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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 13: Skin - Full Chapter
Notes:

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

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13.12  Expand sub section  Antiperspirants
Aluminium chloride hexahydrate 20% (Driclor)
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Formulary  
   
Botulinum toxin type A  (Botox - hyperhidrosis)
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Restricted Drug Restricted
Red
High Cost Medicine

CONSULTANT SPECIALISTS ONLY

Severe hyperhidrosis of the axillae unresponsive to topical antiperspirant or other antihidrotic treatment

Category B* form required

 
   
Glycopyrronium bromide powder
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Formulary  
   
Oxybutynin tabs (hyperhidrosis off-label)
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Formulary
Green

Approved off-label indiction:

Hyperhidrosis where there is failure to respond to a trial of topical antiperspirants or other antihidrotic treatment.

IR tabs dose = 2.5mg daily – 5mg three times a day

MR dose = 5-10mg daily.


Oxybutynin IR preparation 1st line followed by oxybutinin MR preparation or propantheline in case of intolerable adverse effects/inefficacy of oxybutynin IR

Refer to APC recommendation below

 
Link  SE London APC recommendation - propantheline & oxybutynin in hyperhidrosis in ADULTS
   
Propantheline bromide tabs (hyperhidrosis)
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Formulary
Green

Use in accordance with formulary recommendation below

For hyperhidrosis where there is failure to respond to a trial of topical antiperspirants or other antihidrotic treatment

Oxybutynin IR preparation 1st line followed by oxybutinin MR preparation or propantheline in case of intolerable adverse effects/inefficacy of oxybutynin IR

 
Link  SE London APC recommendation - propantheline & oxybutynin in hyperhidrosis in ADULTS
   
Botulinum toxin type A (Xeomin - Frey's syndrome)
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Restricted Drug Restricted
Red
High Cost Medicine

Approved off-label indication:

Frey's syndrome

Use in accordance with local guideline at GSTFT ENT consultants only

 
   
Glycopyrrolate 0.05% w/v in water
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Unlicensed Drug Unlicensed
Amber 2

BAD/APC approved Special

For hyperhidrosis with an iontophoresis machine.

 
   
Glycopyrrolate 2% w/w in cetomacrogol cream
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Unlicensed Drug Unlicensed
Amber 2

BAD/APC approved Special

For disabling facial hyperhidrosis.

 
   
Glycopyrronium topical solution 0.1%
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Unlicensed Drug Unlicensed
Red

APC approved Special

To be initiated and used under the supervision of a Dermatologist only

 
   
 ....
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
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Link to adult BNF
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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

Red

Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. 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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