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/
Compound Antibacterial / Corticosteroid Preparations
• Gentamicin and Hydrocortisone
• Betamethasone and Neomycin
Eye/ear drops containing dexamethasone 0.05%, framycetin sulphate 0.5% & gramicidin 0.005%
CD&D APC Grey List: Nasal sprays for the symptomatic relief of hayfever and congestion can be
purchased by the patient under self-care with community pharmacist support.
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
PasteOTC containing carmellose sodium 16.7%, pectin 16.7%
& gelatin 16.7% in plastibase
Mucoadhesive Buccal Tablets - 2.5mgOTC
MHRA Drug Safety Update (Dec 2018): Hydrocortisone muco-adhesive buccal tablets: should not be used off-label for adrenal insufficiency in children due to serious risks
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
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
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
Preferred to Glandosane as it is less likely to damage tooth enamel
Prescribable on the NHS in primary care as a Borderline Substance.