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 3: Respiratory system - 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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03.02  Expand sub section  Corticosteroids
 note  Patients established on inhaler devices not on the formulary only to be switched to an alternative device if part of a formal clinical review
Alvesco aerosol powder inhaler (ciclesonide)
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Restricted Drug Restricted

Specialist recommendation only

For control of asthma in adults who acquire repeated oropharyngeal candidiasis and/or hoarsness from other inhaled carticosteroids

 
   
Beclometasone dipropionate aerosol inhalers, breath actuated inhalers (Clenil modulite and Qvar products)
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Formulary

Beclometasone diproprionate aerosol inhalers should be prescribed by brand name

Different brands are not dose equivalent

 
   
Beclometasone propionate dry powder inhaler (Easyhaler beclometasone)
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Formulary  
   
Budesonide nebuliser solution
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Formulary  
   
DuoResp Spiromax dry powder inhaler (budesonide and formoterol)
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Formulary Use in COPD restricted to specialist recommendation only 
   
Flutiform aerosol inhaler (fluticasone propionate and formoterol)
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Restricted Drug Restricted Restricted to use in asthma where high strength inhaled corticosteroids are required 
   
Fostair NEXThaler 100/6 micrograms and 200/6 micrograms dry powder inhaler (beclometasone diopropionate and formoterol)
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Formulary Use in COPD restricted to specialist recommendation only 
   
Fostair 100/6 and 200/6 micrograms aerosol inhaler (beclometasone diopropionate and formoterol)
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Formulary Use in COPD restricted to specialist recommendation only 
   
Relvar Ellipta dry powder inhlaer (fluticasone furoate and vilaterol)
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Restricted Drug Restricted

Asthma:

Restricted to use where a single daily dose is preferable for assisting with adherence to the treatment regimen

 

COPD:

Preferred treatment option in patients requiring triple therapy (LAMA, LABA and ICS) in conjunction with umeclidinium inhalation powder (specialist recommedation only)

 
   
03.02.01  Expand sub section  Inhaled Corticosteroids
03.02.02  Expand sub section  Combination products (ICS+LABA) for asthma
03.02.02  Expand sub section  Low dose
03.02.02  Expand sub section  Moderate dose to top
03.02.02  Expand sub section  High dose
03.02.03  Expand sub section  Combination products (ICS+LABA) for COPD
 ....
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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