netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
12.02.03  Expand sub section  Nasal preparations for infection
12.02.03  Expand sub section  Nasal Staphylococci
Bismuth subnitrate & iodoform gauze

Formulary
   
Chloramphenicol 1% eye ointment  (ENT post surgery - off-label)

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Formulary Approved off-label indication:
Topical use post open rhinoplasty. Applied twice daily for a short course post-procedure
   
Mupirocin 2% nasal ointment

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Formulary USE ON MICROBIOLOGY/VIROLOGY ADVICE
   
Naseptin cream

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Formulary USE ON MICROBIOLOGY/VIROLOGY ADVICE

Contains:

  • Chlorhexidine hydrochloride 0.1%
  • Neomycin sulphate 0.5%

    Caution: also contains arachis oil (peanut oil)
  •    
    Octenidine nasal gel

    Formulary
    Red
    USE ON MICROBIOLOGY/VIROLOGY ADVICE
       
    Polyfax eye ointment

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    Restricted Drug Restricted USE ON MICROBIOLOGY/VIROLOGY ADVICE only - for eradication of nasal carriage of MRSA

    Contains:

  • Polymixin B sulphate 10 000units/g
  • Bacitaricin zinc 500 units/g

    Instructions:
  • Eye ointment is used in the nose
  • A matchhead size portion to be applied into each nostril
  • Close nostrils to spread the ointment throughout the nares
  • Dose = 2-3 times daily
  • Continue treatment for 5-7 days
  •    
    Alkaline nasal douche

    Restricted Drug Unlicensed Powder containing:
  • Sodium bicarbonate 20g
  • Sodium chloride 20g
  • Borax 20g

    Indications:
  • Post-operatively after nasal surgery and functional endoscopic sinus surgery.
  • For any condition causing crusting of nasal cavities

    Instructions for use:
  • 5 mL spoonful of powder added to a tumblerful of warm water and mixed well.
  • Small aliquots of the solution are sniffed.
  • Any solution that goes into the throat should not be swallowed
  • Dose = three times daily

  •    
     ....
    Key
    note Notes First Choice Item First Choice item
    Section Title Section Title (top level) Non Formulary Item Non Formulary section
    Section Title Section Title (sub level)
    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    CD
    Controlled Drug
    Unlicensed Drug
    Unlicensed
    High Cost Medicine
    High Cost Medicine
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    Link to SPCs
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    Link to adult BNF
    Track Changes
    Display tracking information
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    Cancer Drugs Fund
    Cancer Drugs Fund
       

     

    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
      Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
      Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
      Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
      Green   Specialist and non-specialist initiation  
      Grey   Not recommended for prescribing  

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