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Off-label use. Specialist initiation and prescribing for at least 1 month before any request is made for primary care prescribing.

Only recommended as an option in secondary prevention where other options have been exhausted.

For post-exposure prophylaxis (e.g. needlestick injuries), follow your organisation's protocols for referral and access. Use as recommended by BHIVA/BASHH guidelines.

Restricted to cardiology

On recommendation from the specilist team

Not on Surrey Heartlands Trust formularies. Trusts with renal centres (locally this is Epsom, Frimley & Brighton) will retain prescribing responsibility’.

Not on Surrey Heartlands Trust formularies. Trusts with renal centres (locally this is Epsom, Frimley & Brighton) will retain prescribing responsibility’.

Specialist to prescribe at least 1 month treatment, prior to transfer of care

 At least 1 month prescribing by the specialist prior to transfer of care.

A DXA scan is recommended after the first 52 weeks of treatment to verify that the patient does not have an unwanted degree of BMD loss, that exceeds the benefit of treatment. This DXA scan will be organised & performed by the specialist team responsible for the ongoing care of the patient

Specialist team initiation and at least 3 months of treatment prior to any request for primary care prescribing.

A DXA scan is recommended after the first 52 weeks of treatment 

1mg, 2mg, 5mg 

SASH Restriction: Adults Special Care Dentistry for indications below: - Frail older adults. - ASA3 medically complex patients, - Patients with severe cognitive disorders, - Complex oral surgery patients, - Patients with severe LD or ASD for whom a fast recovery makes care safer.

Prescribe on advice from specialist e.g. dietitian 

Prescribe on advice from specialist e.g. dietitian 

Prescribe on advice from specialist e.g. dietitian 

Prescribe on advice from specialist e.g. dietitian 

On advice from specialist.  

NHSE do not recommend the routine prescription of vitamins and mineral preparations, with the exceptions of patients with medically diagnosed deficiency, including those with lifelong or chronic conditions, or post surgery resulting in malabsorption (e.g.  Whipple’s procedure and some other GI surgeries), calcium and vitamin D for osteoporosis, prescription-only vitamin D analogues or malnutrition. Continuing need should be reviewed on a regular basis. Not for use for prevention of deficiency  

Prescribe on advice from specialist e.g. dietitian 

Altraplen Energy is the preferred second line 1.5kcal/ml supplement when required in primary care. Ready to drink supplements should only be prescribed if individual cannot prepare milkshake from powder.

Principles for shared care found here: https://surrey.res.services/PAD/Profile/NonClinicalProfile/9136

NHSE commissioned services only. No Surrey Heartlands Trusts are commissioned to provide this.

Weekly tablets are 35mg. Daily tablets are 5mg.
NOTE - 30mg tablets are licensed for Paget's disease only

30mg tablets are licensed for Paget's disease.

Licensed for up to 6 weeks in Alzheimer's dementia. On initiation, patients need a referal to SABP so that an assessment can be made at 6 weeks to weigh up response to treatment and benefit of treatment v risk of harm.

Licensed for up to 6 weeks in Alzheimer's dementia. On initiation, patients need a referal to SABP so that an assessment can be made at 6 weeks to weigh up response to treatment and benefit of treatment v risk of harm.

Only for use where the liquid formulation is unsuitable e.g. for supervised administration to ensure compliance.

Primary Care prescribing on advice from palliative care specialist team

Initiation by a Mental Health specialist and stabilisation for a minimum of 1 month before any request to transfer prescribing responsibility.

Initiation by a Mental Health specialist and stabilisation for a minimum of 1 month before any request to transfer prescribing responsibility.

Only for use where the liquid formulation is unsuitable e.g. for supervised administration to ensure compliance.

For acute and chronic psychoses.

Initiation by a Mental Health specialist and stabilisation for a minimum of 1 month before any request to transfer prescribing responsibility.

For acute and chronic psychoses.

Initiation by a Mental Health specialist and stabilisation for a minimum of 1 month before any request to transfer prescribing responsibility.

Only for use where the liquid formulation is unsuitable e.g. for supervised administration to ensure compliance.

For acute and chronic psychoses.

Initiation by a Mental Health specialist and stabilisation for a minimum of 1 month before any request to transfer prescribing responsibility.

Only for continuation in existing patients.

SASH-Refer to SASH process on High Cost Drug internet page

Commissioned from RSFT only.

Severe disease only