15% liquid paraffin & 15% isopropyl myristate^OTC

Ointment^OTC

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

Also used as soap substitute.

Cream^OTC containing urea 10% & lactic acid 5%

Cream^OTC

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

^OTC

^OTC

^OTC

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

15% liquid paraffin & 15% isopropyl myristate^OTC

^OTC

^OTC

^OTC

^OTC

Emulsifying ointment 30%, phenoxyethanol 1% & cetostearyl alcohol^OTC

30g and 100g cream^OTC

50g, 200g and 500g cream^OTC

2nd line emollient for use in teenage girls as it contains a rose fragrance which may aid compliance.

100g and 500g cream^OTC

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

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

Cream^OTC

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

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

Cream containing benzalkonium chloride 0.01% & Cetrimide 0.2%

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

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

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

Cream

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

10% cream (Eurax)

5% ointment

Cream - 0.05%

Ointment - 0.05%

Scalp application - 0.05%

0.1% cream, ointment, lotion & scalp application

0.025% cream, ointment & gel

0.1% cream

Cream - 0.05%

Ointment - 0.05%

Cream - 0.025%

Ointment - 0.025%

Tape - 4microgram/cm2

Cream - 0.5% & 1%^OTC

Ointment - 0.5% & 1%^OTC

Bandage - 7.5cmx6m (Ichthopaste®)

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

40mg injection (prefilled syringe)

Approved for use in accordance with the following NICE TAs

• NICE TA146: Adalimumab for the treatment of adults with psoriasis
• NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
• NICE TA445: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people

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

For treating active psoriatic arthritis – see NICE TA433

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

210mg solution in pre-filled syringe

Approved for use in accordance with the following NICE TAs:

• NICE TA511: Brodalumab for treating moderate to severe plaque psoriasis

CD&D APC Shared Care Guideline available at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington/transfer-of-prescribing-policies-shared-care-guidelines/

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.

Approved for use in accordance with the following NICE TAs:

• NICE TA103: Etanercept and efalizumab for the treatment of adults with psoriasis
• NICE TA199: Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
• NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people

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

NICE TA134

80mg solution for injection in prefilled pen.

For treating moderate to severe plaque psoriasis – see NICE TA442

Shared Care documents available

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

CD&D APC Shared Care Guideline available at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington/transfer-of-prescribing-policies-shared-care-guidelines/

Cream - 1%

Prescribed in accordance with NICE TA82 

150microgram pre-filled pen & syringe

NICE TA350

Cream - 0.03% & 0.1%

45mg vial

Approved for use in accordance with the following NICE TAs:

• NICE TA180: Ustekinumab for the treatment of adults with moderate to severe psoriasis
• NICE TA340: Ustekinumab for treating active psoriatic arthritis
• NICE TA445: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people

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

150mg pre-filled syringe

Approved for use in accordance with the following NICE TAs:

• NICE TA521: Guselkumab for treating moderate to severe plaque psoriasis

300mg/2ml soln for inj in pre-filled syringe

Approved for use in accordance with the following NICE TAs:

• NICE TA534: Dupilumab for treating moderate to severe atopic dermatitis

Tablets containing cyproterone acetate 2mg & ethinylestradiol 35 micrograms

Generic co-cyprindiol is much cheaper than Dianette®

For use in women only

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

MHRA Drug Safety Update (Oct 2017): Isotretinoin (Roaccutane): rare reports of erectile dysfunction and decreased libido 

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

MHRA Drug Safety Update (June 2017): Brimonidine gel (Mirvaso): risk of systemic cardiovascular effects; not to be applied to damaged skin

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.

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.

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.

Tablets containing cyproterone acetate 2mg &
ethinylestradiol 35 micrograms

Generic co-cyprindiol is much cheaper than Dianette

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).

Clotrimazole 1% cream^OTC

0.16% Dual Action Spray powder ^OTC

Cream - 2% 

Cream - 1% 

Nystatin cream & ointment have now been discontinued

Cream - 5%^OTC

4% lotion (50ml) (Hedrin®)^OTC

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

5% skin cream; 1% cream rinse^OTC

^OTC

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

70% liquid & 70% spray

Containing 70% isopropyl alcohol (Sterets®)

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

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

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

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

1% or 2% skin cleanser
0.5% hand rub

(Aquasept®, Manusept®, & Skinsan®)

Solution Tablets - 400mg 

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

0.5% solutions – used on advice from dermatologists

Paint containing brilliant green and crystal violet^u – for limited use in some operating theatres only

0.5% paint^u - for limited use in some operating theatres / critical care areas only

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

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