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Skin
Skin / Gustatory sweating
  propantheline bromide On Formulary
Skin / Hyperhidrosis
  aluminium chloride hexahydrate On Formulary
  botulinum toxin type A On Formulary NICE TA260
NICE TA605
Botox for patients undergoing abdominal reconstruction surgery

To relax the abdominal wall in preparation of abdominal wall reconstruction. 300 units to be administered 2 to 4 weeks before the procedure (300 units reconstituted in 150ml sodium chloride 0.9%)

Botulinum toxin type A for the prevention of headaches in adults with chronic migraine

NICE Guidelines:Botulinum toxin type A for the prevention of headaches in adults with chronic migraine

Overactive Bladder algorithm

Overactive Bladder algorithm

Sialorrhoea

On Formulary - Approved for use in October 2019 at Drugs and Therapeutics Committee (DTC) - Xeomin brand ONLY

 

  Powder for solution for injection
Azzalure (Galderma (UK) Ltd) Off Formulary
Bocouture (Merz Pharma UK Ltd) Off Formulary
Botox (AbbVie Ltd) On Formulary
Dysport (Ipsen Ltd) Hospital Only
Xeomin (Merz Pharma UK Ltd) Off Formulary
Xeomin for Sialorrhea

On Formulary - Approved for use in October 2019 at Drugs and Therapeutics Committee (DTC) - Xeomin brand ONLY

  glycopyrronium bromide On Formulary
Skin / Scalp and hair conditions
  benzalkonium chloride On Formulary
  cetrimide with undecenoic acid Off Formulary
  coal tar On Formulary
BAD specials, March 2020

These ‘specials’ are medications which are used in rare dermatological conditions and recommended by British Association of Dermatologists. Most of them are used due to no other availability of alternative products.

These products will be restricted to only be prescribed by dermatologists within hospital, and not in primary care.

 

The Committee have agreed to add these to the Barts Health formulary, based on BAD’s recommendations. These will be restricted for use within Dermatology only.

  Shampoo
Polytar Scalp (Thornton & Ross Ltd) On Formulary
  coal tar with salicylic acid and precipitated sulfur Off Formulary
  ketoconazole On Formulary
Skin / Alopecia
  finasteride On Formulary
  minoxidil On Formulary
  Liquid
Minoxidil (Non-proprietary) On Formulary
Regaine (Johnson & Johnson Ltd, McNeil Products Ltd) On Formulary
Alopecia Pathway

Alopecia Pathway

Skin / Hirsutism
  co-cyprindiol On Formulary
  eflornithine On Formulary
Skin / Superficial soft-tissue injuries and superficial thrombophlebitis
  heparinoid On Formulary
Skin / Dry and scaling skin disorders
  barrier creams and ointments On Formulary
  emollient bath and shower products, antimicrobial-containing On Formulary
  emollient bath and shower products, paraffin-containing
  Bath additive
Emollient bath and shower products, paraffin-containing (Non-proprietary) On Formulary
Dermalo (Dermal Laboratories Ltd) On Formulary
Dermalo®

First line choice

  Products without form
Emollient bath and shower products, paraffin-containing (Non-proprietary) On Formulary
  emollient creams and ointments, paraffin-containing
  Liquid
Emollient creams and ointments, paraffin-containing (Non-proprietary) On Formulary
QV®

Cream is a second line option emollient after Zerobase/ Diprobase/ Doublebase

Skin / Acne
  adapalene On Formulary
  adapalene with benzoyl peroxide On Formulary
  benzoyl peroxide On Formulary
  clindamycin On Formulary
  Solution for injection
Clindamycin (Non-proprietary) On Formulary
Dalacin C (Pfizer Ltd) On Formulary
  co-cyprindiol On Formulary
  doxycycline On Formulary
  Modified-release capsule
Efracea (Galderma (UK) Ltd) On Formulary
  erythromycin On Formulary
  Gastro-resistant tablet
Erythromycin (Non-proprietary) On Formulary
  Oral suspension
Erythromycin (Non-proprietary) On Formulary
  erythromycin with zinc acetate On Formulary
  isotretinoin Hospital Only
  lymecycline On Formulary
  minocycline Hospital Only
  nicotinamide Off Formulary
  oxytetracycline On Formulary
  tretinoin with clindamycin On Formulary
  tretinoin with erythromycin Off Formulary
  Liquid
Aknemycin Plus (Almirall Ltd) On Formulary
  trimethoprim On Formulary
  Oral suspension
Trimethoprim (Non-proprietary) On Formulary
Antibiotic prophylaxis in Urology 2014

Please see Microguide (App)

TRIMETHOPRIM

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

Skin / Rosacea
  brimonidine tartrate On Formulary
Skin / Sun protection and photodamage
  fluorouracil On Formulary
  fluorouracil with salicylic acid Off Formulary
  ingenol mebutate On Formulary
Skin / Warts and calluses
  camellia sinensis Off Formulary
  formaldehyde Off Formulary
  imiquimod On Formulary
  podophyllotoxin On Formulary
  Liquid
Warticon (Phoenix Labs Ltd) On Formulary
  salicylic acid On Formulary
  salicylic acid with lactic acid On Formulary
  silver nitrate On Formulary
Skin / Eczema and psoriasis
  acitretin Hospital Only
  adalimumab Hospital Only NICE TA187
NICE TA329
NICE TA199
NICE TA195
NICE TA375
NICE TA715
NICE TA383
NICE TA392
NICE TA146
NICE TA460
  Solution for injection
Humira (AbbVie Ltd) Hospital Only
Yuflyma (Celltrion Healthcare UK Ltd) Hospital Only
  alitretinoin Hospital Only NICE TA177
Alitretinoin Capsules, Severe Chronic Hand Eczema, November 2008

Severe Chronic Hand Eczema in patients who are unresponsive to potent topical corticosteroids.

  apremilast Hospital Only NICE TA433
NICE TA419
  azathioprine On Formulary
IBD Shared Care Guidelines 2019

IBD Shared Care Guidelines

  beclometasone dipropionate Off Formulary
  betamethasone On Formulary
Betesil Medicated Plaster - Inflammatory Skin Disorders (November 2022)

Approved at NEL FPG (Nov 2022)

Betesil® 2.250mg medicated plaster is the only potent corticosteroid indicated in adults for the treatment of inflammatory skin disorders.

The plaster is licensed to use for a maximum of 30 days at a time, with a maximum of 6 plasters being used at any one time. Plasters may be changed once every 24 hours.

Amber-may be prescribed by or on the advice of a specialist 

  Liquid
Betnovate (GlaxoSmithKline UK Ltd) On Formulary
Diprosone (Organon Pharma (UK) Ltd) On Formulary
  betamethasone with clioquinol On Formulary
  betamethasone with fusidic acid On Formulary
  betamethasone with neomycin Off Formulary
  bimekizumab Hospital Only NICE TA723
NICE TA916
NICE TA918
NICE TA 918-November 2023-Bimekizumab for treating axial spondyloarthritis

Bimekizumab approved at NEL FPG for treating axial spondyloarthritis in line with NICE TA.

Moderate to severe plaque psoriasis

Bimekizumab for treating moderate to severe plaque psoriasis- as per NICE TA 723. October 2021 DTC.

NICE TA 916 - October 2023 - Bimekizumab for treating active psoriatic arthritis

Bimekizumab approved at NEL FPG for treating active psoriatic arthritis in line with NICE TA.

  brodalumab Hospital Only NICE TA511
  calcipotriol On Formulary
  Liquid
Calcipotriol (Non-proprietary) On Formulary
  calcipotriol with betamethasone On Formulary
  calcitriol On Formulary
  certolizumab pegol Hospital Only NICE TA375
NICE TA383
NICE TA415
NICE TA445
NICE TA574
NICE TA574-Certolizumab pegol for treating moderate to severe plaque psoriasis

https://www.nice.org.uk/guidance/ta574

  ciclosporin On Formulary NICE TA369
  Oral solution
Neoral (Novartis Pharmaceuticals UK Ltd) On Formulary
  Solution for infusion
Sandimmun (Novartis Pharmaceuticals UK Ltd) Hospital Only
  clobetasol propionate On Formulary
  Liquid
Dermovate (GlaxoSmithKline UK Ltd) On Formulary
  clobetasol propionate with neomycin sulfate and nystatin Off Formulary
  clobetasone butyrate On Formulary
  clobetasone butyrate with nystatin and oxytetracycline On Formulary
  coal tar On Formulary
BAD specials, March 2020

These ‘specials’ are medications which are used in rare dermatological conditions and recommended by British Association of Dermatologists. Most of them are used due to no other availability of alternative products.

These products will be restricted to only be prescribed by dermatologists within hospital, and not in primary care.

 

The Committee have agreed to add these to the Barts Health formulary, based on BAD’s recommendations. These will be restricted for use within Dermatology only.

  Shampoo
Coal tar (Non-proprietary) On Formulary
Polytar Scalp (Thornton & Ross Ltd) On Formulary
  Cutaneous emulsion
Exorex (Teva UK Ltd) On Formulary
  coal tar with calamine Off Formulary
  coal tar with coconut oil and salicylic acid Off Formulary
  coal tar with dithranol and salicylic acid Off Formulary
  coal tar with salicylic acid Off Formulary
  coal tar with salicylic acid and precipitated sulfur Off Formulary
  coal tar with zinc oxide Off Formulary
  deucravacitinib Hospital Only NICE TA907
NICE TA 907- September 2023 - Deucravacitinib for treating moderate to severe plaque psoriasis

Deucravacitinib Approved at NEL FPG for treating moderate to severe plaque psoriasis in line with NICE TA.

  dimethyl fumarate Hospital Only
Skilarence® NICE TA475
Tecfidera® NICE TA320
  Gastro-resistant tablet
Skilarence (Almirall Ltd) Hospital Only
  Gastro-resistant capsule
Tecfidera (Biogen Idec Ltd) On Formulary
  dithranol On Formulary
  dithranol with salicylic acid and zinc oxide Off Formulary
  dupilumab Hospital Only NICE TA534
NICE TA751
  etanercept Hospital Only NICE TA103
NICE TA195
NICE TA375
NICE TA715
NICE TA199
NICE TA383
  Solution for injection
Benepali (Biogen Idec Ltd) Hospital Only
Enbrel (Pfizer Ltd) Hospital Only
Enbrel MyClic (Pfizer Ltd) Off Formulary
Erelzi (Sandoz Ltd) Off Formulary
  Powder and solvent for solution for injection
Enbrel (Pfizer Ltd) On Formulary
  fludroxycortide On Formulary
  Impregnated dressing
Fludroxycortide (Non-proprietary) On Formulary
  fluocinolone acetonide Hospital Only NICE TA301
NICE TA613
NICE TA590
  fluocinonide Off Formulary
  fluticasone Off Formulary
  guselkumab Hospital Only NICE TA521
NICE TA815
Guselkumab in Psoriatic Arthritis, NICE TA 815 (November 2022)

Guselkumab approved alone or with methotrexate, is recommended as an option for treating active psoriatic arthritis in adults whose disease has not responded well enough to disease-modifying antirheumatic drugs (DMARDs) or who cannot tolerate them. It is recommended only if they have had 2 conventional DMARDs and:
• have had at least 1 biological DMARD, or
• tumour necrosis factor (TNF)-alpha inhibitors are contraindicated but would otherwise be considered (as described in NICE's technology appraisal guidance on etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis).

Psoriatic arthritis

Approved for the treatment of active psoriatic arthritis after inadequate response to DMARDs as per NICE TA 711

September 2021 DTC

  hydrocortisone On Formulary
  hydrocortisone butyrate Off Formulary
  hydrocortisone with benzalkonium chloride, dimeticone and nystatin On Formulary
  hydrocortisone with chlorhexidine hydrochloride and nystatin On Formulary
  hydrocortisone with clotrimazole On Formulary
  hydrocortisone with fusidic acid On Formulary
  hydrocortisone with miconazole On Formulary
  hydrocortisone with oxytetracycline Off Formulary
  ichthammol Off Formulary
  ichthammol with zinc oxide On Formulary
  infliximab Hospital Only NICE TA134
NICE TA195
NICE TA375
NICE TA715
NICE TA199
NICE TA187
NICE TA163
NICE TA329
NICE TA383
Adalimumab, Infliximab and Etanercept for moderate Rheumatoid arthritis – NICE TA 715-October 2021

The committee Approved the anti-TNFs onto the Barts Health Formulary, in accordance with NICE TA715.

Use subcutaneous infliximab in patients with IBD, January 2021

Infliximab S/C in patients with IBD approved via chairs action on January 2021.

  ixekizumab Hospital Only NICE TA442
NICE TA537
NICE TA718
Axial spondyloarthritis

Approved for treating axial spondyloarthritis as per NICE TA 718. Hospital Only. October 2021 DTC.

  methotrexate On Formulary
  mometasone furoate On Formulary
  Liquid
Elocon (Organon Pharma (UK) Ltd) On Formulary
  pimecrolimus On Formulary NICE TA82
  salicylic acid with zinc oxide On Formulary
  secukinumab Hospital Only NICE TA350
NICE TA407
NICE TA719
NICE TA445
NICE TA935
NICE TA 935 - Secukinumab - Treating moderate to severe hidradenitis suppurativa

Secukinumab approved at NEL FPG for treating moderate to severe hidradenitis suppurativa in line with NICE TA

Hospital Only

Secukinumab dose escalation in psoriasis, April 2023

Approved at NEL-FPG in April 2023. Discount scheme applies until 2025. Commisioned by the ICB after this point as per the NEL High Cost Drug Pathway for Psoriasis 

Dose increased from 300mg once a month to 300mg fortnightly with a body weight of 90kg or higher. Patients who have an inadequate response after 3 months of dose escalation should be offered alternative treatment as per the NEL Psoriasis Pathway

  tacalcitol Off Formulary
  tacrolimus Hospital Only NICE TA82
NICE TA481
NICE TA481
  tildrakizumab Hospital Only NICE TA575
NICE TA575- Tildrakizumab for treating moderate to severe plaque psoriasis

https://www.nice.org.uk/guidance/ta575

  tralokinumab Hospital Only NICE TA814
Free of Charge Scheme for Severe Atopic dermatitis

Hospital Only FOC Scheme for severe atopic dermatitis- to be reviewed when NICE TA published.

DTC Jan 2022

  upadacitinib Hospital Only NICE TA665
NICE TA744
NICE TA768
NICE TA829
NICE TA861
NICE TA814
NICE TA856
NICE TA905
NICE TA 905 –July 2023, Upadacitinib for previously treated moderately to severely active Crohn’s disease

 Upadacitnib approved at NEL FPG for previously treated moderately to severely active Crohn’s disease in line with NICE TA.

NICE TA 856-Upadacitinib-Treating moderately to severely active ulcerative colitis

Upadacitinib approved at NEL FPG (March 23) for treating moderately to severely active ulcerative colitis in line with NICE TA 856,

Upadacitinib for treating active ankylosing spondylitis, NICE TA 829 (November 2022)

Upadacitinib approved as an option for treating active ankylosing spondylitis that is not controlled well enough with conventional therapy in adults, only if tumour necrosis factor (TNF)-alpha inhibitors are not suitable or do not control the condition well enough.

Upadacitinib (Rinvoq) for treating active non-radiographic axial spondyloarthritis, NICE TA 861, February 2023

Approved at NEL FPG for treating active non-radiographic axial spondyloarthritis.

  ustekinumab Hospital Only NICE TA180
NICE TA340
NICE TA456
NICE TA633
June 2023 - Ustekinumab dose escalation in psoriasis

Ustekinumab approved at NEL FPG for dose escalation in psoriasis.

Commissioned by the ICB under High Cost Drugs Pathway for Psoriasis 

• Patients ≤ 100 kg - Ustekinumab 45 mg SC every 12 weeks (licensed dose) may be increased to a maximum of 90 mg every 8 weeks

• Patients >100kg - Ustekinumab 90 mg every 12 weeks (licensed dose) may be increased to a maximum of 90 mg every 8 weeks

  Solution for injection
Stelara (Janssen-Cilag Ltd) On Formulary
Skin / Urticaria
  acrivastine Off Formulary
  alimemazine tartrate Off Formulary
  desloratadine Off Formulary
  fexofenadine hydrochloride On Formulary
  levocetirizine hydrochloride Off Formulary
  loratadine On Formulary
  Oral solution
Loratadine (Non-proprietary) On Formulary
  mizolastine Off Formulary
  omalizumab Hospital Only NICE TA278
NICE TA339
  Solution for injection
Xolair (Novartis Pharmaceuticals UK Ltd) On Formulary
OMALIZUMAB

Only approved for specialist commissioned centres as per NHS specialist commissioning (currently approved centres are Barts Health, Royal Brompton and Guy's & St Thomas' for asthma and Barts Health is one of the centres for Chronic Spontaneous Urticaria)


  promethazine hydrochloride On Formulary
  Solution for injection
Phenergan (Sanofi Consumer Healthcare) On Formulary
  rupatadine Off Formulary
Skin / Skin cleansers, antiseptics and desloughing agents
  chlorhexidine On Formulary
  chlorhexidine gluconate with isopropyl alcohol Off Formulary
  chlorhexidine with cetrimide Off Formulary
  diethyl phthalate with methyl salicylate Off Formulary
  hydrogen peroxide On Formulary
  potassium permanganate On Formulary
  Tablet for cutaneous solution
Potassium permanganate (Non-proprietary) On Formulary
Permitabs (Alliance Pharmaceuticals Ltd) On Formulary
  povidone-iodine Off Formulary
  proflavine Off Formulary
Skin / Minor cuts and abrasions
  glycerol with magnesium sulfate and phenol Off Formulary
Skin / Pruritus
  alimemazine tartrate Off Formulary
  calamine with zinc oxide Off Formulary
  cetirizine hydrochloride On Formulary
  Oral solution
Cetirizine hydrochloride (Non-proprietary) On Formulary
  chlorphenamine maleate On Formulary
  Oral solution
Chlorphenamine maleate (Non-proprietary) On Formulary
  Solution for injection
Chlorphenamine maleate (Non-proprietary) On Formulary
  coal tar with calamine Off Formulary
  crotamiton On Formulary
  difelikefalin On Formulary NICE TA890
NICE TA 890 - September 2023 - Difelikefalin for treating pruritus in people having haemodialysis

​​Difelikefalin​ approved at NEL FPG for treating pruritus in people having haemodialysis in line with NICE TA.

  doxepin On Formulary
  hydroxyzine hydrochloride On Formulary
  levocetirizine hydrochloride Off Formulary
  levomenthol On Formulary
Skin / Bacterial skin infections
  metronidazole On Formulary
  mupirocin On Formulary
  neomycin sulfate Off Formulary
  silver sulfadiazine On Formulary
Skin / Fungal skin infections
  amorolfine
  Medicated nail lacquer
Amorolfine (Non-proprietary) Off Formulary
Loceryl (Galderma (UK) Ltd) Off Formulary
  benzoic acid with salicylic acid Off Formulary
  chlorhexidine with nystatin On Formulary
  clotrimazole On Formulary
  Liquid
Canesten (Bayer Plc) On Formulary
  Spray
Canesten (Bayer Plc) On Formulary
  econazole nitrate Off Formulary
  griseofulvin On Formulary
  hydrocortisone with clotrimazole On Formulary
  ketoconazole On Formulary
  miconazole On Formulary
  Spray
Daktarin (Johnson & Johnson Ltd) On Formulary
  terbinafine On Formulary
  tioconazole Off Formulary
  undecenoic acid with zinc undecenoate Off Formulary
Skin / Parasitic skin infections
  benzyl benzoate Off Formulary
  dimeticone Off Formulary
  malathion On Formulary
  permethrin On Formulary
Skin / Viral skin infections
  aciclovir On Formulary
Skin / Depigmentation
  Hydroquinone On Formulary
  Isotretinoin- Isotrex gel On Formulary
  Monobenzone 20% cream Hospital Only
Monobenzone 20% - 40% depigmenting cream

Available from GSTT NHS Trust as a special order: obtain approval from dermatology pharmacist

Also known as mono benzyl ether of hydroquinone - usual base is cetomacrogol cream

  Pigmanorm Hospital Only
  Tretinoin- Retin A On Formulary
  adapalene- Differin On Formulary