CD&D APC Patient Decision Aids Resource available at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington/
CD&D APC “Do Not Prescribe List” and “Grey List – drugs prescribed under limited circumstances” available at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington/
NHS England Guidance on “Conditions for which over the counter items should not routinely be prescribed” available at: https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/
Anti-inflammatory Preparations
First Choice
• Betamethasone
Alternative
• Prednisolone
Anti-infective Preparations
• Gentamicin
• Chloramphenicol
• Clotrimazole
Compound Antibacterial / Corticosteroid Preparations
First Choice
• Gentamicin and Hydrocortisone
Alternatives
• Sofradex®
• Otomize®
• Betamethasone and Neomycin
• Otosporin®
Eye/ear drops containing dexamethasone 0.05%, framycetin sulphate 0.5% & gramicidin 0.005%
27.5 microgram / dose nasal spray.
N.B. Take care to
avoid confusion with fluticasone propionate
50 microgram / dose nasal sprayOTC
400 microgram unit dose nasal drops
N.B. Take care to avoid confusion with fluticasone
furoate
PasteOTC containing carmellose sodium 16.7%, pectin 16.7%
& gelatin 16.7% in plastibase
0.2% gel & 0.025% mouthwash (Gengigel)
For limited second-line use on specialist advice in the treatment of orofacial granulomatosis, severe oral ulceration and mucositis secondary to mmunosuppression where conventional treatments are unsuitable or
have failed.
MuGard®
Restricted to use in patients who are currently on sunitinib (Sutent®) treatment, and is cheaper than treatment that is currently used.
1 dose=1 x 15ml Caphosol A + 1 x 15ml Caphosol B mixed
together
CD&D APC Grey List: For limited use in patients having chemo-radiotherapy or radiotherapy to malignancies of the oral cavity, hypopharnyx and oro-pharynx on specialist recommendation.
Oral Gel - 24mg/ml
Gel not recommended under 4m of age due to choking risk
MHRA Drug Safety Update (June 2016): Topical miconazole, including oral gel: reminder of potential for serious interactions with warfarin
MHRA Drug Safety Update (Sept 2017): Miconazole (Daktarin): over-the-counter oral gel contraindicated in patients taking warfarin
50mg muco-adhesive buccal tablets
Restricted to use in immunocompromised patients with severe oropharyngeal candidiasis, where the use of other antifungal agents e.g. nystatin, fluconazole is not appropriate and for use on the advice of microbiologists.
2% oral gelu
For hospital use in the prevention of ventilator-associated pneumonia in adult patients who are ventilated (for >48 hours).
Solution tablets containing antimicrobial, flavouring and
colouring agents
Oral Spray
Preferred to Glandosane as it is less likely to damage tooth enamel
Oralbalance Gel
Prescribable on the NHS in primary care as a Borderline Substance.