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Respiratory system
Respiratory system / Respiratory depression, respiratory distress syndrome and apnoea
  doxapram hydrochloride Restricted
DOXAPRAM HYDROCHLORIDE

ITU, Theatres.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

Respiratory system / Airways disease, obstructive
  aclidinium bromide Restricted
Aclidinium

For treatment of COPD only.

  Inhalation powder
Eklira (Covis Pharma GmbH) Restricted
  aclidinium bromide with formoterol On Formulary
  Inhalation powder
Duaklir (Covis Pharma GmbH) On Formulary
  alpha<sub>1</sub>-proteinase inhibitor Off Formulary
  aminophylline Restricted
AMINOPHYLLINE

Respiratory, ITU and Paeditricians in a HDU, ITU/NNU setting. The IV form is Red in the Black Country IMOC formuary, i.e. for hospital only prescribing.

  Solution for injection
Aminophylline (Non-proprietary) Restricted
  beclometasone dipropionate On Formulary
BECLOMETASONE DIPROPIONATE

Prescribe Beconase and Nasobec by brand. Check individual products for formulary status.

  Modified-release tablet
Clipper (Chiesi Ltd) Off Formulary
  Pressurised inhalation
Clenil Modulite (Chiesi Ltd) On Formulary
Kelhale (Cipla EU Ltd) Off Formulary
Qvar (Teva UK Ltd) Off Formulary
Qvar Autohaler (Teva UK Ltd) Off Formulary
Qvar Easi-Breathe (Teva UK Ltd) Off Formulary
  Spray
Beconase (GlaxoSmithKline UK Ltd, Omega Pharma Ltd) Off Formulary
  beclometasone with formoterol On Formulary
Beclometasone and formoterol

Prescribe by brand.

Licensed for both asthma and COPD.

Asthma - use lowest effective dose. Consider step down at each review. Consider switch if appropriate.

Alternative to Seretide Evohaler / Seretide 250 Accuhaler.


Note: when switching patients already using Beclometasone 250mcg CFC inhaler (e.g. Clenil), Fostair 100/6 can be prescribed and dose adjusted according to response.

  Pressurised inhalation
Fostair (Chiesi Ltd) On Formulary
Luforbec (Lupin Healthcare (UK) Ltd) Off Formulary
  Inhalation powder
Fostair NEXThaler (Chiesi Ltd) On Formulary
  beclometasone with formoterol and glycopyrronium On Formulary
  Pressurised inhalation
Trimbow (Chiesi Ltd) On Formulary
Trimbow

The 172/5/9 product is AI in the Black Country IMOG formulary, i.e. it can be prescribed in primayr care after specialist initiation.

  Inhalation powder
Trimbow NEXThaler (Chiesi Ltd) On Formulary
  benralizumab Restricted NICE TA565
NICE TA1096
Benralizumab

This is commissioned by NHSE for severe eosinophilic asthma nd a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  budesonide Restricted NICE TA708
NICE TA1128
BUDESONIDE

Tabets for Gastroenterology use only. The tablets and enemas are AR in the Black Country formulary, i.e. for prescribing in primary care after specialist recommendation. The orodispersible tablets (Jorveza) are Red in the Black Country formulary, i.e. for hosital prescribing only.

For respiratory uses check individual formulations to check formulary status and prescribe by brand.

Targeted release budesonide (Kinpeygo) is indicated for the treatment of primary immunoglobulin A (IgA) nephropathy in line with NICE TA 937 is funded by ICB. Blueteq form must be completed for Black Country ICB.

  Modified-release tablet
Cortiment (Ferring Pharmaceuticals Ltd) Off Formulary
  Gastro-resistant capsule
Budenofalk (Dr. Falk Pharma UK Ltd) Off Formulary
  Gastro-resistant granules
Budenofalk (Dr. Falk Pharma UK Ltd) Off Formulary
  Inhalation powder
Budelin Novolizer (Viatris UK Healthcare Ltd) Off Formulary
Easyhaler (Orion Pharma (UK) Ltd) On Formulary
Pulmicort Turbohaler (AstraZeneca UK Ltd) On Formulary
  Nebuliser liquid
Budesonide (Non-proprietary) Restricted
Budesonide nebuliser liquid

The nebuliser liquid is AI in the Black Country IMOC formulary, i.e. for prescribing in primary care after specialist initiation.

  Spray
Budesonide (Non-proprietary) Off Formulary
  budesonide with formoterol On Formulary
Budesonide with formoterol

Prescribe by brand

  Pressurised inhalation
Symbicort (AstraZeneca UK Ltd) On Formulary
  Inhalation powder
DuoResp Spiromax (Teva UK Ltd) Off Formulary
Fobumix Easyhaler (Orion Pharma (UK) Ltd) On Formulary
Symbicort Turbohaler (AstraZeneca UK Ltd) On Formulary
WockAIR (Wockhardt UK Ltd) Off Formulary
  ciclesonide Off Formulary
  Pressurised inhalation
Alvesco (Covis Pharma GmbH) Off Formulary
  dupilumab Nice-approved drug NICE TA534
NICE TA751
NICE TA955
NICE TA1134
Dupilumab

This is commissioned by NHSE for for treating severe asthma with type 2 inflammation in adults or adolescents aged 12 years and older, or severe atopic dermatitis in patients aged 6 years or older and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

All other indications are ICB commissioned and a Blueteq form is required before prescribing, if available.

  ephedrine hydrochloride Restricted
Ephedrine hydrochloride

For cardiovascular and respiratory use this is Red in the Black Country IMOG formulary, i.e. for hospital prescribing only.

  Solution for injection
Ephedrine hydrochloride (Non-proprietary) Restricted
  fluticasone Restricted
FLUTICASONE PROPIONATE

Check individual products for formulary status.

The Flixonase nasal drops and Flixotide nebuliser liquid are AI in the Black Country IMOC formulary, i.e. can be prescribed in primary care after specialist initiation

  Pressurised inhalation
Flixotide Evohaler (GlaxoSmithKline UK Ltd) On Formulary
  Inhalation powder
Flixotide Accuhaler (GlaxoSmithKline UK Ltd) On Formulary
  Spray
Avamys (GlaxoSmithKline UK Ltd) On Formulary
Flixonase (GlaxoSmithKline UK Ltd, Haleon UK Trading Ltd) Off Formulary
Flixonase

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

Nasofan (Teva UK Ltd) Off Formulary
Nasofan

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  fluticasone with formoterol Off Formulary
  Pressurised inhalation
Flutiform (Napp Pharmaceuticals Ltd) Off Formulary
  fluticasone with salmeterol Restricted
Seretide®

For paediatric patients only. Should be prescribed by brand.

  Pressurised inhalation
AirFluSal (Sandoz Ltd) Off Formulary
Avenor (Zentiva Pharma UK Ltd) Off Formulary
Combisal (Aspire Pharma Ltd) Restricted
Seretide Evohaler (GlaxoSmithKline UK Ltd) Restricted
Seretide

Seretide 50 is formulary for patients under the age of 12 years only

Sirdupla (Viatris UK Healthcare Ltd) Off Formulary
  Inhalation powder
AirFluSal Forspiro (Sandoz Ltd) Off Formulary
Fixkoh Airmaster (Genus Pharmaceuticals Holdings Ltd) Off Formulary
Fusacomb Easyhaler (Orion Pharma (UK) Ltd) Off Formulary
Sereflo Ciphaler (Cipla EU Ltd) Off Formulary
Seretide Accuhaler (GlaxoSmithKline UK Ltd) Off Formulary
Stalpex (Glenmark Pharmaceuticals Europe Ltd) Off Formulary
  fluticasone with umeclidinium and vilanterol On Formulary
  Inhalation powder
Trelegy Ellipta (GlaxoSmithKline UK Ltd) On Formulary
  fluticasone with vilanterol On Formulary
  Inhalation powder
Relvar Ellipta (GlaxoSmithKline UK Ltd) On Formulary
  formoterol fumarate On Formulary
  Pressurised inhalation
Atimos Modulite (Chiesi Ltd) Off Formulary
  Inhalation powder
Easyhaler (Orion Pharma (UK) Ltd) Off Formulary
Oxis Turbohaler (AstraZeneca UK Ltd) On Formulary
  formoterol fumarate with glycopyrronium and budesonide On Formulary
  glycopyrronium bromide Off Formulary
GLYCOPYRRONIUM BROMIDE

The cream and injection are Red in the Black Country IMOG formulary, i.e. for hospital prescribing only.

  Solution for injection
Glycopyrronium bromide (Non-proprietary) Off Formulary
  Inhalation powder
Seebri Breezhaler (Novartis Pharmaceuticals UK Ltd) Off Formulary
  glycopyrronium with formoterol fumarate On Formulary
  Pressurised inhalation
Bevespi Aerosphere (AstraZeneca UK Ltd) On Formulary
  glycopyrronium with indacaterol Off Formulary
  Inhalation powder
Ultibro Breezhaler (Novartis Pharmaceuticals UK Ltd) Off Formulary
  indacaterol Off Formulary
  Inhalation powder
Onbrez Breezhaler (Novartis Pharmaceuticals UK Ltd) Off Formulary
  ipratropium bromide Restricted
Ipratropium bromide

The inhalers are Black, i.e. non-formulary, in the Black Country IMOC formulary but the nebuliser liquid is Green.

  Pressurised inhalation
Atrovent (Boehringer Ingelheim Ltd) Off Formulary
Inhalvent (Alissa Healthcare Research Ltd) Off Formulary
  Nebuliser liquid
Ipratropium bromide (Non-proprietary) Restricted
Atrovent UDV (Boehringer Ingelheim Ltd) Off Formulary
  ipratropium with salbutamol Off Formulary
  Nebuliser liquid
Combivent (Boehringer Ingelheim Ltd) Off Formulary
  mepolizumab Nice-approved drug NICE TA671
Mepolizumab

This is commissioned by NHSE for treating severe refractory eosinophilic asthma and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

  mometasone furoate On Formulary
  Inhalation powder
Asmanex Twisthaler (Organon Pharma (UK) Ltd) Off Formulary
  Spray
Mometasone furoate (Non-proprietary) On Formulary
Nasonex (Organon Pharma (UK) Ltd) Off Formulary
  mometasone furoate with glycopyrronium bromide and indacaterol Off Formulary
  Inhalation powder
Enerzair Breezhaler (Novartis Pharmaceuticals UK Ltd) Off Formulary
  montelukast On Formulary
Montelukast

Use in line with recommendations in BTS-SIGN asthma guideline.

  Chewable tablet
Montelukast (Non-proprietary) On Formulary
Singulair (Organon Pharma (UK) Ltd) Off Formulary
  olodaterol Off Formulary
  Inhalation solution
Striverdi Respimat (Boehringer Ingelheim Ltd) Off Formulary
  omalizumab Restricted NICE TA278
NICE TA339
OMALIZUMAB

This is commissioned by NHSE for the treatment of severe persistent allergic asthma, and chrionic spontaneous urticaria in children, and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is Red for specialist use only in asthma in the Black Country IMOC formulary, i.e. for hospital prescribing only.

All other indications are ICB commissioned and a Blueteq form is required before prescribing, if available.

  reslizumab Restricted NICE TA479
Reslizumab

This is commissioned by NHSE for severe eosinophilic asthma.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  roflumilast Restricted NICE TA461
ROFLUMILAST

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

Prescribing is restricted to patients who meet the criteria in the NICE TA.

  salbutamol On Formulary
Salbutamol

The IV formulation is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only. See individaul products to check formulary status of other items which are Green

  Solution for injection
Ventolin (GlaxoSmithKline UK Ltd) On Formulary
  Pressurised inhalation
Salamol (Teva UK Ltd) On Formulary
Salamol Easi-Breathe (Teva UK Ltd) On Formulary
Ventolin Evohaler (GlaxoSmithKline UK Ltd) Off Formulary
  Inhalation powder
Easyhaler (Orion Pharma (UK) Ltd) On Formulary
Salbulin Novolizer (Viatris UK Healthcare Ltd) Off Formulary
Ventolin Accuhaler (GlaxoSmithKline UK Ltd) On Formulary
  Nebuliser liquid
Salbutamol (Non-proprietary) Restricted
Salbutamol nebuliser liquid

This is Green in the Black Country IMOC formulary for adults but AR for paediatrics, i.e. can be prescribed in primayr care after specialist recommendation

  salmeterol Off Formulary
  Pressurised inhalation
Serevent Evohaler (GlaxoSmithKline UK Ltd) Off Formulary
Soltel (Cipla EU Ltd) Off Formulary
  Inhalation powder
Serevent Accuhaler (GlaxoSmithKline UK Ltd) Off Formulary
  terbutaline sulfate On Formulary
Terbutaline

Use in pre-term labour is Red in the Black Country formulary, i.e. for hospital prescribing only.

  Inhalation powder
Bricanyl Turbohaler (AstraZeneca UK Ltd) On Formulary
  Nebuliser liquid
Terbutaline sulfate (Non-proprietary) Restricted
Terbutaline nebuliser liquid

This is AR in the Black Country IMOC formulary, i.e. can be prescribed in primary care after specilaist recommendation

Bricanyl Respules (AstraZeneca UK Ltd) Off Formulary
  tezepelumab Restricted NICE TA880
  theophylline Restricted
THEOPHYLLINE

Respiratory, ITU and Paeditricians in a HDU, ITU/NNU setting. Uniphyllin Continus is AI in the Black Country IMOC formulary, i.e. for prescribing in primary care after specialist initiation

  Modified-release tablet
Uniphyllin Continus (Ennogen Healthcare International Ltd) Restricted
  tiotropium On Formulary
  Inhalation powder
Acopair (Viatris UK Healthcare Ltd) Off Formulary
Braltus (Teva UK Ltd) Off Formulary
Spiriva (Boehringer Ingelheim Ltd) Off Formulary
Tiogiva (Glenmark Pharmaceuticals Europe Ltd) Off Formulary
  Inhalation solution
Spiriva Respimat (Boehringer Ingelheim Ltd) On Formulary
  tiotropium with olodaterol On Formulary
  Inhalation solution
Spiolto Respimat (Boehringer Ingelheim Ltd) On Formulary
  umeclidinium On Formulary
  Inhalation powder
Incruse Ellipta (GlaxoSmithKline UK Ltd) On Formulary
  umeclidinium with vilanterol On Formulary
  Inhalation powder
Anoro Ellipta (GlaxoSmithKline UK Ltd) On Formulary
Respiratory system / Cough and congestion
  citric acid On Formulary
Simple Linctus, BP

OTC preparation available. Simple linctus suitable for self care.

  Oral solution
Citric acid (Non-proprietary) On Formulary
  codeine phosphate Restricted
  Oral solution
Codeine phosphate (Non-proprietary) Off Formulary
Galcodine (Thornton & Ross Ltd) Off Formulary
  eucalyptus with menthol Off Formulary
  methadone hydrochloride Restricted NICE TA114
  morphine On Formulary
Morphine

XL formulations only to be used when twice daily MR prearations are not suitable and ONCE daily preparation is required. XL more expensive.

  Modified-release tablet
MST Continus (Napp Pharmaceuticals Ltd) On Formulary
Morphgesic SR (Advanz Pharma) Off Formulary
  Modified-release capsule
MXL (Napp Pharmaceuticals Ltd) Off Formulary
Zomorph (Ethypharm UK Ltd) On Formulary
  Oral solution
Morphine (Non-proprietary) On Formulary
Morhine oral solution

For palliative care the 20 mg/ml preparation is AR in the Black Country formulary

Oramorph (Glenwood GmbH) Off Formulary
Respiratory system / Allergic conditions
  acrivastine Off Formulary
  alimemazine tartrate Off Formulary
Alimemazine

For perioperative sedation only this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

  Oral solution
Alimemazine tartrate (Non-proprietary) Off Formulary
  bee venom extracts Restricted NICE TA246
Bee allergen extract

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  bilastine Off Formulary
  cetirizine hydrochloride On Formulary
  Oral solution
Cetirizine hydrochloride (Non-proprietary) On Formulary
  chlorphenamine maleate On Formulary
Chlorphenamine

Check indiviudal products for formulary status.

  Oral solution
Chlorphenamine maleate (Non-proprietary) Restricted
Chlorphenamine oral liquid

For children and those unable to swallow tablets

  Solution for injection
Chlorphenamine maleate (Non-proprietary) Restricted
  cyproheptadine hydrochloride Off Formulary
Cyproheptadine

Cyproheptadine is non-formulary for allergies but is stocked as an antidote for serotonin syndrome and can be prescribed upon authorisation from Toxicology.

  desloratadine Off Formulary
  fexofenadine hydrochloride On Formulary
  Oral tablet
Fexofenadine hydrochloride (Non-proprietary) On Formulary
  grass pollen extracts Restricted
Grazax

Consultant immunologists.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  Oral lyophilisate
Grazax (ALK-Abello Ltd) Restricted
  Form unstated
Pollinex Grasses + Rye (Allergy Therapeutics (UK) Ltd) Restricted
  house-dust mite extracts Restricted NICE TA1045
NICE TA1045
House dust mite extract

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  Oral lyophilisate
Acarizax (ALK-Abello Ltd) Restricted
  hydroxyzine hydrochloride On Formulary
  ketotifen Off Formulary
  Eye drops
Ketofall (Scope Ophthalmics Ltd) Off Formulary
Zaditen (Thea Pharmaceuticals Ltd) Off Formulary
  levocetirizine hydrochloride Off Formulary
  loratadine On Formulary
  mizolastine Off Formulary
  peanut protein Restricted
Peanut protein

Blueteq form must be completed where available for this drug and required indication. Please contact the Pharmacy High Cost Drug team if any support needed.

https://www.blueteq-secure.co.uk/Trust/default.aspx

  promethazine hydrochloride On Formulary
Promethazine

Suitable for self-care/purchase, if appropriate, for short term use for insomnia, urticaria, allergies, and travel sickness.

  Oral solution
Phenergan (Opella Healthcare UK Ltd) Off Formulary
  Solution for injection
Phenergan (Opella POM UK Ltd) Off Formulary
  Oral tablet
Sominex (Dexcel-Pharma Ltd) Off Formulary
  rupatadine Off Formulary
  tree pollen extracts Restricted NICE TA1087
Tree pollen extract

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  Suspension for injection
Pollinex Trees (Allergy Therapeutics (UK) Ltd) Restricted
  Form unstated
Pollinex Trees (Allergy Therapeutics (UK) Ltd) Restricted
  wasp venom extracts Restricted NICE TA246
Wasp venom extract

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

Respiratory system / Anaphylaxis
  adrenaline/epinephrine On Formulary
  Solution for injection
Adrenaline/epinephrine (Non-proprietary) On Formulary
Adrenaline

For anaphylaxis or acute angioedema. This Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

EpiPen (Viatris UK Healthcare Ltd) On Formulary
Jext (ALK-Abello Ltd) On Formulary
Adrenaline

The cheapest product should be used.

  chlorphenamine maleate On Formulary
Chlorphenamine

Check indiviudal products for formulary status.

  Oral solution
Chlorphenamine maleate (Non-proprietary) Restricted
Chlorphenamine oral liquid

For children and those unable to swallow tablets

  Solution for injection
Chlorphenamine maleate (Non-proprietary) Restricted
Respiratory system / Angioedema
  C1-esterase inhibitor Restricted
C1-ESTERASE INHIBITOR

This is commissioned by NHSE 

1. (Cinryze) for prophylactic treatment of hereditary angioedema (HAE) types I and II in children (in relation to NHSE polic

 2. for prophylactic treatment of hereditary angioedema

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

Berinert® is is for treatment of angioedema attacks and pre-procedural prophylaxis use.

  Powder and solvent for solution for injection
Berinert P (CSL Behring UK Ltd) Restricted
Cinryze (Takeda UK Ltd) Restricted
  berotralstat Restricted NICE TA738
Berotraslstat

This is commissioned by NHSE for angioedema-hereditary (HAE) and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  conestat alfa Restricted
Conestat alfa

This is commissioned by NHSE.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  garadacimab Restricted NICE TA1101
Garadacimab

Initially to be supplied uder the Innovative Medicines Fund until routinely commissioned in February 2026.

Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

  icatibant Restricted
Icatibant

Restricted to specialist immunology services only.

This is commissioned by NHSE.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  lanadelumab Restricted NICE TA606
Lanadelumab

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

This is commssioned by NHSE for the indications below in highly sepcialist allergy centres and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

Preventing recurrent attacks of hereditary angioedema

Respiratory system / Conditions affecting sputum viscosity
  acetylcysteine On Formulary
  Effervescent tablet
Acetylcysteine (Non-proprietary) On Formulary
A-CYS (Ennogen Healthcare International Ltd) Off Formulary
AceCil (Essential-Healthcare Ltd) Off Formulary
NACSYS (Alturix Ltd) On Formulary
Nacsys

This is Green for COPD in the Black Country IMOC formulary

  carbocisteine On Formulary
  erdosteine Off Formulary
Respiratory system / Cystic fibrosis
  dornase alfa Restricted
  ivacaftor Restricted
Ivacaftor

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  ivacaftor with tezacaftor and elexacaftor Off Formulary NICE TA988
  lumacaftor with ivacaftor Restricted NICE TA988
Lumacaftor with ivacaftor

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  mannitol Restricted NICE TA266
MANNITOL

Glaucoma, cerebral oedema, Poisons Unit.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

  tezacaftor with ivacaftor Off Formulary NICE TA988
Respiratory system / Interstitial lung disease
  nintedanib Restricted NICE TA347
NICE TA379
NICE TA864
NICE TA747
Nintedanib

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

This is commssioned by NHSE for the indications below and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

Treatment of idiopathic pulmonary fibrosis

Treating progressive fibrosing interstitial lung diseases

  pirfenidone Restricted NICE TA504