Formulary


	Ipswich and East Suffolk CCG North East Essex CCG East Suffolk and North East Essex NHS Foundation Trust

Search

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

12.02

Drugs acting on the nose

12.02.01

Drugs used in nasal allergy

Azelastine and fluticasone (Dymista)

Formulary

Licensed for 12 and over

Ipswich Hospital

Azelastine / fluticasone (Dymista) is a formulary medicines choice

Colchester Hospital

Azelastine / fluticasone (Dymista) is a non-formulary medicine

Primary care guidance

Relief of symptoms of moderate-severe perennial allergic rhinitis in patients who have failed to respond to a steroid nasal spray with the addition of an oral antihistamine.

Treatment must be reviewed after 3 months and only continued for patients who are benefitting from it.

12.02.01

Antihistamines

12.02.01

Corticosteroids

MHRA:Risk of psychological and behavioural side effects

Beclometasone Dipropionate
(Nasal spray)

First Choice

Available OTC for 18+ yrs

First choice for nasal spray

POM use -Licensed for 6 and over

Betamethasone Sodium Phosphate (eye, ear, nose drops)

First Choice

First choice for nasal drops

Mometasone Furoate

Formulary

Available OTC

Fluticasone Propionate (Nasofan^®)

Formulary

Available OTC for >18 years

POM use- Licensed for 4 and over

Fluticasone Propionate (Flixonase Nasule^®)

Formulary

Licensed for 16 and over

Triamcinolone Acetonide (Nasacort^®)

Restricted

Ipswich Hospital

Triamcinolone acetonide nasal spray (Nasocort) is non-formulary

Colchester Hospital

Triamcinolone acetonide nasal spray (Nasocort) is considered a formulary medicine

Budesonide (Rhinocort Aqua^®)

Restricted

Ipswich Hospital

Budesonide nasal spray (Rhinocort Aqua) is non-formulary

Colchester Hospital

Budesonide nasal spray (Rhinocort Aqua) is considered a formulary medicine

Fluticasone furoate (Avamys^®)

Restricted

Ipswich Hospital

Fluticasone furoate nasal spray (Avamys) is non-formulary

Colchester Hospital

Fluticasone furoate nasal spray (Avamys) is considered a formulary medicine choice

12.02.01

Cromoglicate

12.02.02

Topical nasal decongestants

12.02.02

Sympathomimetics

Ephedrine nasal drops

Formulary

Available OTC

Xylometazoline (Otrivine^®)

Formulary

Avaiable OTC

Avaiable as

0.1% nasal spray and drops,
0.05% paediatric nasal drops

12.02.02

Antimuscarinic

Ipratropium Bromide

Formulary

12.02.02

Other decongestants

Sodium chloride 0.9%

Formulary

Can also be bought OTC

12.02.03

Nasal preparations for infection

12.02.03

Nasal Staphylococci

Naseptin (Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5%)

Formulary

For eradication and prevention of nasal carriage of staphylococci

Avoid in the following groups due to arachis oil content

Nut allergy
Soya allergy

Bactroban Nasal (Mupirocin 2%)
(nasal)

Formulary

Eradication of nasal carriage of MRSA or in patients who cannot have Naseptin^®

Octenidine (Nasal gel)
(nasal)

Formulary

Use in the following cases:

If patient cannot use naseptin due to nut/soya allergy

AND

If bactroban not available

....

Non Formulary Items

Azelastine Hydrochloride (Rhinolast^®)

Non Formulary

Budesonide

Non Formulary

Flunisolide (Syntaris^®)

Non Formulary

Sodium Cromoglicate (Rynacrom^®)

Non Formulary

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
	For routine prescribing in primary and secondary care.
	Initiated (if clinically urgent) or advised (if non-urgent) by specialist in secondary care, prescribing can be continued in primary care.
	Shared care
	Hospital only
	There should be no prescribing of these drugs
	The traffic light of the drug is dependant on the indication. Please see individual drug entry for details