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Herefordshire & Worcestershire
Medicines and Prescribing Committee
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 Formulary Chapter 13: Skin - Full Chapter
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13.01  Management of skin conditions
13.02  Emollient and barrier preparations
13.02.01  Emollients
Epimax® Isomol Gel
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Formulary
Green

First choice emollient gel

Less excipients than Doublebase® gel

 
 
Epimax® Ointment
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Formulary
Green

First choice emollient ointment

Equivalent to Epaderm® ointment and similar to Hydromol® ointment

 
 
Epimax® Original Cream
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Formulary
Green

First choice emollient cream

Equivalent to Diprobase®

 
 
QV® Lotion 
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Formulary
Green

First choice emollient lotion

 
 
Aproderm®
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Formulary
Green

Cream and gel only

 
 
Cetraben®
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Formulary
Green

Lotion and ointment only

 
 
DoubleBase Dayleve®
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Formulary
Green
 
 
Emulsifying ointment
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Formulary
Green
 
 
Epimax® ExCetra Cream
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Formulary
Green

Equivalent to Cetraben®

 
 
Epimax® Oatmeal Cream
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Formulary
Green
 
 
Epimax® Paraffin-Free Ointment
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Formulary
Green
 
 
Hydromol® Ointment
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Formulary
Green
 
 
Liquid and White Soft Paraffin Ointment (50:50)
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Formulary
Green
 
 
Oilatum® Cream
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Formulary
Green
 
 
QV® Cream
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Formulary
Green
 
 
QV® Intensive Ointment
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Formulary
Green
 
 
Ultrabase® cream
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Formulary
Green
 
 
ZeroAQS® Cream
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Formulary
Green

Similar to Aqueous Cream. SLS free.

 
 
Zerobase® Cream
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Formulary
Green

Similar to Diprobase®

 
 
Zeroderm® Ointment
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Formulary
Green

Similar to Epaderm® and Hydromol® ointments

 
 
Zerodouble® Gel
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Formulary
Green

Equivalent to Doublebase® Gel

 
 
Emollin® spray
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Formulary
Green

Only to be prescribed for very painful / fragile skin where "hands on" application of creams or ointments is difficult 

 
 
13.02.01  Emollients - preparations containing urea
ImuDERM®
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Formulary
Green

First choice emollient containing urea

Contains urea 5% and glycerol 5%

 
 
Balneum® Cream
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Formulary
Green

Contains urea 5% and ceramide 0.1%

 
 
Dermatonics Once Heel Balm®
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Formulary
Green

Contains 25% urea

 
 
Flexitol® 10% Urea Cream
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Formulary
Green

Contains urea 10%

 
 
13.02.01  Emollients - with antimicrobials to top
Dermol 500® Lotion
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Formulary
Green

Contains benzalkonium chloride 0.1% & chlorhexidine hydrochloride 0.1%

 
 
Dermol® Cream
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Formulary
Green

Contains benzalkonium chloride 0.1% & chlorhexidine hydrochloride 0.1%

 
 
13.02.01.01  Emollient bath and shower preparations
 note 
  • Bath and shower preparations for any new patient should not be initiated.
  • Existing patients - deprescribe bath and shower preparations and substitute with "leave-on" emollients.
13.02.02  Barrier preparations
Medi Derma-S® barrier cream
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Formulary
Green
 
 
MediHoney® barrier cream
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Formulary
Green
 
 
13.03  Topical local anaesthetics and antipruritics
Crotamiton (Eurax®)
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Formulary
Green
 
 
Menthol in aqueous cream (Dermacool®, Menthoderm®)
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Formulary
Green

PRESCRIBE BY BRAND

Strengths available by brand:

  • Dermacool®: 0.5%, 1%, 2%, 5%
  • Menthoderm®: 0.5%, 1%, 2%
 
 
13.04  Topical corticosteriods.
 note 

Prescribe steroid ointments rather than creams as ointments are oil based and contain fewer preservatives than creams. Creams can be used for weeping eczema or on the face.

Use antibacterials or antifungals with corticosteroids only where inflammatory skin conditions are associated with bacterial or fungal infection, but not as combination preparations.  If no visible signs of infection, use of antibiotics with steroids encourages resistance and does not improve healing.

Hydrocortisone 0.5% or 1%
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Formulary
Green

Potency: MILD

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

 
Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for CCGs
 
Betamethasone valerate 0.025% RD (Betnovate RD®)
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Formulary
Green

Potency: MODERATE

 
 
Clobetasone butyrate 0.05% (Eumovate®)
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Formulary
Green

Potency: MODERATE

 
 
Fludroxycortide tape
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Formulary
Green

Potency: MODERATE

The brand Haelan® has been discontinued.

PRESCRIBE BY GENERIC NAME

 
 
Betamethasone valerate 0.1% (Betacap®, Betnovate®, Bettamousse®)
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Formulary
Green

Potency: POTENT

Cream, ointment, scalp application and cutaneous foam

 
 
Betamethasone valerate medicated plasters (Betesil®)
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Formulary
Green

Potency: POTENT

 
 
Fluocinolone acetonide 0.025% (Synalar®)
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Formulary
Green

Potency: POTENT

 
 
Fluocinonide 0.05% (Metosyn®)
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Formulary
Green

Potency: POTENT

 
 
Hydrocortisone butyrate (Locoid®)
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Formulary
Green

Potency: POTENT

 
 
Mometasone furoate 0.1%
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Formulary
Green

Potency: POTENT

PRESCRIBE BY GENERIC NAME

 
 
Clobetasol propionate 0.05% (Dermovate®, Etrivex®)
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Formulary
Green

Potency: VERY POTENT

Cream, ointment, scalp application and shampoo

 
 
13.05  Preparations for eczema and psoriasis to top
13.05.01  Oral retinoid for eczema
Alitretinoin capsules (Toctino®)
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Formulary
Red

In line with NICE TA177; commissioned by the CCG

Should only be prescribed by Consultant Dermatologist or GPSI only

 
Link  MHRA Drug Safety Alert (Jun 19): Oral retinoid medicines▼: revised and simplified pregnancy prevention educational materials for healthcare professionals and women
Link  NICE TA177 Alitretinoin for the treatment of severe chronic hand eczema
 
13.05.02  Preparations for psoriasis
Psoralen
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Formulary
Red
 
 
13.05.02  Topical preparations for psoriasis
Calcipotriol ointment (Dovonex®)
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Formulary
Green

First choice topical Vitamin D analogue

 
 
Calcitriol ointment (Silkis®)
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Formulary
Green

Second choice topical Vitamin D analogue

 
 
Calcipotriol with betamethasone ointment  (Dovobet® ointment)
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Formulary
Green

First choice combination preparartion of calcipotriol and betamethasone

Review regularly. Max 15g / day.

 
 
Calcipotriol with betamethasone topical foam  (Enstilar®)
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Formulary
Green

Second choice combination preparartion of calcipotriol and betamethasone

• In line with local psoriasis guidance; the use of a combined vitamin D analogue and corticosteroid preparation should be considered for psoriasis affecting large areas of the body.
• Psoriasis affecting smaller areas such as the scalp, face, flexures or genitals should be managed with a short term topical corticosteroid.

 
 
Calcipotriol with betamethasone scalp gel (Xamiol®, Dovobet gel®)
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Formulary
Green

Use after failure of first-line treatments.

 
 
Coal Tar 5% Lotion (Exorex®)
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Formulary
Green
 
 
Coal tar 12%, sulphur 4% & salicylic acid 2% ointment (Sebco®)
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Formulary
Green

Note: Sebco® same formula as Cocois® but less expensive

 
 
13.05.02  Oral retinoids for psoriasis
Acitretin capsules (Neotigason®)
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Formulary
Red

Should only be prescribed within secondary care under the lead of a Consultant Dermatologist

 
Link  MHRA Drug Safety Alert (Jun 19): Oral retinoid medicines▼: revised and simplified pregnancy prevention educational materials for healthcare professionals and women
 
13.05.03  Drugs affecting the immune response to top
Pimecrolimus cream (Elidel® cream)
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Formulary
Amber

In line with NICE TA82; commissioned by the CCG
On recommendation of Dermatology Specialist only; GPs may issue first prescription.

 
Link  NICE TA82 Tacrolimus and pimecrolimus for atopic eczema
 
Tacrolimus ointment (Protopic® ointment)
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Formulary
Amber

In line with NICE TA82; commissioned by the CCG
On recommendation of Dermatology Specialist only; GPs may issue first prescription.

 
Link  NICE TA82 Tacrolimus and pimecrolimus for atopic eczema
 
Cytotoxic Drug Methotrexate tablets
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Formulary
Amber with Shared Care

For initiation by Dermatology Specialist only.

Only 2.5mg tablets should be prescribed and dispensed to avoid potentially fatal errors.

 
Link  Drug Safety Update (Sept 20): Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing
 
Cytotoxic Drug Methotrexate subcutaneous injection  (Metoject®)
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Formulary
Amber with Shared Care

For initiation by Dermatology Specialist only.

 
 
Cytotoxic Drug Azathioprine tablets
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Formulary
Amber with Shared Care

For initiation by Dermatology Specialist only.

 
 
Ciclosporin capsules (Neoral®)
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Formulary
Amber with Shared Care

For initiation by Dermatology Specialist only.

Note prescribing by brand not necessary for dermatology indications.  For use post transplant see section 8.2.2

 
 
Mycophenolate mofetil tablets / capsules
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Formulary
Amber with Shared Care

For initiation by Dermatology Specialist only.

For dermatomyocitis, polymyocitis, psoriasis, atopic dermatitis, autoimmune bullous dermatoses incl pemphigus - all unlicensed indications.  For use post transplant see section 8.2.1.

 
Link  Drug Safety Update (Feb 2018): Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients
Link  Drug Safety Update (Dec 2015): Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men
 
Adalimumab
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Formulary
Red

In line with NICE TA146 and TA199; commissioned by the CCG

NHS England commissioned when used Behcets Sydrome, Hiradenitis Suppurativa and Uveitis - Specialist Centre prescribing only

 
Link  NICE TA146 Adalimumab for the treatment of psoriasis
Link  NICE TA199 Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
 
Apremilast (Otezla® )
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Formulary
Red

In line with NICE TA419 and TA433; commissioned by the CCG

 
Link  MHRA Drug Safety Update (Jan 17): Apremilast (Otezla®▼): risk of suicidal thoughts and behaviour
Link  NICE TA419 Apremilast for treating moderate to severe plaque psoriasis
Link  NICE TA433 Apremilast for treating active psoriatic arthritis
 
Brodalumab (Kyntheum®)
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Formulary
Red

In line with NICE TA511; commissioned by the CCG

 
Link  NICE TA511 Brodalumab for treating moderate to severe plaque psoriasis
 
Certolizumab pegol (Cimzia®)
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Formulary
Red

In line with NICE TA445 and TA574; commissioned by the CCG

 
Link  NICE TA445 Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
Link  NICE TA574 Certolizumab pegol for treating moderate to severe plaque psoriasis
 
Dimethyl fumarate (Skilarence®)
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Formulary
Red

In line with NICE TA475; commissioned by the CCG

NHS England is responsible commissioner for Multiple Sclerosis

 
Link  NICE TA475 Dimethyl fumarate for treating moderate to severe plaque psoriasis
 
Dupilumab (Dupixent®)
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Formulary
Red

In line with NICE TA534; commissioned by the CCG

NHS England is the responsible commissioner for use in asthma through the IFR process - Specialist Centre prescribing only

 
Link  NICE TA534 Dupilumab for treating moderate to severe atopic dermatitis
 
Etanercept
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Formulary
Red

In line with NICE TA103 and TA199; commissioned by the CCG

 
Link  NICE TA103 Etanercept for the treatment of adults with psoriasis
Link  NICE TA199 Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
 
Guselkumab (Tremfya®)
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Formulary
Red

In line with NICE TA521; commissioned by the CCG

 
Link  NICE TA521 Guselkumab for treating moderate to severe plaque psoriasis
 
Infliximab infusion
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Formulary
Red

In line with NICE TA134 and TA199; commissioned by the CCG

  • NHS England is responsible commissioner for JIA and Crohn's disease in children. 
  • NHS England is responsible commissioner for uveitis, connective tissue disease - interstital lung disease, graft versus host disease, renal, pulmonary sarcoidosis, hidradenitis suppurativa and Behcet's syndrome use through the IFR process - Specialist Centre Prescribing Only.
 
Link  NICE TA134 Infliximab for the treatment of adults with psoriasis
Link  NICE TA199 Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
 
Ixekizumab (Taltz®)
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Formulary
Red

In line with NICE TA442 and TA537; commissioned by the CCG

 
Link  NICE TA442 Ixekizumab for treating moderate to severe plaque psoriasis
Link  NICE TA537 Ixekizumab for treating active psoriatic arthritis after inadequate response to DMARDs
 
Risankizumab (Skyrizi®)
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Formulary
Red

In line with NICE TA596; commissioned by the CCG

 
Link  NICE TA596 Risankizumab for treating moderate to severe plaque psoriasis
 
Secukinumab (Cosentyx®)
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Formulary
Red

In line with NICE TA350 and TA445; commissioned by the CCG

 
Link  NICE TA350 Secukinumab for treating moderate to severe plaque psoriasis
Link  NICE TA445 Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
 
Tildrakizumab (Ilumetri®)
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Formulary
Red

In line with NICE TA575; commissioned by the CCG

 
Link  NICE TA575 Tildrakizumab for treating moderate to severe plaque psoriasis
 
Ustekinumab infusion / subcutaneous (Stelara®)
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Formulary
Red

In line with NICE TA180 and TA340; commissioned by the CCG

Commissioned by NHSE when used for Paediatric indications.

 
Link  NICE TA180 Ustekinumab for the treatment of adults with moderate to severe psoriasis
Link  NICE TA340 Ustekinumab for treating active psoriatic arthritis
 
13.06  Acne and rosacea
13.06.01  Topical preparations for acne
 note 

Resistance of P.acnes to both topical and oral antibiotics is rapidly developing. Topical antibiotics should not be used as monotherapy.

13.06.01  Benzoyl peroxide and azelaic acid
Benzoyl Peroxide gel
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Formulary
Green

PREFERRED BRAND: Acnecide

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

 
Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
 
Azelaic acid 20% cream (Skinoren®)
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Formulary
Green

Acne vulgaris - PRESCRIBE BY BRAND and STRENGTH

Most cost-effective strength

 
 
Azelaic Acid 15% gel (Finacea®)
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Formulary
Green

Facial acne vulgaris, papulopustular rosacea

 
 
13.06.01  Topical antibacterials for acne
Benzoyl Peroxide 5% with Clindamycin 1% Gel (Duac® )
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Formulary
Green
 
 
13.06.01  Topical retinoids and related preparations for acne to top
Adapalene (Differin®)
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Formulary
Green
 
 
Adapalene 0.1%, benzoyl peroxide 2.5% gel (Epiduo®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
 
Tretinoin 0.025%, clindamycin 1% gel (Treclin®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
 
13.06.02  Oral preparations for acne
13.06.02  Oral antibiotics for acne
Doxycycline
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Formulary
Green
 
 
Lymecycline
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Formulary
Green
 
 
Oxytetracycline
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Formulary
Green
 
 
13.06.02  Hormone treatment for acne
Co-cyprindiol 2000/35
(Cyproterone Acetate 2mg with Ethinylestradiol 35micrograms)

View adult BNF View SPC online View childrens BNF
Formulary
Green

PRESCRIBE BY GENERIC NAME and not brand Dianette®

 
Link  Drug Safety Update (Jun 20): Cyproterone acetate - new advice to minimise risk of meningioma
 
13.06.02  Oral retinoid for acne
Isotretinoin (Roaccutane®)
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Formulary
Red

Should only be prescribed within secondary care under the lead of a Consultant Dermatologist.

 
Link  MHRA Drug Safety Alert (Jun 19): Oral retinoid medicines▼: revised and simplified pregnancy prevention educational materials for healthcare professionals and women
Link  MHRA Drug Safety Update (Aug 20): Isotretinoin (Roaccutane▼): reminder of important risks and precautions
 
13.06.03  Rosacea to top
13.06.03  Papulopustular rosacea
Ivermectin cream (Soolantra®)
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Formulary
Green

Only consider as an option in patients where topical metronidazole and/or azelaic acid gel are ineffective or not tolerated.

 
 
13.07  Preparations for warts and calluses
 note 

For most people there is a strong case for not treating warts or verrucae.  Most cutaneous warts resolve spontaneously within months or, at the most, within 2 years.  Treatment may be prolonged and can have adverse effects.

13.07  Anogenital warts
Podophyllotoxin (Warticon®)
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Formulary
Green

For the topical treatment of anogenital warts affecting the penis or the external female genitalia only.  Refer to Sexual Health Clinic for advice.

 
 
Imiquimod 5% cream (Aldara®)
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Formulary

Red Secondary care use only for patients with external anogenital warts

Amber For use in basal cell carcinoma

Green For use in actinic keratosis

 
 
13.08  Sunscreens and camouflagers
13.08.01  Sunscreen preparations to top
Sunscreens - Borderline Substances
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Restricted Drug Restricted
Green

The British Association of Dermatology (BAD) recommend amongst their top sun safety tips for EVERYONE as standard that:

  • Skin should be protected with clothing, including a hat, t-shirt and sunglasses
  • Time should be spent in the shade between 11am and 3pm when it’s sunny
  • A ‘high protection’ sunscreen of at least SPF 30 which also has high UVA protection should be used, making sure it is applied generously and frequently when in the sun.

Most people prevent symptoms of sunburn developing with the routine use of sun protection with products that can easily be bought over the counter (OTC) in a pharmacy or supermarket.   The Medicines and Prescribing Committee does not support the prescribing of sunscreen preparations for routine use for the protection against the harmful effects of ultraviolet radiation.

A prescription for sun protection should not routinely be offered in primary care as the condition is appropriate for self-care.  Patients requesting a prescription for a sunscreen should be assessed on a case by case basis following a clinical consultation and in conjunction with Advisory Committee on Borderline Substances (ACBS) criteria.  Sunscreens approved for use by the ACBS and listed in the ‘Borderline Substances’ section of the British National Formulary (BNF) may ONLY be prescribed for skin protection against UV radiation in abnormal cutaneous photosensitivity.  Certain medicines may cause photosensitivity, however not all patients taking these medications will have photosensitivity and need sunscreen routinely prescribed. 

 
 
13.08.01  Photodamage
Cytotoxic Drug Fluorouracil 0.5%, salicylic acid 10% solution (Actikerall®)
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Formulary
Green
 
 
Cytotoxic Drug Fluorouracil 5% cream (Efudix®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
 
Imiquimod 5% cream (Aldara®)
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Formulary

Red Secondary care use only for patients with external anogenital warts

Amber For use in basal cell carcinoma

Green For use in actinic keratosis

 
 
13.08.02  Camouflagers
13.09  Shampoos and other preparations for scalp and hair conditions
 note 

Patients should be advised to buy shampoos over the counter for dandruff, defined as mild scaling of the scalp without itching, in line with NHS England recommendations for 'conditions for which over the counter items should not routinely be prescribed in primary care'.

Capasal® Shampoo
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Formulary
Green

Contains distilled coal tar, salicylic acid and coconut oil

 
 
Ketoconazole 2% Shampoo
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Formulary
Green

For pityriasis versicolor in line with local H&W Guidelines for Primary Care Antimicrobial Prescribing.

Contains ketoconazole

PRESCRIBE BY GENERIC NAME 

 
 
Selsun® Shampoo
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Formulary
Green

Contains selenium sulphide

 
 
13.09  Hirsutism
13.09  Androgenetic alopecia to top
13.10  Anti-infective skin preparations
13.10.01  Antibacterial preparations
13.10.01.01  Antibacterial preparations only used topically
Fusidic Acid 2% (Fucidin®)
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Formulary
Green

To be used in line with local H&W Guidelines for Primary Care Antimicrobial Prescribing.

Not for repeated use

 
Link  Herefordshire and Worcestershire Guidelines for Primary Care Antimicrobial Prescribing
 
Metronidazole 0.75% gel (Anabact®)
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Formulary
Green

PRESCRIBE ONLY 15g and by BRAND.

Only licensed indication(s) fungating tumours, gravitational ulcers and decubitus ulcers.

 

 
 
Metronidazole 0.75% gel (Metrogel®)
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Formulary
Green

PRESCRIBE BY BRAND

Quantity available 40g

Licensed indications are:

  • For the treatment of acute inflammatory exacerbation of rosacea.
  • For fungating tumours.
 
 
Metronidazole 0.75% cream (Rozex®)
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Formulary
Green

PRESCRIBE BY BRAND.

Most cost effective choice of topical metronidazole for the treatment of  Rosacea.

 
 
Mupirocin ointment/cream (Bactroban®)
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Formulary
Green

To be used in line with local H&W Guidelines for Primary Care Antimicrobial Prescribing.

 
Link  Herefordshire and Worcestershire Guidelines for Primary Care Antimicrobial Prescribing
 
13.10.01.02  Antibacterial preparations also used systemically
13.10.02  Antifungal preparations to top
Clotrimazole cream
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Formulary
Green

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

 
Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
 
Amorolfine 5% nail lacquer
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Formulary
Green

Prescribe by GENERIC NAME

In line with local H&W Guidelines for Primary Care Antimicrobial Prescribing.  Topical treatment is expensive and only appropriate where infection is limited to distal end of nails.

Products may be purchased OTC from community pharmacies according to license

 
 
Griseofulvin tablets
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Formulary
Amber

Tinea Capitis on specialist advice only

 
 
Miconazole nitrate cream
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Formulary
Green

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

 
Link  MHRA Drug Safety Update (June 2016): Topical miconazole, including oral gel: reminder of potential for serious interactions with warfarin
Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
 
Terbinafine Hydrochloride 1% cream (Lamisil®)
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Formulary
Green

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

 
Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
 
13.10.03  Antiviral preparations
Aciclovir 5% cream
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Formulary
Green

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

 
Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
 
13.10.04  Parasiticidal preparations
 note 

A prescription for head lice treatment should not routinely be offered in primary care as the condition is appropriate for self-care. 

13.10.04  Scabies
Permethrin 5% (Lyclear® Dermal Cream)
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Formulary
Green

First choice

 
 
Malathion 0.5% (Derbac-M®)
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Formulary
Green

Second choice

Patients with conditions appropriate for self-care i.e. headlice should be advised to buy over the counter, in line with NHSE guidance.

 
Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
 
13.10.05  Preparations for minor cuts and abrasions
13.11  Skin cleansers, antiseptics, and desloughing agents to top
13.11.01  Alcohols and saline
13.11.02  Chlorhexidine salts
Octenisan®
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Formulary
Green

In line with local H&W Guidelines for Primary Care Antimicrobial Prescribing:

  • Antimicrobial wash lotion for MRSA skin carriage for 5 days.
  • MD nasal gel for use as a first line alternative option at times there is a national shortage of Bactroban® (mupirocin) 2% nasal ointment.
 
 
13.11.03  Cationic surfactants and soaps
13.11.04  Iodine and Chlorine
13.11.05  Phenolics to top
13.11.06  Oxidisers, and dyes
Potassium Permanganate (Permitabs®)
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Formulary
Green

For potassium permanganate soaks for weeping hand and/or foot eczema only. Maximum use 1-2 weeks

 
 
13.11.07  Desloughing agents
13.12  Antiperspirants
13.13  Topical circulatory preparations
 ....
 Non Formulary Items
Aluminimum Salts  (Anhydrol Forte®, Driclor®, ZeaSORB®)

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Non Formulary

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
Aqueous Cream BP

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Non Formulary

ZeroAQS® is an alternative formulary preparation

Barrier preparation  (Sudocrem®)

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Non Formulary

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
Betamethasone (as Dipropionate) 0.05% with clotrimazole 1%  (Lotriderm®)

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Non Formulary

The use of topical antifungal preparations with corticosteroids is not recommended


Combination preparations are licensed to be used once or twice a day for a maximum of 7 days, but topical antifungal treatment is usually required for a longer period.

Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 3%  (Diprosalic®)

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Non Formulary

The use of topical antibiotic and corticosteroid combination products are not routinely recommended.


There is a lack of evidence from controlled trials to support the use of topical antibiotics to treat infected atopic eczema.

Betamethasone valerate 0.1% with Clioquinol  (Betnovate-C®)

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Non Formulary

The use of topical antifungal preparations with corticosteroids is not recommended


Combination preparations are licensed to be used once or twice a day for a maximum of 7 days, but topical antifungal treatment is usually required for a longer period.

Betamethasone valerate 0.1% with Fucidic Acid 2%  (Fucibet®)

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Non Formulary

The use of topical antibiotic and corticosteroid combination products are not routinely recommended.


There is a lack of evidence from controlled trials to support the use of topical antibiotics to treat infected atopic eczema.

Brimonidine tartrate 5mg/g gel  (Mirvaso®)

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Non Formulary
Link  MHRA Drug Safety Update (Nov 16): Brimonidine gel (Mirvaso): Risk of Exacerbation of Rosacea
Link  MHRA Drug Safety Update (Oct 16): Etoricoxib (Arcoxia): revised dose recommendation for rheumatoid arthritis and ankylosing spondylitis
Calmurid®

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Non Formulary

ImuDERM® is an alternative formulary urea (5%) product

Clindamycin 1% topical lotion/solution  (Dalacin T®)

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Non Formulary
Clobetasone Butyrate 0.05%, Oxytetracycline 3%, Nystatin 100,000 units/g  (Trimovate®)

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Non Formulary

The use of combination products are not routinely recommended.

Coal Tar Solution, Arachis (peanut) oil extract of Coal Tar, Tar, Cade Oil, Liquid Paraffin  (Polytar Emollient®)

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Non Formulary
Coconut Oil Compound Ointment  (Cocois®)

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Non Formulary
Diclofenac 3% gel  (Solaraze Gel)

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Non Formulary First line option: Efudix (Local Dermatologist recommendation).
Diprobase®

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Non Formulary

Zerobase® is an alternative formulary preparation

Dithranol  (Micanol®, Psorin®)

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Non Formulary

Includes cream, ointment and paste formulations.

DoubleBase®

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Non Formulary

Isomol® gel is an alternative formulary preparation

Econazole Nitrate  (Pevaryl®)

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Non Formulary
Eflornithine  (Vaniqa®)

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Non Formulary
Link  Eflornithine (Vaniqa®) cream for facial hirsutism - Position Statement
Emollient Bath Additive or Shower Gel

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Non Formulary

Should not be routinely be prescribed in primary care, in line with national NHSE&I guidance.

Link  NHS England: Items which should not be routinely prescribed in primary care
Epaderm®

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Non Formulary

Epimax® ointment and Zeroderm® are alternative formulary preparations

Erythromycin solution with zinc  (Zineryt®)

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Non Formulary Prescribing of topical erythromycin (Zineryt®) is no longer supported because it has been associated with increased levels of antibiotic resistance
Finasteride  (Propecia®)

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Non Formulary

Finasteride is not prescribable in NHS primary care for the treatment of androgenetic alopecia in men.

Flucinolone Acetonide 0.025% with Neomycin Sulphate 0.5%  (Synalar N®)

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Non Formulary

The use of topical antibiotic and corticosteroid combination products are not routinely recommended.


There is a lack of evidence from controlled trials to support the use of topical antibiotics to treat infected atopic eczema.

Formaldehyde  (Veracur®)

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Non Formulary

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

Link  NHSE: Conditions for which over the counter items should not routinely be prescribed in primary care
Glutaraldehyde  (Glutarol®)

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Non Formulary

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

Link  NHSE: Conditions for which over the counter items should not routinely be prescribed in primary care
Heparinoid 0.3%  (Hirudoid®)

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Non Formulary
Hydrocortisone 0.5%, Nystatin 100,000 units/g
Benzalkonium Chloride Solution 0.2%, Dimeticone 350 10%
 (Timodine®)

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Non Formulary

The use of topical antifungal preparations with corticosteroids is not recommended


Combination preparations are licensed to be used once or twice a day for a maximum of 7 days, but topical antifungal treatment is usually required for a longer period.

Hydrocortisone 1% & urea 10%  (Hydromol® HC Intensive)

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Non Formulary
Hydrocortisone 1% with Clotrimazole 1%  (Canesten HC®)

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Non Formulary

The use of topical antifungal preparations with corticosteroids is not recommended


Combination preparations are licensed to be used once or twice a day for a maximum of 7 days, but topical antifungal treatment is usually required for a longer period.

Hydrocortisone 1% with Miconazole Nitrate 2%  (Daktacort®)

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Non Formulary

The use of topical antifungal preparations with corticosteroids is not recommended


Combination preparations are licensed to be used once or twice a day for a maximum of 7 days, but topical antifungal treatment is usually required for a longer period.

Link  MHRA Drug Safety Update (June 2016): Topical miconazole, including oral gel: reminder of potential for serious interactions with warfarin
Hydrocortisone 1% with Nystatin and Chlorhexidine Acetate  (Nystaform-HC®)

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Non Formulary

The use of combination products are not routinely recommended.

Hydrocortisone 1% with Urea 10%  (Alphaderm®)

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Non Formulary Potency: MILD
Hydrocortisone Acetate 1% with Fusidic Acid 2%  (Fucidin H®)

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Non Formulary

The use of topical antibiotic and corticosteroid combination products are not routinely recommended.


There is a lack of evidence from controlled trials to support the use of topical antibiotics to treat infected atopic eczema.

Hydrogen Peroxide Solution BP

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Non Formulary
Hydrous ointment

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Non Formulary

Epimax® ointment and Zeroderm® are alternative formulary preparations

Ichthammol

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Non Formulary

All ichthammol containing products; including bandages, ointment and paste

Imiquimod 3.75% cream  (Zyclara®)

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Non Formulary
Ketoconazole cream  (Nizoral®)

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Non Formulary
Magnesium Sulphate Paste BP

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Non Formulary
Minoxidil  (Regaine®)

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Non Formulary
Nystatin 100,000 units/g with Chlorhexidine Hydrochloride 1%  (Nystaform®)

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Non Formulary

The use of combination products are not routinely recommended.

Penciclovir

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Non Formulary
Potassium hydroxide 5% soln  (MolluDab®)

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Non Formulary
Potassium Permanganate Solution

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Non Formulary
Povidone-Iodine

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Non Formulary
Povidone-Iodine  (Savlon® Dry Antiseptic)

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Non Formulary
Povidone-Iodine  (Videne®)

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Non Formulary
Salicylic acid

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Non Formulary

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.


Salicylic containing cutaenous treatments; including Cuplex®, Duofilm®, Occlusal®, Phytex®, Salactol®, Salatac®, Verrugon®

Link  NHSE : Conditions for which over the counter items should not routinely be prescribed in primary care
Salicylic Acid  (Zinc and Salicylic Acid Paste BP)

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Non Formulary
Salicylic Acid 3% w/w, Sulphur 3% w/w in Aqueous Cream

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Non Formulary
Salicylic Acid in White Soft Paraffin

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Non Formulary
Shampoo  (Alphosyl®, Betadine®, Ceanel Concentrate®, Clinitar®, Dermax®, Meted®, Pentrax®,Polytar®, Polytar Plus®, Psoriderm®, T/Gel®)

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Non Formulary
Sodium Chloride

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Non Formulary

Brands including Flowfuser®, Irriclens®, Miniversol®, Normasol®, Stericlens®, Steripod®

Tacalcitol  (Curatoderm®)

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Non Formulary
Tars

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Non Formulary

Including brands Calamine and Coal Tart Ointment, Clinitar®, Coal Tar Solution BP, Coal Tar and Salicylic Acid Ointment, Coal Tar Paste BP, Pinetarsol®, Psoriderm®, Zinc and Coal Tar Paste®

Tazarotene 0.05% Gel  (Zorac®)

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Non Formulary
Tioconazole  (Trosyl®)

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Non Formulary
Tretinoin 0.025%, erythromycin 4% solution  (Aknemycin® Plus)

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Non Formulary
Triclosan

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Non Formulary
Zinc and Caster Oil Ointment BP

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Non Formulary

Patients with conditions appropriate for self-care should be advised to buy over the counter, in line with NHSE guidance.

Link  NHSE Guidance: Conditions for which over the counter items should not routinely be prescribed in primary care
  
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
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

Secondary care only, not to be prescribed in primary care.   

Amber 2

Specialist initiation with shared care guidance Medicines which should be initiated in secondary care by the specialist with follow-on prescription and monitoring according to a specific Shared Care (SC) Guideline. Prescribing may be continued in primary care in line with a shared care guideline   

Amber with Shared Care

Specialist initiation with shared care guidance Medicines which should be initiated in secondary care by the specialist with follow-on prescription and monitoring according to a specific Shared Care (SC) Guideline. Prescribing may be continued in primary care in line with a shared care guideline   

Amber

Considered suitable for primary care prescribing following specialist initiation/recommendation.  

Green

Considered appropriate for prescribing in both secondary and primary care. Suitable for initiation in primary care.   

netFormulary