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
 Formulary Chapter 3: Respiratory system - Full Chapter

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.

Chapter Links...
03.04.03  Expand sub section  Allergic emergencies
03.04.03  Expand sub section  Anaphylaxis
03.04.03  Expand sub section  Angioedema
C1 esterase inhibitor injection
View adult BNF View SPC online
High Cost Medicine

Acute attacks of hereditary angioedema, and prophylaxis of attacks as per NHSE Policy 16045/P

Link  NHSE 16045/P: C1 - esterase inhibitor for prophylactic treatment of hereditary angioedema (HAE) types I and II
Icatibant injection
View adult BNF View SPC online
Restricted Drug Restricted
High Cost Medicine

Initiation by consultants specialising in hereditary angioedema only

Symptomatic treatment of acute attacks of hereditary angioedema (HAE) in adults with C1-esterase inhibitor deficiency. Conditional on the there being a clear rationale for prescribing icatibant instead of C1-esterase inhibitor.

Use in accordance with local guidelines

Recombinant C1 esterase inhibitor injection (Ruconest, Conestat Alpha)
View adult BNF View SPC online

Acute attacks of hereditary angioedema,  as per NHSE Policy B09/P/b

(see page 7 for specific comissioning criteria that apply)

Link  NHSE B09/P/b: Treatment of Acute Attacks in Hereditary Angiodema (Adult)
Adrenaline inhaler  (Primatene Mist)
View adult BNF View SPC online
Unlicensed Drug Unlicensed

For angioedema Dose: 2-4 sprays to be applied topically, up to hourly as required

Note: this product is currently not available

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
Track Changes
Display tracking information
click to search
Link to adult BNF
click to search
Link to SPCs
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHS England

Traffic Light Status Information

Status Description


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  


Specialist and non-specialist initiation  


Not recommended for prescribing