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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.01.04  Expand sub section  Compound bronchodilator preparations
Tiotropium & olodaterol (Spiolto Respimat)
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First Choice
Green
  • See CCG COPD Pathway (link below).
  • 1st line choice in patients who require a LAMA/LABA combination, currently receiving tiotropium monotherapy 
  • Indacaterol & glycopyrrolate inhaler (Ultibro Breezhaler)
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    Second Choice
    Green
  • See CCG COPD Pathway (link below).
  • Second line LABA/LAMA for COPD who do not tolerate Spiolto Respimat or who need step up to LABA/LAMA combination and currently on Glycopyyronium monotherapy ( Seebri Breezhaler). 
  • Link  C & P CCG COPD Pathway ( March 2016)
    Link  NICE New Medicine Evidence Summary 33: indacaterol/glycopyrronium (Ultibro Breezhaler)
       
    Aclidinium and formoterol inhaler (Duaklir Genuair )
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    Third Choice
    Green
  • See CCG COPD Pathway (link below).
  • Third line LABA/LAMA combined inhaler for COPD who do not tolerate Spiolto Respimat or Ultibro Breezhaler or who are currently receiving either aclidinium or formoterol monotherapy and need to step up to a LABA/LAMA combination. 
  • Link  C & P CCG COPD Pathway ( March 2016)
       
    Ipratropium bromide with salbutamol
    (Single dose units nebuliser solution)
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    Restricted Drug Restricted
    Red Hospital

    NWAFT only Non- Formulary at other Trusts.

     
       
     ....
     Non Formulary Items
    Duovent

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    Non Formulary
    Grey
     
    Umeclidinium & vilanterol  (Anoro Ellipta)

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    Non Formulary
    Black
  • Considered by JPG March '16- Agreed as NOT recommended
  •  
      
    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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