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 Formulary Chapter 3: Respiratory system - Full Chapter
Notes:

MHRA:Pressurised metered dose inhalers (pMDI): risk of airway obstruction from aspiration of loose objects

Inhalers

The following acronyms may be mentioned in this section in reference to inhalers

  • MDI- Metered dose inhaler
  • DPI- Dry powder inhaler
  • BAA- Breath actuated aerosol
  • ICS- Inhaled corticosteroid
  • SABA- Short-acting bronchodilator
  • LABA- Long-acting bronchodilator
  • SAMA- Short-acting muscarinic
  • LAMA - Long-acting muscarinic
Chapter Links...
 Details...
03.01  Bronchodilators
03.01.01  Adrenoceptor agonists
03.01.01.01  Selective Beta2 agonists
03.01.01.01  Short-acting beta2 agonists
Salbutamol (MDI)
View adult BNF View SPC online View childrens BNF
First Choice
Blue
 
Salbutamol (DPI- Easyhaler®)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Not stocked at IHT

 
   
Terbutaline (DPI)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Reserved for patients intolerant or allergic to salbutamol.

Licensed for adults and children >5 years

 
   
Salbutamol (2.5mg and 5mg nebulisers)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Only if patient unable to use inhalers / patients with severe disease.

 
   
Terbutaline (Nebulisers)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Reserved for patients intolerant or allergic to salbutamol where a patient is unable to use inhalers or has severe disease

 
   
Salbutamol  (intravenous)
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
 
   
03.01.01.01  Long-acting beta2 agonists to top
Formoterol  (Easyhaler®)
(DPI)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

A LABA should only be used in asthmatic patients with an ICS.

Adults and children >6 years

 
   
Formoterol  (Turbohaler®)
(DPI)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

A LABA should only be used in asthmatic patients with an ICS.

Adults and children >6 years

 

 
   
03.01.01.02  Other adrenoceptor agonists
03.01.02  Antimuscarinic bronchodilators
Umeclidinium (Incruse Ellipta®)
View adult BNF View SPC online View childrens BNF
First Choice
Blue

Licensed for adults >18 years for COPD

 
Aclidinium (Eklira Genuair®)
View adult BNF View SPC online View childrens BNF
Formulary

Licensed for adults > 18 years for COPD

 
   
Ipratropium (inhaler)
View adult BNF View SPC online View childrens BNF
Formulary
Blue
 
   
Ipratropium (nebules)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Only if patient unable to use inhalers / patients with severe disease.

 
   
Tiotropium (Spiriva® Respimat)
View adult BNF View SPC online View childrens BNF
Formulary
Green

On specialist recommendation (asthma)


May be continued for existing patients only, consider moving to a formulary option at next review (COPD)

 
   
03.01.02  Short Acting Anti-muscarinic Bronchodilators
03.01.02  Long Acting Anti-muscarinic Bronchodilators
03.01.03  Theophylline to top
 note 

Therapuetic Drug Monitoring Information

Please note oral theophylline/aminophylline must be specified by brand

Different brands are not interchangeable

Check interactions with theophyline before prescribing new drugs as further monitoring may be required

Factors to consider in TDM Information Further details
When level should be done (after initiation) 5 days  
When bloods should be taken 4-6hrs post dose  
Optimal drug levels 10–20 mg/litre
(55–110 micromol/litre)
Lower drug levels may still provide therapuetic benefit
When levels should be taken again following dose alteration 3 days  
Non-drugs factors which can affect levels Increased in:
  • Heart failure
  • Hepatic impairment
  • Viral infections
  • Elderly patients
Decreased in:
  • Smokers
  • Alcohol consumption
Consider levels if there are changes in the non-drug factors listed
Signs of toxicity
  • Nausea
  • Vomiting - Severe and protracted
  • Abdominal pain
  • Mild metabolic acidosis
  • Hypokalemia
  • Tachycardia
  • Hypophosphatemia
  • Hypomagnesemia
  • Hypocalcemia/hypercalcemia
  • Hyperglycemia
Seek advice if suspected
Uniphyllin® Continus
(Theophylline )
View adult BNF View SPC online View childrens BNF
First Choice
Blue

Always prescribe by brand

 
Phyllocontin Continus® (Aminophylline)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Always prescribe by brand

February 2021:  

Phyllocontin® (aminophylline) Continus 225mg and Phyllocontin® Forte Continus 350mg modified-release tablets are being discontinued in the UK.  
 
Remaining supplies of the 225mg strength are expected to be exhausted by 2nd March 2021 and the 350mg strength are expected to be exhausted by 5th April 2021.
 
Please click here for further information
 
   
Aminophylline IV
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
 
   
03.01.04  LAMA plus LABA
Umeclidinium & vilanterol (Anoro Ellipta®)
View adult BNF View SPC online View childrens BNF
First Choice
Blue

Licensed for adults >18 years for COPD

 
Aclidinium and formoterol inhaler (Duaklir Genuair ®)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Licensed for adults >18 years for COPD

 
   
03.01.05  Peak flow meters, inhaler devices and nebulisers
03.01.05  Peak flow meters
Low range peak flow meter (Pocket peak®)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Specify as "low range peak flow meter" on prescription 

 
   
Standard range peak flow meter (Airzone®)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Specify as "standard range peak flow meter" on prescription 

 
   
03.01.05  Drug delivery devices
AeroChamber Plus ®
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available with a mask.

Check spacer fits prescribed inhaler(s)

 
   
Space Chamber Plus Compact®
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available with a mask.

Check spacer fits prescribed inhaler(s).

Dishwasher safe

 
   
Volumatic ®
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available with a mask.

Check spacer fits prescribed inhaler(s)

 
   
Haleraid ®
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available as 

  • Haleraid 120 (for 120 dose MDI)
  • Haleraid 200 (for 200 dose MDI)
 
   
Flo-Tone MDI
View adult BNF View SPC online View childrens BNF
Formulary
Blue
 
   
03.02  Corticosteroids to top
03.02.01  Inhaled corticosteroids (ICS)
Qvar (Beclometasone )
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Prescribe by brand


Avaiable as

  • MDI device
  • Autohaler (BAA)

Licensed for adults and children >12 years

QVAR is approximately half the dose of clenil

 
   
Clenil Modulite (Beclometasone )
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Prescribe by brand


Licensed for adults and children of any age

 
   
Budesonide (Easyhaler®)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Only if beclometasone not suitable.

Licensed for adults and children >6 years

 
   
Budesonide (Respules®)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Adults - may be continued for existing patients only, consider moving to a formulary option at next review

 
   
03.02.02  Combination products (ICS+LABA) for asthma
03.02.02  Low dose
Seretide 50 (Fluticasone propionate and salmeterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Paediatric use only
Licenced for children >5 years


Adults - may be continued for existing patients only, consider moving to a formulary option at next review

 
   
Flutiform 50/5 (Fluticasone propionate and formoterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available as
- MDI
- K-haler (see note below re: discontinuation of the K-haler device)

Licensed for adults and children >12 years

 

February 2021 - All strengths of the K-haler device are being discontinued from the UK market. The 50/5mcg device will be discontinued from August 2021. 

 
   
Fostair 100/6 ( Beclometasone and formoterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available as

  • MDI
  • DPI (NEXThaler device)

Licensed for adults >18 years only.

Low dose= 1 puff BD

 
   
03.02.02  Moderate dose
Flutiform 125/5 (Fluticasone propionate and formoterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available as
- MDI
- K-haler (see note below re: discontinuation of the K-haler device)

Licensed for adults and children >12 years

 

February 2021 - All strengths of the K-haler device are being discontinued from the UK market. The 125/5mcg device will be discontinued from April 2021.  

 

 

 

 
   
Fostair 100/6 (Beclometasone and formoterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available as

  • MDI
  • DPI (NEXThaler device)

Licensed for adults >18 years only.

Moderate dose= 2 puffs BD

 
   
Relvar Ellipta 92/22 (Fluticasone furoate & vilanterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Reserved for patients intolerant to Fostair or Flutiform
Licensed for adults and children >12 years (for asthma)

 
   
03.02.02  High dose to top
Flutiform 250/10 (Fluticasone propionate and formoterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Licensed for adults and children >12 years

 
   
Fostair 200/6 (Beclometasone and formoterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available as

  • MDI
  • DPI (NEXThaler device)

Licensed for adults >18 years only.

 
   
Relvar Ellipta 184/22 (Fluticasone furoate & vilanterol)
View adult BNF View SPC online View childrens BNF
Formulary
Green

On specialist recommendation only (for asthma)
Licensed for adults and children >12 years (for asthma)

 
   
03.02.03  Combination products (ICS+LABA) for COPD
Fostair 100/6 (Beclometasone and formoterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available as

  • MDI
  • DPI (NEXThaler device)

Licensed for adults >18 years only.

 
   
Relvar Ellipta 92/22 (Fluticasone furoate & vilanterol)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Licensed for adults >18 years only (for COPD)

 
   
03.02.03  Triple Therapy products for COPD
 note 

Joint guidance

Prescribing advice- triple therapy inhalers

Only to be used where the patient requires all three drugs to manage the condition 

If control improves, step back down to LABA/LAMA combined product

Trelegy
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Components

    • fluticasone furoate - 92 micrograms
    • umeclidinium - 55 micrograms
    • vilanterol - 22 micrograms

Once daily dosing

 
   
Trimbow
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Components

    • beclometasone dipropionate - 100 micrograms
    • glycopyrronium - 10 micrograms
    • formoterol fumarate - 6 micrograms

Twice daily dosing

 
   
03.03  Cromoglicate, related therapy and leukotriene receptor antagonists
03.03.01  Cromoglicate and related therapy
03.03.02  Leukotriene receptor antagonists to top
Montelukast (Singulair®)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

MHRA:reminder of the risk of neuropsychiatric reactions

Adults – see asthma pathway 

Children over 5 years: see asthma pathway 

Children under 5 years: see asthma pathway 

Child 13-18 years:see asthma pathway 

 
   
03.03.03  Phosphodiesterase type-4 inhibitors
Roflumilast (Daxas®)
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
 
Link  NICE TA244: Chronic obstructive pulmonary disease - roflumilast (only as part of a trial)
Link  NICE TA461 : Roflumilast for treating chronic obstructive pulmonary disease
   
03.04  Antihistamines, hyposensitisation, and allergic emergencies
03.04.01  Antihistamines
 note 

Primary care guidance

Self care leaflets

Hay fever

Hay fever in chilldren

03.04.01  Non-sedating antihistamines
Cetirizine
View adult BNF View SPC online View childrens BNF
First Choice
Blue

Available OTC

 
Loratadine
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available OTC

 
   
Fexofenadine
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Only if other antihistamines ineffective or not tolerated

 
   
03.04.01  Sedating antihistamines to top
Chlorphenamine
View adult BNF View SPC online View childrens BNF
First Choice
Blue

Available OTC

 
Hydroxyzine
View adult BNF View SPC online View childrens BNF
Formulary
Blue

MHRA:Risk of QT interval prolongation and Torsade de Pointes

 
   
03.04.02  Allergen Immunotherapy
Grass pollen extract (Grazax®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red Hospital

Ipswich Hospital

Grazax is considered a non-formulary medicine

Colchester Hospital

Grazax is considered a very restricted but a formulary medicine

 
   
03.04.02  Omalizumab
BenralizumabBlack Triangle (Fasenra)
(Pre-filled syringe for subcutaneous injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
High Cost Medicine
NHS England
BlueTeq

A humanised monoclonal antibody that interferes with interleukin-5 receptor binding, thereby reducing the survival of eosinophils and basophils.

For severe oesinophilic asthma (specilaist use only).

Initiated  from a specialist centre eg Addenbrrokes

 
Link  NICE TA 565 Benralizumab for treating severe eosinophilic asthma
   
Omalizumab (Xolair®)
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
High Cost Medicine
 
Link  NICE TA278: Omalizumab for treating allergic asthma
Link  NICE TA339: Omalizumab for previously treated chronic spontaneous urticaria
   
03.04.03  Allergic emergencies
 note 

Hospital only guidance

03.04.03  Anaphylaxis
Adrenaline / Epinephrine (Epipen,Jext, Emerade)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

MHRA:Adrenaline auto-injectors

MHRA: Emerade Recall

Injection technique is device specific. To ensure patients receive the auto-injector device that they have been trained to use, prescribers must prescribe by brand.

 
Link  NICE CG134: Anaphylaxis: Assessment and referral after emergency treatment
   
03.04.03  Angioedema to top
C1 Esterase Inhibitor (Berinert®)
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
High Cost Medicine
NHS England
 
   
Lanadelumab
(For subcutaneous injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
High Cost Medicine
NHS England

For preventing recurrent attacks of hereditary angioedema

 
Link  NICE TA606 Lanadelumab for preventing recurrent attacks of hereditary angioedema
   
03.05  Respiratory stimulants and pulmonary surfactants
03.05.01  Respiratory stimulants
Caffeine Citrate
Formulary
Red Hospital

Hospital Neonatal use only

Administered by mouth or by intravenous infusion

 
   
Doxapram
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
 
   
03.05.02  Pulmonary surfactants
Poractant Alfa (Curosurf®)
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
High Cost Medicine
NHS England
 
   
03.06  Oxygen
 note 

Hospital only guidance

 

Primary care guidance

Click here to see further information on oxygen

03.07  Mucolytics to top
Carbocisteine
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Joint guidance

Stepping down guidance

Please see below for guidance on stepping down carbocisteine for primary and secondary care

Should be stopped if there is no benefit after a 4 week trial

 
Link  IESCCG Primary care- Carbocisteine step down
Link  IHT- Therapeutic Substitution Register
Link  NEECCG Primary care- Carbocisteine step down
   
03.07  Dornase alfa
Dornase Alfa (Pulmozyme®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red Hospital
High Cost Medicine
NHS England
Homecare

Commissioned by NHSE.

Do not prescribe in primary care for new patients (since April 2013)


At Ipswich hospital - to be supplied by Addenbrokes on homecare

At Colchester hospital - not to be supplied unless confirmation of funding achieved (existing patients should utilise their own previosly funded supply)

 
   
03.07  Hypertonic Sodium Chloride
Sodium chloride 7% (Hypertonic)
(for nebulisation)
First Choice
Green
 
Sodium chloride 3% (Hypertonic)
(for nebulisation)
Restricted Drug Restricted
Green

Ipswich Hospital

Formulary medicine - only to be used if patients are sensitive to 7% preparation

Colchester Hospital

Sodium chloride 3% (hypertonic) is considered to be non-formulary

 
   
Sodium chloride 6% (hypertonic) (MucoClear®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted

Ipswich Hospital

MucoClear is a non-formulary medicine

Colchester Hospital

Mucoclear is considered a formulary medicine

 
   
03.07  Mannitol
Mannitol inhalation (Bronchitol ®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
High Cost Medicine
NHS England

Cystic Fibrosis Only

 
Link  NICE TA266: Cystic fibrosis - mannitol dry powder for inhalation
   
03.08  Aromatic inhalations
03.09  Cough preparations to top
 note 

Cough may be a symptom of an underlying disorder, such as asthma, gastrooesophageal reflux disease, or rhinitis or a side effect of medication.

Any secondary cause should be addressed before recommending cough suppressants.

If needed, suggest they are purchased OTC.

03.09.01  Cough suppressants
Pholcodine Linctus, BP
View adult BNF View SPC online View childrens BNF
Formulary
Blue

For hospital inpatient use.

Please recommend OTC in community

 
   
Codeine Linctus BP (15mg/5ml)
View adult BNF View SPC online View childrens BNF
Formulary
Blue
 
   
03.09.01  Palliative care
03.09.02  Expectorant and demulcent cough preparations
 note 

Evidence of efficacy lacking.

If needed, suggest they are purchased OTC (simple linctus etc).

Nb. Simple linctus is stocked at Ipswich Hospital for inpatient use only.

Simple Linctus, BP
View adult BNF View SPC online View childrens BNF
Formulary
Blue

Available OTC

 
   
03.10  Systemic nasal decongestants
03.11  Antifibrotics to top
Pirfenidone (Esbriet®)
View adult BNF View SPC online View childrens BNF
Formulary
Red Hospital
High Cost Medicine
NHS England

Initiated by tertiary centre

 
Link  NICE TA282: Idiopathic pulmonary fibrosis - pirfenidone
Link  NICE TA504 Pirfenidone for treating idiopathic pulmonary fibrosis
   
 ....
 Non Formulary Items
 (Seretide 100 accuhaler (Fluticasone propionate and salmeterol))

View adult BNF View SPC online View childrens BNF
Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review.

 
Seretide 125  (Fluticasone propionate and salmeterol)

View adult BNF View SPC online View childrens BNF
Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Acrivastine

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Adrenaline / Epinephrine  (Minijet® Adrenaline 1 in 1000)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Adrenaline / epinephrine 1 in 1,000

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Adrenaline / epinephrine 1 in 10,000 (dilute)
(anaphylaxis)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Alimemazine  (Vallergan®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ammonia and Ipecacuanha Mixture BP

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Beclometasone  (Easyhaler®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Bee and Wasp Allergen Extracts  (Pharmalgen®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Beractant  (Survanta®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Bilastine  (Ilaxten®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Budesonide  (Novolizer®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Budesonide  (Pulmicort®)

View adult BNF View SPC online View childrens BNF
Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Budesonide and formoterol  (DuoResp Spiromax®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Budesonide and formoterol  (Symbicort®)

View adult BNF View SPC online View childrens BNF
Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
C1 esterase inhibitor

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Ciclesonide  (Alvesco®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Clemastine  (Tevegil®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Codeine Linctus, Paediatric BP

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Codeine Phosphate

View adult BNF View SPC online View childrens BNF
Non Formulary

Controlled Drug Injection Only
 
Conestat Alfa  (Ruconest®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Cyproheptadine  (Periactin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Desloratadine  (Neoclarityn®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  IHT- Therapeutic Substitution Register
 
Dextromethorphan / quinidine  (Nuedexta®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Diphenhydramine  (Nytol® Simply Sleep Hot Chocolate)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (Able Spacer®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (Babyhaler®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (E-Z Spacer®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (E-Z Spacer®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (Nebuchamber®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (Nebuhaler®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (PARI Vortex® Spacer)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (Pocket Chamber®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Drug Delivery Device  (Spinhaler®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Duovent

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ephedrine Hydrochloride

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Erdosteine  (Erdotin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fluticasone propionate  (Flixotide®)

View adult BNF View SPC online View childrens BNF
Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Fluticasone propionate and salmeterol  (AirFluSal Forspiro® )

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Glycopyrrolate/ indacaterol inhaler  (Ultibro Breezhaler®)

View adult BNF View SPC online View childrens BNF
Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review
Licensed for adults >18 years for COPD

 
Glycopyrronium  (Seebri breezhaler®)

View adult BNF View SPC online View childrens BNF
Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

Licensed for adults >18 years for COPD

 
Grass and Tree Pollen Extract  (Pollinex®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
House dust mite allergen immunotherapy  (Mitizax®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Icatibant  (Firazyr®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Indacaterol  (Onbrez)

View adult BNF View SPC online View childrens BNF
Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Ipratropium bromide with salbutamol  (Combivent®)

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Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Ivacaftor
(Kalydeco)

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Non Formulary
High Cost Medicine
 
Karvol

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Non Formulary
 
Ketotifen  (Zaditen®)

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Non Formulary
 
Levocetirizine  (Xyzal®)

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Non Formulary
 
Lumacaftor + Ivacaftor  (Orkambi®)

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Non Formulary
Link  NICE TA398: Lumacaftor–ivacaftor for treating cystic fibrosis homozygous for the F508del mutation
 
Mecysteine  (Visclair®)

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Non Formulary
 
Menthol and Eucalyptus Inhalation BP 1980

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Non Formulary
 
Mepolizumab  (Nucala®)

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Non Formulary
Link  NICE TA431 : Mepolizumab for treating severe refractory eosinophilic asthma
 
Mizolastine  (Mizollen®)

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Non Formulary
 
Mometasone Furoate  (Asmanex®)

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Non Formulary
 
N-Acetylcysteine
(Mucolytic)

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Non Formulary
 
Nedocromil  (Tilade® CFC-free inhaler)

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Non Formulary
 
Nintedanib  (Ofev®)

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Non Formulary
High Cost Medicine
Link  NICE TA379:Nintedanib for treating idiopathic pulmonary fibrosis
 
Nintedanib  (Vargatef®)

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Non Formulary
High Cost Medicine
Link  NICE TA347: Recurrent non-small-cell lung cancer
 
Orciprenaline Sulphate  (Alupent®)

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Non Formulary
 
Pholcodine Linctus, Strong, BP

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Non Formulary
 
Pseudoephedrine Hydrochloride  (Gulpseud®)

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Non Formulary
 
Reslizumab  (Cinquil®)

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Non Formulary
 
Rupatadine  (Rupafin®)

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Non Formulary
 
Salbutamol  (tablets, syrup)

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Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Salmeterol

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Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Seretide 250 accuhaler (Fluticasone propionate and salmeterol)

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Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Seretide 250 MDI  (Fluticasone propionate and salmeterol)

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Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Seretide 500 Accuhaler  (Fluticasone propionate and salmeterol)

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Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Simple Linctus, Paediatric BP

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Non Formulary
 
Sodium Cromoglicate  (Comogen Easi-Breathe®)

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Non Formulary
 
Sodium Cromoglicate  (Intal®)

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Non Formulary
 
Sodium Cromoglicate MDI

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Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

 
Standard range peak flow meter  (Mini-Wright®)

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Non Formulary
 
Standard range peak flow meter  (Piko-1®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Standard range peak flow meter  (Pocketpeak®)

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Non Formulary
 
Standard range peak flow meter  (Vitalograph®)

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Non Formulary
 
Tiotropium & olodaterol  (Spiolto Respimat®)

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Non Formulary

May be continued for existing patients only, consider moving to a formulary option at next review

Licensed for adults >18 years for COPD

 
Zafirlukast  (Accolate®)

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Non Formulary
 
  
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

Blue

For routine prescribing in primary and secondary care.   

Green

Initiated (if clinically urgent) or advised (if non-urgent) by specialist in secondary care, prescribing can be continued in primary care.   

Amber

Shared care  

Red Hospital

Hospital only  

Double Red

There should be no prescribing of these drugs  

Mixed

The traffic light of the drug is dependant on the indication. Please see individual drug entry for details  

netFormulary