Cambridgeshire and Peterborough Formulary


	Cambridgeshire and Peterborough Formulary

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Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter

12.02.01

Drugs used in nasal allergy

Azelastine and fluticasone (Dymista)

Formulary

Status Ratified by C&P CCG JPG at the March 2019 meeting.

Allergic rhinitis treatment in pregnancy UKMI Q&A

C & P CCG: Allergic Rhinitis Pathway - Adults and adolescents (12 years and above)

12.02.01

Antihistamines

Azelastine Hydrochloride (Rhinolast^®)

Formulary

Status Ratified by C&P CCG JPG at the March 2019 meeting.

12.02.01

Corticosteroids

Beclometasone Dipropionate
(Nasal spray)

Formulary

Nasal spray 50micrograms per spray

Suitable for self care - patients aged 18 years and over may purchase from a Community Pharmacy.

Mometasone Furoate (Nasonex®, Clarinaze^® (OTC))
(mometasone furoate 50 micrograms/metered spray.)

Formulary

Suitable for self care - patients aged 18 years and over may purchase from a Community Pharmacy.

RPH and NWAFT: Formulary.

CUHFT: Specialist advice/initiation via Lloyds OP.

Non formulary at all other trusts.

Betamethasone Sodium Phosphate

Formulary

Drops (for ear, eye, or nose) 0.1%

Fluticasone Propionate (Flixonase Nasule^®)

Formulary

Recommended second line after mometasone nasal spray for the management of nasal polyps in chronic rhinosinusitis. Flixonase (fluticasone proprionate) nasules should be prescribed for a 6-week course and if treatment successful patient can then be switched back to a nasal steroid spray.

For the treatment of oral lichen planus see link below.

Not recommended for any other indication.

Flixonase® Nasules for the management of oral lichen planus in adults and children 16 years and over

Link to reviews

Fluticasone Propionate
(Nasal spray)

Restricted

Suitable for self care - patients aged 18 years and over may purchase from a Community Pharmacy.

NWAFT: Formulary.

Non-formulary at all other Trusts and in Primary Care

12.02.01

Cromoglicate

Sodium Cromoglicate (Rynacrom^®)

Formulary

Sodium cromoglicate 4% (5.2 mg/spray).

....

Non Formulary Items

Budesonide

Non Formulary

Rhinocort Aqua® 64micrograms per spray
Budesonide 100micrograms per spray

Fluticasone furoate (Avamys^®)

Non Formulary

Fluticasone furoate 27.5 micrograms/metered spray.

Avamys is more expensive than current formulary choices.

Triamcinolone Acetonide

Non Formulary

Nasacort® triamcinolone acetonide 55 micrograms/metered spray.

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG

Traffic Light Status Information

Status	Description
	Available Over the Counter. Consider Self Care
	Formulary - Can be prescribed in both secondary and primary care.
	Formulary - Specialist Advice, secondary care advice provided for primary care initiation.
	Formulary - Specialist initiation without shared care guidance.
	Formulary - Specialist initiation with shared care guidance.
	Restricted - Prescribing (and monitoring where applicable) to remain with the hospital or specialist service. Not to be prescribed in Primary Care
	Not recommended for prescribing. Switch to alternative cost-effective option.
	Not recommended for prescribing in primary or secondary care.
	Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.
	Non-Formulary (category under review).