netFormulary Grampian Area NHS
Formulary  
 Search
 Formulary Chapter 5: Infections - Full Chapter
05.01  Antibacterial drugs
05.01.01.05  Mecillinams
05.01.04  Aminoglycosides
TOBI Podhaler® (Tobramycin inhaler)
(cystic fibrosis)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber 2
High Cost Medicine

Restricted Item In line with NICE MTA 276 as an option for treating chronic pulmonary infection caused by P. aeruginosa in people with cystic fibrosis only if:

  • nebulised tobramycin is considered an appropriate treatment, that is, when colistimethate sodium is contraindicated, is not tolerated or has not produced an adequate clinical response and
  • the manufacturer provides tobramycin DPI with the discount agreed as part of the patient access scheme to primary, secondary and tertiary care in the NHS.
 
Link  NICE TA276: Cystic fibrosis (pseudomonas lung infection) - colistimethate sodium and tobramycin
   
Tobramycin (nebulised)
(cystic fibrosis)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber 2
High Cost Medicine

300mg nebuliser solution

Management of chronic pulmonary infection due to Pseudomonas aeruginosa in people with cystic fibrosis aged 6 years and older.

Restricted Item Second-line when colistimethate sodium is contraindicated, is not tolerated or has not produced an adequate clinical response.

Therapy should be initiated by a physician experienced in the management of cystic fibrosis.

 
   
05.01.07  Some other antibacterials
05.01.07  Fosfomycin to top
05.01.07  Polymyxins
Colobreathe® (Colistimethate inhaler)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber 2
High Cost Medicine

Restricted Item In line with NICE MTA 276 as an option for treating chronic pulmonary infection caused by P. aeruginosa in people with cystic fibrosis only if:

  • they would clinically benefit from continued colistimethate sodium but do not tolerate it in its nebulised form and thus tobramycin therapy would otherwise be considered and
  • the manufacturer provides colistimethate sodium DPI with the discount agreed as part of the patient access scheme to primary, secondary and tertiary care in the NHS.
 
Link  NICE TA276: Cystic fibrosis (pseudomonas lung infection) - colistimethate sodium and tobramycin
   
05.01.07  Rifaximin
Targaxan® (Rifaximin 550mg)
(Recurrent hepatic encephalopathy)
View adult BNF View SPC online
Restricted Drug Restricted
Amber 1

Restricted Item 'Alert' antimicrobial - only on the advice of a GI specialist

note Second line antibiotic in adults who present with recurrent encephalopathy despite being on lactulose and neomycin.

 
Link  SMC 893/13: Rifaximin for the reduction in recurrence of episodes of overt hepatic encephalopathy (HE) in patients ≥18 years of age (Sept 2013)
   
05.01.07  Fidaxomicin
05.01.12  Quinolones
LevofloxacinBlack Triangle (Quinsair®)
(Inhaled)
View adult BNF View SPC online
Restricted Drug Restricted
Amber 2
High Cost Medicine

Restricted Item Restricted for the management of chronic pulmonary infections due to Pseudomonas aeruginosa in adult patients with cystic fibrosis as a third line treatment option after colistimethate sodium (first line) and tobramycin (second line).

  • Treatment should be under the supervision of a physician experienced in the treatment of lung infection in cystic fibrosis.
 
Link  Drug Safety Update Articles: Levofloxacin
Link  Drug Safety Update: Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects
   
moxifloxacin 400mg tablets
(Azithromycin resistant/macrolide resistant mycoplasma genitalium (off-label use))
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Restricted Item Restricted (off-label use) for the treatment of azithromycin resistant/macrolide resistant mycoplasma genitalium in adolescents and adults (16 years and older) in line with BASHH guidelines.

Consideration should be given to official guidance on the appropriate use of antibacterial agents.

 
Link  Drug Safety Update Articles: Moxifloxacin
Link  Drug Safety Update: Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects
   
05.02  Antifungal drugs to top
IsavuconazoleBlack Triangle (Cresemba®)
View adult BNF
Restricted Drug Restricted
Blue
High Cost Medicine

Consideration should be given to official guidance on the appropriate use of antifungal agents.

Restricted Item Restricted to use on the advice of a Medical Microbiologist, Infection specialist or Haematologist and inclusion in the NHS Grampian Staff Guidance for Optimising Use of Alert (Restricted) Antimicrobials in Adults, for the treatment of adults with:

  • invasive aspergillosis
  • mucormycosis in patients for whom amphotericin B is inappropriate

Red Isavuconazole 200mg powder for concentrate for solution (Cresemba®)

Amber 2 Isavuconazole 100mg hard capsules (Cresemba®)

 
Link  SmPC: Isavuconazole
Link  Summary guidance: Optimising Use of Alert (Restricted) Antimicrobials in Adults
Link  NHS Grampian Staff Guidance for Optimising Use of Alert (Restricted) Antimicrobials in Adults
Link  SMC 1129/16: Isavuconazole in adults for the treatment of invasive aspergillosis and mucormycosis in patients for whom amphotericin B is inappropriate (April 2016).
   
05.02  Drugs used in fungal infections
05.03.01  HIV infection
 note 

Note: The classification ‘hospital use only’ does not prevent supply of medicines by Primary Care, e.g. use of hospital-based prescription (HBP) stationery.

Abacavir
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

RMM Risk Minimisation Materials

 
Link  Risk Minimisation Materials
Link  Risk Minimisation Materials: Patient Alert Card
Link  Drug Safety Update: Abacavir: risk of myocardial infarction - update from epidemiological studies (July 2009)
Link  SMC 174/05: Abacavir for the treatment of HIV-1 infection in adults and adolescents (May 2005)
   
Abacavir/lamivudine
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

RMM Risk Minimisation Materials

 
Link  Risk Minimisation Materials
Link  Risk Minimisation Materials: Patient Alert Card
Link  Drug Safety Update: Abacavir: risk of myocardial infarction—update from epidemiological studies (July 2009)
   
Atazanavir
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  SMC 656/10: Atazanavir for the treatment of paediatric patients 6 years of age and older in combination with other antiretroviral medicinal products (Dec 2010)
Link  SMC 520/08: Atazanavir for antiretroviral treatment naïve HIV-1 infected adults (Dec 2008)
Link  SMC 120/04: Atazanavir for the treatment of HIV-1 infected, antiretroviral treatment experienced adults (Sept 2004)
   
bictegravir/emtricitabine/tenofovir alafenamideBlack Triangle (Biktarvy®)
(50mg/200mg/25mg film-coated tablets)
View adult BNF View SPC online
Formulary
Red
 
Link  SMC 2093: Biktarvy® for the treatment of adults infected with human immunodeficiency virus 1 (HIV-1) without present or past evidence of viral resistance to the integrase inhibitor class, emtricitabine or tenofovir (Sept. 2018).
   
Darunavir
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  Drug Safety Update Articles: Darunavir
Link  SMC advice directory: Darunavir for the treatment of HIV-1 infection
   
Darunavir/cobicistat Black Triangle
(Rezolsta®)
View adult BNF
Formulary
Red
High Cost Medicine
 
Link  Drug Safety Update: Darunavir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 (July 2018)
Link  Drug Safety Update: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects (Dec 2016)
Link  SmPC: darunavir/cobicistat
Link  SMC 1081/15: Darunavir/cobicistat for the treatment of HIV-1 infection in adults aged 18 years or older (Aug 2015).
   
Darunavir/cobicistat/emtricitabine/tenofovir alafenamideBlack Triangle
(Symtuza®)
View adult BNF View childrens BNF
Formulary
Red
 
Link  SmPC: darunavir/cobicistat/emtricitabine/tenofovir alafenamide
Link  Drug Safety Update: Darunavir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 (July 2018)
Link  SMC 1290/18: Symtuza® for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults and adolescents (aged 12 years and older with body weight at least 40kg) (Jan 2018)
   
Dolutegravir
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  Drug Safety Update Articles: Dolutegravir
Link  SMC 1253/17: Dolutegravir for the treatment of HIV-1 infected children aged >6 to 12 years of age (July 2017)
Link  SMC 961/14: Dolutegravir for the treatment of HIV-1 infected adults and adolescents above 12 years of age (May 2014)
   
Dolutegravir/abacavir/lamivudine Black Triangle
(Triumeq®)
View adult BNF View childrens BNF
Formulary
Red
High Cost Medicine

RMM Risk Minimisation Materials

 
Link  Risk Minimisation Materials
Link  SmPC: dolutegravir/abacavir/lamivudine
Link  Drug Safety Update Articles: Triumeq
Link  SMC 1009/14: Dolutegravir/abacavir/lamivudine for the treatment of HIV infected adults and adolescents above 12 years of age weighing at least 40 kg (Dec 2014).
   
Dolutegravir/lamivudineBlack Triangle
(Dovato®)
View adult BNF View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  SmPC: dolutegravir/lamivudine
Link  SMC 2205: Dolutegravir/lamivudine for the treatment of HIV-1 infection in adults and adolescents above 12 years of age weighing at least 40kg, with no known or suspected resistance to the integrase inhibitor class, or lamivudine (Sept 2019)
   
dolutegravir/rilvipirineBlack Triangle (Juluca®)
(50mg/25mg film-coated tablets)
View adult BNF
Formulary
Red
 
Link  SmPC: dolutegravir/rilvipirine
Link  SMC 2091: Juluca® for the treatment of HIV-1 infection in adults who are virologically-suppressed on a stable antiretroviral regimen for at least six months no history of virological failure and no resistance to NNRTI or integrase inhibitor (Sept 2018)
   
Efavirenz
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  SMC 1125/15: Efavirenz for the treatment of HIV-1 infected children aged 3 months to 3 years and weighing at least 3.5kg (Dec 2015)
   
Efavirenz/emtricitabine/tenofovir disoproxil
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
 
Link  SMC 442/08: Efavirenz/emtricitabine/tenofovir disoproxil for the treatment of HIV-1 infection in adults (April 2008)
   
Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamideBlack Triangle
(Genvoya®)
View adult BNF View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  SmPC: elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide
Link  Drug Safety Update Articles: Elvitegravir
Link  Drug Safety Update: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects (Dec 2016)
Link  SMC 1142/16: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide for the treatment of HIV-1 infection in adults and adolescents (May 2016)
   
Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil
(Stribild® )
View adult BNF
Formulary
Red
High Cost Medicine
 
Link  SmPC: elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil
Link  Drug Safety Update Articles: Elvitegravir
Link  Drug Safety Update: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects (Dec 2016)
Link  SMC 887/13: elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil treatment of HIV-1 infection in adults aged 18 years and over ( Aug 2013).
   
Emtricitabine/rilpivirine/tenofovir disoproxil
(Eviplera®)
View adult BNF
Formulary
Red
High Cost Medicine
 
Link  SmPC: emtricitabine/rilpivirine/tenofovir disoproxil
Link  SMC 951/14: Emtricitabine/tenofovir/rilpiverine for the treatment of HIV-1 infection in adults (April 2014)
Link  SMC 759/12: Emtricitabine/tenofovir/rilpiverine for the treatment of HIV-1 infection in antiretroviral treatment-naive adults (Feb 2012)
   
Emtricitabine/tenofovir alafenamideBlack Triangle
(Descovy®)
View adult BNF View childrens BNF
Formulary
Red

Descovy® 200/25 film-coated tablets
(200mg emtricitabine/25mg tenofovir alafenamide)
Descovy® 200/10 film-coated tablets
(200mg emtricitabine/10mg tenofovir alafenamide)

 
Link  SmPC: emtricitabine/tenofovir alafenamide
Link  SMC 1169/16: Emtricitabine/tenofovir alafenamide for the treatment of HIV-1 infection in adults and adolescents (Aug 2016)
   
Emtricitabine/tenofovir disoproxil
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
 
Link  SMC 1225/17: Emtricitabine/tenofovir disoproxil in combination with safer sex practices for pre-exposure prophylaxis to reduce the risk of sexually acquired HIV-1 infection in adults at high risk (April 2017)
Link  SMC 237/06: Emtricitabine/tenofovir disoproxil for the treatment of HIV-1 infection in adults (Feb 2006)
   
Etravirine
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  SMC 901/13: Etravirine for the treatment of HIV-1 infection in antiretroviral treatment-experienced paediatric patients from 6 years to less than 18 years of age (Sept 2013)
Link  SMC 530/09: Etravirine for the treatment of HIV-1 infection in antiretroviral treatment experienced adult patients (Aug 2009)
   
Lamivudine
(150mg, 300mg)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Lamivudine/zidovudine
View adult BNF View childrens BNF
Formulary
Red
 
Link  SmPC: lamivudine/zidovudine
   
Lopinavir/ritonavir
(Kaletra®)
View adult BNF View childrens BNF
Formulary
Red
High Cost Medicine

Kaletra® 200/50 film-coated tablets (200mg lopinavir/50mg ritonavir)
Kaletra® 400mg/100mg/5mL oral solution (80mg lopinavir/20mg ritonavir/mL)

 
Link  SmPC: lopinavir/ritonavir
Link  Drug Safety Update: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects (Dec 2016)
Link  SMC 1302/18: Lopinavir/ritonavir oral solution for the treatment of human immunodeficiency virus (HIV-1) infected children aged from 14 days to ≤2 years (Feb 2018)
Link  SMC 326/06: Lopinavir/ritonavir for the treatment of HIV-1 infected adults and children above the age of 2 years (Nov 2006).
   
Nevirapine
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  SMC 760/12: for the treatment of HIV-1 infected adults, adolescents, and children three years and above and able to swallow tablets (Feb 2012).
   
Raltegravir
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  SMC advice directory: Raltegravir for the treatment of HIV-1 infection
   
Rilpiverine/emtrictabine/tenofovir alafenamideBlack Triangle
(Odefsey®)
View adult BNF View childrens BNF
Formulary
Red
 
Link  SmPC: rilpiverine/emtrictabine/tenofovir alafenamide
Link  SMC 1189/16: Rilpiverine/emtrictabine/tenofovir alafenamide for the treatment of HIV-1 infection in adults and adolescents (Oct 2016)
   
Rilpivirine hydrochloride
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  SMC 1168/16: Rilpivirine for the treatment of HIV-1 infection in adolescents (Aug 2016)
Link  SMC 758/12: Rilpivirine for the treatment of HIV-1 infection in adults (Feb 2012)
   
Ritonavir
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  Drug Safety Update: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects (Dec 2016)
   
Tenofovir disoproxil
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  SMC 900/13: Tenofovir disoproxil for the treatment of HIV 1 infected paediatric and adolescent patients aged 6 to < 12 years (Sept 2013).
Link  Q&A: Switching between liquid and tablet/capsule formulations – Which medicines require extra care?
   
Zidovudine
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
   
Lamivudine 100mg
(HIV (off-label))
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Restricted Item To be used in the management of HIV for dialysis and severely impaired renal patients.

 
   
05.03.02.01  Herpes simplex and varicella-zoster infection
05.03.02.02  Cytomegalovirus infection
LetermovirBlack Triangle (Prevymis®)
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine

Letermovir should be initiated by a physician experienced in the management of patients who have had an allogeneic HSCT.

Restricted Item To be supervised by the haematology department.

For prophylaxis of cytomegalovirus (CMV) reactivation and disease in adult CMV-seropositive recipients [R+] of an allogeneic haematopoietic stem cell transplant (HSCT) as per SMC 1338/18.

 
Link  SMC 1338/18: letermovir for prophylaxis of cytomegalovirus (CMV) reactivation and disease in adult CMV-seropositive recipients [R+] of an allogeneic haematopoietic stem cell transplant (HSCT) (March 2019).
   
Valganciclovir
(Prevention of CMV disease in solid organ transplantation)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber 2
High Cost Medicine

Restricted Item Valganciclovir should be initiated by physicians experienced in the care of post-transplant patients.

Prevention of cytomegalovirus (CMV) disease in CMV negative patients adults and children (aged from birth to 18 years) who have received a solid organ transplant from a CMV positive donor.

Duration of treatment: starting within 10 days post-transplantation and continuing until 100 days post-transplantation; for kidney transplant patients, prophylaxis may be continued until 200 days post-transplantation, see SmPC for more information.

 
Link  Alert (Restricted) Antimicrobials [intranet]
Link  SMC 662/10: Renal transplantation - Prevention of cytomegalovirus (CMV) disease in CMV negative patients who have received a solid organ transplant from a CMV positive donor (Jan 2011)
   
05.03.03  Viral hepatitis to top
05.03.03.01  Chronic hepatitis B
 note 

Hepatitis Drug Interaction Checker 
http://www.hep-druginteractions.org/ 
This University of Liverpool Hep-drug interaction checker allows access to a comprehensive, user-friendly, free drug interaction charts. Providing clinically useful, reliable, up-to date, evidence-based information.

NICE Clinical Guideline 165 Hepatitis B (chronic): diagnosis and management
https://www.nice.org.uk/guidance/cg165

Tenofovir disoproxil
(245mg tablets)
View adult BNF View SPC online View childrens BNF
First Choice
Amber 1

RMM Risk Minimisation Materials

 
Entecavir
(tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  SMC 1049/15: Entecavir for thetreatment of chronic hepatitis B virus infection in nucleoside naive paediatric patients from 2 to <18 years of age with compensated liver disease (May 2015)
Link  SMC 320/06: Entecavir for the treatment of chronic hepatitis B virus infection in adults with compensated liver disease and evidence of active viral replication (Oct 2006)
   
Lamivudine 100mg tablets
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine

Restricted Item For adults with chronic hepatitis B infection when first-line treatments cannot be used

 
   
Tenofovir disoproxil 33mg/g granules (Viread®)
(Chronic Hepatitis B)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber 1

RMM Risk Minimisation Materials

Restricted Item Restricted to use in patients for whom a solid dosage form is not appropriate:

  • adolescents 12 to < 18 years of age  with compensated liver disease and evidence of immune active disease, i.e. active viral replication, persistently elevated serum ALT levels and histological evidence of active inflammation and/or fibrosis
  • adults with compensated liver disease, with evidence of active viral replication, persistently elevated serum alanine aminotransferase (ALT) levels and histological evidence of active inflammation and/or fibrosis
  • adults with decompensated liver disease
 
Link  Risk Minimisation Materials
Link  SMC 905/13: Tenofovir disoproxil granules for for the treatment of chronic hepatitis B in adolescents 12 to <18 years and adults for whom a solid dosage form is not appropriate (Sept 2013)
   
Entecavir
(Oral solution)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine

Restricted Item Restricted to use in paediatric patients and those unable to swallow tablets.

 
Link  SMC 1049/15: Entecavir for the treatment of chronic hepatitis B virus infection in nucleoside naive paediatric patients from 2 to <18 years of age with compensated liver disease (May 2015)
Link  SMC 320/06: Entecavir for the treatment of chronic hepatitis B virus infection in adults with compensated liver disease and evidence of active viral replication (Oct 2006)
   
05.03.03.02  Chronic hepatitis C
 note 

Treatment choice will be guided by the National Clinical Guidelines for the treatment of Hepatitis C virus (HCV) in adults. Where no contraindication exists, the most cost effective regimen amongst the recommended options should be chosen to maximise the number of patients who can be treated.

National Clinical Guidelines for the treatment of Hepatitis C virus in adults
http://www.hps.scot.nhs.uk/resourcedocument.aspx?id=6621
These guidelines provide expert guidance to Health Boards, Area Drug and Therapeutics Committees and treating clinicians on the efficacy of available hepatitis C virus drugs and a clinical reference source for NHS National Procurement to produce rankings on cost-effectiveness.

Hepatitis Drug Interaction Checker
http://www.hep-druginteractions.org/
This University of Liverpool Hep-drug interaction checker allows access to a comprehensive, user-friendly, free drug interaction charts. Providing clinically useful, reliable, up-to date, evidence-based information.

MHRA Articles: Hepatitis C
https://www.gov.uk/search?q=%22hepatitis+c%22&filter_organisations%5B%5D=medicines-and-healthcare-products-regulatory-agency

MHRA Articles: Direct-acting antivirals 
https://www.gov.uk/search?q=%22Direct+acting+antivirals%22&filter_organisations%5B%5D=medicines-and-healthcare-products-regulatory-agency

 

Elbasvir/grazoprevir Black Triangle (Zepatier®)
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine

Available in line with national guidance

 
Link  National Clinical Guidelines for the treatment of HCV in adults (June 2018)
Link  SMC 1203/17: Elbasvir/grazoprevir for the treatment of CHC in adults (Jan 2017)
   
Glecaprevir/pibrentasvirBlack Triangle (Maviret®)
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine

Available in line with national guidance.

 
Link  National Clinical Guidelines for the treatment of HCV in adults (June 2018)
Link  SMC 2214: Glecaprevir/pibrentasvir for the treatment of chronic hepatitis C virus (HCV) infection in adolescents aged 12 to <18 years (Nov 2019)
Link  SMC 1278/17: Glecaprevir/pibrentasvir for the treatment of chronic hepatitis C virus (HCV) infection in adults (Nov 2017)
   
SofosbuvirBlack Triangle (Sovaldi®)
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine

Available in line with national guidance

 
Link  Drug Safety Update: Direct-acting antiviral interferon-free regimens to treat chronic hepatitis C: risk of hepatitis B reactivation (Jan 2017)
Link  Drug Safety Update: Direct-acting antivirals to treat chronic hepatitis C: risk of interaction with vitamin K antagonists and changes in INR (Jan 2017)
Link  Drug Safety Update: Simeprevir with sofosbuvir: risk of severe bradycardia and heart block when taken with amiodarone (Aug 2015)
Link  Drug Safety Update: Sofosbuvir with daclatasvir; sofosbuvir and ledipasvir: risks of severe bradycardia and heart block when taken with amiodarone (May 2015)
Link  National Clinical Guidelines for the treatment of HCV in adults (June 2018)
Link  SMC 964/14: Sofosbuvir for the treatment of CHC in adults (June 2014)
   
Sofosbuvir/ledipasvirBlack Triangle (Harvoni®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine

Available in line with national guidance

 
Link  Drug Safety Update: Direct-acting antiviral interferon-free regimens to treat chronic hepatitis C: risk of hepatitis B reactivation (Jan 2017)
Link  Drug Safety Update: Direct-acting antivirals to treat chronic hepatitis C: risk of interaction with vitamin K antagonists and changes in INR (Jan 2017)
Link  Drug Safety Update: Sofosbuvir with daclatasvir; sofosbuvir and ledipasvir: risks of severe bradycardia and heart block when taken with amiodarone (May 2015)
Link  National Clinical Guidelines for the treatment of HCV in adults (June 2018)
Link  SMC 1343/18: Sofosbuvir/ledipasvir for the treatment of chronic hepatitis C infection in adolescents aged 12 to < 18 years with genotype 1 or 4 HCV infection (June 2018)
Link  SMC 1084/15: Sofosbuvir/ledipasvir for the treatment of CHC in adults (Sept 2015)
Link  SMC 1030/15: Sofosbuvir/ledipasvir for the treatment of CHC in adults (March 2015)
   
Sofosbuvir/velpatasvirBlack Triangle (Epclusa®)
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine

Available in line with national guidance

 
Link  National Clinical Guidelines for the treatment of HCV in adults (June 2018)
Link  SMC 1271/17: Sofosbuvir/velpatasvir for the treatment of CHC in adults with genotype 1 or 4 chronic HCV infection (April 2018)
Link  SMC 1271/17: Sofosbuvir/velpatasvir for the treatment of CHC in adults with genotype 2,5 or 6, or with decompensated cirrhosis, irrespective of chronic HCV genotype (Oct 2017)
Link  SMC 1195/16: Sofosbuvir/velpatasvir for the treatment of CHC in adults with genotype 3 (GT3) chronic HCV infection (Nov 2016)
   
Sofosbuvir/velpatasvir/voxilaprevirBlack Triangle (Vosevi®)
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine

Available in line with national guidance

 
Link  National Clinical Guidelines for the treatment of HCV in adults (June 2018)
Link  SMC 1317/18: sofosbuvir/velpatasvir/voxilaprevir for the treatment of chronic hepatitis C virus infection in adults who have failed to achieve a sustained virologic response (SVR) with a direct-acting anti-viral (DAA) (April 2018)
Link  SMC 1317/18: sofosbuvir/velpatasvir/voxilaprevir for the treatment of chronic hepatitis C virus infection in adults with genotype 3 HCV infection with or without cirrhosis (April 2018)
   
05.03.04  Influenza
 note 

Please refer to: Health Protection Scotland Influenza guidance:

Oseltamivir (Tamiflu®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green

Antivirals for the treatment and prophylaxis of influenza should only to be used when predefined threshold is reached and announcement made by the Scottish Government

 
   
Zanamivir inhalation (Relenza®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green

Antivirals for the treatment and prophylaxis of influenza should only to be used when predefined threshold is reached and announcement made by the Scottish Government

 
   
ZanamivirBlack Triangle (Dectova®)
(solution for infusion)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Restricted Item For the treatment of complicated and potentially life-threatening influenza A or B virus infection in adult and paediatric patients (aged ≥ 6 months) when:

  • the patient’s influenza virus is known or suspected to be resistant to anti-influenza medicinal products other than zanamivir, and/or
  • other antiviral medicinal products for treatment of influenza, including inhaled zanamivir, are not suitable for the individual patient
 
Link  SMC 2256: Zanamivir for the treatment of complicated and potentially life-threatening influenza A or B virus infection in adult and paediatric patients (aged ≥ 6 months) who are resistant to or unsuitable for other anti-influenza products (Dec 2019)
   
05.03.05  Respiratory syncytial virus
Palivizumab (Synagis®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
   
 ....
 Non Formulary Items
Abacavir/lamivudine/zidovudine
(Trizivir®)

View adult BNF View childrens BNF
Non Formulary
Black
High Cost Medicine

RMM Risk Minimisation Materials

Link  Risk Minimisation Materials
Link  SmPC: abacavir/lamivudine/zidovudine
 
Adefovir Dipivoxil  (Hepsera®)
(Chronic Hepatitis B)

View adult BNF View SPC online
Non Formulary
Black

Adefovir dipivoxil is no longer recommended for the treatment of chronic hepatitis B

Link  NICE CG165: Hepatitis B (chronic) - incorporates TA96
Link  NICE TA96: Hep B - adefovir dipivoxil and pegylated interferon alpha-2a
 
Atazanavir/cobicistat Black Triangle 
(Evotaz®)

View adult BNF
Non Formulary
Black
High Cost Medicine
Link  SmPC: atazanavir/cobicistat
Link  Drug Safety Update: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects (Dec 2016)
Link  SMC 1098/15: Atazanavir/cobicistat for the treatment of HIV-1 infection in adults and adolescents (Nov 2015)
 
Boceprevir  (Victrelis®)

Non Formulary
High Cost Medicine
Link  EMA: Victrelis (boceprevir) withdrawal of the marketing authorisation in the European Union (July 2018)
 
Daclatasvir  (Daklinza®)

Non Formulary

30 September 2018 Daklinza 30mg tablets and 60mg tablets were discontinued in the United Kingdom.

 
Dasabuvir  (Exviera®)

Non Formulary

The Marketing Authorisation holder has discontinued this product.

 
Didanosine

Non Formulary
Black
High Cost Medicine
 
Doravirine Black Triangle  (Pifeltro ®)

View adult BNF
Non Formulary
Grey
Link  SmPC: doravirine (Pifeltro®) 100mg film-coated tablets
Link  SMC 2332: Doravirine in combination with other antiretroviral medicinal products, for the treatment of adults infected with HIV-1 without past or present evidence of resistance to the NNRTI class (March 2021).
 
Doravirine/lamivudine/tenofovir disoproxil Black Triangle  (Delstrigo®)

View adult BNF
Non Formulary
Grey
Link  SmPC: Delstrigo® 100mg/300mg/245mg film-coated tablets
Link  SMC 2333: Delstrigo for the treatment of adults infected with HIV-1 without past or present evidence of resistance to the NNRTI class, lamivudine or tenofovir (March 2021).
 
Emtricitabine

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine
 
Fosamprenavir

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine
 
Indinavir

View adult BNF View childrens BNF
Non Formulary
Black
High Cost Medicine
Link  Summary of Product Characteristics: Indinavir
 
Maraviroc  (Celsentri®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

Maraviroc (Celsentri®) is not recommended for use within NHS Scotland as per SMC 458/08 and SMC 1282/17

Link  SMC 1282/17: Maraviroc for treatment-experienced adolescents and children of 2 years and older and weighing at least 10kg infected with only CCR5-tropic HIV-1 detectable (Oct 2017)
Link  SMC 458/08: Maraviroc for treatment-experienced adult patients infected with only CCR5-tropic HIV-1 detectable (Oct 2008)
 
Ombitasvir/paritaprevir/ritonavir
(Viekirax®)

Non Formulary

The Marketing Authorisation holder has discontinued this product.

 
Rifaximin 200mg  (Xifaxanta®)
(travellers' diarrhoea)

View adult BNF
Non Formulary
Black

Rifaximin (Xifaxanta®) is not recommended for use within NHS Scotland as per SMC 808/12

Link  SmPC: Rifaximin 200mg
Link  SMC 808/12: Rifaximin for the treatment of travellers’ diarrhoea that is not associated with fever, blood diarrhoea, eight or more unformed stools in the previous 24h, occult blood or leucocytes in the stool (Aug 2012).
 
Saquinavir

View adult BNF View SPC online
Non Formulary
Black
High Cost Medicine
 
Simeprevir  (Olysio®)

Non Formulary
High Cost Medicine
Link  EMA: Olysio (simeprevir) withdrawal of the marketing authorisation in the European Union (May 2018)
 
Telaprevir  (Incivo®)

Non Formulary
High Cost Medicine
Link  EMA: This medicine is now withdrawn from use in the European union (Oct 2016)
 
Tenofovir alafenamide Black Triangle  (Vemlidy®)
(Chronic Hepatitis B)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Tenofovir alafenamide (Vemlidy®is not recommended for use within NHS Scotland as per SMC 1238/17

Link  SMC 1238/17: Tenofovir alafenamide for the treatment of chronic hepatitis B in adults and adolescents (aged 12 years and older with body weight at least 35kg) (Apr 2017).
 
Tipranavir

Non Formulary
Black
High Cost Medicine
 
  
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
Homecare
Homecare

Traffic Light Status Information

Status Description

Green

General use.
Treatment may be initiated in either Primary or Secondary Care.  

Amber 1

Available for restricted use under specialist supervision.
Treatment may be initiated in Primary Care on the recommendation of a consultant/specialist.  

Amber 2

Available for restricted use under specialist supervision.
Treatment to be initiated in hospital prior to handover.  

Red

Hospital use only.
Treatment should be supplied by the hospital for the duration of the treatment course.  

Blue

Products shown as blue have multiple indications with varying formulary classifications. For further information see text next to the product.  

Grey

Work is ongoing and will be reviewed at a future meeting  

Non Formulary

Not routinely available in NHS Grampian however if local need is identified:
  • Contact the Pharmacist Team Leader/Principal Pharmacist – Supply (ARI)
  • Treatment is available:
    • From a Specialist Centre in another health board
    • From the National Specialist Service for pulmonary arterial hypertension (Scottish Pulmonary Vascular Unit or similar specialists)
    • Through the National Services Scotland:
      • Ultra-Orphan Medicines Risk Share Scheme
      • Inherited Metabolic Disorders Risk Share Scheme
    • For SMC recommended medicines/indications where local clinical experts do not wish to add to the formulary at this time
  

Black

Not routinely available in NHS Grampian.
Includes medicines/indications that:
  • Are not recommended for use within NHS Grampian
  • Are not recommended for use within NHS Scotland
  • Have not been considered by SMC or NHSG Formulary Group
  • Are not recommended for use at present due to limited clinical and/or cost effective data
  • There is a local preference for alternative medicines
  

netFormulary