| Formulary Chapter 1: Gastro-intestinal system - Full Chapter
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| 01.02 |
Antispasmodics and other drugs altering gut motility |
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Hyoscine Butylbromide
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Formulary
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10mg Tablet
20mg/ml Injection
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 NICE CG61: Irritable bowel syndrome in adults: diagnosis and management
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Botulinium Toxin A
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Formulary
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Metoclopramide
(Tablets, Oral solution, Injection)
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Formulary
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Nausea and vomiting
Not recommended for patients under 20 years of age due to risk of dystonic reactions
For restrictions for use in younger patients see MHRA guidance below
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MHRA: Metoclopramide: risk of neurological adverse effects (Published 11 December 2014)
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| 01.02 |
Antimuscarinics |
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| 01.02 |
Other antispasmodics |
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Mebeverine Hydrochloride
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Formulary
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NICE CG61: Irritable bowel syndrome in adults: diagnosis and management
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Peppermint Oil
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Formulary
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Prescribe as capsules E/C 0.2ml
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NICE CG61 : Irritable bowel syndrome in adults: diagnosis and management
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Peppermint water
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 Restricted
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Peppermint water is an unlicensed special and should only be prescribed (initiation and maintenance) by specialists, where no suitable alternative exists
For specialist use only
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| 01.02 |
Motility stimulants |
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Domperidone
(Tablets, Suspension, Suppositories)
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Formulary
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The MHRA has issued new advice for domperidone which states that it is no longer licensed for the relief of nausea and vomiting in children under the age of 12 years or those weighing less than 35kg (16th December 2019).
See MHRA Dug Safety Update
Domperidone is no longer recommended for managing heartburn,bloating and stomach discomfort
It should only be used for relief of nausea and vomiting at low doses for short periods (generally upto 1 week)
MHRA advice on domperidone
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MHRA: Domperidone: risk of cardiac side effects (Published 11 December 2014)
NICE: Promoting tolerance of enteral feeds in children and young people: domperidone
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| .... |
| Non Formulary Items |
Algicon®
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Non Formulary
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Alverine Citrate (Spasmonal®)
(Capsules)
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Non Formulary
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Dicycloverine
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Non Formulary
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Eluxadoline
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Non Formulary
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In line with NICE
Specialist initiation, transfer of prescribing supported by a RICaD |
NICE TA471: Eluxadoline for treating irritable bowel syndrome with diarrhoea
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Fybogel Mebeverine (Fybogel® Mebeverine)
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Non Formulary
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Lubiprostone (Amitiza®)
(Capsule)
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Non Formulary
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Manufacturer has now discontinued the product |
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Mebeverine Hydrochloride MR (Colofac MR®)
(Capsules)
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Non Formulary
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Mebeverine with ispaghula husk
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Non Formulary
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Peppermin Oil (Colpermin®)
(MR Capsules)
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Non Formulary
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Propantheline
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Non Formulary
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Renie Duo
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Non Formulary
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Sodium citrate 0.3M
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Non Formulary
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Topal (Topal®)
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Non Formulary
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Key |
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Restricted Drug |
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Unlicensed |
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
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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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ICB |
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Low carbon footprint |
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Medium carbon footprint |
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High carbon footprint |
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| Status |
Description |
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Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications |
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Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
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Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist. |
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Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only |
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Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
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Check Notes as varies across the area |
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