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Airedale NHS Foundation Trust
Airedale, Wharfedale and Craven CCG
 
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 Formulary Chapter 20: Unlicensed Medicines / Significant off-label use - Full Chapter
20  Expand sub section  Unlicensed Medicines
ACETYLCYSTEINE
(Mucolytic)
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Restricted Drug Restricted
Red ULM
Acetylcysteine Capsules 600mg

Respiratory Consultants Only 
   
CAFFEINE BASE 10mg/ml
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Formulary
Red ULM
Caffeine citrate Solution (50mg/5ml) 
   
CAFFEINE CITRATE 10mg/ml INJ
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Formulary
Red ULM
Caffeine citrate Injection (10mg/ml) 
Link  MHRA letter to healthcare professionals regarding caffeine citrate products
Link  MHRA safety advice regarding caffeine citrate product strengths
   
LIQUID PARAFFIN STERILE (20ml)
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Red ULM
 
Link  Unlicensed Medicine Request forms required for this product
   
PENTOSAN POLYSULPHATE Capsules 50 mg
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Formulary

Pentosan Polysulphate Capsules (50mg)

Black For new patients

Red For existing patients only

 

 
Link  DSU: Elmiron (pentosan polysulfate sodium): rare risk of pigmentary maculopathy (September 2019)
   
Povidone Iodine 5% Sterile
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Formulary
Red ULM
Povidone Iodine 5% Sterile (10mL) 
   
TALC BP purified sterile
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Red ULM
  • Talc Dusting Powder (Sterile)
 
Link  Unlicensed Medicines Consultant Request Form (ANHSFT access only)
Link  Unlicensed Medicines Patient Agreement for Use Form (ANHSFT access only)
Link  Unlicensed Medicines Patient Information Leaflet (ANHSFT access only)
Link  Unlicensed Medicines Policy (ANHSFT access only)
   
 ....
 Non Formulary Items
Potassium hydroxide  (Molutrex / Molludab)

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Non Formulary
Black
Not routinely commissioned
 
  
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
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Link to children's BNF
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Link to SPCs
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

Green

Green - Drugs suitable for generalised use in accordance with position summary. Inform primary care of need to prescribe using a TTO chart if in patient or Treatment Advice Note (TAN) if Outpatient.   

Amber

Amber - these drugs require specialist initiation or recommendation  

Amber SCG

Amber Share Care - Drugs suitable for generalist use, in accordance with position summary, normally following specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Red

Red - Drugs for specialist use only, in accordance with position summary. GPs should not be asked to prescribe these products.  

Red ULM

Red ULM - Unlicensed medicines for specialist use only, in accordance with position summary. GPs should not be asked to prescribe these products.  

Grey

Grey drugs - No formal commissioning position. Check appropriate CCG /NHSE commissioning list or contact CCG/NHSE Medicines Management team for advice. Fill in individual funding request for appropriate CCG/NHSE. This will need to be signed by the Chief Pharmacist and a copy of the relevant DTC submission attached.   

Black

Black - Drugs not routinely commissioned so should not usually be prescribed  

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