| Formulary Chapter 3: Respiratory system - Full Chapter
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| Chapter Links... |
 BCICB Asthma Treatment Guidelines - Adolescents 12-17 years old |
| BCICB Asthma Treatment Guidelines - Adults 18+ |
| BCICB Asthma Treatment Guidelines For Children Under 12 |
| BCICB COPD Inhaler Treatment Guidelines |
| BCICB Difficult Asthma Referral Pathway - Adults 18+ |
| Greener Inhaler Guide Switching Information |
| How to improve respiratory control in asthma and COPD |
| NICE CG115: Chronic obstructive pulmonary disease in over 16s: diagnosis and management |
| NICE TA10: Guidance on the use of inhaler systems (devices) in children under the age of 5 years with chronic asthma |
| NICE TA138: Inhaled corticosteroids for the treatment of chronic asthma in adults and in children aged 12 years and over |
| NICE TA38: Inhaler devices for routine treatment of chronic asthma in older children (aged 5–15 years) |
| COVID-19: information for the respiratory community |
| Details... |
| 03.01 |
Bronchodilators |
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| 03.01 |
Asthma |
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| 03.01 |
Chronic obstructive pulmonary disease |
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| 03.01 |
Croup |
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| 03.01.01 |
Adrenoceptor agonists |
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| 03.01.01.01 |
Selective Beta2 agonists |
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Salbutamol
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Formulary
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BRANDS/FORMULATION
- Easyhaler
- Ventolin Accuhaler
- Salamol
- Salamol Easi-Breathe
How to use a Metered Dose Inhaler
How to use a Metered Dose Inhaler with a Large Volume Spacer Device
How to use a Metered Dose Inhaler with a Small Volume Spacer Device
How to use an Accuhaler inhaler
How to use an Easyhaler Inhaler
How to use an Easi-Breathe Inhaler
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Salbutamol
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Formulary
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- Salbutamol IV
- Ventolin Solution for Infusion
- Ventolin Solution for Injection
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Formoterol Fumarate (Oxis Turbohaler®)
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Formulary
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Salbutamol (Nebuliser Liquid ® )
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Formulary
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 Green-Nebuliser Liquid
 Amber Recommended- Nebuliser Liquid in Paediatrics
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MHRA Alert: Nebulised asthma rescue therapy in children
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Terbutaline
(Nebuliser Liquid)
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Formulary
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How to use a Turbohaler Inhaler
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Terbutaline (Bricanyl®)
(Inhaler)
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Formulary
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How to use a Turbohaler Inhaler
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| 03.01.01.01 |
Short-acting beta2 agonists |
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| 03.01.01.01 |
Long-acting beta2 agonists |
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| 03.01.01.02 |
Other adrenoceptor agonists |
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Ephedrine Hydrochloride
(Solution for injections)
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Formulary
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| 03.01.02 |
Antimuscarinic bronchodilators |
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Tiotropium (Spiriva Respimat®)
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Formulary
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How to use a Respimat Inhaler
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Aclidinium (Eklira Genuair®)
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Formulary
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For COPD only
How to use a Genuair Inhaler
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Ipratropium bromide
(Nebuliser Liquid)
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Formulary
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Umeclidinium (Incruse® Ellipta®)
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Formulary
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How to use an Ellipta Inhaler
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| 03.01.02 |
Short Acting Anti-muscarinic Bronchodilators |
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| 03.01.02 |
Long Acting Anti-muscarinic Bronchodilators |
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| 03.01.03 |
Theophylline |
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Theophylline (Uniphyllin Continus )
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Formulary
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Aminophylline IV
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Formulary
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 UKMI Q&A: Switching between aminophylline and theophylline in adults
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| 03.01.04 |
Compound bronchodilator preparations |
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Aclidinium & formoterol inhaler (Duaklir Genuair®)
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Formulary
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How to use a Genuair Inhaler
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Glycopyrronium/formoterol (Bevespi Aerosphere®)
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Formulary
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Tiotropium & Olodaterol (Spiolto® Respimat®)
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Formulary
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How to use a Respimat Inhaler
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Umeclidinium & vilanterol (Anoro Ellipta®)
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Formulary
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How to use an Ellipta Inhaler
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| 03.01.05 |
Peak flow meters, inhaler devices and nebulisers |
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| 03.01.05 |
Peak flow meters |
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Low range peak flow meter
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Formulary
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BRANDS
- Rossmax Peak Flow Meter
- Easy Peak Flow Meter Low Range
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Standard range peak flow meter
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Formulary
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BRANDS
- Easy Peak Flow Meter
- Rossmax Peak Flow Meter
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| 03.01.05 |
Drug delivery devices |
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AeroChamber Plus®
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Formulary
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Drug Delivery Device
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Formulary
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- Aerochamber Plus
- Aerochamber Plus Flow-vu Anti-static
- Aerochamber Plus Flow-vu Anti-static With Adult Large Mask
- Aerochamber Plus Flow-vu Anti-static With Adult Small Mask
- Aerochamber Plus Flow-vu Anti-static With Medium Mask Child 1-5 Years
- Aerochamber Plus Flow-vu Anti-static With Small Mask Infant 0-18 Months
- Aerochamber Plus Flow-vu Anti-static Youth 5
- Aerochamber Plus With Adult Mask
- Aerochamber Plus With Child Mask
- Aerochamber Plus With Infant Mask
- Volumatic
- Volumatic With Paediatric Mask
- Zerostat Vt Spacer
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How to use a Metered Dose Inhaler with a Large Volume Spacer
HOw to use a Meterted Dose Inhaler with a Small Spacer
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| 03.01.05 |
Nebulisers |
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| 03.01.05 |
Nebuliser Diluent |
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Sodium Chloride
(nebulised)
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Formulary
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| .... |
| Non Formulary Items |
Bambuterol (Bambec®)
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Non Formulary
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Benzoin Tincture, Compound
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Non Formulary
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Drug Delivery Device
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Non Formulary
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- A2a Spacer
- A2a Spacer With Medium Mask
- A2a Spacer With Small Mask
- Able Spacer
- Able Spacer With Medium Mask
- Able Spacer With Small Mask
- Aer8
- Antistatic Space Chamber Plus
- Antistatic Space Chamber Plus Compact
- Antistatic Space Chamber Plus Compact With Large Mask
- Antistatic Space Chamber Plus Compact With Medium Mask
- Antistatic Space Chamber Plus Compact With Small Mask
- Antistatic Space Chamber Plus With Large Mask
- Antistatic Space Chamber Plus With Medium Mask
- Antistatic Space Chamber Plus With Small Mask
- Babyhaler
- Babyhaler Mini Mask
- Babyhaler Standard Mask
- Clip-tone E
- Clip-tone F
- Easychamber Spacer
- Easychamber Spacer With Adult Mask
- Easychamber Spacer With Child Mask
- Easychamber Spacer With Infant Mask
- E-chamber La Grande Spacer
- E-chamber La Petite Spacer
- E-chamber La Petite Spacer With Mask
- E-z Spacer
- Flo-tone Mdi Circular Fit
- Flo-tone Mdi Regular Fit
- Free Breath Spacer
- Free Breath Spacer With Adult Mask
- Free Breath Spacer With Child Mask
- Free Breath Spacer With Infant Mask
- Optichamber
- Optichamber Diamond
- Optichamber Diamond With Large Litetouch Mask 5 Years-adult
- Optichamber Diamond With Medium Litetouch Mask 1-5 Years
- Optichamber Diamond With Small Litetouch Mask 0-18 Months
- Pocket Chamber
- Pocket Chamber With Adult Mask
- Pocket Chamber With Child Mask
- Pocket Chamber With Infant Mask
- Pocket Chamber With Teenager Mask
- Rossmax Anti-static Aero Spacer
- Rossmax Anti-static Aero Spacer With Large Mask 5 Years-adult
- Rossmax Anti-static Aero Spacer With Medium Mask 1-5 Years
- Rossmax Anti-static Aero Spacer With Small Mask 0-18 Months
- Space Chamber Plus
- Space Chamber Plus Compact
- Space Chamber Plus Compact With Large Mask
- Space Chamber Plus Compact With Medium Mask
- Space Chamber Plus Compact With Small Mask
- Space Chamber Plus With Large Mask
- Space Chamber Plus With Medium Mask
- Space Chamber Plus With Small Mask
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Ephedrine Hydrochloride
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Non Formulary
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Formoterol Fumarate
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Non Formulary
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Glycopyrrolate/ indacaterol inhaler
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Non Formulary
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Glycopyrronium (Seebri breezhaler®)
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Non Formulary
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As per COPD guidelines from 11/10/22
How to use a Breezhaler Inhaler |
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Glycopyrronium/indacaterol (Ultibro Breezhaler®)
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Non Formulary
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Black from 11/10/22
How to use a Breezhaler Inhaler |
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Human alpha1- proteinase inhibitor (Respreeza®)
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Non Formulary
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Indacaterol (Onbrez Breezhaler®)
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Non Formulary
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Indacaterol/Mometasone furoate (Atectura Breezhaler®)
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Non Formulary
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Ipratropium bromide
(Pressurised inhalation)
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Non Formulary
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- Atrovent
- Inhalvent(Black from 23/5/23. Okay for historic patients.Other LAMAs preferred)
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Ipratropium bromide with salbutamol (Combivent®)
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Non Formulary
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Low range peak flow meter
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Non Formulary
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BRANDS
- Medi Peak Flow Meter
- Mini-wright Peak Flow
- Nspire Pocket Peak Peak
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Mometasone/Glycopyrronium bromide/Indacaterol (Enerzair Breezhaler®)
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Non Formulary
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Olodaterol (Striverdi Respimat ®)
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Non Formulary
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Orciprenaline Sulphate (Alupent®)
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Non Formulary
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Salbutamol
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Non Formulary
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- Salbulin Novolizer
- Ventolin Oral Solution
- Airomir
- Airomir Autohaler
- Ventolin Evohaler
- Salbutamol Tablet
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Salmeterol
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Non Formulary
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- Serevent Accuhaler
- Serevent Evohaler
- Neovent
- Soltel
How to use an Accuhaler Inhaler
How to use a Metered Dose Inhaler
How to use a Metered Dose Inhaler with a Large Volume Spacer Device
How to use a Metered Dose Inhaler with a Small Volume Spacer Device |
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Salmeterol (Serevent® accuhaler)
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Non Formulary
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Removed from formulary for new patients with COPD February 2017
FOR EXISTING PATIENTS ONLY |
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Standard range peak flow meter
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Non Formulary
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BRANDS
- Airzone Peak Flow Meter
- Fyne Dynamics Pinnacle Peak Flow Meter
- Medi Peak Flow Meter
- Micropeak Peak Flow Meter
- Mini-wright Peak Flow Meter
- Nspire Piko-1 Peak Flow Meter
- Nspire Pocket Peak Peak Flow Meter
- Philips Respironics Personalbest Peak Flow Meter
- Vitalograph Child Peak Flow Meter
- Vitalograph Mypef Peak Flow Meter
- Vitalograph Peak Flow Meter
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Terbutaline
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Non Formulary
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- Bricanyl Respules
- Bricanyl Tablet
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Tiotropium
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Non Formulary
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- Acopair
- Braltus
- Spiriva
- Tiogiva
- Spiriva Handihaler
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Key |
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Restricted Drug |
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Unlicensed |
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
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Cytotoxic Drug |
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Controlled Drug |
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High Cost Medicine |
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Cancer Drugs Fund |
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NHS England |
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Homecare |
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ICB |
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Low carbon footprint |
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Medium carbon footprint |
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High carbon footprint |
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| Status |
Description |
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All Settings
Suitable for initiation, ongoing prescribing, and discontinuation in both primary and secondary care settings. They are generally familiar, frequently used therapies that can be started within their licensed indications without specialist oversight. |
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Specialist only
Designated for initiation, ongoing prescribing, monitoring, exclusively by a specialists either in a hospital or as part of a specialist service (to note this could be in a non-hospital setting). Primary care should neither start nor continue these treatments except as part of a specialist service. A specialist could be either a medical or non-medical prescriber. |
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Specialist advice
Prescribers in primary care should seek advice and a recommendation from a specialists prior to initiating a medicine. Once agreed with a specialist, medicines can be initiated, prescribed and monitored in primary care without a formal shared-care agreement. |
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Specialist initiation
Medicines in this category require a specialist to start therapy, titrate dosage, and assess initial efficacy or tolerability. Once stabilised, prescribing responsibility may transfer to primary care without the need for a formal shared-care agreement. |
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Shared care agreement
Prescribing responsibility can be shared across health settings and between specialists and GPs only when formal shared care arrangement has been made. For example, there may be extensive and complex monitoring requirements or significant safety concerns (note would need a national policy on this to define the criteria for requiring a formal SCA), this will be produced once nationally. |
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Do not prescribe
Not approved for routine prescribing in primary or secondary care. For example, because they are agents classified in the BNF as “not NHS” or “Drugs of Low Clinical Value”, or they are products on NICE’s “do not do” list or NHS England’s “should not routinely prescribe” list. |
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Self Care
Not for routine prescribed in primary or secondary care unless as part of care for a long term condition. Instead, patients should be encouraged to self care with support from community pharmacy. |
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Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications |
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Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
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Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist. |
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Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only |
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Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
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