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 Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
12.03.01  Expand sub section  Drugs for oral ulceration and inflammation
Benzydamine Hydrochloride
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Formulary
OTC

  • Mouthwash

  • Oromucosal spray

  • Consider whether prescribing in Primary Care should be by a dentist. Suitable for self-care. Can be purchased from a Community Pharmacist

 
   
Betamethasone
(mouth ulcers)
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Formulary
Green

  • Soluble betamethasone 500 micrograms tablets (as sodium phosphate).

 
   
Choline Salicylate (Bonjela® Adult)
(Dental Gel)
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Formulary
OTC

  • NB: Bonjela Adult is suitable from 16 years only.

  • Suitable for self-care. Advise patients they can purchase from a Community Pharmacist

 
   
Fluticasone Propionate (Flixonase®)
(Nasules)
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Formulary
Amber No SCG

 

  • Second line to betamethasone soluble for the management of oral lichen planus in adults and children 16 years and over (off-label indication).
  • Use first line only where betamethasone soluble (licensed treatment) is unavailable or contraindicated.
  • For the management of nasal polyps in chronic rhinosinusitis see link below. 

 

 
Link  Flixonase® nasules for the management of nasal polyps in chronic rhinosinusitis
   
Lidocaine hydrochloride / Cetylpyridinium chloride (Bonjela® Junior Gel)
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Formulary
OTC

  • Suitable for self-care. Advise patients they can purchase from a Community Pharmacist

  • CUHFT and NWAFT: Formulary

 
   
Anaesthetic throat lozenges (Tyrozets®)
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Restricted Drug Restricted
Red Hospital

  • CUHFT only - Tyrozets lozenges post general anaesthesia in recovery areas only (available on stocklist only)

  • Non formulary at all other trusts

 
   
Hydrocortisone
(mouth ulcers)
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Formulary
Green
  • Mucoadhesive buccal tablets (= oromucosal tablets), hydrocortisone 2.5 mg (as sodium succinate).  
  • Link  MHRA Drug Safety Update: Hydrocortisone muco-adhesive buccal tablets: should not be used off-label for adrenal insufficiency in children due to serious risks
       
     ....
     Non Formulary Items
    Doxycycline

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    Non Formulary
    Non Formulary
  • Disperse 100mg tablet in water and use as a mouthwash [unlicensed indication].
  • Periostat®
  •  
    Flurbiprofen lozenge

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    Non Formulary
    Non Formulary
  • Strefen® Lozenges, flurbiprofen 8.75 mg.
  •  
    Lidocaine 10% mouth spray  (Xylocaine® )

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    Non Formulary
    Non Formulary
     
    Lidocaine 5% ointment
    (mouth)

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    Non Formulary
    Non Formulary
    15g tube (Ł5)
  • For external use on nipples, genitals, gums etc.
  • For intact skin use EMLA® or Ametop® instead.
  • Weaker versions which can also be used for mouth ulcers are dentinox teething gel (0.33% lidocaine) or Instillagel (2% lidocaine, tastes foul)


  •  
    Salicylic acid  (Pyralvex®)

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    Non Formulary
    Non Formulary
  • Oral paint anthraquinone glycosides 0.5%), salicylic acid 1%.
  •  
      
    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
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    OTC

    Available Over the Counter. Consider Self Care   

    Green

    Formulary - Can be prescribed in both secondary and primary care.   

    Advice

    Formulary - Specialist Advice, secondary care advice provided for primary care initiation.  

    Amber No SCG

    Formulary - Specialist initiation without shared care guidance.  

    Amber SCG

    Formulary - Specialist initiation with shared care guidance.  

    Red Hospital

    Restricted - Hospital only, not to be prescribed in primary care.  

    Switch

    Not recommended for prescribing. Switch to alternative cost-effective option.   

    Black

    Not recommended for prescribing in primary or secondary care.  

    Grey

    Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.   

    Non Formulary

    Non-Formulary (category under review).  

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