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13. Skin

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/

County Durham & Darlington Appendix to “Specials Recommended by the British Association of Dermatologists for Skin Disease” can be found:

Area Prescribing Committee website

CDDFT intranet

See local guideline on emollient prescribing for dry skin conditions:

Area Prescribing Committee website

CDDFT Intranet

MHRA Drug Safety Update (April 2016): Paraffin-based skin emollients on dressings or clothing: fire risk

Plain Emollients
First choice
• Zeroderm® Ointment
• Hydromol® Ointment
• Zerobase® Cream
• QV® Cream
• Cetraben®
• Zerodouble Gel®
Second choice
• Dermol® Cream
• Balneum® Cream (contains fragrance)
• Emollin® Spray
• Doublebase® Gel
• Hydromol® Cream (this is a humectant and so less is used)
Third line
Prescribing usually reserved for dermatology services.
• Balneum® Plus
• Aveeno® (ACBS)
• Hydromol® Intensive
• Calmurid® (Urea Containing Emollient)

Plain Emollients
First choice
• Zeroderm® Ointment
• Hydromol® Ointment
• Zerobase® Cream
• QV® Cream
• Cetraben®
• Zerodouble Gel®
Second choice
• Dermol® Cream
• Balneum® Cream (contains fragrance)
• Emollin® Spray
• Doublebase® Gel
• Hydromol® Cream (this is a humectant and so less is used)
Third line
Prescribing usually reserved for dermatology services.
• Balneum® Plus
• Aveeno® (ACBS)
• Hydromol® Intensive
• Calmurid® (Urea Containing Emollient)

Doublebase gel
BNF | BNFC | SPC

15% liquid paraffin & 15% isopropyl myristate

Hydromol Ointment
BNF | BNFC | SPC

Ointment

Yellow soft paraffin 30%, emulsifying wax 30% & liquid paraffin 40%.

Calmurid
BNF | BNFC | SPC

Cream containing urea 10% & lactic acid 5%

Dermol cream
BNF | BNFC | SPC

Cream

10% liquid paraffin, 10% isopropyl myristate & 0.1% benzalkonium chloride & 0.1% chlorhexidine chloride

Zeroderm Ointment
BNF | BNFC | SPC
Zerobase Cream
BNF | BNFC | SPC
QV Cream
BNF | BNFC | SPC
Cetraben
BNF | BNFC | SPC

Liquid paraffin 10.5%, white soft paraffin (WSP) 13.2%

Zerodouble Gel
BNF | BNFC | SPC

15% liquid paraffin & 15% isopropyl myristate

Balneum Cream
BNF | BNFC | SPC
Emollin Spray
BNF | BNFC | SPC
Hydromol Cream
BNF | BNFC | SPC
Balneum Plus
BNF | BNFC | SPC
Aveeno cream
BNF | BNFC | SPC

Emulsifying ointment 30%, phenoxyethanol 1% & cetostearyl alcohol

Hydromol Intensive
BNF | BNFC | SPC
Hydromol bath/shower
BNF | BNFC | SPC

Bath Emollient

Oilatum
BNF | BNFC | SPC

Bath Emollient

Liquid containing liquid paraffin 63.4% & acetylated wool alcohols 5%

Dermol 600
BNF | BNFC | SPC

Bath Emollient

Dermol 500 lotion
BNF | BNFC | SPC
Dermol 200 Shower Emollient
BNF | BNFC | SPC
Hydromol bath/shower
BNF | BNFC | SPC
Hydromol Ointment
BNF | BNFC | SPC
Zerodouble Gel
BNF | BNFC | SPC
Doublebase Gel
BNF | BNFC | SPC
QV Gentle Wash
BNF | BNFC | SPC
QV Bath Oil
BNF | BNFC | SPC
Zerodouble Gel
BNF | BNFC | SPC
Doublebase Gel
BNF | BNFC | SPC
Zerolatum
BNF | BNFC | SPC

Liquid containing liquid paraffin 63.4% & acetylated wool alcohols 5%

Zeroneum
BNF | BNFC | SPC

Liquid containing soya oil 83.35%

Metanium
BNF | BNFC | SPC

Ointment containing titanium oxide 20%, titanium peroxide 5% and titanium salicylate 3% in a basis containing dimeticone, paraffins and benzoin compound tincture

Sudocrem
BNF | BNFC | SPC

Cream containing benzyl alcohol 0.39%, benzyl benzoate 1.01%, benzyl cinnamate 0.15%, hydrous wool fat (hypoallergenic lanolin) 4%, zinc oxide 15.25%

Vasogen
BNF | BNFC | SPC

Cream

Sorbaderm
BNF | BNFC | SPC

2g & 92g barrier cream, 28ml pump spray, sterile 1ml no sting barrier film foam applicator, sterile 3ml no sting barrier film foam applicator

Dimeticone (Siopel)
BNF | BNFC | SPC

Cream containing dimeticone ‘1000’ 10% & Cetrimide 0.3%. Also contains arachis (peanut) oil

Drapolene
BNF | BNFC | SPC

Cream containing benzalkonium chloride 0.01% & Cetrimide 0.2%

Zinc and Castor Oil Ointment
BNF | BNFC | SPC

Ointment containing zinc oxide 7.5%, castor oil 50%, arachis (peanut) oil 30.5%, white beeswax 10% and cetostearyl alcohol 2%

Deegan's Ointment
BNF | BNFC | SPC

Ointment containing 3% benzoin compound tincture in a base containing zinc and castor oil paste and olive oilu

Sucralfate
BNF | BNFC | SPC

4% creamu
For limited use around gastrostomies when wound breakdown is thought to be aggravated by leakage of gastric acid.

Menthol 1% in Aqueous Cream
BNF | BNFC | SPC

Cream

Calamine Lotion
BNF | BNFC | SPC

Lotion (calamine 15%, zinc oxide 5%, glycerol 5% bento-nite 3%, sodium citrate 0.5% & liquefied phenol 0.5%)

Crotamiton (Eurax)
BNF | BNFC | SPC

10% cream (Eurax)

Lidocaine
BNF | BNFC | SPC

5% ointment

NICE TA81

Clobetasol Propionate (Dermovate)
BNF | BNFC | SPC

Cream - 0.05%

Ointment - 0.05%

Scalp application - 0.05%

Betamethasone 0.05% + Clioquinol 3%
BNF | BNFC | SPC

Ointment

Betamethasone 0.05% + Neomycin 0.5%
BNF | BNFC | SPC

Cream

Ointment

Dermovate NN
BNF | BNFC | SPC

Ointment (clobetasol propionate 0.05%, neomycin sulphate
0.5%, nystatin 100,000 units/g) u

25% Betnovate in 1% clioquinol
BNF | BNFC | SPC

100g

Indication: control of eczema that gets infected recurrently.

Unlicensed

Diprosalic (Betamethasone 0.05%, Salicyclic Acid 3%)
BNF | BNFC | SPC

Ointment

Scalp Application

Betamethasone Valerate (Betnovate®)
BNF | BNFC | SPC

0.1% cream, ointment, lotion & scalp application

Fluocinolone Acetonide (Synalar®)
BNF | BNFC | SPC

0.025% cream, ointment & gel

Hydrocortisone Butyrate (Locoid®)
BNF | BNFC | SPC

0.1% cream

Trimovate (Clobetasone Butyrate 0.05%, Oxytetracycline 3%, Nystatin)
BNF | BNFC | SPC

Cream

Triadcortyl®
BNF | BNFC | SPC

Nystatin, neomycin, gramicidin ointmentu

For the treatment of otitis externa in those patients who have ear canal stenosis or who have failed to respond to other first or second line treatments.

Clobetasone Butyrate (Eumovate)
BNF | BNFC | SPC

Cream - 0.05%

Ointment - 0.05%

Betamethasone 0.025% (Betnovate RD®)
BNF | BNFC | SPC

 

Cream - 0.025%

Ointment - 0.025%

Fludroxycortide
BNF | BNFC | SPC

Tape - 4microgram/cm2

Canesten HC (Clotrimazole 1%, Hydrocortisone 1%)
BNF | BNFC | SPC

Cream

Daktacort (Miconazole 2% Hydrocortisone 1%)
BNF | BNFC | SPC

Cream

Ointment

Timodine (Hydrocortisone, Nystatin, Benzalkonium, Dimeticone)
BNF | BNFC | SPC

Cream

Nystaform HC®
BNF | BNFC | SPC

Cream (chlorhexidine HCl 1%, nystatin 100,000 units/g &
hydrocortisone 0.5%)

Eurax-hydrocortisone
BNF | BNFC | SPC

Cream (crotamiton 10% & hydrocortisone 0.25%)

Hydrocortisone
BNF | BNFC | SPC

Cream - 0.5% & 1%

Ointment - 0.5% & 1%

Icthammol with zinc oxide
BNF | BNFC | SPC

Bandage - 7.5cmx6m (Ichthopaste®)

Alitretinoin
BNF | BNFC | SPC

10mg and 30mg capsules

Approved for use as a treatment option for adults with severe chronic hand eczema that have not responded to potent topical corticosteroids in accordance with NICE guidance.

NICE TA177

Sebco (Coal Tar Solution 12%, Salicylic Acid 2%, Preciptated Sulfur 4%)
BNF | BNFC | SPC

Scalp Ointment

Coal Tar
BNF | BNFC | SPC

Coal tar lotion 1% - see Exorex

Coal tar strong solution 1%, 2.5% & 5% in emulsifying
ointment RVI u

Coal Tar & Salicylic Acid
BNF | BNFC | SPC

Ointment containing coal tar 2% & salicylic acid 2%

Exorex®
BNF | BNFC | SPC

Lotion containing prepared coal tar 1% in an emollient basis. Excipients include hydroxybenzoates (parabens) and polysorbate 80.

Tar Pomade (RVI)
BNF | BNFC | SPC

Pomade containing 6% coal tar solution and salicylic acid 2% in an emulsifying ointment baseu

Zinc & Coal Tar (White’s Tar Paste)
BNF | BNFC | SPC

Paste containing zinc oxide 6%, coal tar 6%, emulsifying wax 5%, starch 38% and yellow soft paraffin 45%.u

Alphosyl HC®
BNF | BNFC | SPC

Cream containing coal tar extract 5%, hydrocortisone 0.5% and allantoin 2%.

Dithranol (Dithrocream®)
BNF | BNFC | SPC

Cream - 0.1%, 0.25%, 0.5%, 1%, 2%

Dithranol in Full Strength Lassar’s Paste
BNF | BNFC | SPC

0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1%, 2%, 4%, 6% & 8%u

Unlicensed

Dithranol with Salicylic Acid 0.5%
BNF | BNFC | SPC

0.2%, 0.4%, 0.6%, 0.8%, 1%, 2%, 4%, 6%, 8% & 16% in emulsifying baseu

Unlicensed

Dithranol with Salicyclic Acid
BNF | BNFC | SPC

Dithranol 1% and salicylic acid 2% in emulsifying ointment 100g
Dithranol 2% and salicylic acid 2% in emulsifying ointment 100g
Dithranol 4% and salicylic acid 2% in emulsifying ointment 100g
Dithranol 8% and salicylic acid 2% in emulsifying ointment 100g
Dithranol 16% and salicylic acid 2% in emulsifying ointment 100g

Indication: Chronic plaque psoriasis predominantly used as short contact treatment for
outpatients coming in for daily treatments

Unlicensed

Dovobet (Calcipotriol 50microgram/g, Betamethasone 0.05%)
BNF | BNFC | SPC

Ointment

Gel

Dovonex®
BNF | BNFC | SPC

50 micrograms/g (0.005%) cream & ointment
50 micrograms/ml (0.005%) scalp application

Salicylic acid
BNF | BNFC | SPC

2%, 5%, 10% & 20% in emulsifying ointment

Salicyclic acid 1% in aqueous cream 100g
Salicyclic acid 2% in aqueous cream 100g

All unlicensed

Zinc and salicylic acid
BNF | BNFC | SPC

Half Strength Lassar’s Pasteu - unlicensed

Enstilar® cutaneous foam spray
BNF | BNFC | SPC

Contains Calcipotriol monohydrate and betamethasone dipropionate

Acitretin
BNF | BNFC | SPC

Capsules - 10mg, 25mgu

Consultant only

8-Methoxypsoralen
BNF | BNFC | SPC

10mg tabletsu

5-Methoxypsoralen
BNF | BNFC | SPC

20mg tabletsu

Methoxypsoralen 1.2% bath additive
BNF | BNFC | SPC

1.2% bath additiveu

Fumaric acid esters
BNF | BNFC | SPC

30mg & 120mg tabletsu

Dimethyl fumarate
BNF | BNFC | SPC

30mg & 120mg tabletsu

NTAG Advice: Dimethyl fumarate for moderate to severe chronic plaque psoriasis

Ciclosporin – see 8.2.2
BNF | BNFC | SPC

Shared Care documents available

Methotrexate – see 8.1.3
BNF | BNFC | SPC

Shared Care documents available

See local guideline on emollient Low-dose Methotrexate for Eczema – A Guideline for Paediatric Prescribing – found here

Pimecrolimus
BNF | BNFC | SPC

Cream - 1%

Prescribed in accordance with NICE TA82 

Tacrolimus
BNF | BNFC | SPC

Cream - 0.03% & 0.1%

Adalimumab
BNF | BNFC | SPC

40mg injection (prefilled syringe)

NICE TA146

NICE TA392

Etanercept▼
BNF | BNFC | SPC

25mg injection (Enbrel® & Benapali®)

NTAG April 2016: The Northern (NHS) Treatment Advisory Group recommends the use of etanercept biosimilar Benepali® as an option for use in adults where the originator product (Enbrel®) would normally be prescribed.

Infliximab ▼
BNF | BNFC | SPC

100mg injection (Remicade®, Inflectra® & Remsima®)

NICE TA134

Secukinumab▼
BNF | BNFC | SPC

150microgram pre-filled pen & syringe

NICE TA350

 

Ustekinumab
BNF | BNFC | SPC

45mg vial

NICE TA180

Not to be used for treating active psoriatic arthritis – see NICE TA313

MHRA Drug Safety Update (Jan 2015): Ustekinumab (Stelara): risk of exfoliative dermatitis

Apremilast ▼
BNF | BNFC | SPC

For treating moderate to severe chronic plaque psoriasis – see NICE TA419

Not to be used for treating active psoriatic arthritis – see NICE TA372

MHRA Drug Safety Update (Jan 2017): Apremilast (Otezla ▼): risk of suicidal thoughts and behaviour

Ixekizumab▼
BNF | BNFC | SPC

80mg solution for injection in prefilled pen.

For treating moderate to severe plaque psoriasis – see NICE TA442

Clindamycin
BNF | BNFC | SPC

 

1% topical solution (alcohol – water basis)
1% lotion (aqueous)

Antibacterial agent not for continual use

Zineryt®
BNF | BNFC | SPC

Topical solution containing erythromycin 4% zinc acetate 1.2% (when reconstituted)

Erythromycin
BNF | BNFC | SPC

2% topical solution (alcoholic)

Azelaic Acid
BNF | BNFC | SPC

15% gel (Finacea®)

Benzoyl Peroxide
BNF | BNFC | SPC

2.5%, 5% & 10% aqueous gel (Panoxyl Aquagel®)

Adapalene
BNF | BNFC | SPC

0.1% gel and cream

See section 5.1 for systemic antibiotics

Co‐cyprindiol▼
BNF | BNFC | SPC

Tablets containing cyproterone acetate 2mg & ethinylestradiol 35 micrograms

Generic co-cyprindiol is much cheaper than Dianette®

For use in women only

Isotretionoin
BNF | BNFC | SPC

Capsules - 5mg, 20mg

Isotretinoin is a toxic drug that must only be prescribed by or under the supervision of a consultant dermatologist.

MHRA Drug Safety Update (Dec 2014): Isotretinoin (Roaccutane): reminder of possible risk of psychiatric disorders

Brimonidine tartrate
BNF | BNFC | SPC

0.33% gel

Not approved: Brimonidine tartrate for facial erythema in rosacea

MHRA Drug Safety Update (Nov 2016): Brimonidine gel (Mirvaso): risk of exacerbation of rosacea

Ivermectin 1% Cream
BNF | BNFC | SPC

Approved for the topical treatment of inflammatory lesions of papulopustular rosacea in adults for use after more established therapies such metronidazole gel and azelaic acid have failed.

Glutaraldehyde Paint
BNF | BNFC | SPC

10% Solution (paint) – Glutarol

Silver Nitrate
BNF | BNFC | SPC

75% & 95% applicators – 6 inch & 95% pencils (Caustic pencils). 0.5% solution also available see section 13.11.6

Salactol® Paint
BNF | BNFC | SPC

Paint (salicylic acid 16.7% & lactic acid 16.7% in flexible collodion)

Salicyclic Acid
BNF | BNFC | SPC

Various strength preparations in Emulsifying ointmentu – see section 13.5.2

Podophyllotoxin solution
BNF | BNFC | SPC

0.15% cream (Warticon)

To be initiated with specialist advice

Imiquimod
BNF | BNFC | SPC

5% cream 12 sachet pack
- 2nd line specialist use for treatment of ano-genital warts (mainly in genitourinary medicine [GUM] clinics)

Trichloracetic acid
BNF | BNFC | SPC

10%, 75% & 90% solutions

90% w/v 10 ml - Used to destroy facial xanthelasmata; highly irritant

Formaldehyde
BNF | BNFC | SPC

3% formaldehyde 300ml (unlicensed)

Indication: Plantar warts as alternative to laser treatment

Uvistat Ultrablock® (Sunblock factor 30)
BNF | BNFC | SPC

Cream (UVB – SPF 30) - mexenone 2%, ethylhexyl pmethoxycinnamate 7.5%, Butylmethoxydibenzoylmethane 4% & titanium dioxide 6.5%

CD&D APC Grey List: Sunscreens are limited to patients that are having treatment that may render them susceptible to sunlight only as per ACBS guidelines.

Sunsense Ultra® (Sunblock factor 50+)
BNF | BNFC | SPC

Lotion (UVA and UVB – SPF 50+ protection) – containing octinoxate 7.5%, oxybenzone 3%, titanium dioxide 3.5% - 125ml pack

CD&D APC Grey List: Sunscreens are limited to patients that are having treatment that may render them susceptible to sunlight only as per ACBS guidelines.

Fluorouracil (Efudix®)
BNF | BNFC | SPC

5% cream

For the treatment of superficial malignant and premalignant skin lesions

Ingenol mebutate ▼
BNF | BNFC | SPC
Diclofenac 3% in sodium hyaluronate
BNF | BNFC | SPC
Imiquimod Cream 5% (Aldara®)
BNF | BNFC | SPC

For the management of actinic keratosis.

Products from the Dermacolor® Camouflage Crème and Veil cover cream ranges are included in this Formulary. They are classified as borderline substances and can be prescribed on FP10 prescription forms (marked ACBS) for postoperative scars and other deformities and as an adjunctive therapy in the relief of emotional disturbances due to disfiguring skin disease, such as vitiligo. 

Dermax
BNF | BNFC | SPC

Shampoo

Capasal
BNF | BNFC | SPC

Shampoo

Ketoconazole
BNF | BNFC | SPC

2% shampoo (Nizoral®)

Co-cyprindiol
BNF | BNFC | SPC

Tablets containing cyproterone acetate 2mg &
ethinylestradiol 35 micrograms

Generic co-cyprindiol is much cheaper than Dianette

Eflornithine
BNF | BNFC | SPC

11.5% cream

CD&D APC Grey List: Eflornithine: for use as a second-line treatment of facial hirsutism in patients where co-cyprindiol (Dianette) is ineffective, contra-indicated or considered inappropriate. Treatment should be initiated by or on the specific advice of an appropriate specialist - endocrinologist (or gynaecologist).

T-gel
BNF | BNFC | SPC
Ceanal
BNF | BNFC | SPC

Reserve topical antibiotics for very localised lesions to reduce risk of resistance

Mupirocin Ointment
BNF | BNFC | SPC

2% ointment (Bactroban)

Polyfax® Ointment
BNF | BNFC | SPC

Ointment (polymyxin B sulph. 10,000 units & bacitracin zinc 500 units/g)

Silver Sulfadiazine 1% Cream (Flamazine®)
BNF | BNFC | SPC

1% Cream (Flamazine®)

Nitrofurazone Soluble
BNF | BNFC | SPC

0.2% Ointment
For limited use in burns/ plastic surgery patients only

Fusidic Acid
BNF | BNFC | SPC

2% cream, gel & ointment

Hospital use limited to dermatology and urology outpatients.

Metronidazole
BNF | BNFC | SPC

0.75% cream & gel

Clotrimazole
BNF | BNFC | SPC
Miconazole Nitrate
BNF | BNFC | SPC

0.16% Dual Action Spray powder 

Ketoconazole
BNF | BNFC | SPC

Cream - 2% 

Terbinafine
BNF | BNFC | SPC

Cream - 1% 

Nystatin
BNF | BNFC | SPC

Nystatin cream & ointment have now been discontinued

Amorolfine 5% nail lacquer cream
BNF | BNFC | SPC
Aciclovir
BNF | BNFC | SPC

Cream - 5%

Molludab topical solution
BNF | BNFC | SPC
Idoxuridine in dimethyl sulfoxide
BNF | BNFC | SPC
Dimeticone
BNF | BNFC | SPC

4% lotion (50ml) (Hedrin®)

Malathion
BNF | BNFC | SPC

0.5% lotion (aqueous), 0.5% lotion (alcoholic)

Permethrin
BNF | BNFC | SPC

5% skin cream; 1% cream rinse

Phenothrin (Full Marks®)
BNF | BNFC | SPC
Drapolene®
BNF | BNFC | SPC

Cream (cetrimide 0.2%, benzalkonium chloride 0.01%)

Proflavine cream
BNF | BNFC | SPC

Oily emulsion containing 0.1% Proflavine hemisulphate –
for limited use in hospitals

Lanolin Cream
BNF | BNFC | SPC
Magnesium Sulphate
BNF | BNFC | SPC

Paste (dried magnesium sulphate 45g, glycerol 55g & phenol 500mg  per 100.5g)

Flexible Collodion
BNF | BNFC | SPC

2.5% castor oil & colophony 2.5% in a collodion base

Enbucrilate
BNF | BNFC | SPC

Tissue adhesives (Liquiband®, Liquiband Optima®, Indermil
X-Fine, Histoacryl Blue®)

Bioglue®
BNF | BNFC | SPC

For use in neurosurgery and vascular surgery.

Floseal® matrix sealant
BNF | BNFC | SPC
Evicel® Human Fibrin Glue
BNF | BNFC | SPC

2ml & 5ml kit

Tisseel® Lyo Fibrin Glue
BNF | BNFC | SPC

2ml, 4ml & 10ml kit

Also approved for use in the treatment of mesh fixation in hernia repair.

TachoSil
BNF | BNFC | SPC

4.8 & 9.5 sq cm Haemostatic (collagen sponge coated with
fibrinogen and thrombin) for use in liver and renal surgery

Artiss fibrin sealant
BNF | BNFC | SPC

2ml, 4ml & 10ml prefilled syringe

Approved for use in plastic surgery to close dead spaces, adhere skin graft, close simple wounds and stabilise bone grafts.

Bismuth Subnitrate and Iodoform (B.I.P.P.) Paste
BNF | BNFC | SPC

Paste
1.25cm x 100cm & 2.5cm x 100cm impregnated gauze

Alcohol Impregnated Wipes
BNF | BNFC | SPC

Containing 70% isopropyl alcohol or methylated spirit (e.g. Clini-wipes®, Alcowipes®)

Methylated spirit (industrial)
BNF | BNFC | SPC

70% liquid & 70% spray

Skin preparation swabs
BNF | BNFC | SPC

Containing 70% isopropyl alcohol (Sterets®)

Alcohol hand rub
BNF | BNFC | SPC
Sodium Chloride
BNF | BNFC | SPC

Sterile solution – bottles, 25ml & 100ml sachets (Normasol®) & 45ml plastic ampoules/pods (Miniversol®)

Water for irrigation
BNF | BNFC | SPC
Chlorhexidine
BNF | BNFC | SPC

1% chlorhexidine acetate dusting powder
Chlorhexidine Gluconate 0.02% & 0.05% solutions, 25ml & 100ml sachets
0.5% solution in 70% methylated spirit (pink, colourless &
red staining),
2.5% in 70% methylated spirit wipes
0.5% hand rub (contains 70% isopropyl alcohol + emollients)
4% surgical scrub
2% in 70% isopropyl alcohol wipes (Sanicloth® & Clinell®),
skin swabs & skin cleanser
3ml & 10.5ml applicators (Chloraprep®)
Obstetric cream

MHRA Medical Device Alert (November 2012) re: chlorhexidine and risk of anaphylaxis

MHRA Drug Safety Update (November 2014) reminder of the risk of chemical burns in premature infants

Prontosan®
BNF | BNFC | SPC

Solution containing Betaine 0.1% (surfactant) and
Polyhexanide 0.1% (a chlorhexidine polymer). Mainly for
use from 40ml plastic ampoules.
Also available as a gel. Prontosan

To be prescribed/ used only on the advice of tissue viability specialists

Mediscrub®
BNF | BNFC | SPC
Octenisan®
BNF | BNFC | SPC

Body wash containing octenidine –as an alternative to chlorhexidine scrub and Triclosan skin cleanser in MRSA prophylaxis/eradication.

Povidone Iodine
BNF | BNFC | SPC

2.5% dry powder spray 10% alcoholic solution
7.5% surgical scrub10% antiseptic solution (aqueous)

Sodium Hypochlorite
BNF | BNFC | SPC

1% sterilising solutionu (unlicensed)

Sodium dichloroisocyanurate
BNF | BNFC | SPC

500mg & 5g solution tablets:
granules

Hexachlorophene and Triclosan
BNF | BNFC | SPC

1% or 2% skin cleanser
0.5% hand rub

(Aquasept®, Manusept®, & Skinsan®)

Potassium Permanganate
BNF | BNFC | SPC

Solution Tablets - 400mg 

Hydrogen Peroxide
BNF | BNFC | SPC

10 volume (3%) & 20 volume (6%) solutions

Silver Nitrate
BNF | BNFC | SPC

0.5% solutions – used on advice from dermatologists

Bonney's Blue
BNF | BNFC | SPC

Paint containing brilliant green and crystal violetu – for limited use in some operating theatres only

Crystal Violet
BNF | BNFC | SPC

0.5% paintu - for limited use in some operating theatres / critical care areas only

Magenta paint BPC (Castellani’s paint)
BNF | BNFC | SPC

Paint containing magenta 0.4%, boric acid 0.8%, phenol 0.004%, resorcinol 8%, acetone and alcohol (or industrial methylated spirit)u – unlicensed

LarvE
BNF | BNFC | SPC

Sterile larvae (maggots) used for the management of sloughy wounds.

CDDFT Intranet link Policy for the use of sterile maggots in wound management within in-patient settings

Aluminium Chloride
BNF | BNFC | SPC

Aluminium chloride hexahydrate 20% solution in an alcoholic basis (Driclor®, Anhydrol forte®)

Botulinum Toxin
BNF | BNFC | SPC

For limited use as an alternative to surgery in some patients.

Glycopyrrolate
BNF | BNFC | SPC

1% cream – To be initiated by specialist (Unlicensed)