netFormulary Central Lancashire Formulary NHS
Lancashire Teaching Hospitals NHS Foundation Trust
Chorley and South Ribble CCG
Greater Preston CCG
 
 Search
 Formulary Chapter 1: Gastro-intestinal system - Full Chapter
01.01  Dyspepsia and gastro-oesophageal reflux disease
01.01.01  Antacids and simeticone
01.01.01  Aluminium and magnesium containing antacids
Magnesium Trisilicate
View adult BNF View childrens BNF  Track Changes
First Choice
Green

Suspension, 5% each of magnesium trisilicate, light magnesium carbonate and sodium bicarbonate in a suitable vehicle with a peppermnt flavour. Contains approximately 6 mmol sodium per 10 ml

 
Co-magaldrox (Mucogel®)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green

Suspension, sugar-free, co-magaldrox 195mg/220mg5ml (magnesium hydroxide 195mg, dried aluminium hydroxide 220mg per 5ml)

Low Sodium

Equivalent to Maalox but less expensive

 

 
   
01.01.01  Antacid preparations containing simeticone
Maalox Plus
(Antacid containing simeticone)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber

Palliative Care Use

Simeticone 5 mg per 1 ml, Magnesium hydroxide 39 mg per 1 ml, Aluminium hydroxide gel dried 44mg per 1 ml

Sugar-free

 
   
01.01.01  Simeticone alone to top
Simeticone (infacol®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Purple

Oral suspension 40mg per 1 ml

Red unlicensed use in Endoscopy

Drug included within CCG low priority prescribing policy. EXEMPTIONS EXIST FOR CERTAIN INDICATIONS. Please consult attached policy for list of excepted indications for prescribing of this drug.

 
   
01.01.01  Antacid preparations containing dimeticone or local anaesthetics
Antacid and Oxetacaine SF suspension
View adult BNF View SPC online View SMC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red

Unlicensed Oncology use only

 
   
01.01.02  Compound alginates and proprietary indigestion preparations
01.01.02  Compound alginate preparations
Peptac®
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Purple

Suspension, sugar-free, sodium bicarbonate 133.5 mg, sodium alginate 250 mg, calcium carbonate 80 mg per 5 ml. Contains 3.1 mmol Na+/5 ml

Drug included within CCG low priority prescribing policy. EXEMPTIONS EXIST FOR CERTAIN INDICATIONS. Please consult attached policy for list of excepted indications for prescribing of this drug.

 
Infant Gaviscon®
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Green

Oral powder, sugar-free, Magnesium alginate 87.5 mg, Sodium alginate 225 mg. Contains 0.92 mmol Na+/dose 

 
   
01.02  Antispasmodics and other drugs altering gut motility
Glucagon (Glucagen®)
View adult BNF View SPC online View SMC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Red

Examinations of gi tract by radiography or endoscopy

 
   
01.02  Antimuscarinics to top
Hyoscine Butylbromide (Buscopan)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Amber

Tablets 10mg

Injection 20 mg per 1 ml

 
Link  Drug Safety Update February 2017: Hyoscine butylbromide (Buscopan) injection: risk of serious adverse effects in patients with underlying cardiac disease
   
01.02  Other antispasmodics
Mebeverine
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Tablets 135 mg

Modified release capsule 200 mg

Oral suspension 50 mg/5 ml sugar-free

 
Peppermint Oil
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green

Capsule 0.2 ml

 
   
Alverine citrate
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Amber

Capsules 60 mg

 
   
01.03  Antisecretory drugs and mucosal protectants
01.03  NSAID-associated ulcers
01.03.01  H2-receptor antagonists
Ranitidine
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Tablets 150 mg, 300 mg

Effervescent tablets 150 mg

Oral solution 75 mg/5 ml (75 mg/ 5ml is a licensed standard strength used in paediatrics (either Zantac or Rosemont product which contain 8% alcohol)

Injection 25 mg/1 ml

 
01.03.02  Selective antimuscarinics to top
01.03.03  Chelates and complexes
Sucralfate
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber

Consultant Initiation

Tablets 1 g

Suspension 1 g/5 ml

 
   
01.03.04  Prostaglandin analogues
01.03.05  Proton pump inhibitors (PPIs)
Lansoprazole
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Capsules 15 mg, 30 mg

Orodispersible tablets 15 mg, 30 mg - For swallowing difficulties only

 
Omeprazole
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Capsules 10 mg, 20 mg, 40 mg

Mups dispersible 10 mg- Paediatric only

 

 
Esomeprazole
View adult BNF View SPC online View childrens BNF
Second Choice
Amber

Consultant Initiation

Capsules / tablets 20 mg, 40 mg

Granules 10 mg/sachet N.B. Granules are much more expensive.

Injection, powder for solution for Injection/Infusion 40 mg

 
   
Omeprazole IV
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
01.03.06  Other ulcer-healing drugs
01.04  Acute diarrhoea to top
01.04.01  Adsorbents and bulk-forming drugs
01.04.02  Antimotility drugs
Loperamide
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Purple

Tablets or capsules 2 mg

Syrup sugar-free 1 mg/5 ml

Contains sorbitol

Drug included within CCG low priority prescribing policy. EXEMPTIONS EXIST FOR CERTAIN INDICATIONS. Please consult attached policy for list of excepted indications for prescribing of this drug.

 
Codeine
(Antidiarrhoeal)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green

Tablets 15 mg, 30 mg

Syrup 25 mg/5 ml

 
   
Co-Phenotrope (Lomotil®)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber

Consultant Initiation

Tablets Atropine sulfate 25 microgram, Diphenoxylate hydrochloride 2.5 mg

 
   
01.04.03  Enkephalinase Inhibitors
01.05  Chronic bowel disorders
01.05  Irritable bowel syndrome to top
Eluxadoline
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red

Consultant Gastroenterologist initiation only

 
Link  Drug Safety Update - December 2017
Link  NICE TA 471: Eluxadoline for treating irritable bowel syndrome with diarrhoea
   
01.05  Inflammatory bowel disease
01.05  Antibiotic-associated colitis
01.05  Diverticular disease
01.05  Aminosalicylates
01.05  Corticosteroids to top
01.05  Food allergy
01.05  Cytokine inhibitors
01.05  Food Allergy
01.05.01  Aminosalicylates
Mesalazine
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Amber

Patients should be maintained on the same brand of mesalazine and only switched with advice from gastroenterology.

 
Mesalazine (Octasa)
View adult BNF View SPC online View SMC online View childrens BNF  Track Changes
First Choice
Amber

Tablets m/r, e/c 400 mg, 800 mg, 1600mg

 
Mesalazine (Asacol®)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Amber

Suppositories 250 mg and 500mg

 
Mesalazine (Salofalk®)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Amber

1 gram foam enema

2 gram foam enema

 
Mesalazine (Pentasa®)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Amber

Tablets m/r, e/c, 500mg, 1g

Granules, m/r, 1g/sachet, 4g/sachet

Retention enema 1g in 100ml

1 gram suppositories

 
Balsalazide
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Amber

Consultant Initiation

Capsules 750 mg

 
   
01.05.02  Corticosteroids to top
Prednisolone
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Tablets 1 mg, 2.5 mg, 5 mg

Retention enema 20 mg in 100 ml

Suppositories 5 mg

 
Hydrocortisone (Colifoam ®)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Amber

Rectal foam in aerosol pack, hydrocortisone acetate 10%

 
   
Budesonide  (Budenofalk®)
View adult BNF View SPC online View SMC online View childrens BNF  Track Changes
Formulary
Amber

3mg gastro-resistant Capsule

2mg per actuation foam enema

 
   
Budesonide (Entocort®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Amber

CR Capsules, enclosing e/c, m/r granules 3 mg

 
   
Budesonide (Cortiment MMX®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red

Tablets 9 mg m/r

 
   
01.05.02  Oral
01.05.02  Topical
01.05.02  Parenteral
01.05.03  Drugs affecting the immune response
TofactinibBlack Triangle
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
BlueTeq

Xeljanz® 5mg and 10mg tablets

To be used in line with NICE TA547 for moderately to severely active ulcerative colitis

 
Link  NICE TA547
   
Ustekinumab
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
BlueTeq

Stelara For use in line with NICE TA 456 for previously treated moderately to severely active Crohn’s disease in adults.

 
Link  NICE TA 456
   
Adalimumab
(Gastroenterology)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red
High Cost Medicine
BlueTeq

Injection 40 mg prefilled pen or prefilled syringe, 40 mg/0.8 ml vial

Should only be used under expert supervision

 
Link  NICE TA187: Crohn’s disease - infliximab and adalimumab
Link  NICE TA329: Infliximab, adalimumab and golimumab for moderately to severely active ulcerative colitis
   
Infliximab
(Gastroenterology)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red
High Cost Medicine
BlueTeq

Intravenous infusion, powder for reconstitution, 100 mg

Should only be used under expert supervision

 
Link  NICE TA163: Ulcerative colitis (acute manifestations) Infliximab
Link  NICE TA187: Crohns disease - infliximab & adalimumab
Link  NICE TA329: Infliximab, adalimumab and golimumab for moderately to severely active ulcerative colitis
   
Cytotoxic Drug Azathioprine
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Amber 2

Tablets 25 mg, 50 mg

Should only be used under expert supervision

Unlicensed use - IBD

 
Link  Crohn’s disease managment
Link  Shared Care Guideline
Link  Ulcerative Colitis management
   
Golimumab
(Ulcerative Colitis)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red
High Cost Medicine
BlueTeq

Injection, Prefilled syringe 90 mg

Should only be used under expert supervision

 
Link  NICE TA329: Infliximab, adalimumab and golimumab for moderately to severely active ulcerative colitis
   
VedolizumabBlack Triangle
(Gastroenterology)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
High Cost Medicine
BlueTeq

Concentrate for intravenous infusion, powder for reconstitution 300 mg vials

Should only be used under expert supervision

 
Link  NICE TA352: Vedolizumab for treating moderately to severely active Crohn’s disease after prior therapy
Link  NICE TA342: Vedolizumab for treating moderately to severely active ulcerative colitis
   
Ciclosporin
(Gastroenterology)
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Amber 2

Capsules 25 mg, 50 mg, 100 mg

100 mg/1 ml oral solution

Concentrate for intravenous infusion (oily) 50 mg/1 ml

Should only be used under expert supervision

 
Link  Ciclosporin Shared Care Guideline LMMG
   
Cytotoxic Drug Mercaptopurine
(Gastroenterology)
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Amber 2

Tablets 50 mg

Should only be used under expert supervision

 
Link  Crohn’s disease management
Link  Mercaptopurine Shared Care Guideline LMMG
Link  Ulcerative Colitis management
   
Cytotoxic Drug Methotrexate
(Gastroenterology)
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Amber 2

Tablets 2.5 mg

Oral solution 10 mg in 5 ml (Rosemont)

Subcutaneous injection 50 mg/1 ml prefilled pen, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 17.5 mg, 20 mg, 22.5 mg, 25 mg, 27.5 mg, 30 mg (Licensed in Crohn's disease)

Should only be used under expert supervision

The dose is always a weekly dose.

 
Link  Methotrexate Shared Care Guideline LMMG
   
01.05.04  Food allergy to top
01.06  Laxatives
01.06.01  Bulk-forming laxatives
Ispaghula Husk
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Granules 3.5 g/sachet

 
01.06.02  Stimulant laxatives
Bisacodyl
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Tablets e/c 5 mg

Suppositories 10 mg

Paediatric suppositories 5 mg

 
Docusate
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Capsules 100 mg

Adult oral solution, sugar-free, 50 mg/5 ml

Paediatric oral solution, sugar-free, 12.5 mg/5 ml

 
Glycerol
(suppositories)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Suppositories 1 g, 2 g, 4 g

 
Senna
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Tablets 7.5 mg

Syrup sugar-free, 7.5 mg/5 ml

 
Sodium Picosulfate 1mg/1ml Oral SF solution
 Track Changes
Formulary
Amber
 
   
Co-danthrusate (Dantron)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Green

Capsules 50/60 (dantron 50 mg, docusate sodium 60 mg)

Suspension 50/60 (dantron 50 mg, docusaate sodium 60 mg/5 ml)

Palliative Care Only

 
   
01.06.02  Other Stimulant laxatives
01.06.03  Faecal softeners to top
Arachis Oil
(Fletchers arachis oil retention enema)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Enema 130 ml

 
01.06.04  Osmotic laxatives
Lactulose
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Solution 3.1-3.7 g/5 ml

 
Phosphates (Rectal) (Fleet® Ready to use Enema)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Fleet Ready to use enema

 
Sodium Citrate
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Micro-enema

Acute constipation

 
Macrogol oral powder
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green

Macrogol 13.8g sachets

Macrogol Paediatric 6.9g sachets

 
   
01.06.05  Bowel cleansing preparations
Macrogols (Moviprep®)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Oral powder, macrogol '3350'

 
Klean-Prep®
View adult BNF View SPC online View SMC online View childrens BNF  Track Changes
Second Choice
Green

Oral powder, sugar-free sachets, Potassium chloride 742.5mg, Sodium chloride 1.465 g, Sodium bicarbonate 1.685 g, Sodium sulfate anhydrous 5.685 g, Polyethylene glycol 3350 59 g.

 
   
Macrogols (Plenvu®)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Red

Oral powder - macrogol 3550

For patients who have tried and failed with other PEG bowel cleansing preparations

 
   
Picolax®
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Red

Oral Powder, Sachets sugar-free, Sodium picosulfate 10mg, Magnesium Oxide 3.5 g, Citric acid anhydrous 12 g

 
   
01.06.06  Peripheral opioid-receptor antagonist
NaloxegolBlack Triangle
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green

Tablets 12.5 mg, 25 mg

 
Link  NICE TA345
   
01.06.07  Other drugs used in constipation
LinaclotideBlack Triangle (Constella®)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Amber

Capsules 290 micrograms

 
   
Prucalopride (Resolor®)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Amber

Tablets 1 mg, 2 mg

 
Link  NICE TA211: Constipation (women) - prucalopride
   
01.07  Local preparations for anal and rectal disorders to top
01.07.01  Soothing haemorrhoidal preparations
Anusol®
(Soothing preparation)
View adult BNF View SPC online View SMC online View childrens BNF  Track Changes
First Choice
Green

Cream 23 g, Ointment 25 g, suppositories 12

 
01.07.02  Compound haemorrhoidal preparations with corticosteroids
Anusol-HC
(soothing plus steroid)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Ointment 30 g, cream 30 g, suppositories 12

 
Scheriproct®
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

Ointment 30 g, suppositories 12

 
Cinchocaine with hydrocortisone
View adult BNF View SPC online View SMC online View childrens BNF  Track Changes
Formulary
Green

Radiotherapy patients only

Ointment

Suppositories

Uniroid HC

Proctosedyl

 
   
01.07.03  Rectal sclerosants
Phenol, Oily
(rectal)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Red

Injection 5% - 5 ml ampoule

 
01.07.04  Management of anal fissures
Glyceryl Trinitrate 0.4%
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Amber

Ointment 30 g

 
Diltiazem Cream 2%
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Red

Cream 30 g

Second choice

 
   
01.08  Stoma care to top
01.09  Drugs affecting intestinal secretions
01.09.01  Drugs affecting biliary composition and flow
Ursodeoxycholic acid
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Amber

Tablets 150 mg

Capsules 250 mg

Suspension 250 mg in 5 ml

Consultant initiation

 
Obeticholic Acid (Ocaliva )
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red Specialist Centre

For use in line with NICE TA443 in treatment of Primary Biliary Cholangitis

 
Link  MHRA Drug Safety Update
Link  NICE TA443
   
01.09.01  Other prepatations for biliary disorders
01.09.02  Bile acid sequestrants
Colestyramine powder
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Amber

Powder 4 g/sachet

Consultant initiation

Unlicensed use - Diarrhoea secondary to bile acid malabsorption

 
01.09.03  Aprotinin to top
01.09.04  Pancreatin
Pancreatin
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Amber

Prescribe by brand name

Creon 10,000

Pancrex V capsules

Pancrease V powder

 
Pancreatin (Higher Strength)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Amber

Prescribe by brand name

Creon 25,000

Creon 40.000

 

 
   
 ....
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
SMC
Scottish Medicines Consortium
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

Amber

Suitable for prescribing in primary care following recommendation or initiation by a specialist. Little or no specific monitoring required. Patient may need a regular review, but this would not exceed that required for other medicines routinely prescribed in primary care. Brief prescribing document or information sheet may be required.  

Amber 1

Suitable for prescribing in primary care following recommendation or initiation by a specialist. Minimal monitoring required. Patient may need a regular review, but this would not exceed that required for other medicines routinely prescribed in primary care. Full prior agreement about patient’s on-going care must be reached under the shared care agreement.  

Amber 2

Initiated by specialist and transferred to primary care following a successful initiation period. Significant monitoring required on an on-going basis. Full prior agreement about patient’s on-going care must be reached under the shared care agreement. Suitable for enhanced service.  

Black

NOT recommended for use by the NHS in Lancashire. Includes medicines that NICE has not recommended for use and terminated technology appraisals, unless there is a local need.  

Blue

Products shown as blue have different Traffic Light List classifications dependent on indication. See the accompanying text next to the product for further information  

Green

Appropriate for initiation and ongoing prescribing in both primary and secondary care. Generally, little or no routine drug monitoring is required.  

Purple

Low Priority for Prescribing - see Low Priority for Prescribing Policy  

Red

Medicine is supplied by the hospital for the duration of the treatment course. Primary care initiation or continuation of treatment is not recommended unless exceptional circumstances such as specialist GP.  

Red Specialist Centre

Prescribing restricted to Specialist Centres only  

netFormulary