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- Bladder instillation
- Oral solution
- Tablets
On advice from palliative care specialist team
- Oral solution
- Tablets
- Intrathecal injection
- Not Specified
- Tablets
- Tablets
- Not Specified
- Tablets
- Not Specified
NHSE Specialist Centres only. Not a service that is provided by any of the Surrey Heartlands Acute Trusts.
- Not Specified
- Inhaler (Metered Dose)
Children only - ICS alone not recommended in adults with asthma.
First line ICS in children.
Prescribe by BRAND
- Inhaler (dry powder)
Not licensed in <18 years. ICS alone not recommended in adults with asthma.
Not to be initiated in new patients.
- Inhaler (breath actuated Metered Dose)
No dose counter, high carbon footprint.
Not for initiation in new patients.
- Inhaler (breath actuated Metered Dose)
No dose counter, high carbon footprint.
Not for initiation in new patients.
- Inhaler (Metered Dose)
Children only - ICS alone not recommended in adults with asthma.
Second line ICS in children (Clenil Modulite is 1st line).
No dose counter.
Prescribe by BRAND
- Nasal spray
Beclometasone 50mcg/dose (200 dose container) is recommended as a 1st line alternative treatment option. NOTE Beconase Hayfever and other container sizes (180 dose and 100 dose) are much more expensive and should not be used.
- Inhaler (dry powder)
Fostair NEXThaler 100/6
Prescribe by BRAND
- Inhaler (dry powder)
Fostair NEXThaler 100/6 - licensed from 18 years of age.
Not licensed for AIR.
Second line in adult asthma requiring MART. (Fobumix Easyhaler (budesonide/formoterol) is the more cost-effective option DPI)
- Inhaler (dry powder)
Fostair NEXThaler 200/6 - High dose ICS/LABA for specialist recommendation only.
Not licensed for COPD.
Prescribe by BRAND.
- Inhaler (Metered Dose)
Fostair 100/6, 200/6 not licensed in under 18 years. Not licensed for AIR.
Not for initiation in new patients. Proxor device is much less expensive.
Further information is being sought with regard to Proxor / Fostair bioequivalence. To be reviewed in Jul/Aug 2025.
- Inhaler (Metered Dose)
Fostair 100/6, 200/6 not licensed in under 18 years. Not licensed for AIR.
Not for initiation in new patients. Proxor device is much less expensive.
Further information is being sought with regard to Proxor / Fostair bioequivalence. To be reviewed in Jul/Aug 2025.
- Inhaler (Metered Dose)
Proxor 100/6 - NEW device.
Fostair equivalent - Proxor is the most cost-effective ICS/formoterol pMDI. Licensed for MART in adults.
Prescribe by BRAND.
- Inhaler (Metered Dose)
Proxor 100/6 (new device) - licensed for MART in adults - second line. (Fobumix Easyhaler (budesonide/formoterol) is the more cost-effective option DPI)
Not licensed in under 18 years.
Proxor is equivalent to Fostair and is the most cost-effective ICS/formoterol pMDI.
- Inhaler (Metered Dose)
Proxor 200/6 (new device) - higher dose ICS/LABA for specialist recommendation only.
Licensed for MART in adults - second line.
Not licensed in under 18 years. Not licensed for COPD
Proxor is equivalent to Fostair and is the most cost-effective ICS/formoterol pMDI.
- Inhaler (Metered Dose)
Trimbow 87/5/9 (higher strengths not licensed for COPD)
Prescribe by BRAND
- Inhaler (dry powder)
- Inhaler (Metered Dose)
Trimbow 87/5/9 and 172/5/9 - specialist recommendation only
- Tablets
- Not Specified
- Not Specified
- Tablets
- Tablets
- Tablets
- Tablets
- Not Specified
- Mouthwash
- Oromucosal spray
- Injection
- Not Specified
- Tablets
- Not Specified
- Soluble tablets
- Injection
- Soluble tablets
- Nasal drops
- Ear drops
- Eye drops
- Eye ointment
- Eye drops
- Ear drops
- Eye drops
- Eye drops (preservative free)
- Tablets
Off-label use.
Palliative care only - RSFT
- Intravitreal injection
- Intravitreal injection
- Intravitreal injection
- Modified release tablets
- Tablets
- Not Specified
- Not Specified
- Tablets
To be prescribed on recommendation from a specialist.
- Not Specified
- Not Specified
- Eye drops
- Eye drops
- Eye drops (preservative free
- unit dose)
- Subcutaneous injection (sc)
- Not Specified
- Subcutaneous injection (sc)
- Not Specified
NHSE Specialist Commissioned Services only. Not commissioned from any Surrey Heartlands Trusts.
- Cartridges
- Pre-filled pen
- Cartridges
- Pre-filled pen
- Vials
- Cartridges
- Pre-filled pen
- Vials
- Not Specified
- Gel
- Suppositories
- Tablets
- Not Specified
- Gauze
- Paste
- Gauze
- Paste
- Tablets
- Tablets
- Tablets
- Tablets
- Intravenous infusion
- Not Specified
- Not Specified
NHSE commissioned services only. No Surrey Heartlands Trusts are commissioned to provide this.
- Injection
RSFT: For chronic anal fissure. If first dose unsuccessful refer for sphincterectomy
- Injection
- RSFT: Neurology Only
- SASH: Xeomin only
- Injection
Includes blepharospasm and hemifacial spasm. NOTE; different brands of botulinum toxin have difference licenses, please check SmPC.
- RSFT: Opthalmology and Neurology only. Dysport to be supplied to neurology if specifically requested
- SASH: Xeomin only
- Injection
- RSFT: Cerebral palsy paediatrics only.
- RSFT: Focal spasicitity: neurology, joint paediatric and orthopaedic team or care of the elderly
- SASH: Adults only
NOTE; different brands of botulinum toxin have difference licenses, please check SmPC.
- Injection
RSCH - endoscopy only.
NOTE; different brands of botulinum toxin have difference licenses, please check SmPC
- Not Specified
Not assessed for formulary status. Contact pharmacy to make a formulary application.
- Not Specified
For Chronic migraine only.
- RSFT: Neurology only
- SASH: Botox only Neurology Only
- Injection
Focal dystonia, dystonic torticollis, cervical dystonia, spasmodic torticollis.
NOTE; different brands of botulinum toxin have difference licenses, please check SmPC
- RSFT: Neurology only. Dysport to be supplied to neurology if specifically requested
- Injection
RSFT: Pain Team only
- Injection
- RSFT: Urology Only
- SASH: Botox only. Urology Only
NOTE; different brands of botulinum toxin have difference licenses, please check SmPC
- Injection
NOTE; different brands of botulinum toxin have difference licenses, please check SmPC.
RSFT: Opthalmology Only
- Injection
RSCH - endoscopy only.
NOTE; different brands of botulinum toxin have difference licenses, please check SmPC
- Injection
RSFT - Dr Walker’s team use only; 50 units/vial. NOTE; different brands of botulinum toxin have difference licenses, please check SmPC
- Injection
- Eye drops
- Eye drops
- Eye drops
- Eye drops
- Eye drops
- Oral solution
- Tablets
- Injection
- Not Specified
- Intravitreal injection
- Intravitreal injection
- Tablets
- Tablets
Cabergoline should be considered 1st-line. Initiation and supply of at least one month of treatment before transfer of prescribing to primary care. Monitoring remains the responsibility of secondary care in line with position statement of the British Society of Echocardiography, the British Heart Valve Society and the Society for Endocrinology. https://pubmed.ncbi.nlm.nih.gov/30818417/
- Tablets
- Tablets
- Inhaler (dry powder)
Not for initiation in new patients.
- Inhaler (dry powder)
Children only - ICS alone not recommended in adults with asthma.
DPI licensed in children, cost effective.
Prescribe by BRAND.
Licensed in children.
- Inhaler (dry powder)
Children only - ICS alone not recommended in adults with asthma.
Licensed in children. Second line (Easyhaler budesonide device is preferred).
Prescribe by BRAND
- Nasal spray
Mometasone Furoate 50mcg/dose 140 dose container is the recommended 1st line treatment option. Budesonide is recommended as a 2nd line option
- Nebules
- Foam enema
- Modified release capsules
- Suppositories
Not assessed for formulary status. Applications for formulary entry via APC.
- Nasal spray
- Modified release capsules
- Oro-dispersible
- Oro-dispersible
- Nebules
Specialist recommendation following patient initiation and education on nebuliser therapy.
- Nebules
Specialist recommendation following patient initiation and education on nebuliser therapy.
- Inhaler (dry powder)
DuoResp Spiromax 160/4.5 - licensed for AIR and MART from 12 years of age.
Second line. (Fobumix Easyhaler (budesonide/formoterol) is the more cost-effective option DPI)
Prescribe by BRAND.
- Inhaler (dry powder)
DuoResp Spiromax 320/9 - higher dose ICS/LABA for specialist recommendation only.
Prescribe by BRAND.
- Inhaler (dry powder)
DuoResp Spiromax 160/4.5 - second line (Fobumix Easyhaler (budesonide/formoterol) is the more cost-effective option DPI).
Prescribe by BRAND.
- Inhaler (dry powder)
DuoResp Spiromax 320/9 - this strength is not recommended in the Surrey Heartlands COPD guidelines.
- Inhaler (dry powder)
Fobumix Easyhaler 80/4.5 and 160/4.5 - licensed in children.
Cost-effective choice for AIR and MART.
Prescribe by BRAND.
- Inhaler (dry powder)
Fobumix Easyhaler 320/9 - higher dose ICS/LABA for specialist recommendation only.
Prescribe by BRAND.
- Inhaler (dry powder)
Prescribe by BRAND.
- Inhaler (Metered Dose)
Symbicort 100/3 - Useful in children and under 18yrs . Useful for patients needing a pMDI licensed for MART.
Prescribe by BRAND
- Inhaler (Metered Dose)
Symbicort 200/6 - only for use if an MDI is needed.
- Inhaler (dry powder)
Symbicort Turbohaler 400/12 - second line (Fobumix Easyhaler (budesonide/formoterol) is the more cost-effective option DPI)
Prescribe by BRAND
- Inhaler (dry powder)
Symbicort Turbohaler 100/6 and 200/6 - Licensed for AIR and MART.
More costly device so second line option. (Fobumix Easyhaler (budesonide/formoterol) is the more cost-effective option DPI)
Prescribe by BRAND.
- Inhaler (dry powder)
Symbicort Turbohaler 400/12 - higher dose ICS/LABA for specialist recommendation only.
Prescribe by BRAND
- Injection
- Oral solution
- Tablets
- Injection
- Patches
- Sublingual tablets
- Nasal spray
- Subcutaneous injection (sc)