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 Formulary Chapter 3: Respiratory system - Full Chapter
Notes:

COPD Treatment Guidelines

Prescribing Steroids in Respiratory Conditions

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03.07  Expand sub section  Mucolytics
Acetylcysteine
(Mucolytic)
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Restricted Drug Restricted
Amber

Prescribe by brand Oronac® [licensed food supplement]

For pulmonary fibrosis, limited to historic use, specialist initiation. NICE CG163

Nebulised Acetylcysteine is unlicensed and for consultant initiation only. Wye Valley NHS Trust use the injectable preparation via this route. Contact ext 4017 for details.

 
   
Carbocisteine
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Restricted Drug Restricted
Amber

The evidence for mucolytics is poor. Use on advice from a respiratory specialist. Review after a trial period e.g. 3 – 6 months and discontinue if no benefit.

 
   
03.07  Expand sub section  Dornase alfa
Dornase Alfa (Pulmozyme®)
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Restricted Drug Restricted
Red
High Cost Medicine

Do not prescribe for new CF patients: NHSE commissioned  

 
   
03.07  Expand sub section  Hypertonic Sodium Chloride
Sodium chloride 7% (Hypertonic)
(for nebulisation)
Formulary
Green
 
   
03.07  Expand sub section  Mannitol
 ....
 Non Formulary Items
Erdosteine  (Erdotin®)

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Non Formulary
 
Ivacaftor
(Kalydeco)

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Non Formulary
High Cost Medicine
 
Lumacaftor + Ivacaftor  (Orkambi®)

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Non Formulary
Link  NICE TA398: Lumacaftor–ivacaftor for treating cystic fibrosis homozygous for the F508del mutation
 
Mannitol inhalation  (Bronchitol ®)

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Non Formulary
High Cost Medicine
Link  NICE TA266: Cystic fibrosis - mannitol dry powder for inhalation
 
Mecysteine  (Visclair®)

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Non Formulary
 
  
Key
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
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Suitable for use in primary care  

Amber

Specialist initiation. Shared care in place  

Red

Red do not use..  

Advice

Some formulations restricted  

Black

NICE "Do not do"  

Green 1

1st line option  

Green 2

2nd line option  

Green 3

3rd line option only  

Not Recomended / Black

Low Value Medicine not recommended for use - see NHSE guidelines  

OTC

This preparation should be bought over the counter for self-care  

Red Amber

Check product description for traffic light status  

Red Black

Low Value Medicine  

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