltd)
  Powder for solution for injection
Co-amoxiclav (Non-proprietary)
  Oral tablet
Co-amoxiclav (Non-proprietary)
Augmentin (GlaxoSmithKline UK Ltd)
  co-fluampicil Off Formulary
Cystic Fibrosis Drug Doses

PRESCRIBING IN PENICILLIN ALLERGY

  Oral capsule
Co-fluampicil (Non-proprietary)
  co-trimoxazole On Formulary
Cystic Fibrosis Drug Doses

CO-TRIMOXAZOLE

Oral is used for the treatment of mild Pneuomocystic carinii
IV or high dose oral is for severe PCP disease

Also for prophylaxis of PCP and toxoplasmosis 480mg three times weekly or 960mg if previous infection.

IV is HOSPITAL ONLY

  Oral suspension
Co-trimoxazole (Non-proprietary)
  Solution for infusion
Co-trimoxazole (Non-proprietary)
  Oral tablet
Co-trimoxazole (Non-proprietary)
  colistimethate sodium On Formulary NICE TA276
Colistimethate sodium

On Microbiology advice only
Rapid Desensitisation Protocol

Colistimethate sodium injection and nebulisers in cystic fibrosis

Hospital only medicine
  Powder for solution for injection
Colomycin (Teva UK Ltd)
  Inhalation powder
Colobreathe (Essential Pharma Ltd) Hospital Only
  Powder for nebuliser solution
Colicym (Kent Pharma (UK) Ltd)
Promixin (Zambon UK Ltd) Hospital Only
  dalbavancin On Formulary
Dalbavancin

ON MICROBIOLOGY ADVICE ONLY

HOSPITAL ONLY MEDICINE
  Powder for solution for infusion
Xydalba (Advanz Pharma)
  daptomycin On Formulary
Daptomycin

ON MICROBIOLOGY ADVICE ONLY

HOSPITAL ONLY MEDICINE
  Powder for solution for infusion
Daptomycin (Non-proprietary)
Cubicin (Merck Sharp & Dohme (UK) Ltd)
  delafloxacin
  Powder for solution for infusion
Quofenix (A. Menarini Farmaceutica Internazionale SRL)
  Oral tablet
Quofenix (A. Menarini Farmaceutica Internazionale SRL)
  demeclocycline hydrochloride Off Formulary
DEMECLOCYCLINE HYDROCHLORIDE

Second line option for SIADH

  Oral tablet
Demeclocycline hydrochloride (Non-proprietary)
  Oral capsule
Demeclocycline hydrochloride (Non-proprietary)
  doxycycline On Formulary
Malaria prophylaxis and treatment

Refer to Parasitology section of MicroGuide
Doxycycline

Update of malaria prevention guidelines for travellers from the UK
Cystic Fibrosis Drug Doses

see attached
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)
  Dispersible tablet
Vibramycin-D (Pfizer Ltd)
  Modified-release capsule
Efracea (Galderma (UK) Ltd) On Formulary
Cystic Fibrosis Drug Doses

  Oral tablet
Periostat (Alliance Pharmaceuticals Ltd)
  Oral capsule
Doxycycline (Non-proprietary)
  eravacycline
  Powder for solution for infusion
Xerava (PAION Deutschland GmbH)
  ertapenem On Formulary
MicroGuide App

For how to access MicroGuide app follow link
Ertapenem

On Microbiology advice only

Hospital only medicine
Rapid Desensitisation Protocol

Cystic Fibrosis Drug Doses

  Powder for solution for infusion
Ertapenem (Non-proprietary)
Invanz (Merck Sharp & Dohme (UK) Ltd)
  erythromycin On Formulary
Intravenous erythromycin

Hospital only medicine
MicroGuide App

For how to access MicroGuide App follow the link
Syphilis guidance

Cystic Fibrosis Drug Doses

ERYTHROMYCIN

Second line for acne

Used as a prokinetic at 250mg qds

  Gastro-resistant tablet
Erythromycin (Non-proprietary) On Formulary
  Oral suspension
Erythromycin (Non-proprietary) On Formulary
Syphilis guidance

see attached
Cystic Fibrosis Drug Doses

see attached
  Powder for solution for infusion
Erythromycin (Non-proprietary)
  Oral tablet
Erythromycin (Non-proprietary)
Erythrocin (Advanz Pharma)
  fidaxomicin Hospital Only
MicroGuide App

For how to access MicroGuide App follow link
Cystic Fibrosis Drug Doses

see attached
  Oral suspension
Fidaxomicin (Non-proprietary)
  Oral tablet
Fidaxomicin (Non-proprietary)
  flucloxacillin On Formulary
Cystic Fibrosis Drug Doses

PRESCRIBING IN PENICILLIN ALLERGY

Injectable flucloxacillin

Hospital only medicine
MicroGuide App

For how to access MicroGuide App follow link
  Oral solution
Flucloxacillin (Non-proprietary) On Formulary
  Powder for solution for injection
Flucloxacillin (Non-proprietary) Hospital Only
  Oral capsule
Flucloxacillin (Non-proprietary)
  fosfomycin On Formulary
MICROGUIDE APP

For how to access to Microguide app open poster below or follow link

   
Intravenous fosfomycin

Hospital only medicine
  Powder for solution for infusion
Fosfomycin (Non-proprietary)
Fomicyt (Kent Pharma (UK) Ltd)
  Granules for oral solution
Fosfomycin (Non-proprietary)
Alexi (Nordic Pharma Ltd)
Monuril (Zambon UK Ltd)
  fusidic acid On Formulary
MicroGuide App

For how to access MicroGuide App follow link
Intravenous fusidic acid

Avoid use due to increased risk of hepatotoxicity

Hospital only medicine
Cystic Fibrosis Drug Doses

see attached
  Oral suspension
Fucidin (LEO Pharma)
  Modified-release drops
Fusidic acid (Non-proprietary)
  Powder and solvent for solution for infusion
Fusidic acid (Non-proprietary) On Formulary
Cystic Fibrosis Drug Doses

CF Drug doses changes Aug 17
  Oral tablet
Fucidin (LEO Pharma)
  Cutaneous ointment
Fucidin (LEO Pharma)
  Cutaneous cream
Fusidic acid (Non-proprietary)
Fucidin (LEO Pharma)
  gentamicin On Formulary
Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)
Antibiotic prophylaxis in trauma and orthopaedic surgery

Please see Microguide (App)
Antibiotic line lock Guideline - adults

see attached
Rapid Desensitisation Protocol

see attached
Cystic Fibrosis Drug Doses

see attached
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)
Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)
Antibiotic prophylaxis Head and Neck 2014

Please see Microguide (App)
Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)
Antibiotic Prophylaxis in GI Surgery

Please see Microguide (App)
  Solution for injection
Gentamicin (Non-proprietary) On Formulary
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)
Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)
Antibiotic Prophylaxis in GI Surgery

Please see Microguide (App)
Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)
Antibiotic prophylaxis in trauma and orthopaedic surgery

Please see Microguide (App)
Rapid Desensitisation Protocol

see attached
Antibiotic line lock Guideline - adults

see attached
Cystic Fibrosis Drug Doses

see attached
Cidomycin (Advanz Pharma) Hospital Only
Cystic Fibrosis Drug Doses

  Infusion
Gentamicin (Non-proprietary) On Formulary
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)
Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)
Antibiotic Prophylaxis in GI Surgery

Please see Microguide (App)
Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)
Antibiotic prophylaxis in trauma and orthopaedic surgery

Please see Microguide (App)
Rapid Desensitisation Protocol

see attached
Antibiotic line lock Guideline - adults

see attached
Cystic Fibrosis Drug Doses

see attached
  Ear/eye drops solution
Gentamicin (Non-proprietary)
  imipenem with cilastatin On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Cystic Fibrosis Drug Doses

IMIPENEM WITH CILASTATIN

FOR HOSPITAL USE ONLY

  Powder for solution for infusion
Imipenem with cilastatin (Non-proprietary)
  imipenem with cilastatin and relebactam
  Powder for solution for infusion
Recarbrio (Merck Sharp & Dohme (UK) Ltd)
  levofloxacin On Formulary
Rapid Desensitisation Protocol

 

see attached

 
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

MicroGuide App

For how to access MicroGuide App follow the link
IV Levofloxacin

Hospital only medicine
Fluoroquinolone antibiotics

March 2019 Drug safety update
  Infusion
Levofloxacin (Non-proprietary) On Formulary
  Solution for infusion
Levofloxacin (Non-proprietary) On Formulary
  Nebuliser liquid
Quinsair (Chiesi Ltd)
  Eye drops
Levofloxacin (Non-proprietary)
Eyflox (Aspire Pharma Ltd)
Oftaquix (Santen UK Ltd)
Oxalux (Kestrel Ophthalmics Ltd)
  Oral tablet
Levofloxacin (Non-proprietary)
Evoxil (Kent Pharma (UK) Ltd)
  linezolid Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Cystic Fibrosis Drug Doses

MicroGuide App

For how to access MicroGuide App follow the link
  Oral suspension
Zyvox (Pfizer Ltd)
  Infusion
Linezolid (Non-proprietary)
Zyvox (Pfizer Ltd)
  Oral tablet
Linezolid (Non-proprietary)
Zyvox (Pfizer Ltd)
  lymecycline On Formulary
Lymecycline for acne

 

  • To replace minocycline as the tetracycline of choice to manage moderately/severely  inflammed acne  in adults, and children > 12 years of age that fail to respond to topical management.
  • Lymecycline has similar efficacy and tolerability to other tetracyclines with some advantages as below
  • Minocycline is a common cause of drug induced  lupus, and associated with hyperpigmentation and hepatotoxicity.
  • Doxycycline is associated with oesophagitis, photosensitivity and nausea.
  • Oxytetracycline  is poorly absorbed and requires multiple daily administration for optimal effect.
LYMECYCLINE

First line option for rosacea and acne

  Oral capsule
Lymecycline (Non-proprietary)
Tetralysal (Galderma (UK) Ltd)
  meropenem On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Cystic Fibrosis Drug Doses

MicroGuide App

For how to access MicroGuide App follow the link
Intravenous Meropenem

Hospital only medicine
  Powder for solution for injection
Meropenem (Non-proprietary) On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Treatment of prosthetic joint infections

Cystic Fibrosis Drug Doses

Meronem (Pfizer Ltd) On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Treatment of prosthetic joint infections

Cystic Fibrosis Drug Doses

  meropenem with vaborbactam
  Powder for solution for infusion
Vaborem (A. Menarini Farmaceutica Internazionale SRL)
  metronidazole On Formulary
Intravenous Metronidazole

Hospital only medicine
Dental Hospital antibiotic guidance

Please see Microguide (App)
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)
Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)
Antibiotic Prophylaxis in GI Surgery

Please see Microguide (App)
Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)
Cystic Fibrosis Drug Doses

see attached
MicroGuide App

For how to access MicroGuide App follow the link
  Oral suspension
Metronidazole (Non-proprietary) On Formulary
  Infusion
Metronidazole (Non-proprietary) On Formulary
  Suppository
Flagyl (Sanofi)
  Vaginal gel
Zidoval (Viatris UK Healthcare Ltd)
  Oral tablet
Metronidazole (Non-proprietary)
Flagyl (Sanofi)
  Cutaneous cream
Rozex (Galderma (UK) Ltd)
  Cutaneous gel
Metronidazole (Non-proprietary)
Acea (Ferndale Pharmaceuticals Ltd)
Anabact (Cambridge Healthcare Supplies Ltd)
Metrogel (Galderma (UK) Ltd)
Metrosa (Beaumont Pharma Ltd)
Rozex (Galderma (UK) Ltd)
  minocycline Hospital Only
Cystic Fibrosis Drug Doses

  Modified-release capsule
Acnamino MR (Dexcel-Pharma Ltd)
Minocin MR (Viatris UK Healthcare Ltd)
  Oral tablet
Minocycline (Non-proprietary)
  moxifloxacin On Formulary
Intravenous moxifloxacin

Hospital only medicine
Moxifloxacin

On microbiology advice only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
Cystic Fibrosis Drug Doses

see attached
Fluoroquinolone antibiotics

March 2019 Drug safety update
  Infusion
Moxifloxacin (Non-proprietary)
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
Cystic Fibrosis Drug Doses

CF Drug Doses changes Aug 17
  Solution for infusion
Moxifloxacin (Non-proprietary)
  Eye drops
Moxifloxacin (Non-proprietary)
Moxivig (Novartis Pharmaceuticals UK Ltd)
  Oral tablet
Moxifloxacin (Non-proprietary)
  neomycin sulfate Off Formulary
Cystic Fibrosis Drug Doses

  Oral solution
Neomycin sulfate (Non-proprietary)
  ofloxacin
Fluoroquinolone antibiotics

March 2019 Drug safety update
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
  Eye drops
Exocin (AbbVie Ltd)
  Oral tablet
Ofloxacin (Non-proprietary)
  oritavancin
  Powder for solution for infusion
Tenkasi (A. Menarini Farmaceutica Internazionale SRL)
  oxytetracycline On Formulary
OXYTETRACYCLINE

First line option for acne
  Oral tablet
Oxytetracycline (Non-proprietary)
  phenoxymethylpenicillin On Formulary
MicroGuide App

For how to access MicroGuide App follow the link
Sickle Cell Trust Guideline

PRESCRIBING IN PENICILLIN ALLERGY

  Oral solution
Phenoxymethylpenicillin (Non-proprietary) On Formulary
Sickle Cell Trust Guideline

Sickle Cell Trust Guideline
PRESCRIBING IN PENICILLIN ALLERGY

Prescribing in Penicillin Allergy
  Oral tablet
Phenoxymethylpenicillin (Non-proprietary)
  piperacillin with tazobactam On Formulary
MicroGuide App

For how to access MicroGuide App follow the link
Piperacillin with tazobactam

Hospital only medicine
Cystic Fibrosis Drug Doses

PRESCRIBING IN PENICILLIN ALLERGY

  Powder for solution for infusion
Piperacillin with tazobactam (Non-proprietary)
Tazocin (Pfizer Ltd)
  pivmecillinam hydrochloride On Formulary
MicroGuide App

For how to access MicroGuide App follow the link
PRESCRIBING IN PENICILLIN ALLERGY

  Oral tablet
Pivmecillinam hydrochloride (Non-proprietary)
Selexid (Karo Healthcare UK Ltd)
  rifabutin On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

  Oral capsule
Mycobutin (Pfizer Ltd)
  rifampicin
  Oral suspension
Rifadin (Sanofi)
  Powder and solvent for solution for injection
Rifampicin (Non-proprietary)
  Powder and solvent for solution for infusion
Rifadin (Sanofi)
  Oral capsule
Rifampicin (Non-proprietary)
Rifadin (Sanofi)
Rimactane (Sandoz Ltd)
  rifaximin On Formulary NICE TA337
  Oral suspension
Rifaximin (Non-proprietary)
  Oral tablet
Targaxan (Norgine Pharmaceuticals Ltd)
Xifaxanta (Norgine Pharmaceuticals Ltd)
  streptomycin On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

  sulfadiazine
Toxoplasmosis- on formulary

On formulary for Toxoplasmosis.

 
  Oral tablet
Sulfadiazine (Non-proprietary)
  tedizolid Off Formulary
  Powder for solution for infusion
Sivextro (Merck Sharp & Dohme (UK) Ltd)
  Oral tablet
Sivextro (Merck Sharp & Dohme (UK) Ltd)
  teicoplanin On Formulary
MicroGuide App

For how to access MicroGuide app follow the link
Teicoplanin IV

Hospital only medicine
Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)

Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)

Antibiotic prophylaxis Head and Neck 2014

Please see Microguide (App)

Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)

Antibiotic Prophylaxis in GI Surgery

Please see Microguide (App)

Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)

Antibiotic prophylaxis in trauma and orthopaedic surgery

Please see Microguide (App)

Antibiotic line lock Guideline - adults

Cystic Fibrosis Drug Doses

  Powder and solvent for solution for injection
Teicoplanin (Non-proprietary)
Targocid (Sanofi) On Formulary
Antibiotic Prophylaxis in Gastroendoscopy

Please see Microguide (App)

Antibiotic prophylaxis for interventional radiology procedures

Please see Microguide (App)

Antibiotic prophylaxis in trauma and orthopaedic surgery

Please see Microguide (App)

Antibiotic line lock Guideline - adults

Cystic Fibrosis Drug Doses

Antibiotic Prophylaxis in Obstetrics and Gynae

Please see Microguide (App)
Antibiotic Prophylaxis in GI Surgery

Please see Microguide (App)
Treatment of prosthetic joint infections

Treatment of prosthetic joint infections
  temocillin On Formulary
Cystic Fibrosis Drug Doses

PRESCRIBING IN PENICILLIN ALLERGY

MicroGuide App

For how to access MicroGuide App follow the link
Intravenous Temocillin

Hospital only medicine

On microbilogy advice only
  Powder for solution for injection
Negaban (Eumedica Pharma Ltd) On Formulary
  tetracycline On Formulary
Cystic Fibrosis Drug Doses

  Oral tablet
Tetracycline (Non-proprietary)
  tigecycline On Formulary
Cystic Fibrosis Drug Doses

Tigecycline

Hospital only medicine

On microbiology advice only
MicroGuide App

For how to access MicroGuide App follow the link
  Powder for solution for infusion
Tigecycline (Non-proprietary)
Tygacil (Pfizer Ltd)
  tobramycin On Formulary NICE TA276
Cystic Fibrosis Drug Doses

see attached
MicroGuide App

For how to access MicroGuide app follow the link
Intravenous Tobramycin

Hospital only medicine
  Solution for injection
Tobramycin (Non-proprietary)
Cystic Fibrosis Drug Doses

see attached
  Inhalation powder
Tobi Podhaler (Viatris UK Healthcare Ltd) On Formulary
Cystic Fibrosis Drug Doses

Cystic Fibrosis Drug Doses
  Nebuliser liquid
Tobramycin (Non-proprietary)
Bramitob (Chiesi Ltd)
Munuza (Aristo Pharma Ltd)
TOBI (Viatris UK Healthcare Ltd)
Tymbrineb (Teva UK Ltd)
Vantobra (Pari Medical Ltd)
  trimethoprim On Formulary
Cystic Fibrosis Drug Doses

TRIMETHOPRIM

Used for acne at a dose of 300mg twice daily for 4-8 weeks

MicroGuide App

For how to access MicroGuide App follow the link
Trimethoprim for UTI

Following sensitivity pattern results
  Oral suspension
Trimethoprim (Non-proprietary) On Formulary
Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)
Cystic Fibrosis Drug Doses

see attached
TRIMETHOPRIM

Used for acne at a dose of 300mg twice daily for 4-8 weeks
  Oral tablet
Trimethoprim (Non-proprietary)
  vancomycin On Formulary
GBS maternity guideline- severe penicillin allergy drug info

    
Cystic Fibrosis Drug Doses

Oral Vancomycin Guidance

Vancomycin in Labour ward to prevent GBS infection to newborn

Approved to prevent early onset neonatal group B Streptococcal disease in women in Labour with severe penicillin allergy.

 
Continuous Vancomycin Infusion Guideline (Adult Critical Care ONLY)

Guidance for the administration of continous vancomycin infusions. For use in adult critical care areas only.
MicroGuide App

For how to access MicroGuide App follow link
Intravenous Vancomycin

Hospital only medicine
  Powder for solution for infusion
Vancomycin (Non-proprietary)
  Oral capsule
Vancomycin (Non-proprietary)
Vancocin Matrigel (Flynn Pharma Ltd)
Anti-infective / Leprosy
  clofazimine On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

CLOFAZIMINE

Also for Multi-Drug Resistant Tuberculosis

  Oral capsule
Clofazimine (Non-proprietary)
  dapsone Hospital Only
Dapsone:

Dose of 100mg daily used as second line prophylaxis option for PCP.

Treatment of mild PCP disease: dapsone is used together with pyrimethamine as third line option.

  Oral tablet
Dapsone (Non-proprietary)
  rifampicin Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

Cystic Fibrosis Drug Doses

MicroGuide App

For how to access MicroGuide App follow the link
  Oral suspension
Rifadin (Sanofi)
  Powder and solvent for solution for injection
Rifampicin (Non-proprietary)
  Powder and solvent for solution for infusion
Rifadin (Sanofi)
  Oral capsule
Rifampicin (Non-proprietary)
Rifadin (Sanofi)
Rimactane (Sandoz Ltd)
Anti-infective / Tuberculosis
  aminosalicylic acid On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

  Gastro-resistant granules
Granupas (Eurocept International bv) On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

  bedaquiline Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Bedaquiline

Hospital only medicine- as per NHSE commissioning policy for MDR-TB- Blueteq form required
  Oral tablet
Sirturo (Janssen-Cilag Ltd)
  cycloserine On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

Shortage memo - cycloserine

Cycloserine 250mg capsules are out of stock with no confirmed resupply date. There are no other licensed strengths of cycloserine available in the UK market. Cycloserine is indicated for treatment of multi-drug resistant tuberculosis (MDR TB). Terizidone 250mg capsules, a derivative of cycloserine, will be used as an alternative. Terizidone is currently not licensed in the UK. Please see the memo attached for further information on this medicine shortage.
  Oral capsule
Cycloserine (Non-proprietary)
  delamanid Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Delamanid

Hospital only medicine- as per NHSE commissioning policy for MDR TB- blueteq form required.
  Oral tablet
Deltyba (Imported)
  ethambutol hydrochloride Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

Cystic Fibrosis Drug Doses

  Oral tablet
Ethambutol hydrochloride (Non-proprietary)
  isoniazid Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

Isoniazid 100mg in 5mLs


ISONIAZID

Injection formulation is for HOSPITAL USE ONLY

100mg in 5mL is stocked.  An infusion in 100-250mLs normal saline or dextrose 5% in water is preferred for doses above 200mg.
Hospital only

For renal patients post-transplant
  Solution for injection
Isoniazid (Non-proprietary)
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol
Isoniazid 100mg in 5mLs

see attached
Isoniazid

Please note that the injection is HOSPITAL PHARMACY.

100mg in 5mL is stocked.  An infusion in 100-250mLs of normal saline or dextrose 5% in water is preferred for doses above 200mg.
  Oral tablet
Isoniazid (Non-proprietary)
  pyrazinamide Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

  Oral tablet
Pyrazinamide (Non-proprietary)
Zinamide (Genus Pharmaceuticals Ltd)
  rifabutin On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

  Oral capsule
Mycobutin (Pfizer Ltd)
  rifampicin Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

Cystic Fibrosis Drug Doses

MicroGuide App

For how to access MicroGuide App follow the link
  Oral suspension
Rifadin (Sanofi) Hospital Only
Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
Treatment of prosthetic joint infections

see attached
Cystic Fibrosis Drug Doses

see attached
  Powder and solvent for solution for injection
Rifampicin (Non-proprietary) Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
Treatment of prosthetic joint infections

Treatment of prosthetic joint infections
  Powder and solvent for solution for infusion
Rifadin (Sanofi) Hospital Only
Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
Treatment of prosthetic joint infections

see attached
Cystic Fibrosis Drug Doses

see attached
  Oral capsule
Rifampicin (Non-proprietary)
Rifadin (Sanofi)
Rimactane (Sandoz Ltd)
  rifampicin with ethambutol, isoniazid and pyrazinamide Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
  Oral tablet
Voractiv (Genus Pharmaceuticals Ltd)
  rifampicin with isoniazid Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Tuberculosis: Latent TB Protocol Newham Only

The latent TB protocol is a novel system in the UK to identify and treat tuberculosis in the community: for the Newham area only anti tuberculosis drugs are not hospital only.

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

  Oral tablet
Rifinah (Sanofi)
  rifampicin with isoniazid and pyrazinamide Hospital Only
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB
  Oral tablet
Rifater (Sanofi)
  streptomycin On Formulary
Tuberculosis Guidance

Including guidance on Multi Drug Resistant TB

Anti tuberculosis drugs are hospital only

Exception: Newham area as per latent TB protocol

Anti-infective / Urinary tract infections
  estradiol
Estradiol (Lenzetto) spray for the management of menopause (December 2021)

Approved at December 2021 DTC 

Lenzetto is a transdermal estrogen spray indicated as Hormone Replacement Therapy (HRT) for oestrogen deficiency symptoms in postmenopausal women (in women at least 6 months since last menses or surgical menopause, with or without a uterus).

The experience in treating women older than 65 years is limited.
  Pessary
Estradiol (Non-proprietary)
Vagifem (Novo Nordisk Ltd)
Vagirux (Gedeon Richter (UK) Ltd)
  Vaginal delivery system
Estring (Pfizer Ltd)
  Transdermal patch
Estraderm MX (Norgine Pharmaceuticals Ltd)
Estradot (Sandoz Ltd)
Evorel (Theramex HQ UK Ltd)
FemSeven (Theramex HQ UK Ltd)
Progynova TS (Bayer Plc)
  Spray
Lenzetto (Gedeon Richter (UK) Ltd)
  Oral tablet
Estradiol (Non-proprietary)
Elleste Solo (Exeltis UK Ltd)
Progynova (Bayer Plc)
Zumenon (Viatris UK Healthcare Ltd)
  Transdermal gel
Oestrogel (Besins Healthcare (UK) Ltd)
Sandrena (Orion Pharma (UK) Ltd)
  estriol
  Pessary
Estriol (Non-proprietary)
Imvaggis (Besins Healthcare (UK) Ltd)
  Vaginal gel
Blissel (Consilient Health Ltd)
  Vaginal cream
Estriol (Non-proprietary)
  methenamine hippurate On Formulary
MicroGuide

For how to access MicroGuide App follow the link
  Oral tablet
Methenamine hippurate (Non-proprietary)
  nitrofurantoin On Formulary
MicroGuide App

For how to access MicroGuide App follow link
Nitrofurantoin MHRA advice in renal dysfunction

Nitrofurantoin liquid - Non formulary

Switch from nitrofurantoin liquid to nitrofurantoin tablets

As part of the Trust cost improvement programme, Pharmacy will no longer procure nitrofurantoin liquid and is now non-formulary, effective from 1st May 2019. Nitrofurantoin tablets are still available.  Patients requiring administration as a liquid can disperse the tablets in 10mL water for 5 minutes giving a bright yellow fine dispersion that flushes easily without blockage1.

Please contact your clinical pharmacy teams if you have any queries relating to this.

Reference

 

  1. Handbook of Drug Administration via Enteral Feeding Tubes accessed via https://www.medicinescomplete.com/#/content/tubes/c275?hspl=nitrofurantoin on 8.5.2019
  Modified-release capsule
Nitrofurantoin (Non-proprietary)
  Oral suspension
Nitrofurantoin (Non-proprietary) Off Formulary
Nitrofurantoin MHRA advice in renal dysfunction

See attached
  Oral tablet
Nitrofurantoin (Non-proprietary)
  Oral capsule
Nitrofurantoin (Non-proprietary)
Anti-infective / Fungal infection
  amphotericin B On Formulary
AMPHOTERICIN

HOSPITAL ONLY

On advice of microbiologist

Cystic Fibrosis Drug Doses

see attached
  Powder for solution for infusion
Fungizone (Neon Healthcare Ltd) Hospital Only
  Powder for dispersion for infusion
Amphotericin B (Non-proprietary)
AmBisome (Gilead Sciences Ltd)
  anidulafungin On Formulary
Anidulafungin

Generic preparation on formulary

Hospital only medicine
  Powder for solution for infusion
Anidulafungin (Non-proprietary)
Ecalta (Pfizer Ltd)
  caspofungin On Formulary
Caspofungin

Hospital only medicine.Micafungin preferred choice for invasive candidiasis.

On microbiology advice unless part of specific Trust guideline
Cystic Fibrosis Drug Doses

  Powder for solution for infusion
Caspofungin (Non-proprietary)
Cancidas (Merck Sharp & Dohme (UK) Ltd)
  fluconazole On Formulary
Cystic Fibrosis Drug Doses

FLUCONAZOLE

INJECTION IS HOSPITAL ONLY

  Oral suspension
Fluconazole (Non-proprietary) On Formulary
Cystic Fibrosis Drug Doses

see attached
Diflucan (Pfizer Ltd) On Formulary
Cystic Fibrosis Drug Doses

see attached
  Solution for infusion
Fluconazole (Non-proprietary) Hospital Only
Cystic Fibrosis Drug Doses

see attached
Fluconazole

IV IS HOSPITAL ONLY
  Oral capsule
Fluconazole (Non-proprietary)
Diflucan (Pfizer Ltd)
  flucytosine On Formulary
Cystic Fibrosis Drug Doses

Flucytosine tablets (unlicensed) for Cryptococcal meningitis-December-2023

Flucytosine tablets approved via chairs action as an alternative to Flucytosine IV which is on formulary as an in tariff drug, but has been discontinued. It is bioequivalent to the intravenous preparation.
Flucytosine

Hospital only medicine
  griseofulvin On Formulary
Grisol AF

Topical griseofulvin - non formulary
Griseofulvin not first line for dermatophyte infections

Is used for tinea infections caused by trichophyton spp

Cystic Fibrosis Drug Doses

see attached
  Oral tablet
Griseofulvin (Non-proprietary)
  isavuconazole Hospital Only
Isavuconazole

On advice of a medical microbiologist or ID specialist.

 
  Powder for solution for infusion
Cresemba (Pfizer Ltd)
  Oral capsule
Cresemba (Pfizer Ltd)
  itraconazole On Formulary
Cystic Fibrosis Drug Doses

Itraconazole IV

Injectable itraconazole is hospital only medicine
  Oral solution
Itraconazole (Non-proprietary)
  Solution for infusion
Itraconazole (Non-proprietary)
  Oral capsule
Itraconazole (Non-proprietary)
  micafungin Hospital Only
Cystic Fibrosis Drug Doses

MICAFUNGIN

Preferred choice at Barts Health instead of caspofungin :  HOSPITAL ONLY

On advice of microbiologist only

  Powder for solution for infusion
Micafungin (Non-proprietary)
Mycamine (Astellas Pharma Ltd)
  nystatin On Formulary
  Oral suspension
Nystatin (Non-proprietary)
  posaconazole Hospital Only
Cystic Fibrosis Drug Doses

Oncology Infection Prophylaxis Guidelines

POSACONAZOLE

On the advice of microbiology only
HOSPITAL ONLY

Posaconazole tablets are associated with an improved absorption profile resulting in better serum steady-state concentrations and ultimately a significantly higher proportion of patients achieving target therapeutic concentrations. Such patients also experienced fewer breakthrough fungal infections when compared to those on Posaconazole suspension.
 
The ARG and Cancer team believe that cost are likely by switching patients to Posaconazole tablets. Cost savings are likely from a reduction in use of antifungals to treat breakthrough infections (caused by poor plasma levels with liquid formulation), lower doses of Posaconazole MR Tablets being needed to achieve therapeutic levels, less wastage from tablet formulations and the need for less frequent Therapeutic Drug Monitoring requirements.
  Gastro-resistant tablet
Posaconazole (Non-proprietary)
Noxafil (Merck Sharp & Dohme (UK) Ltd) On Formulary
Cystic Fibrosis Drug Doses

see attached
Oncology Infection Prophylaxis Guidelines

see attached
Note:

On the advice of microbiologist only
HOSPITAL ONLY

Posaconazole tablets are associated with an improved absorption profile resulting in better serum steady-state concentrations and ultimately a significantly higher proportion of patients achieving target therapeutic concentrations. Such patients also experienced fewer breakthrough fungal infections when compared to those on Posaconazole suspension.
 
The ARG and Cancer team believe that cost are likely by switching patients to Posaconazole tablets. Cost savings are likely from a reduction in use of antifungals to treat breakthrough infections (caused by poor plasma levels with liquid formulation), lower doses of Posaconazole MR Tablets being needed to achieve therapeutic levels, less wastage from tablet formulations and the need for less frequent Therapeutic Drug Monitoring requirements.
  Oral suspension
Posaconazole (Non-proprietary)
Noxafil (Merck Sharp & Dohme (UK) Ltd) On Formulary
Cystic Fibrosis Drug Doses

see attached
Oncology Infection Prophylaxis Guidelines

see attached
Note:

On the advice of microbiologist only
HOSPITAL ONLY

Posaconazole tablets are associated with an improved absorption profile resulting in better serum steady-state concentrations and ultimately a significantly higher proportion of patients achieving target therapeutic concentrations. Such patients also experienced fewer breakthrough fungal infections when compared to those on Posaconazole suspension.
 
The ARG and Cancer team believe that cost are likely by switching patients to Posaconazole tablets. Cost savings are likely from a reduction in use of antifungals to treat breakthrough infections (caused by poor plasma levels with liquid formulation), lower doses of Posaconazole MR Tablets being needed to achieve therapeutic levels, less wastage from tablet formulations and the need for less frequent Therapeutic Drug Monitoring requirements.
  Solution for infusion
Noxafil (Merck Sharp & Dohme (UK) Ltd) On Formulary
Cystic Fibrosis Drug Doses

see attached
Oncology Infection Prophylaxis Guidelines

see attached
Note:

On the advice of microbiologist only
HOSPITAL ONLY

Posaconazole tablets are associated with an improved absorption profile resulting in better serum steady-state concentrations and ultimately a significantly higher proportion of patients achieving target therapeutic concentrations. Such patients also experienced fewer breakthrough fungal infections when compared to those on Posaconazole suspension.
 
The ARG and Cancer team believe that cost are likely by switching patients to Posaconazole tablets. Cost savings are likely from a reduction in use of antifungals to treat breakthrough infections (caused by poor plasma levels with liquid formulation), lower doses of Posaconazole MR Tablets being needed to achieve therapeutic levels, less wastage from tablet formulations and the need for less frequent Therapeutic Drug Monitoring requirements.
  rezafungin
  Powder for solution for infusion
Rezafungin (Non-proprietary)
  voriconazole Hospital Only
Cystic Fibrosis Drug Doses

VORICONAZOLE

 
On advice of microbiologist unless on specific Trust guidelines
  Oral suspension
VFEND (Pfizer Ltd) Hospital Only
Vfend®

HOSPITAL ONLY

On advice of microbiologist
Cystic Fibrosis Drug Doses

see attached
  Powder for solution for infusion
Voriconazole (Non-proprietary)
VFEND (Pfizer Ltd)
  Oral tablet
Voriconazole (Non-proprietary)
VFEND (Pfizer Ltd)
Anti-infective / Pneumocystis pneumonia
  atovaquone Hospital Only
ATOVAQUONE

HOSPITAL ONLY for PCP TREATMENT

  Oral suspension
Atovaquone (Non-proprietary)
Wellvone (GlaxoSmithKline UK Ltd) Hospital Only
Wellvone®

HOSPITAL ONLY for PCP TREATMENT

  co-trimoxazole On Formulary
Cystic Fibrosis Drug Doses

CO-TRIMOXAZOLE

Oral is used for the treatment of mild Pneuomocystic carinii
IV or high dose oral is for severe PCP disease

Also for prophylaxis of PCP and toxoplasmosis 480mg three times weekly or 960mg if previous infection.

IV is HOSPITAL ONLY

  Oral suspension
Co-trimoxazole (Non-proprietary)
  Solution for infusion
Co-trimoxazole (Non-proprietary)
  Oral tablet
Co-trimoxazole (Non-proprietary)
  dapsone Hospital Only
Dapsone:

Dose of 100mg daily used as second line prophylaxis option for PCP.

Treatment of mild PCP disease: dapsone is used together with pyrimethamine as third line option.

  Oral tablet
Dapsone (Non-proprietary)
  pentamidine isetionate Hospital Only
MicroGuide App

For how to access MicroGuide App follow the link
Pentamidine nebulised in renal patients for PCP

Pentamidine injection is reconstituted and 600mg made up to 6mLs with normal saline and nebulised to treat PCP in renal transplant patients.  Repeated daily for three weeks.
Its use is confined to a negative pressure room (currently GHU at RLH or other)
Prophylactic dose is 300mg every four weeks.

  Powder for solution for injection
Pentamidine isetionate (Non-proprietary)
Pentacarinat (Sanofi) Hospital Only
Pentamidine nebulised in renal patients for PCP

Pentamidine injection is reconstituted and 600mg made up to 6mLs with normal saline and nebulised to treat PCP in renal transplant patients.  Repeated daily for three weeks.
Its use is confined to a negative pressure room (currently GHU at RLH or other)
Prophylactic dose is 300mg every four weeks.
Anti-infective / Helminth infection
  albendazole On Formulary
  Chewable tablet
Albendazole (Non-proprietary)
  Oral tablet
Albendazole (Non-proprietary)
  diethylcarbamazine On Formulary
Diethylcarbamazine

On microbiology advice only
  ivermectin On Formulary
Ivermectin

Unlicensed use.

On microbiology advice only.
  Oral tablet
Ivermectin (Non-proprietary)
  Cutaneous cream
Soolantra (Galderma (UK) Ltd)
  levamisole Off Formulary
  Oral tablet
Ergamisol (Imported (Belgium))
  mebendazole On Formulary
  Chewable tablet
Vermox (Janssen-Cilag Ltd) On Formulary
  Oral suspension
Vermox (Janssen-Cilag Ltd) On Formulary
  praziquantel On Formulary
  Oral tablet
Praziquantel (Non-proprietary)
Anti-infective / Coronavirus
  molnupiravir
  Oral capsule
Lagevrio (Merck Sharp & Dohme (UK) Ltd)
  nirmatrelvir with ritonavir Hospital Only NICE TA878
NICE TA 878 - Nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19

Nirmatrelvir plus ritonavir, sotrovimab and tocilizumab approved at NEL FPG for treating COVID-19.

 

Formulary Status: Hospital or specialist centre (CMDU) only
December 2023 - Paxlovid® (nirmatrelvir and ritonavir) 150mg/100mg tablet for treatment of COVID-19 in children 12 – 18 years old

Paxlovid® (nirmatrelvir and ritonavir) 150mg/100mg tablet Approved at NEL FPG for treatment of COVID-19 in children 12 – 18 years old in the
COVID Medicines Delivery Unit (CMDU)

Formulary Status: Hospital ONLY (to be prescribed only by the CMDU)
  Form unstated
Paxlovid (Pfizer Ltd)
  remdesivir Hospital Only NICE TA971
  Powder for solution for infusion
Veklury (Gilead Sciences Ltd)
  sotrovimab On Formulary NICE TA878
Sotrovimab-Corona Virus-(December 2021)

Aproved at DTC for Corona virus, genotyping required to check if not omicrom variant so to give Ronapreve. If omicrom variant give Sotrovimab
  Solution for infusion
Xevudy (GlaxoSmithKline UK Ltd)
  tocilizumab NICE TA375
NICE TA247
NICE TA518
NICE TA878
  Solution for injection
RoActemra (Roche Products Ltd)
Tyenne (Fresenius Kabi Ltd)
  Solution for infusion
RoActemra (Roche Products Ltd)
Tyenne (Fresenius Kabi Ltd)
Anti-infective / HIV infection
  INDINAVIR Hospital Only
Crixivan®

For Continuation Only
  abacavir Hospital Only
CAUTION - patients with HLA-B*5701 allele

Patients with HLA-B*5701 Allele should not receive Abacavir due to higher risk of hypersensititivy reaction. HLA-B*5701 status must be checked before initiating Abacavir, positive status is a contra-indication for Abacavir.
  Oral solution
Ziagen (ViiV Healthcare UK Ltd) Hospital Only
  Oral tablet
Abacavir (Non-proprietary)
Ziagen (ViiV Healthcare UK Ltd)
  abacavir with dolutegravir and lamivudine Hospital Only
CAUTION - women of childbearing age and pregnancy

See MHRA guidance in main text of Dolutegravir drug information.
CAUTION - patients with HLA-B*5701 Allele

Patients with HLA-B*5701 Allele should not receive Abacavir due to higher risk of hypersensititivy reaction. HLA-B*5701 status must be checked before initiating Abacavir, positive status is a contra-indication for Abacavir.
  Oral tablet
Triumeq (ViiV Healthcare UK Ltd)
  abacavir with lamivudine Hospital Only
CAUTION - Patients with HLA-B*5701 Allele

Patients with HLA-B*5701 Allele should not receive Abacavir due to higher risk of hypersensititivy reaction. HLA-B*5701 status must be checked before initiating Abacavir, positive status is a contra-indication for Abacavir
  Oral tablet
Abacavir with lamivudine (Non-proprietary)
Kivexa (ViiV Healthcare UK Ltd)
  abacavir with lamivudine and zidovudine Hospital Only
CAUTION - patients with HLA-B*5701 Allele

Patients with HLA-B*5701 Allele should not receive Abacavir due to higher risk of hypersensititivy reaction. HLA-B*5701 status must be checked before initiating Abacavir, positive status is a contra-indication for Abacavir.
  atazanavir Hospital Only
  Oral capsule
Atazanavir (Non-proprietary)
  atazanavir with cobicistat Hospital Only
  Oral tablet
Evotaz (Bristol-Myers Squibb Pharmaceuticals Ltd)
  bictegravir with emtricitabine and tenofovir alafenamide Hospital Only
NHSE funding supported

 On Formulary as per November DTC 2019 decision. Contact Specialist HIV Pharmacist for details.
  Oral tablet
Bictegravir with emtricitabine and tenofovir alafenamide (Non-proprietary)
Biktarvy (Gilead Sciences Ltd)
  cabotegravir NICE TA757
  Prolonged-release suspension for injection
Vocabria (ViiV Healthcare UK Ltd)
  Oral tablet
Vocabria (ViiV Healthcare UK Ltd)
  cobicistat Hospital Only
HOSPITAL ONLY

  Oral tablet
Tybost (Gilead Sciences Ltd)
  darunavir Hospital Only
  Oral suspension
Prezista (Janssen-Cilag Ltd) Hospital Only
  Oral tablet
Darunavir (Non-proprietary)
Prezista (Janssen-Cilag Ltd)
  darunavir with cobicistat Hospital Only
CAUTION

See MHRA warning re avoid in pregnancy due to low drug levels and risk of treatment failure 
  Oral tablet
Rezolsta (Janssen-Cilag Ltd)
  darunavir with cobicistat, emtricitabine and tenofovir alafenamide Hospital Only
CAUTION

See MHRA warning re avoid in pregnancy due to low drug levels and risk of treatment failure 
  Oral tablet
Symtuza (Janssen-Cilag Ltd)
  dolutegravir Hospital Only
CAUTION - women of childbearing age and pregnancy

See MHRA guidance in main text below
  Dispersible tablet
Tivicay (ViiV Healthcare UK Ltd)
  Oral tablet
Tivicay (ViiV Healthcare UK Ltd)
  dolutegravir with rilpivirine Hospital Only
CAUTION for women of childbearing age and use in pregnancy

See individual entry for Dolutegravir re use in women of childbearing age
To be taken with MAIN MEAL of the DAY

To be taken with food - protein drinks and supplements foods will likely not be enough - consult Specialist HIV Pharmacist for further advice 
CAUTION with antacids and acid lowering medications

Acid lowering agents can reduce absorption of Rilpivirine - see indiudual entry for Rilpivirine and interacitons information
  Oral tablet
Juluca (ViiV Healthcare UK Ltd)
  doravirine Hospital Only
  Oral tablet
Pifeltro (Merck Sharp & Dohme (UK) Ltd)
  efavirenz Hospital Only
HOSPITAL ONLY

  Oral tablet
Efavirenz (Non-proprietary)
  efavirenz with emtricitabine and tenofovir disoproxil Hospital Only
Note:

HOSPITAL ONLY
  Oral tablet
Efavirenz with emtricitabine and tenofovir disoproxil (Non-proprietary)
  elvitegravir Hospital Only
AVAILABLE IN COMBINATION FORMULATIONS ONLY

Currently only available in two combination pills;

STRIBILD - tenofovir disoproxil 245mg, emtricitabine 200mg, elvitegravir 150mg, cobicistat 150mg

GENVOYA - tenofovir alafenamide 25mg, emtricitabine 200mg, elvitegravir 150mg, cobicistat 150mg

 

NOT avaiable as elvitegravir as a single drug

 
  elvitegravir with cobicistat, emtricitabine and tenofovir alafenamide Hospital Only
GENVOYA (branded combination pill)

(GENVOYA) contains; tenofovir alafenamide 25mg, emtricitabine 200mg, elvitegravir 150mg, cobicistat 150mg
  Oral tablet
Genvoya (Gilead Sciences Ltd)
  elvitegravir with cobicistat, emtricitabine and tenofovir disoproxil Hospital Only
Note:

HOSPITAL ONLY
STRIBILD (branded combination pill)

(STRIBILD) contains; tenofovir disoproxil 245mg, emtricitabine 200mg, elvitegravir 150mg, cobicistat 150mg
  Oral tablet
Stribild (Gilead Sciences Ltd)
  emtricitabine Hospital Only
HOSPITAL ONLY

  Oral solution
Emtriva (Gilead Sciences Ltd) On Formulary
Note:

HOSPITAL ONLY
  Oral capsule
Emtriva (Gilead Sciences Ltd)
  emtricitabine with rilpivirine and tenofovir alafenamide Hospital Only
To be taken with the MAIN MEAL of the DAY

To be taken with food - protein drinks and supplements foods will likely not be enough - consult Specialist HIV Pharmacist for further advice 
CAUTION with antacids and acid lowering drugs

Acid lowering agents can reduce absorption of Rilpivirine - see indiudual entry for Rilpivirine and interacitons information
  Oral tablet
Odefsey (Gilead Sciences Ltd)
  emtricitabine with rilpivirine and tenofovir disoproxil Hospital Only
To be taken with MAIN MEAL of the DAY

To be taken with food - protein drinks and supplements foods will likely not be enough - consult Specialist HIV Pharmacist for further advice 
CAUTION with antacids and acid lowering medications

Acid lowering agents can reduce absorption of Rilpivirine - see indiudual entry for Rilpivirine and interacitons information
HOSPITAL ONLY

hospital only
  Oral tablet
Eviplera (Gilead Sciences Ltd)
  emtricitabine with tenofovir alafenamide Hospital Only
CAUTION with dosing

Caution TWO doses available - ensure correct dose pill is supplied, consult product literature or specialist HIV Pharmacist

Tenofovir alafenamide 25mg/Emtricitabine 200mg (brand name; Descovy 25/200) - use with HIV combinations without a boositng agent such as ritonavir or cobicistat 

Tenofovir alafenamide 10mg/Emtricitabine 200mg (brand name; Descovy 10/200) - use with HIV combinations with a boositng agent such as ritonavir or cobicistat

 
  Oral tablet
Descovy (Gilead Sciences Ltd)
  emtricitabine with tenofovir disoproxil Hospital Only
HIV treatment

Tenofovir disoproxil 245mg/Emtricitabine 200mg (brand Truvada) is used as part of HIV treatment in combination with other ARVs
CAUTION in renal impairment

Dose reduce in renal impairment - consult product literature and discuss with Specialist HIV Pharmacist 
PEP (post exposure prophylaxis)

Tenofovir disoproxil 245mg/Emtricitabine 200mg (brand Truvada) is used as part of PEP/PEPSE treatment to prevent transmission of HIV.

If indicated current treatment as per BHIVA guidelines is; Tenofovir disoproxil 245mg/Emtricitabine 200mg (brand Truvada) 1 od together with Rategravir 400mg BD for 28 days. 

PEP/PEPSE can be accessed via pro-forma and supply of PEP packs containing both drugs made from A&E Dept and Sexual Health/GUM Clinics.

5 day (initiation) packs are available in RLH/NUH/WX A&E departments and both 5 day (initiation) and 23 day (continuation) packs are available from Barts Sexual Health Clinics at Ambrose King Centre, Royal London Hospital or Sir Ludwig Guttman Centre, Stratford.

Documentation of how much has been supplied should be made on CRS so that when patients are subsequently seen by a different clinician it is easy to find out how much is required to complete the full course if indicated.
  Oral tablet
Emtricitabine with tenofovir disoproxil (Non-proprietary)
Truvada (Gilead Sciences Ltd)
  enfuvirtide Hospital Only
  Powder and solvent for solution for injection
Fuzeon (Roche Products Ltd)
  etravirine Hospital Only
Etravirine

HOSPITAL ONLY
  Oral tablet
Intelence (Janssen-Cilag Ltd)
  fosamprenavir Hospital Only
  fostemsavir
  Modified-release tablet
Rukobia (ViiV Healthcare UK Ltd)
  lamivudine Hospital Only
  Oral solution
Epivir (ViiV Healthcare UK Ltd) Hospital Only
  Oral tablet
Lamivudine (Non-proprietary)
Epivir (ViiV Healthcare UK Ltd)
Zeffix (GlaxoSmithKline UK Ltd)
  lamivudine with dolutegravir On Formulary
  Oral tablet
Dovato (ViiV Healthcare UK Ltd)
  lamivudine with tenofovir disoproxil and doravirine Hospital Only
  Oral tablet
Delstrigo (Merck Sharp & Dohme (UK) Ltd)
  lopinavir with ritonavir Hospital Only
  Oral solution
Kaletra (AbbVie Ltd) On Formulary
  Oral tablet
Lopinavir with ritonavir (Non-proprietary)
Kaletra (AbbVie Ltd)
  maraviroc Hospital Only
  Oral tablet
Celsentri (ViiV Healthcare UK Ltd)
  nevirapine Hospital Only
Nevirapine

HOSPITAL ONLY
  Modified-release tablet
Nevirapine (Non-proprietary) Hospital Only
  Oral suspension
Viramune (Boehringer Ingelheim Ltd) Hospital Only
  Oral tablet
Nevirapine (Non-proprietary)
  raltegravir Hospital Only
HIV Treatment

Raltegravir is used as part of HIV treatment in combination with (usually two) other ARVs
NOTE two strengths available

Two pill strengths available 400mg and 600mg.

For treatment of HIV, in combination with other drugs, dose can be either;

400mg bd or 1200mg od (2 x 600mg tablets).  

Contact Specialist HIV Pharmacist for clarification if necessary.
PEP (post exposure prophylaxis)

Raltegravir is used as part of PEP/PEPSE treatment to prevent transmission of HIV.

If indicated current treatment as per BHIVA guidelines is; Rategravir 400mg BD together with Tenofovir disoproxil 245mg/Emtricitabine 200mg (brand Truvada) 1 od for 28 days. 

PEP/PEPSE can be accessed via pro-forma and supply of PEP packs containing both drugs made from A&E Dept and Sexual Health/GUM Clinics.

5 day (initiation) packs are available in RLH/NUH/WX A&E departments and both 5 day (initiation) and 23 day (continuation) packs are available from Barts Sexual Health Clinics at Ambrose King Centre, Royal London Hospital or Sir Ludwig Guttman Centre, Stratford.

Documentation of how much has been supplied should be made on CRS so that when patients are subsequently seen by a different clinician it is easy to find out how much is required to complete the full course if indicated.
  Oral tablet
Isentress (Merck Sharp & Dohme (UK) Ltd)
  rilpivirine Hospital Only NICE TA757
To be taken with the MAIN MEAL of the DAY

To be taken with food - protein drinks and supplements foods will likely not be enough - consult Specialist HIV Pharmacist for further advice 
CAUTION with antacids and acid lowering medications

Acid lowering agents can reduce absorption of Rilpivirine - see indiudual entry for Rilpivirine and interacitons information
  Prolonged-release suspension for injection
Rekambys (ViiV Healthcare UK Ltd)
  Oral tablet
Edurant (Janssen-Cilag Ltd)
  ritonavir Hospital Only
  Oral tablet
Ritonavir (Non-proprietary)
Norvir (AbbVie Ltd)
  tenofovir disoproxil Hospital Only NICE TA173
PEP (post exposure prophylaxis)

Tenofovir disoproxil 245mg/Emtricitabine 200mg (brand Truvada) is used as part of PEP/PEPSE treatment to prevent transmission of HIV.

If indicated current treatment as per BHIVA guidelines is; Tenofovir disoproxil 245mg/Emtricitabine 200mg (brand Truvada) 1 od together with Rategravir 400mg BD for 28 days. 

PEP/PEPSE can be accessed via pro-forma and supply of PEP packs containing both drugs made from A&E Dept and Sexual Health/GUM Clinics.

5 day (initiation) packs are available in RLH/NUH/WX A&E departments and both 5 day (initiation) and 23 day (continuation) packs are available from Barts Sexual Health Clinics at Ambrose King Centre, Royal London Hospital or Sir Ludwig Guttman Centre, Stratford.

Documentation of how much has been supplied should be made on CRS so that when patients are subsequently seen by a different clinician it is easy to find out how much is required to complete the full course if indicated.
CAUTION in renal impairment

Dose reduce in renal impairment - consult product literature and discuss with Specialist HIV Pharmacist 
  Oral tablet
Tenofovir disoproxil (Non-proprietary)
Viread (Gilead Sciences Ltd)
  Oral granules
Viread (Gilead Sciences Ltd)
  zidovudine Hospital Only
  Oral solution
Retrovir (ViiV Healthcare UK Ltd)
  Solution for infusion
Retrovir (ViiV Healthcare UK Ltd)
  Oral capsule
Zidovudine (Non-proprietary)
Retrovir (ViiV Healthcare UK Ltd)
  zidovudine with lamivudine Hospital Only
Zidovudine and Lamivudine

Combination tablet contains 150mg Lamivudine/300mg Zidovudine, usual dose 1 tablet bd
  Oral tablet
Zidovudine with lamivudine (Non-proprietary)
Combivir (ViiV Healthcare UK Ltd)
Anti-infective / Respiratory syncytial virus
  palivizumab Hospital Only
  Solution for injection
Synagis (AstraZeneca UK Ltd)
  ribavirin Hospital Only NICE TA200
NICE TA300
Ribavirin for Respiratory Syncytial Virus

see attached
  Oral tablet
Ribavirin (Non-proprietary)
  Oral capsule
Ribavirin (Non-proprietary)
Anti-infective / Influenza
  amantadine hydrochloride Off Formulary NICE TA158
NICE TA168
Amantadine

Amantadine is not recommended for prophylaxis of influenza(NICE September 2008).

Amantadine is not recommended for treatment of infuenza(NICE February 2009).
  Oral solution
Amantadine hydrochloride (Non-proprietary) On Formulary
  Oral capsule
Amantadine hydrochloride (Non-proprietary)
  baloxavir marboxil
  Oral tablet
Baloxavir marboxil (Non-proprietary)
Xofluza (Roche Products Ltd)
  oseltamivir On Formulary NICE TA158
NICE TA168
Public Health England Guidance on Influenza treatment and prophylaxis

OSELTAMIVIR

Oseltamivir is still the first line treatment in non-compromised patients.
 
For paediatrics, oseltamivir liquid (recommended for <1yrs) is OUT OT STOCK at the manufacturers so the tablets are being dissolved and used for all paediatric age group.
  Oral suspension
Tamiflu (Roche Products Ltd) On Formulary
Public Health England Guidance on Influenza treatment and prophylaxis

see attached
Note:

Oseltamivir is still the first line treatment in non-compromised patients.
 
For paediatrics, oseltamivir liquid (recommended for <1yrs) is OUT OT STOCK at the manufacturers so the tablets are being dissolved and used for all paediatric age group.
  Oral capsule
Oseltamivir (Non-proprietary)
Ebilfumin (Teva UK Ltd)
Tamiflu (Roche Products Ltd)
  zanamivir On Formulary NICE TA158
NICE TA168
Zanamavir solution for infusion

January 2020 UPDATE

The compassionate supply programme for Zanamivir infusion ended on 25th November 2019 and a licenced preparation is now available. This formulation was added to the formulary by the Trust Drugs and Therapeutics Committee at the December 2019 meeting, for a period of three months, to cover the 2019-20 influenza season. Ongoing formulary status will be reviewed in due course.

Intravenous zanamivir should only be initiated following discussion with, and approval by Microbiology or Virology, and in line with national guidance.

 

IV zanamivir can be considered for use in the treatment of complicated and potentially life-threatening influenza A or B virus infection in adult and paediatric inpatients (aged ≥6months), that is not treatable by inhaled or enteral antivirals, in line with Public Health England guidance (see link).

Usage will be restricted to cases where:

• The patient's influenza virus is known or suspected to be resistant to anti-influenza medicinal products other than zanamivir, and/or

• Other anti-viral medicinal products for treatment of influenza, including inhaled zanamivir via diskhaler, are not suitable for the individual patient.

 

Nebulised administration of the intravenous preparation is outside of the marketing authorisation of the licenced product and would also require DTC Chair's approval. Zanamivir diskhaler powder must NEVER be nebulised as this practice has been linked to deaths in the ICU.
Public Health England Guidance on Influenza treatment and prophylaxis

For the link see below:
  Solution for infusion
Dectova (GlaxoSmithKline UK Ltd)
  Inhalation powder
Relenza (GlaxoSmithKline UK Ltd)
Zanamavir aqueous solution for IV or nebulisation (UNLICENCED) Zanamavir aqueous solution for IV or nebulisation (UNLICENCED)


It is the treatment of choice in immunocompromised patients.  Only on recommendation of Consultant Virologist.
Public Health England Guidance on Influenza treatment and prophylaxis

see attached
Anti-infective / Herpesvirus infections
  aciclovir On Formulary
ACICLOVIR

Intravenous preparations are hospital only
  Dispersible tablet
Aciclovir (Non-proprietary)
Zovirax (GlaxoSmithKline UK Ltd)
  Oral suspension
Aciclovir (Non-proprietary) On Formulary
Zovirax (GlaxoSmithKline UK Ltd) On Formulary
  Solution for infusion
Aciclovir (Non-proprietary) On Formulary
Aciclovir

Intravenous preparations are hospital only
  Powder for solution for infusion
Aciclovir (Non-proprietary)
Zovirax I.V. (GlaxoSmithKline UK Ltd)
  Eye ointment
Aciclovir (Non-proprietary)
  Oral tablet
Aciclovir (Non-proprietary)
  Cutaneous cream
Aciclovir (Non-proprietary)
Zovirax (GlaxoSmithKline UK Ltd, Haleon UK Trading Ltd)
  famciclovir
FAMCICLOVIR

An alternative, far more expensive option for HSV and zoster.  Valaciclovir is first line in GU and HIV patients
Reserved for aciclovir / valaciclovir resistance

  Oral tablet
Famciclovir (Non-proprietary)
Famvir (Phoenix Labs Ltd)
  inosine pranobex Off Formulary
  Oral tablet
Imunovir (Kora Healthcare)
  valaciclovir On Formulary
Valaciclovir

This should be used first line for herpes simplex patients in GU and HIV
It is a prodrug of aciclovir

RLH Adult ENT A&E guidelines 2015

  Oral tablet
Valaciclovir (Non-proprietary)
Valtrex (GlaxoSmithKline UK Ltd)
Anti-infective / Cytomegalovirus infections
  cidofovir
  Solution for infusion
Cidofovir (Non-proprietary)
  foscarnet sodium On Formulary
Treatment of CMV in renal patients

At the Trust we use valganciclovir for the treatment of CMV in renal patients.
If patients are not absorbing orally or the viral count is not reducing then IV ganciclovir will be used.
Foscarnet is reserved for resistant CMV.

Foscarnet sodium

Hospital only medicine
  Solution for infusion
Foscarnet sodium (Non-proprietary)
Foscavir (Clinigen Healthcare Ltd) On Formulary
  ganciclovir On Formulary
Treatment of CMV in renal patients

At the Trust we use valganciclovir for the treatment of CMV in renal patients.
If patients are not absorbing orally or the viral count is not reducing then IV ganciclovir will be used.
Foscarnet is reserved for resistant CMV.
  Powder for solution for infusion
Ganciclovir (Non-proprietary)
Cymevene (Neon Healthcare Ltd)
  Eye gel
Virgan (Thea Pharmaceuticals Ltd)
  letermovir NICE TA591
  Oral tablet
Prevymis (Merck Sharp & Dohme (UK) Ltd)
  maribavir On Formulary NICE TA860
NICE TA 860-March 2023-Maribavir-Treating refractory cytomegalovirus infection after transplant.

Maribavir approved at NEL FPG for treating refractory cytomegalovirus infection after transplant in line with NICE TA 860.
  Oral tablet
Livtencity (Takeda UK Ltd)
  valganciclovir On Formulary
Renal Transplant including ATG guidance

Treatment of CMV in renal patients, September 2009

At the Trust we use valganciclovir for the treatment of CMV in renal patients.
If patients are not absorbing orally or the viral count is not reducing then IV ganciclovir will be used.
Foscarnet is reserved for resistant CMV.
  Oral solution
Valcyte (Neon Healthcare Ltd) On Formulary
  Oral tablet
Valganciclovir (Non-proprietary)
Valcyte (Neon Healthcare Ltd)
Anti-infective / Chronic hepatitis B
  adefovir dipivoxil Hospital Only
ADEFOVIR DIPIVOXIL

HOSPITAL ONLY

  entecavir Hospital Only NICE TA153
ENTECAVIR

HOSPITAL ONLY

  Oral solution
Baraclude (Bristol-Myers Squibb Pharmaceuticals Ltd) On Formulary
  Oral tablet
Entecavir (Non-proprietary)
Baraclude (Bristol-Myers Squibb Pharmaceuticals Ltd)
  lamivudine Hospital Only
  Oral solution
Epivir (ViiV Healthcare UK Ltd) Hospital Only
  Oral tablet
Lamivudine (Non-proprietary)
Epivir (ViiV Healthcare UK Ltd)
Zeffix (GlaxoSmithKline UK Ltd)
  peginterferon alfa Hospital Only NICE TA200
PEGINTERFERON ALFA

FOR HOSPITAL USE ONLY

  Solution for injection
Pegasys (Aspire Pharma Ltd)
  tenofovir alafenamide Hospital Only
  Oral tablet
Vemlidy (Gilead Sciences Ltd)
  tenofovir disoproxil Hospital Only NICE TA173
PEP (post exposure prophylaxis)

Tenofovir disoproxil 245mg/Emtricitabine 200mg (brand Truvada) is used as part of PEP/PEPSE treatment to prevent transmission of HIV.

If indicated current treatment as per BHIVA guidelines is; Tenofovir disoproxil 245mg/Emtricitabine 200mg (brand Truvada) 1 od together with Rategravir 400mg BD for 28 days. 

PEP/PEPSE can be accessed via pro-forma and supply of PEP packs containing both drugs made from A&E Dept and Sexual Health/GUM Clinics.

5 day (initiation) packs are available in RLH/NUH/WX A&E departments and both 5 day (initiation) and 23 day (continuation) packs are available from Barts Sexual Health Clinics at Ambrose King Centre, Royal London Hospital or Sir Ludwig Guttman Centre, Stratford.

Documentation of how much has been supplied should be made on CRS so that when patients are subsequently seen by a different clinician it is easy to find out how much is required to complete the full course if indicated.
CAUTION in renal impairment

Dose reduce in renal impairment - consult product literature and discuss with Specialist HIV Pharmacist 
  Oral tablet
Tenofovir disoproxil (Non-proprietary)
Viread (Gilead Sciences Ltd)
  Oral granules
Viread (Gilead Sciences Ltd)
Anti-infective / Chronic hepatitis C
  elbasvir with grazoprevir Hospital Only NICE TA413
Pharmacy Note

Please note this medication can only be supplied via the hepatitis C MDT. If a patient is admitted into the hospital on a treatment course of this medication please contact the hepatology team through switchboard.

This medicine must be supplied through outpatient services, if possible please obtain the patient’s supply from home. Please do NOT order from inpatient pharmacy as a single missed dose is not a medical emergency.
  Oral tablet
Zepatier (Merck Sharp & Dohme (UK) Ltd)
  glecaprevir with pibrentasvir Hospital Only NICE TA499
Pharmacy Note

Please note this medication can only be supplied via the hepatitis C MDT. If a patient is admitted into the hospital on a treatment course of this medication please contact the hepatology team through switchboard.

This medicine must be supplied through outpatient services, if possible please obtain the patient’s supply from home. Please do NOT order from inpatient pharmacy as a single missed dose is not a medical emergency.
  Oral tablet
Glecaprevir with pibrentasvir (Non-proprietary)
  ledipasvir with sofosbuvir Hospital Only NICE TA363
Pharmacy Note

Please note this medication can only be supplied via the hepatitis C MDT. If a patient is admitted into the hospital on a treatment course of this medication please contact the hepatology team through switchboard.

This medicine must be supplied through outpatient services, if possible please obtain the patient’s supply from home. Please do NOT order from inpatient pharmacy as a single missed dose is not a medical emergency.
  Oral tablet
Harvoni (Gilead Sciences Ltd)
  Oral granules
Harvoni (Gilead Sciences Ltd)
  peginterferon alfa Hospital Only NICE TA200
PEGINTERFERON ALFA

FOR HOSPITAL USE ONLY

  Solution for injection
Pegasys (Aspire Pharma Ltd)
  ribavirin Hospital Only NICE TA200
NICE TA300
Ribavirin for Respiratory Syncytial Virus

see attached
  Oral tablet
Ribavirin (Non-proprietary)
  Oral capsule
Ribavirin (Non-proprietary)
  sofosbuvir Hospital Only NICE TA330
NICE TA330
  Oral tablet
Sovaldi (Gilead Sciences Ltd)
  Oral granules
Sovaldi (Gilead Sciences Ltd)
  sofosbuvir with velpatasvir Hospital Only NICE TA430
Pharmacy Note

Please note this medication can only be supplied via the hepatitis C MDT. If a patient is admitted into the hospital on a treatment course of this medication please contact the hepatology team through switchboard.

This medicine must be supplied through outpatient services, if possible please obtain the patient’s supply from home. Please do NOT order from inpatient pharmacy as a single missed dose is not a medical emergency.
  Oral tablet
Epclusa (Gilead Sciences Ltd)
  Oral granules
Epclusa (Gilead Sciences Ltd)
  sofosbuvir with velpatasvir and voxilaprevir Hospital Only NICE TA507
Pharmacy Note

Please note this medication can only be supplied via the hepatitis C MDT. If a patient is admitted into the hospital on a treatment course of this medication please contact the hepatology team through switchboard.

This medicine must be supplied through outpatient services, if possible please obtain the patient’s supply from home. Please do NOT order from inpatient pharmacy as a single missed dose is not a medical emergency.
  Oral tablet
Vosevi (Gilead Sciences Ltd)
Anti-infective / Chronic hepatitis D
  bulevirtide Hospital Only NICE TA896
NICE TA 896 - September 2023 - Bulevirtide for treating chronic hepatitis D

Bulevirtide approved at NEL FPG for treating chronic hepatitis D in line with NICE TA.

 

Hospital Only
  Powder for solution for injection
Hepcludex (Gilead Sciences Ltd)
Anti-infective / Leishmaniasis
  amphotericin B On Formulary
AMPHOTERICIN

HOSPITAL ONLY

On advice of microbiologist

  Powder for solution for infusion
Fungizone (Neon Healthcare Ltd)
  Powder for dispersion for infusion
Amphotericin B (Non-proprietary)
AmBisome (Gilead Sciences Ltd)
  pentamidine isetionate Hospital Only
MicroGuide App

For how to access MicroGuide App follow the link
Pentamidine nebulised in renal patients for PCP

Pentamidine injection is reconstituted and 600mg made up to 6mLs with normal saline and nebulised to treat PCP in renal transplant patients.  Repeated daily for three weeks.
Its use is confined to a negative pressure room (currently GHU at RLH or other)
Prophylactic dose is 300mg every four weeks.

  Powder for solution for injection
Pentamidine isetionate (Non-proprietary)
Pentacarinat (Sanofi) Hospital Only
Pentamidine nebulised in renal patients for PCP

Pentamidine injection is reconstituted and 600mg made up to 6mLs with normal saline and nebulised to treat PCP in renal transplant patients.  Repeated daily for three weeks.
Its use is confined to a negative pressure room (currently GHU at RLH or other)
Prophylactic dose is 300mg every four weeks.
Anti-infective / Malaria
  artemether with lumefantrine Hospital Only
Malaria treatment

Refer to Parasitology section of Micro Guide
ARTEMETHER WITH LUMEFANTRINE

HOSPITAL ONLY

  Oral tablet
Riamet (Novartis Pharmaceuticals UK Ltd)
  atovaquone with proguanil hydrochloride On Formulary
Malaria treatment guidelines

Refer to Parasitology section of MicroGuide
  Oral tablet
Atovaquone with proguanil hydrochloride (Non-proprietary)
Malarone (GlaxoSmithKline UK Ltd)
  chloroquine On Formulary
Malaria treatment and prophylaxis

Refer to Parasitology section of MicroGuide.
Chloroquine

Update of malaria prevention guidelines for travellers from the UK
  Oral solution
Malarivon (Wallace Manufacturing Chemists Ltd) On Formulary
  Oral tablet
Avloclor (Alliance Pharmaceuticals Ltd)
  doxycycline On Formulary
Malaria prophylaxis and treatment

Refer to Parasitology section of MicroGuide
Doxycycline

Update of malaria prevention guidelines for travellers from the UK
  Dispersible tablet
Vibramycin-D (Pfizer Ltd)
  Modified-release capsule
Efracea (Galderma (UK) Ltd) On Formulary
Cystic Fibrosis Drug Doses

  Oral tablet
Periostat (Alliance Pharmaceuticals Ltd)
  Oral capsule
Doxycycline (Non-proprietary)
  mefloquine On Formulary
Mefloquine

Update of malaria prevention guidelines for travellers from the UK
Malaria prophylaxis

Refer to Parasitology section of MicroGuide
  Oral tablet
Lariam (Neon Healthcare Ltd)
  primaquine Hospital Only
Malaria treatment

Refer to Parasitology section of MicroGuide
  Oral tablet
Primaquine (Non-proprietary)
  quinine On Formulary
Malaria treatment

Refer to Parasitology section  of MicroGuide
Quinine Sulfate

For relief of nocturnal leg cramps associated with renal replacement therapies
Intravenous Quinine

Hospital only medicine
  Oral tablet
Quinine (Non-proprietary)
Anti-infective / Toxoplasmosis
  pyrimethamine Hospital Only
  Oral tablet
Daraprim (GlaxoSmithKline UK Ltd)