| Formulary Chapter 5: Infections - Full Chapter
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| 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.
This section advises on the choice of anti-infective agents available at each Trust. Doctors should refer to local or departmental antibiotic guidelines for advice regarding specific treatments within specialised units (including prophylaxis for surgical, medical and dental procedures). Different antibiotic policies can be found in different hospitals due to local variations in resistance and antibiotic susceptibility.
M: Use of this agent only to be initiated under the advice of a microbiologist or virologist as appropriate.
S: Use of this agent only to be initiated under the advice of a relevant clinical specialist. |
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| Chapter Links... |
 NICE CG54: Urinary tract infection in under 16s: diagnosis and management |
| NICE NG84: Sore throat (acute): antimicrobial prescribing |
| NICE NG89: Sinusitis (acute): antimicrobial prescribing |
| NICE NG91: Otitis media (acute): antimicrobial prescribing |
| Details... |
| 05.03.01 |
HIV infection |
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| 05.03.01 |
Nucleoside reverse transcriptase inhibitors |
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Abacavir tabs, oral solution
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Formulary
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Abacavir with lamiviudine (generic - Kivexa® brand no longer stocked)
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Formulary
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Atripla® tabs (tenofovir disoproxil with emtricitabine and efavirenz)
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Formulary
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No longer stocked. Prescribe Truvada® (tenofovir disoproxil and emtricitabine) and efavirenz as separate preparations
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Combivir® tabs (zidovudine and lamivudine)
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Formulary
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Descovy® tabs (emtricitabine with tenofovir alafenamide)
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Formulary
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 NHSE 16043/P: Clinical Commissioning Policy: Tenofovir Alafenamide for treatment of HIV 1 in adults and adolescents
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Didanosine tabs, caps
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Formulary
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Emtricitabine caps, oral solution
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Formulary
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Eviplera® (tenofovir disoproxil with emtricitabine and rilpivirine)
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Formulary
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Genvoya® tabs (elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide)
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Formulary
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MHRA Dec 2016: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects
NHSE 16043/P: Clinical Commissioning Policy: Tenofovir Alafenamide for treatment of HIV 1 in adults and adolescents
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Lamivudine tabs, oral solution
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Formulary
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Odefsey® tabs (emtricitabine with rilpivirine and tenofovir alafenamide)
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Formulary
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NHSE 16043/P: Clinical Commissioning Policy: Tenofovir Alafenamide for treatment of HIV 1 in adults and adolescents
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Stavudine caps, oral solution
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Formulary
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Stribild® tabs (tenofovir disoproxil with cobicistat, elvitegravir and emtricitabine)
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Formulary
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MHRA Dec 2016: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects
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Tenofovir disoproxil tabs (Viread®)
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Formulary
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NICE CG165: Hepatitis B (chronic) - incorporates TA173
NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
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Triumeq® tabs (dolutegravir, abacavir & lamivudine)
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Formulary
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MHRA Jun 18: Dolutegravir (Tivicay▼, Triumeq▼, Juluca▼): signal of increased risk of neural tube defects; do not prescribe to women seeking to become pregnant; exclude pregnancy before initiation and advise use of effective contraception
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Trizivir® tabs (abacavir, lamivudine and zidovudine)
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Formulary
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Truvada® tabs (tenofovir disoproxil with emtricitabine)
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Formulary
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Zidovudine caps, oral solution
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Formulary
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| 05.03.01 |
Protease inhibitors |
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Atazanavir caps
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Formulary
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Darunavir tabs
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Formulary
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Evotaz tablets® (atazanavir with cobicistat)
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Formulary
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MHRA Dec 2016: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects
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Fosamprenavir tabs, oral suspension
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Formulary
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Kaletra® tabs, oral solution (lopinavir and ritonavir)
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Formulary
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MHRA Dec 2016: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects
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Rezolsta® tabs (darunavir with cobicistat)
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Formulary
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MHRA Dec 2016: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects
MHRA Jul 2018: Darunavir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1
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Ritonavir caps, oral solution
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Formulary
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MHRA Dec 2016: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects
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Saquinavir caps, tabs
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Formulary
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| 05.03.01 |
Non-nucleoside reverse transcriptase inhibitors |
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Efavirenz caps, tabs, oral soultion
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Formulary
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Etravirine tabs
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Formulary
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Nevirapine tabs, m/r tabs, oral suspension
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Formulary
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Confirm correct tablet formulation
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Rilpivirine tabs
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Formulary
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| 05.03.01 |
Other antiretrovirals |
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Cobicistat tabs
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Formulary
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MHRA Dec 2016: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects
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Dolutegravir tabs
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Formulary
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MHRA Jun 18: Dolutegravir (Tivicay▼, Triumeq▼, Juluca▼) - signal of increased risk of neural tube defects, do not prescribe to women seeking to become pregnant
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Enfuvirtide injection
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Formulary
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Maraviroc tabs
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Formulary
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Raltegravir tabs
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Formulary
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Both once daily (1200 mg daily) and twice daily (400 mg twice daily) regimens are approved
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Delavirdine tabs
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 Unlicensed
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  Antiretroviral: 400 mg three times a day. Alternatively 600 mg twice daily
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Didanosine powder
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Unlicensed
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 Antiretroviral
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Mylanta extra strength liquid cherry flavour
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Unlicensed
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 Antacid, used as a constituent of didanosine solution
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| 05.03.01 |
Pharmacokinetic enhancers of antiretrovirals |
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| 05.03.01 |
Combination Products |
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Symtuza (Darunavir/cobicistat/emtricitabine/tenofovir alafenamide)
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Formulary
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Approved for use as per NHSE Policy FO3/P/b
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MHRA Jul 2018: Darunavir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1
NHSE F03/P/b: Use of cobicistat as a booster in treatment of HIV infection (all ages)
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Key |
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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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CCG |
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Traffic Light Status Information
| Status |
Description |
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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.
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Treatment can be initiated in primary care after a recommendation from an appropriate specialist |
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Specialist initiation followed by maintenance prescribing in primary care |
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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 |
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Specialist and non-specialist initiation |
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Not recommended for prescribing |
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