NHS NEL Formulary


	NHS NEL Demonstration Formulary

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Formulary Chapter 1: Gastro-intestinal system - Full Chapter

01.03.05

Proton pump inhibitors (PPIs)

Lansoprazole
(Capsules 15mg, 30mg)

First Choice

Capsules are more cost effective than tablets

Can be opened and beads swallowed without crushing or can be mixed with food or drink

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Lansoprazole
(Indication 2)

First Choice

Capsules are more cost effective than tablets

Can be opened and beads swallowed without crushing or can be mixed with food or drink

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Omeprazole
(Capsules 10mg, 20mg)

First Choice

Capsules are more cost effective than tablets

Most brands of capsules can be opened and beads swallowed without crushing or can be mixed with food or drink

Esomeprazole

Second Choice

Esomeprazole injection

Formulary

Lansoprazole dispersible

Formulary

Orodispersible tablets 15mg, 30mg
Orodispersible tablets cost twice as much as capsules

For use in patients with swallowing difficulties or who are on enteral tube feeding

Omeprazole Dispersible tablets
(Losec MUPS^®)

Formulary

££ - Orodispersible tablets are significantly more expensive than capsules

For use in swallowing difficulties or via nasogastric tubes when beads in the capsules are too large and lansoprazole orodispersible are not acceptable (e.g. children with fine NG tubes)

Omeprazole IV
(IV Infusion 40mg vial)

Formulary

Hospital use only

NICE CG184: Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management

PHE: Helicbacter pylori in dyspepsia: test and treat (diagnosis and treatment guide for primary care)

NICE CG 184: Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management

NICE CG141: Acute upper gastro-intestinal bleeding in over 16s: management

UKMI Q&A: Can proton pump inhibitors be used during pregnancy?

UKMI Q&A: Is there an interaction between bisphosphonates and proton pump inhibitors?

....

Non Formulary Items

Dexlansoprazole

Non Formulary

Esomeprazole & Aspirin (Axanum^®)

Non Formulary

Lansoprazole as part of Heliclear^®

Non Formulary

Pantoprazole IV (Protium^®)

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