NHS NEL Formulary


	NHS NEL Demonstration Formulary

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Formulary Chapter 1: Gastro-intestinal system - Full Chapter

01.04

Acute diarrhoea

Oral Rehydration Salts
(Powder)

Formulary

Follow OptimiseRx advice for most cost-effective prescribing option

St Mark's recipe

Formulary

For fluid and electrolye replacement following diarrhoea

Click here for St Mark's recipe

St Mark’s powder & solution (unlicensed)
(Powder)

Unlicensed

UNLICENSED

Specialist use only

NICE CG84: Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management

01.04.01

Adsorbents and bulk-forming drugs

01.04.02

Antimotility drugs

Codeine
(Tablets 15mg, 30mg. Syrup 25mg/5ml)

Formulary

Avoid long term use due to possible dependence

Loperamide
(Capsules 2mg)

Formulary

Capsules are more cost effective than tablets

Loperamide melts (orodispersible) tablets are reserved for high risk stoma output patients and patients with swallowing difficulty only

Not to be used if C.diff is suspected

Caution in patients with a history of recent or repeated antibiotic use as increased risk of C.diff infection in this group

UKMI Q&A: High dose loperamide to reduce stoma output

Loperamide with simeticone

Formulary

01.04.03

Enkephalinase Inhibitors

....

Non Formulary Items

Co-Phenotrope

Non Formulary

Kaolin and Morphine Mixture

Non Formulary

Kaolin with morphine

Non Formulary

Kaolin, Light

Non Formulary

Laolin, Light

Non Formulary

Morphine

Non Formulary

Racecadotril (Hidrasec^®)

Non Formulary

Key

	Restricted Drug
	Unlicensed
	Link to adult BNF
	Link to children's BNF
	Link to SPCs
	Cytotoxic Drug
	Controlled Drug

	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	ICB
	Low carbon footprint
	Medium carbon footprint
	High carbon footprint

Status	Description
	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
	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.
	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.
	Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist.
	Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only
	Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.
	Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.
	Check Notes as varies across the area