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Bedfordshire and Luton Joint Formulary
Bedford Hospital NHS Trust
Bedfordshire CCG
Luton & Dunstable University Hospital NHS Foundation Trust
Luton CCG
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 Formulary Chapter 3: Respiratory system - Full Chapter
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

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03.07  Expand sub section  Mucolytics
Acetylcysteine
(Tablets)
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Formulary
Amber

Nacsys 600mg Effervescent tablets ONCE a day (lower pill burden than carbocisteine).

Brand prescribe on FP10. Most cost-effective brand is NACSYS.

 
   
Acetylcysteine 2g/10mL
(nebulised)
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Formulary
Red

Off-label use of the injection.

Most commonly use undiluted injection (20% solution) 3 to 5ml 3 to 4 times daily alternatively 400mg (2ml) mixed with 2mls sodium chloride 0.9% three or four times a day can be used.

 
   
Carbocisteine
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Formulary
Green
375mg Capsules
250mg in 5mL Syrup 
   
03.07  Expand sub section  Dornase alfa
Dornase Alfa 2.5mg (2500 units) / 2.5mL (Pulmozyme)
(Nebuliser Solution)
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Restricted Drug Restricted
Red
High Cost Medicine

Specialist prescribing for:

1. Cystic fibrosis patients according to NICE guidelines. Funded by NHS England.

2. Respiratory consultants for the management of severe empyema together with intrapleural aleplase following the attached protocol.

 
Link  PROTOCOL FOR INTRAPLEURAL (IP) ALTEPLASE AND DORNASE ALFA FOR THE TREATMENT OF EMPYEMA
   
03.07  Expand sub section  Hypertonic Sodium Chloride
Sodium chloride 3% (Hypertonic) (MucoClear)
Formulary
Green
3% Nebuliser Solution 
   
Sodium chloride 7% (Hypertonic) (Nebusal)
Formulary
Green
7% Nebuliser Solution 
   
 ....
 Non Formulary Items
Erdosteine  (Erdotin)

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Non Formulary
 
Ivacaftor

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Non Formulary
High Cost Medicine
 
Mecysteine  (Visclair)

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Non Formulary
 
Sodium chloride 6% (hypertonic)  (MucoClear)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment  

Amber

Amber medicines are considered suitable for GP prescribing following specialist initiation.  

Green

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations   

Amber SCG

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.   

Black

A decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.   

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