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Herefordshire & Worcestershire
Medicines and Prescribing Committee
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 Formulary Chapter 3: Respiratory system - Full Chapter
Notes:
Osmohale as been approved as a standardised BHR challenge test in secondary care in line with the product's marketing authorisation in the Summary of Product Characteristics (SPC)
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03.01.02  Expand sub section  Antimuscarinic bronchodilators
Aclidinium (Eklira®Genuair)
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Formulary
Green

Approved for the maintenance treatment of COPD; to be considered as a twice daily option when initiating treatment for a new patient.

PRESCRIBE BY BRAND

 
 
Glycopyrronium
(Seebri® Breezhaler)
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Formulary
Green

Approved for the maintenance treatment of COPD; to be considered as a daily option when initiating treatment for a new patient.

PRESCRIBE BY BRAND

 
 
Tiotropium (Spiriva Respimat®)
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Formulary
Green

For COPD & asthma

COPD:To be considered as a daily option when initiating treatment for a new patient where a dry powder inhaler is not suitable.

Asthma:Recommended as adjunctive treatment at BTS specialist therapies step.  

PRESCRIBE BY BRAND

 
 
Umeclidinium
(Incruse ® Ellipta)
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Formulary
Green

Approved for the maintenance treatment of COPD; to be considered as a daily option when initiating treatment for a new patient.

 PRESCRIBE BY BRAND

 
 
Tiotropium (Braltus Zonda® )
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Restricted Drug Restricted
Green

Braltus Zonda® Inhaler - Preferred alternative for existing Spiriva Handihaler® patients only.

PRESCRIBE BY BRAND

 
Link  Braltus-tiotropium risk of inhalation of capsule if placed in the mouthpiece of the inhaler
 
Tiotropium (Spiriva Handihaler® )
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Restricted Drug Restricted
Green

Restricted for existing patients only

PRESCRIBE BY BRAND

 
 
Ipratropium Bromide
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Formulary
Green

Inhaler devices and nebules

 
 
03.01.02  Expand sub section  Short Acting Anti-muscarinic Bronchodilators
03.01.02  Expand sub section  Long Acting Anti-muscarinic Bronchodilators
 ....
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
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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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