netFormulary NHS
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 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
Notes:

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

 Details...
07.01  Drugs used in obstetrics
07.01.01  Prostaglandins and oxytocics
Carboprost
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Formulary
Red
250microgram/1mL Injection  
   
Dinoprostone (Prostin E2®)
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Formulary
Red

1mg & 2mg Vaginal Gel
10mg MR Pessaries (releasing 10mg over approx. 24 hours)

3mg vaginal tablets

 
   
Dinoprostone
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Formulary
Red
750 micrograms/0.75mL Injection  
   
Ergometrine
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Formulary
Red
500microgram/1mL Injection  
   
Gemeprost
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Formulary
Red
1mg Pessaries
Should be stored in freezer and allowed to warm up to room temperature for 30 minutes before use. 
   
Misoprostol 200microgram
(Tablets)
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Formulary
Red
For non-surgical management of miscarriage (unlicensed indication). Can be given orally or vaginally following Trust guidelines. 
   
Oxytocin
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Formulary
Red
5units/1mL Injection
10units/1mL Injection  
   
07.01.01.01  Drugs affecting the ductus arteriosus
07.01.01.01  Maintenance of patency
07.01.01.01  Closure of ductus arteriosus to top
Ibuprofen 10mg/ 2mL (Pedea® injection)
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Restricted Drug Restricted
Red
SCBU patients only for closure of PDA. 
   
07.01.02  Mifepristone
Controlled Drug Mifepristone
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Formulary
Red
200mg Tablets  
   
07.01.03  Myometrial relaxants
Atosiban
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Restricted Drug Restricted
Red

6.75mg/0.9mL Injection
37.5mg/5mL Injection

 
   
Salbutamol
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Restricted Drug Restricted
Red

500microgram/1mL & 5mg/5mL Injection

 
   
07.02  Treatment of vaginal and vulval conditions
07.02.01  Preparations for vaginal and vulval changes
07.02.01  Topical HRT to top
Oestrogens, Topical
(Estriol)
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Formulary
Green
0.01% Cream
Gynest brand has been discontinued, only available as generic 
   
Oestrogens, Topical (Ovestin®)
(Estriol)
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Formulary
Green
0.1% Vaginal Cream 
   
Oestrogens, Topical (Vagifem®)
(Estradiol)
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Formulary
Green
10microgram Vaginal Tablets 
   
07.02.01  Non-hormonal preparations
07.02.02  Vaginal and vulval infections
07.02.02  Fungal infections
Clotrimazole
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Formulary
Green

100mg & 500mg Pessaries
1% Cream

In pregnancy 100mg at night for six nights

 
   
07.02.02  Other vaginal infections
Clindamycin
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Formulary
Green
2% Vaginal Cream (40g with 7 applicators)
 
   
07.03  Contraceptives to top
07.03.01  Combined hormonal contraceptives
Ethinylestradiol 20 mcg / norethisterone 1mg (Loestrin 20®)
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Formulary
Green
Stock for Luton Sexual Health Clinic. 
   
Ethinylestradiol 20mcg / desogestrel 150mcg (Gedarel®)
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Formulary
Green
Stock for Luton Sexual Health Clinic. 
   
Ethinylestradiol 30 mcg / drospirenone 3 mg (Yasmin®)
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Restricted Drug Restricted
Black
Restricted to Luton Sexual Health Clinic.

For continuation only. Most patients recommended to switch to pills with lower DVT risks  
   
Ethinylestradiol 30 mcg / levonorgestrel 150 mcg
(Generic)
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Formulary
Green
Stock for Luton Sexual Health Clinic. 
   
Ethinylestradiol 30mcg / desogestrel 150mcg (Gedarel®)
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Formulary
Green
Stock for Luton Sexual Health Clinic. 
   
Ethinylestradiol 35 mcg / norgestimate 250 mcg
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Formulary
Green

Stock for Luton Sexual Health Clinic.

Most cost effective brand to be advised via ScriptSwitch/Optimise

 
   
07.03.01  Emergency contraception
07.03.02  Progestogen-only contraceptives
07.03.02.01  Oral progestogen-only contraceptives
Desogestrel
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Formulary
Green

75microgram Tablets
Stock for Luton Sexual Health Clinic. 

 
   
Norethisterone
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Formulary
Green
350micrograms Tablets
Stock for Luton Sexual Health Clinic. 
   
07.03.02.02  Parenteral progestogen-only contraceptives to top
Etonorgestrel (Nexplanon®)
(Implant)
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Formulary
Green
Training is required to adminster these devices.  
Link  MHRA Drug Safety Update (June 2016) - Nexplanon (etonogestrel) contraceptive implants: reports of device in vasculature and lung
   
Medroxyprogesterone Acetate (Depo-Provera®)
(Injection, prefilled syringe)
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Formulary
Green
150mg/1mL Pre-filled Syringe
 
   
Medroxyprogesterone acetate (Sayana Press®)
(Subcutaneous injection)
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Restricted Drug Restricted
Green
104mg subcutaneous injection every 13 weeks.

Restricted - for Luton Sexual Health Clnic only. 
   
07.03.02.03  Intra-uterine progestogen-only contraceptive
Intra-uterine Progestogen Only System (Jaydess®)
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Restricted Drug Restricted
Green
13.5 mg intrauterine delivery system.

Restricted - for Luton Sexual Health Clinic only.
Levonorgestrol-releasing IUDs should be prescribed by brand name. 
Link  MHRA Drug Safety Update ( January 2016) - Levonorgestrol-releasing intrauterine systems: prescribe by brand name
Link  MHRA Drug Safety Update (June 2015) - Intrauterine contraception: uterine perforation—updated information on risk factors
   
Intra-uterine Progestogen Only System (Levosert®)
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Formulary
Green
Releasing levonorgestrel 20micrograms/24hours.

Restricted to Obs & Gynae Consultants/SPRs only.
Levonorgestrel releasing IUDs should be prescribed by brand name.
 
Link  MHRA Drug Safety Update (January 2016) - Levonorgestrel-releasing intrauterine systems: prescribe by brand name
Link  MHRA Drug Safety Update (June 2015): Intrauterine contraception: uterine perforation—updated information on risk factors
   
Intra-uterine Progestogen Only System (Mirena®)
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Restricted Drug Restricted
Green
Releasing levonorgestrel 20micrograms/24hours.

Restricted - to Family Planning (Luton Sexual Health Clinic) and Obs & Gynae Consultants/SPRs only.
Levonorgestrel releasing IUDs should be prescribed by brand name.
 
Link  MHRA Drug Safety Update (January 2016) - Levonorgestrel-releasing intrauterine systems: prescribe by brand name
Link  MHRA Drug Safety Update (June 2015): Intrauterine contraception: uterine perforation—updated information on risk factors
   
07.03.03  Spermicidal contraceptives
07.03.04  Contraceptive devices
07.03.04  Intra-uterine devices
Intra-uterine Contraceptive Devices (Nova-T® 360)
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Formulary
Green
 
Link  MHRA Drug Safety Update (June 2015) - Intrauterine contraception: uterine perforation—updated information on risk factors
   
Intra-uterine Contraceptive Devices (T-Safe® CU 380 A)
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Formulary
Green
 
Link  MHRA Drug Safety Update (June 2015) - Intrauterine contraception: uterine perforation—updated information on risk factors
   
Intra-uterine Contraceptive Devices (TT 380 Slimline Mini®)
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Restricted Drug Restricted
Green
Restricted - for Luton sexual Health Clinic only  
Link  MHRA Drug Safety Update (June 2015) - Intrauterine contraception: uterine perforation—updated information on risk factors
   
Intra-uterine Contraceptive Devices (TT 380 Slimline®)
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Restricted Drug Restricted
Green
Restricted - for Luton sexual Health Clinic only 
Link  MHRA Drug Safety Update (June 2015) - Intrauterine contraception: uterine perforation—updated information on risk factors
   
07.03.04  Other contraceptive devices to top
07.03.05  Emergency Contraception
07.03.05  Hormonal methods
Levonorgestrel 1.5mg
(Tablets)
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Restricted Drug Restricted
Green
Restricted - for Luton Sexual Health Clinic only.

In primary care may also be purchased over the counter. 
   
Ulipristal (EllaOne®)
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Restricted Drug Restricted
Green
30mg Tablets
Restricted to Luton Sexual Health Clinic only

Option for emergency contraception in women presenting within 120 hours after unprotected intercourse in patients where an IUD is not a suitable option. 
   
07.03.05  Intra-uterine device
07.04  Drugs for genito-urinary disorders
07.04.01  Drugs for urinary retention to top
Solifenacin and Tamsulosin (Vesomni®)
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Restricted Drug Restricted
Green
Solifenacin 6mg/Tamsulosin 0.4mg Film Coated Tablets

Restricted for the treatment of moderate to severe symptoms not adequately responding to monotherapy with alpha-blockers. 
   
07.04.01  Alpha-blockers
Alfuzosin Hydrochloride
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Formulary
Green
2.5mg Tablets
10mg Modified Release Tablets  
   
Doxazosin
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Formulary
Green
1mg, 2mg, 4mg tablets.

Modified release tablets non-Formulary since no evidence of superiority and non-MR tablets can be given once daily. 
   
Prazosin
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Formulary
Green
500microgram & 1mg Tablets 
   
Tamsulosin
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Formulary
Green
400microgram modified release capsule 
   
07.04.01  Parasympathomimetics
07.04.02  Drugs for urinary frequency, enuresis, and incontinence
07.04.02  Urinary incontinence
Oxybutynin Hydrochloride 2.5mg, 3mg & 5mg
(Tablets )
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First Choice
Green
NOTE - immediate release (ordinary) tablets can be dispersed/crushed in 10ml water and administered orally or via NG/PEG tubes.
 
Fesoterodine
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Second Choice
Green
4mg & 8mg Modified-Release Tablets 
   
Solifenacin
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Second Choice
Green
10mg Tablets
5mg Film Coated Tablets 
   
Tolterodine
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Second Choice
Green
1mg, 2mg tablets
4mg XL capsules

Most cost-effective second choice 
   
Mirabegron
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Restricted Drug Restricted
Amber
25mg & 50mg Prolonged Release Tablets

Must fulfil criteria in NICE TA290 for the treatment of an overactive bladder.  
Link  MHRA Drug Safety Update (October 2015) - Mirabegron (Betmiga▼): risk of severe hypertension and associated cerebrovascular and cardiac events
Link  NICE TA290: Mirabegron for overactive bladder
   
Oxybutynin Hydrochloride Modified Release
(5mg, 10mg Tablets)
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Restricted Drug Restricted
Green
Restricted to be used where ordinary tablets have caused side effects or where concordance is an issue.
 
   
Oxybutynin Hydrochloride 5mg/5mL
(Elixir)
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Restricted Drug Restricted
Amber
5mg in 5ml - Unlicensed - Low Risk
Restricted - for use only in patients unable to swallow tablets or for whom crushing/dispersing immediate release tablets is not suitable. N.B. £240 per 150mL bottle.
NOTE - immediate release (ordinary) tablets can be dispersed/crushed in 10ml water and administered orally or via NG/PEG tubes.
In primary care this is a pharmaceutical special.
 
   
07.04.02  Nocturnal enuresis to top
07.04.03  Drugs used in urological pain
Pentosan Polysulphate (Elmiron®)
(100 mg Capsules)
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Restricted Drug Restricted
Red

Restricted use in accordance with the following NICE TA (s):

 
Link  MHRA Drug Safety Update (Sept 2019) : rare risk of pigmentary maculopathy
Link  NICE TA610 Pentosan polysulfate sodium for treating bladder pain syndrome
   
07.04.03  Alkalinisation of urine
Potassium Citrate
(3g/ 10mL Oral Solution)
Formulary 200mL Pack
NOTE: Usual dose is 10mL, three times daily for two days.
 
   
07.04.03  Acidification of urine
07.04.03  Other preparations for urinary disorders
07.04.04  Bladder instillations and urological surgery to top
07.04.04  Urological surgery
07.04.04  Maintenance of indwelling urinary catheters
07.04.05  Drugs for erectile dysfunction
07.04.05  Alprostadil
Alprostadil (Caverject®)
(Intra-cavernosal Injection)
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Restricted Drug Restricted
Green
Only prescribable on the NHS for erectile dysfunction if fulfil NHS SLS criteria (listed in part XVIIIB of the Drug Tariff).

 
   
07.04.05  Phosphodiesterase type 5 inhibitors to top
Sildenafil 25mg, 50mg
(Tablets)
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First Choice
Green
Must prescribe generically.
Restricted Item Only prescribable on the NHS for erectile dysfunction if fulfil NHS SLS criteria (listed in part XVIIIB of the Drug Tariff).

 
Tadalafil 10mg, 20mg
(Tablets)
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Restricted Drug Restricted
Green

Only prescribable on the NHS for erectile dysfunction if fulfil NHS SLS criteria (listed in part XVIIIB of the Drug Tariff). Approved for use by the Urology consultants.

N.B. the 5mg daily dose has not been approved at DTC for any indication and for erectile dysfunction  is considered a low value medicine by NHSE. This is therefore unlikely to be continued in Primary care and should not be prescribed.

Amber Traffic Light  Approved for 2nd-line use for the treatment of severe Raynaud's disease when prescribed by a Consultant Rheumatologist. This indication is off-label.

 
Link  NICE TA273: Hyperplasia (benign prostatic) - tadalafil (terminated appraisal) (TA273)
   
07.04.05  Papaverine and phentolamine
07.04.06  Drugs for premature ejaculation
07.04.06  Dapoxetine
 ....
 Non Formulary Items
Alprostadil  (MUSE®)

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Non Formulary
 
Alprostadil  (Prostin VR®)

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Non Formulary
 
Alprostadil  (Viridal® Duo)

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Non Formulary
 
Alprostadil 3mg/g cream  (Vitaros®)

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Non Formulary
 
Anethol, Borneol, Camphene, Cineole, Fenchone, Pinene  (Rowatinex®)

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Non Formulary
 
Avanafil

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Non Formulary
 
Bethanechol Chloride  (Myotonine®)

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Non Formulary
 
Carbetocin  (Pabel®)

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Non Formulary
 
Catheter Patency Solutions

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Non Formulary
 
Catheter Patency Solutions

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Non Formulary
 
Catheter Patency Solutions

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Non Formulary
 
Catheter Patency Solutions

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Non Formulary
 
Combined Hormonal Contraceptives  (Evra)

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Non Formulary
 
Combined Hormonal Contraceptives  (Femodene® ED)

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Non Formulary
 
Combined Hormonal Contraceptives  (Levest®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Logynon ED®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Microgynon 30 ED®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Minulet®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Norinyl-1®)

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Non Formulary
 
Combined Hormonal Contraceptives  (NuvaRing®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Qlaira®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Synphase®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Triadene®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Tri-minulet®)

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Non Formulary
 
Combined Hormonal Contraceptives  (Trinordiol®)

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Non Formulary
 
Combined Hormonal Contraceptives  (TriNovum®)

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Non Formulary
 
Dapoxetine  (Priligy®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Darifenacin  (Emselex®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
DIMETHYL SULPHOXIDE Bladder Instillation 50%

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dinoprostone  (Propess®)

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Non Formulary
 
Distigmine Bromide  (Ubretid®)

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Non Formulary
 
Duloxetine  (Cymbalta®)

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Non Formulary
 
Duloxetine  (Yentreve®)

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Non Formulary
 
Dutasteride and Tamsulosin  (Combodart®)

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Non Formulary
 
Econazole  (Gyno-Pevaryl®)

View adult BNF View SPC online View childrens BNF
Non Formulary DISCONTINUED
 
Ergometrine Maleate

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ethinylestradiol / levonorgestrel phased pill  (TriRegol®, Logynon®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ethinylestradiol 20 mcg / drospirenone 3 mg  (Eloine®)

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Non Formulary
 
Ethinylestradiol 20mcg / desogestrel 150mcg  (Alenini®)

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Non Formulary
 
Ethinylestradiol 20mcg / gestodene 75 mcg  (Millinette®, Femodette®)

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Non Formulary
 
Ethinylestradiol 30 mcg /desogestrel 150 mcg  (Cimizt®)

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Non Formulary
 
Ethinylestradiol 30mcg / gestodene 75 mcg  (Millinette®, Femodene®)

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Non Formulary
 
Ethinylestradiol 30mcg / levonorgestrel 150mcg  (Rigevidon®, Microgynon 30®, Levest®)

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Non Formulary
 
Ethinylestradiol 35 mcg / noresthisterone 1mg  (Norimin®)

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Non Formulary
 
Ethinylestradiol 35 mcg / noresthisterone 500mcg  (Ovysmen®, Brevinor®)

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Non Formulary
Green
 
Fenticonazole  (Gynoxin®)

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Non Formulary
 
Flavoxate  (Urispas 200®)

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Non Formulary
 
Fluconazole

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Non Formulary
 
Glycine

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Non Formulary
 
Imipramine

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Non Formulary
 
Indoramin  (Doralese®)

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Non Formulary
 
Intra-uterine Contraceptive Devices  (Flexi-T® + 300)

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Non Formulary
 
Intra-uterine Contraceptive Devices  (Flexi-T® 300)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Intra-uterine Contraceptive Devices  (GyneFix®)

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Non Formulary
 
Intra-uterine Contraceptive Devices  (Load® 375)

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Non Formulary
 
Intra-uterine Contraceptive Devices  (UT 380 Short®)

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Non Formulary
 
Intra-uterine Contraceptive Devices  (UT 380 Standard®)

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Non Formulary
 
Ketoconazole 2%  (Nizoral®)

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Non Formulary
 
Lactic acid  (Balance Activ Rx®)

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Non Formulary
 
Lactic Acid  (Relactagel®)

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Non Formulary
 
Metronidazole  (Zidoval®)

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Non Formulary
 
Miconazole  (Gyno-Daktarin®)

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Non Formulary
 
Misoprostol vaginal delivery system  (Mysodelle®)

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Non Formulary
 
nomegestrol acetate and beta estradiol  (Zoely®)

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Non Formulary
 
Norethisterone enantate  (Noristerat®)

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Non Formulary
 
Nystatin

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Non Formulary
 
Oestrogens, Topical  (Estring®)

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Non Formulary
 
Oral Progestogen Only Contraceptives  (Norgeston®)

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Non Formulary
 
Oral Progestogen-Only Contraceptives  (Cerazette®)

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Non Formulary
 
Oral Progestogen-Only Contraceptives  (Micronor®)

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Non Formulary
 
Oral Progestogen-Only Contraceptives  (Norgeston®)

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Non Formulary
 
Oral Progestogen-Only Contraceptives  (Noriday®)

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Non Formulary
 
Ospemifene  (Senshio®)

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Non Formulary
 
Other Contraceptive Devices

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Non Formulary
 
Other Contraceptive Devices

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Other Contraceptive Devices

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Other Contraceptive Devices

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Other Contraceptive Devices

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Other Contraceptive Devices

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Other Contraceptive Devices

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oxybutynin Hydrochloride  (Kentera®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oxybutynin Hydrochloride 2.5mg, 5mg
(Tablets)

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Non Formulary
Green
NOTE - immediate release (ordinary) tablets can be dispersed/crushed in 10ml water and administered orally or via NG/PEG tubes.
 
Oxybutynin Intra-vesical

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Non Formulary
 
Papaverine

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Non Formulary
 
Phentolamine

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Non Formulary
 
Preparations for other Vaginal Infections  (Betadine®)

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Non Formulary
 
Preparations for Vaginal and Vulval Candidiasis  (Canesten®)

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Non Formulary
 
Propantheline

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Non Formulary
 
Propiverine  (Detrunorm®)

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Non Formulary
 
Replens MD®

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Non Formulary
 
Sildenafil chewable tablets  (Nipatra®)

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Non Formulary
 
Sodium Bicarbonate

Non Formulary
 
Sodium Citrate

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Non Formulary
 
Spremicidal Contraceptives  (Ortho-Creme®)

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Non Formulary
 
Spremicidal Contraceptives  (Orthoforms®)

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Non Formulary
 
Terazosin

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Non Formulary
 
Terazosin  (Hytrin®)

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Non Formulary
 
Terbutaline

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Non Formulary
 
Trospium

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Non Formulary
 
Trospium  (Regurin® XL )

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Non Formulary
 
Vardenafil  (Levitra®)

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Non Formulary
 
Yes® water-based intimate lubricant

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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
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
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.   

netFormulary