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Herefordshire & Worcestershire
Medicines and Prescribing Committee
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 Formulary Chapter 13: Skin - Full Chapter
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13.06.01  Expand sub section  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  Expand sub section  Benzoyl peroxide and azelaic acid
Benzoyl Peroxide gel
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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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Green

Acne vulgaris - PRESCRIBE BY BRAND and STRENGTH

Most cost-effective strength

 
 
Azelaic Acid 15% gel (Finacea®)
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Green

Facial acne vulgaris, papulopustular rosacea

 
 
13.06.01  Expand sub section  Topical antibacterials for acne
Benzoyl Peroxide 5% with Clindamycin 1% Gel (Duac® )
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Green
 
 
13.06.01  Expand sub section  Topical retinoids and related preparations for acne
Adapalene (Differin®)
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Green
 
 
Adapalene 0.1%, benzoyl peroxide 2.5% gel (Epiduo®)
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Tretinoin 0.025%, clindamycin 1% gel (Treclin®)
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 ....
 Non Formulary Items
Clindamycin 1% topical lotion/solution  (Dalacin T®)

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

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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
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Link to adult BNF
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Link to children's BNF
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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.   

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