| Formulary Chapter 5: Infections - Full Chapter
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| Chapter Links... |
 NICE NG199: Clostridioides difficile infection: antimicrobial prescribing |
| NICE NG15: Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use |
| NICE NG79: Sinusitis (acute): antimicrobial prescribing |
| NICE NG79: Sinusitis (acute): antimicrobial prescribing (visual summary) |
 Summary of antimicrobial prescribing guidance - managing common infections |
| Details... |
| 05.03 |
Antiviral drugs |
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Molnupiravir
(Oral )
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Formulary
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Peginterferon Alfa
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Formulary
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Hospital only
In line with NICE
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NICE TA106: Peginterferon alfa and ribavirin for the treatment of mild chronic hepatitis C
NICE TA200: Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C
NICE TA300: Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people
NICE TA75: Interferon alfa (pegylated and non-pegylated) and ribavirin for the treatment of chronic hepatitis C
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Peginterferon Alfa (Pegasys®)
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Formulary
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Hospital only
In line with NICE
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NICE TA106: Peginterferon alfa and ribavirin for the treatment of mild chronic hepatitis C
NICE TA200: Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C
NICE TA300: Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people
NICE TA75: Interferon alfa (pegylated and non-pegylated) and ribavirin for the treatment of chronic hepatitis C
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Remdesivir (Veklury®)
(IV)
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Formulary
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| 05.03.01 |
HIV infection |
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| 05.03.01 |
Nucleoside reverse transcriptase inhibitors |
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Abacavir
(Tablets)
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Formulary
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Abacavir and Lamivudine
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Formulary
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Abacavir with dolutegravir and lamivudine (Triumeq ®)
(Tablets)
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Formulary
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Efavirenz with emtricitabine and tenofovir disoproxil
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Formulary
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Elvitegravir with cobicistat, emtricitabine and tenofovir alafenamide (Genvoya®)
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Formulary
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Emtricitabine (Emtriva®)
(Oral presentations)
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Formulary
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Emtricitabine 200mg, Rilpivirine 25mg and Tenofovir 245mg (Eviplera®)
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Formulary
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Blueteq /prior approval form
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Emtricitabine with rilpivirine and tenofovir alafenamide ( Odefsey® )
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Formulary
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Emtricitabine with tenofovir alafenamide (Descovy®)
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Formulary
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Emtricitabine with tenofovir disoproxil
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Formulary
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Lamivudine
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Formulary
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Lamivudine (Epivir®, Zeffix®)
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Formulary
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Lamivudine with dolutegravir (Dovato®)
(Oral )
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Formulary
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Lamivudine with tenofovir disoproxil and doravirine (Delstrigo®)
(Oral )
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Formulary
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Rilpivirine hydrochloride (Edurant®)
(tablets)
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Formulary
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Rilpivirine hydrochloride (Rekambys®)
(IV)
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Formulary
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Tenofovir, cobicistat, elvitegravir & emtricitabine (Stribild®)
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Formulary
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Zidovudine
(capsules )
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Formulary
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Zidovudine (Retrovir®)
(IV & SF solution)
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Formulary
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Zidovudine and Lamivudine
(tablets)
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Formulary
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| 05.03.01 |
Protease inhibitors |
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Atazanavir
(capsules)
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Formulary
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Atazanavir with cobicistat (Evotaz®)
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Formulary
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Blueteq /prior approval form
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Baloxavir marboxil
(Tablets)
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Formulary
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Bictegravir with emtricitabine and tenofovir alafenamide (Biktarvy®)
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Formulary
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Darunavir
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Formulary
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Darunavir with cobicistat (Rezolsta®)
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Formulary
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Blueteq /prior approval form
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Darunavir with cobicistat, emtricitabine and tenofovir alafenamide (Symtuza®)
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Formulary
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Blueteq /prior approval form
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Dolutegravir (Tivicay ®)
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Formulary
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Dolutegravir with rilpivirine (Juluca®)
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Formulary
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Fosamprenavir (Telzir®)
(tablets)
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Formulary
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Lopinavir and Ritonavir (Kaletra®)
(tablets & solution)
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Formulary
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Lopinavir with Ritonavir
(Oral )
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Formulary
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Nirmatrelvir With Ritonavir
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Formulary
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Ritonavir
(Oral presentations)
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Formulary
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| 05.03.01 |
Non-nucleoside reverse transcriptase inhibitors |
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Doravirine (Pifeltro®)
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Formulary
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Etravirine (Intelence®)
(tablets)
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Formulary
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Nevirapine
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Formulary
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Nevirapine (Viramune®)
(tablets, extended release tablets & suspension)
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Formulary
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| 05.03.01 |
Other antiretrovirals |
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Cabotegravir (Vocabria®)
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Formulary
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In line with NICE
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NICE TA757: Cabotegravir with rilpivirine for treating HIV-1
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Elbasvir with grazoprevir (Zepatier®)
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Formulary
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Enfuvirtide (Fuzeon®)
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Formulary
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Maraviroc
(tablets)
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Formulary
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Maraviroc (Celsentri®)
(tablets)
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Formulary
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Raltegravir (Isentress ®)
(tablets)
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Formulary
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| 05.03.01 |
Pharmacokinetic enhancers of antiretrovirals |
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Cobicistat (Tybost ®)
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Formulary
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| 05.03.01 |
Combination Products |
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| 05.03.02 |
Herpesvirus infections |
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Aciclovir lauriad (Sitavig)
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Formulary
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| 05.03.02.01 |
Herpes simplex and varicella-zoster infection |
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Famciclovir
(Oral )
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Second Choice
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Second line for Shingles
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Valaciclovir
(Oral presentations)
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Second Choice
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To be used in exceptional cases only
Least cost effective option
Second line for shingles if compliance is a problem
£££££
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Aciclovir
(injection)
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Formulary
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Aciclovir
(Oral presentations)
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Formulary
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Tablets most cost effective choice
Dispersible tablets £
Suspension ££
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Inosine Pranobex (Imunovir®)
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Formulary
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| 05.03.02.02 |
Cytomegalovirus infection |
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Cidofovir
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Formulary
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Foscarnet Sodium
(infusion)
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Formulary
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Foscarnet Sodium (Foscavir®)
(infusion)
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Formulary
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Ganciclovir
(infusion)
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Formulary
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Ganciclovir (Cymevene®)
(infusion)
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Formulary
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Letermovir (Prevymis®)
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Formulary
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In line with NICE
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NICE TA591: Letermovir for preventing cytomegalovirus disease after a stem cell transplant
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Valganciclovir
(Oral presentations)
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Formulary
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| 05.03.03 |
Viral hepatitis |
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Adefovir Dipivoxil (Hepsera®)
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Formulary
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NICE CG165: Hepatitis B (chronic) - diagnosis and management
NICE TA96: Adefovir dipivoxil and peginterfeon alfa-2a for the treatment of chronic hepatitis B
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Entecavir
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Formulary
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NICE CG165: Hepatitis B (chronic) - diagnosis and management
NICE TA153: Entecavir for the treatment of chronic hepatitis B
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Entecavir (Baraclude®)
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Formulary
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NICE CG165: Hepatitis B (chronic) - diagnosis and management
NICE TA153: Entecavir for the treatment of chronic hepatitis B
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| 05.03.03.01 |
Chronic hepatitis B |
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Tenofovir alafenamide (Vemlidy®)
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Formulary
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Tenofovir Disproxil
(Oral presentations)
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Formulary
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| 05.03.03.02 |
Chronic hepatitis C |
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Glecaprevir-pibrentasvir (Maviret®)
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Formulary
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In line with NICE
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NICE TA499: Glecaprevir–pibrentasvir for treating chronic hepatitis C
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Ledipasvir/sofosbuvir (Harvoni®)
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Formulary
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In line with NICE
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NICE TA363: Ledipasvir–sofosbuvir for treating chronic hepatitis C
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Sofosbuvir (Sovaldi®)
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Formulary
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Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi®)
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Formulary
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In line with NICE
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NICE TA507: Sofosbuvir–velpatasvir–voxilaprevir for treating chronic hepatitis C
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Sofosbuvir/velpatasvir (Epclusa®)
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Formulary
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In line with NICE
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NICE TA430: Sofosbuvir–velpatasvir for treating chronic hepatitis C
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| 05.03.04 |
Influenza |
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Oseltamivir
(Oral presentations)
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First Choice
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 -For Primary Care- Green only during Flu season and on authorisation by NHS England/Department of Health & Social Care or via commissioned service for out of season supply
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UKMI Q&A: Oseltamivir or zanamivir – can mothers breastfeed after treatment for influenza?
TA158: Oseltamivir, amantadine (review) and zanamivir for the prophylaxis of influenza
TA168: Amantadine, oseltamivir and zanamivir for the treatment of influenza
PHE guidance on use of antiviral agents for the treatment and prophylaxis of seasonal influenza
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Oseltamivir (Tamiflu®)
(capsules & suspension SF)
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First Choice
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-For Primary Care- Green only during Flu season and on authorisation by NHS England/Department of Health & Social Care or via commissioned service for out of season supply
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UKMI Q&A: Oseltamivir or zanamivir – can mothers breastfeed after treatment for influenza?
TA158: Oseltamivir, amantadine (review) and zanamivir for the prophylaxis of influenza
TA168: Amantadine, oseltamivir and zanamivir for the treatment of influenza
PHE guidance on use of antiviral agents for the treatment and prophylaxis of seasonal influenza
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Zanamivir (Relenza®)
(dry powder for inhalation )
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Second Choice
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For Primary Care-Green only during Flu season and on authorisation by NHS England/Department of Health & Social Care or via commissioned service for out of season supply
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UKM I Q&A: Oseltamivir or zanamivir – can mothers breastfeed after treatment for influenza?
TA 168: Amantadine, oseltamivir and zanamivir for the treatment of influenza
TA158: Oseltamivir, amantadine (review) and zanamivir for the prophylaxis of influenza
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Amantadine Hydrochloride
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Formulary
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Zanamivir Injection (Dectova ®)
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Formulary
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| 05.03.05 |
Respiratory syncytial virus |
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Palivizumab (Synagis®)
(Injection)
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Formulary
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Ribavirin
(Tablet, Capsules & Inhalation)
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Formulary
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NICE TA300: Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people
NICE TA106: Hepatitis C - peginterferon alfa and ribavirin
NICE TA200: Hepatitis C - peginterferon alfa and ribavirin
NICE TA75: Hepatitis C - pegylated interferons, ribavirin and alfa interferon
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| .... |
| Non Formulary Items |
Abacavir (Ziagen®)
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Non Formulary
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Abacavir and Lamivudine (Kivexa®)
(tablets)
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Non Formulary
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Abacavir and Lamivudine and Zidovudine (Trizivir®)
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Non Formulary
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Amantadine Hydrochloride (Symmetrel®)
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Non Formulary
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Amprenavir (Agenerase®)
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Non Formulary
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Darunavir (Prezista®)
(tablets)
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Non Formulary
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Didanosine (Videx®)
(capsules)
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Non Formulary
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Efavirenz
(Tablets)
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Non Formulary
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Efavirenz with emtricitabine and tenofovir disoproxil (Atripla® )
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Non Formulary
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Emtricitabine with tenofovir disoproxil (Ictastan®)
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Non Formulary
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Emtricitabine with tenofovir disoproxil (Truvada®)
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Non Formulary
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Fostemsavir (Rukobia®)
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Non Formulary
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Indinavir (Crixivan®)
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Non Formulary
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Nelfinavir
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Non Formulary
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Ritonavir (Norvir®)
(tablets & SF solution)
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Non Formulary
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Saquinavir (Invirase®)
(tablets)
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Non Formulary
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Stavudine
(capsules)
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Non Formulary
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Tenofovir Disproxil (Viread®)
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Non Formulary
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Tenofovir Disproxil (Viread®)
(tablets)
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Non Formulary
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NICE CG165: Hepatitis B (chronic) - diagnosis and management
NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
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test Chronic hepatitis C
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Non Formulary
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Tipranavir (Aptivus®)
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Non Formulary
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Zidovudine (Retrovir®)
(capsules )
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Non Formulary
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Zidovudine and Lamivudine (Combivir®)
(tablets)
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Non Formulary
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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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