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- Tablets
50mg tablets for bone metastases in breast cancer. Specialist initiation and prescribing for at least 1 month before any request is made for primary care prescribing.
- Intravenous infusion
Used in
- hypercalcaemia of malignancy
- bone metastases
- prevention of skeletal events
- Tablets
150mg tablets
(note - 50mg tablets are not licensed for this indication)
- Intravenous infusion
- Infusion
- Oral suspension
- Tablets
- Gel
- Oral suspension
- Tablets
- Intravenous infusion
- Oral suspension
- Tablets
- Oro-dispersible tablets
- Infusion
- Capsules
- Modified release capsules
- Injection
- Capsules
- Intravenous infusion
- Intravenous injection (IV)
- Not Specified
NHSE - comissioned from specialist centres only. Not provided by any Surrey Heartlands Trusts.
- Tablets
- Not Specified
NHSE commissioned services only. No Surrey Heartlands Trusts are commissioned to provide this.
- Intravenous infusion
- Not Specified
NHSE Specialist Centres only. Not a service that is provided by any of the Surrey Heartlands Acute Trusts.
NHS England specialist centres only. Not a service that is provided by any of the Surrey Heartlands Acute Trusts
- Infusion
- Oral solution
- Tablets
- Not Specified
- Not Specified
- Cream
Imiquimod 5% cream
Primary care iniatiation only on recommendation from dermatology specialist team.
- Cream
Imiquimod 3.75% cream (Zyclara) - not to be prescribed. The 5% cream is a more cost-effective option.
- Cream
- Topical solution
Imiquimod 5% cream - specialist diagnosis / initiation is usually required. See PAD for the limited circumstances in which initiation may ocurr in Primary Care.
- Not Specified
- Cream
Consider if self-care is appropriate
- Subcutaneous injection (sc)
Prescribing in secondary care is commissioned by NHSE
- Inhaler (dry powder)
LABA monotherapy no longer recommended for asthma or COPD.
Not for initiation in new patients.
- Immediate release tablets
Preferred thiazide diuretic
- Modified release tablets
Modified-release indpapmide tablets are not a preferred treatment option. Immediate-release tablets are recommended.
- Injection
For use in endoscopic procedures.
- Oral solution
- Tablets
Restricted Antimicrobial - requires GUM Specialist approval
- Injection
- Injection
- Capsules
- Capsules (slow release)
- Not Specified
- Liquid
Prescribe on advice from specialist e.g. dietitian
500ml presentation for enteral feeding only.
- Liquid
Prescribe on advice from specialist e.g. dietitian
- Intravenous infusion
- Subcutaneous injection (sc)
- Not Specified
- Not Specified
- Intravenous infusion
NHSE Specilaist centres only. Not commissioned from any Surrey Heartlands Trusts.
- Intravenous infusion
- Subcutaneous injection (sc)
- Intravenous infusion
- Subcutaneous injection (sc)
- Not Specified
- Injection
Dermatology specialist team only.
- Intravenous infusion
- Subcutaneous injection (sc)
- Not Specified
- Intravenous infusion
- Subcutaneous injection (sc)
- Intravenous infusion
- Subcutaneous injection (sc)
- Not Specified
- Tablets
- Not Specified
- Cartridges
- Pre-filled pen
- Vials
For adult patients ONLY
Prescribe by brand and state form.
Initiation by diabetologists only. A minimum prescribing duration of three months by secondary care before transferring to primary care.
- Cartridges
- Pre-filled pen
- PumpCart
- Vials
Biosimilar insulin aspart (Trurapi) should be used in preference to NovoRapid. Prescribe by brand and state form.
- Cartridges
- Pre-filled pen
- Vials
- Cartridges
- Pre-filled pen
- Injection
- Cartridges
- Pre-filled pen
Levemir (insulin detemir Penfill / FlexPen) is being discontinued. Supplies are expected to run out by Dec 2026. It is recommended that this is not initiated in new patients.
Patients on these devices will need to be switched to an alternative::
- First line - Semglee pre-filled pens (insulin glargine). No cartridges available.
- Second line - Lantus or Abasaglar cartridges (insulin glargine) or Lantus Solostar pens / Abasaglar Kwikpen (insulin glargine)
See PAD page for further information and switching advice.
- Cartridges
- Pre-filled pen
- Cartridges
- Pre-filled pen
- Vials
- Pre-filled pen
- Pre-filled pen
- Cartridges
- Pre-filled pen
- Vials
- Cartridges
- Pre-filled pen
- Vials
- Cartridges
- Pre-filled pen
- Vials
- Cartridges
- Pre-filled pen
- Vials
- Device
Note; Neither Continuous Glucose Monitoring (CGM) nor Omnipod 5 is commissioned for this cohort.
- Device
- Intramuscular injection (IM)
- Subcutaneous injection (sc)
Interferon beta 1a (Avonex, Rebif)
- Subcutaneous injection (sc)
Interferon beta 1b (Betaferon, Extavia)
- Intravenous infusion
- Topical solution

- Topical solution
- Oral solution
For patients unable to take tablets.
Iodine 5%, potassium iodide 10% (130mg/ml iodine)
- Inhaler (Metered Dose)
No added benefit in patient's on LAMA.
Not for initiation in new patients.
- Inhaler (Metered Dose)
Specialist paediatric recommendation.
- Nebules
Specialist* recommendation following patient initiation and education on nebuliser therapy, unless for administration as PSD in practice for acute attack.
* a healthcare professional with higher training in respiratory medicine and proficeincy in the management of asthma
- Nebules
Specialist recommendation following patient initiation and education on nebuliser therapy, unless for administration as PSD in practice for acute attack.
- Nasal spray
- Nasal spray
- Sublingual spray
- Inhaler (Metered Dose)
- Sublingual spray
- Nebules
Specialist recommendation following patient initiation and education on nebuliser therapy
- Not Specified
Primary care prescribers are not expected to have the clinical expertise to prescribe these devices and should therefore not be asked to prescribe until a formal evaluation and recommendations have been submitted to the APC. Contact pharmacy for advice.
- Tablets
- Not Specified
- Intramuscular injection (IM)
- Intravenous infusion
- Intravenous injection (IV)
Ferric derisomaltose is preferred.
- Intravenous infusion
- Intravenous injection (IV)
Ferric derisomaltose is preferred.
- Tablets
Initiation and stabilisation by the mental health specialist team for a minimum of 6 months before any transfer of care.
- Not Specified
- Cartridges
Initiation by diabetes team only. Usage is low but available for existing patients
- Cartridges
- Pre-filled pen
Prescribe by brand and state form.
- Cartridges
- Vials
- Cartridges
- Vials
- Injection
- Modified release tablets
- Tablets
- Tablets
- Modified release capsules
- Modified release tablets
- Capsules
Important information and resources relating to the Pregnancy Prevention Programme and neuropsychiatric disorders are available on PAD (click drug name to see the PAD page for isotretinoin)
- Sachets (granules)
- Tablets
- Tablets
- Not Specified
- Not Specified
- Cream
For mild to moderate rosacea as per CKS.
- Subcutaneous injection (sc)
- Injection
Dermatology specialist team only.
- Not Specified
- Subcutaneous injection (sc)