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9. Nutrition and Blood

NICE NG8: Anaemia management in people with chronic kidney disease

County Durham and Darlington  APC - Guidance for the treatment of Vitamin D insufficiency and deficiency – June 2015

County Durham and Darlington  APC - Adult Vitamin D Guideline – Quick Reference Guide Guidance for the treatment of Vitamin D insufficiency and deficiency – September 2017

CD&D Guidelines for Diagnosing and Managing Cows Milk Protein Allergy (CMPA) and Lactose Intolerance

Guidelines for the Supply of Gluten Free Products in Durham and Darlington

CD&D Guidelines for Diagnosing and Managing Cows Milk Protein Allergy (CMPA) and Lactose Intolerance

Guidelines for the Supply of Gluten Free Products in Durham and Darlington

Cumbria Vitamin D Guidelines - Approved for use in Tees CCGs

GP Guidance for the long term follow-up and management of patients who have had Bariatric Surgery

Guidelines for the supply of gluten-free (GF) products in Tees CCGs

HAST Guidance for Monitoring and Treatment of Vitamin B12 Deficiency

HaST pathway for review of patients on long-term vitamin B12 replacement

North Tees and Hartlepool Adult Dietetic Referral Form

North Tees Pathway for the Management of Undernutrition (Adults)

North Tees Pathway for the Management of Undernutrition (Care Homes)

South Tees GP Guidance on the Monitoring of Oral Nutritional Supplements

South Tees Hospitals Dietary Advice to Help Improve Nutritional Intake

South Tees Hospitals Referral Form for Community Nutrition & Dietetic Services

South Tees Pathway for the Management of Undernutrition (Adults)

South Tees Pathway for the Management of Undernutrition (Nursing/Care Homes)

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

CD&D Patient Decision Aids Resource 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/

Conditions for which over the counter items should not routinely be prescribed in primary care: exception criteria

Prescribing of medicines available to purchase over the counter for self-care

Self-Care and Medicines Available Over The Counter (OTC)

Common medicines available to purchase over the counter (OTC) for minor illnesses and self-limiting conditions

Ferrous Fumarate
BNF | BNFC | SPC

Tablets - 210mg

Syrup - 140mg/5ml

Ferrous Sulphate
BNF | BNFC | SPC

Tablets - 200mg

For liquid preparation use ferrous fumarate

Sodium Feredetate
BNF | BNFC | SPC

Liquid - 190mg/5ml

Ferric Maltol
BNF | BNFC | SPC

231.5mg capsules

NTAG Sept 2018: The Northern (NHS) Treatment Advisory Group recommends the use of oral Ferric Maltol as an alternative option in patients with mild to moderate IDA with IBD who have been unable to tolerate at least two oral
ferrous salts due to adverse effects after an adequate trial. The recommendation to prescribe Ferric Maltol should be made by an IBD specialist. Feraccru should not be used in patients with inflammatory bowel disease (IBD) flare or in IBD-patients with haemoglobin (Hb).

NTAG Sept 2018: ​The Northern (NHS) Treatment Advisory Group recommends the use of oral Ferric Maltol as an alternative option in adult patients with mild to 
moderate iron deficiency anaemia who have been unable to tolerate at least two oral ferrous salts due to adverse effects after an adequate trial (e.g. 3 months) and who would otherwise be treated with IV iron. The recommendation to prescribe Ferric Maltol should be made by a secondary care specialist experienced in the management of IDA.

Spatone
BNF | BNFC | SPC

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

Iron Modified Release Preparations
BNF | BNFC | SPC

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

MHRA Drug Safety Update (Aug 2013) intravenous iron and serious hypersensitivity reactions: new strengthened recommendations to manage and minimise risk

Iron Sucrose▼
BNF | BNFC | SPC

100mg in 5ml injection

Cannot be used for total dose infusion
Maximum 200mg per administration no more than 3 times per week

 

Iron Dextran▼
BNF | BNFC | SPC

100ml in 2ml & 500mg in 10ml injections

Ferric Carboxymaltose▼
BNF | BNFC | SPC

100ml in 2ml & 500mg in 10ml injections


For use as an alternative to iron dextran or iron sucrose. Approved for use by renal physicians, gastroenterologists and haematologists.
Unlicensed for use in children under 14 years of age. If used in this age-group, use should only be on the advice of a consultant with the informed consent of the patient and/or his/her parents/carers.

Hydroxocobalamin
BNF | BNFC | SPC

Injection - 1mg/ml

Folic Acid
BNF | BNFC | SPC

Tablets - 400microgram, 5mg

Liquid - 2.5mg/5ml

Erythropoietins

See MHRA Drug Safety Update (May 2015) - Epoetin beta (NeoRecormon): increased risk of retinopathy in preterm infants cannot be excluded

Darbepoetin alfa (Aranesp)
BNF | BNFC | SPC

10, 15, 20, 30, 40, 50, 60, 80, 100, 150 & 300 microgram injections in prefilled syringes

20, 40, 60, 80, 100 & 300 microgram Sureclick® pens

Commissioner: NHS England – renal dialysis only as per NICE CG114

MHRA Drug Safety Alert (Oct 2017):  risk of severe cutaneous adverse reactions 

MHRA Drug Safety Update (Jan 2018): Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (SCARs)

Epoetin alfa (Eprex)
BNF | BNFC | SPC

Injection - 20,000units, 30,000units, 40,000units

Prescribed in accordance with NICE TA323

MHRA Drug Safety Alert (Oct 2017):  risk of severe cutaneous adverse reactions 

MHRA Drug Safety Update (Jan 2018): Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (SCARs)

 

Epoetin beta (NeoRecormon)
BNF | BNFC | SPC

Injection

Prescribed in accordance with NICE TA323

Commissioner: NHS England – renal dialysis only as per NICE CG114

MHRA Drug Safety Alert (Oct 2017):  risk of severe cutaneous adverse reactions

MHRA Drug Safety Update (Jan 2018): Recombinant human erythropoietins: very rare risk of severe cutaneous adverse reactions (SCARs)

Epoetin delta
BNF | BNFC | SPC
Epoetin theta
BNF | BNFC | SPC

Tariff Excluded (dialysis-induced anaemia only); NHSE Commissioned

Approved: NICE TA323

Epoetin zeta
BNF | BNFC | SPC

Tariff Excluded (dialysis-induced anaemia only); NHSE Commissioned

Approved: NICE TA323

Methoxy Polethylene Glycol-Epoetin Beta (Mircera)
BNF | BNFC | SPC
Desferrioxamine
BNF | BNFC | SPC

500mg & 2g injections

Deferasirox▼
BNF | BNFC | SPC

125mg, 500mg & 250mg tablets


Approved for iron chelation in patients with myelodysplastic syndromes (MDS) - (as per NECN Haematology Group Guidelines) and recommended for use in patients when treatment with desferrioxamine is no longer considered to be appropriate due to progressive iron overload despite maximally tolerated doses of desferrioxamine. – Initiated by specialists only

Deferiprone
BNF | BNFC | SPC

Commissioner: NHS England

Antilymphocyte Globulin
BNF | BNFC | SPC

NHS England – Not routinely commissioned

Anagrelide▼
BNF | BNFC | SPC

500 microgram capsules

For the treatment of thrombocythaemia as a 2nd line agent in patients poorly/non-responsive to hydroxycarbamide therapy.

Eltrombopag
BNF | BNFC | SPC

25mg, 50mg and 75mg film coated tablets 

Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
NICE TA293:Eltrombopag for treating chronic immune (idiopathic) thrombocytopenic purpura

Romiplostim
BNF | BNFC | SPC

250 microgram vial

For the treatment of adults with chronic immune (idiopathic) thrombocytopenia purpura NICE TA221.

Pegfligrastim (G-CSF)▼
BNF | BNFC | SPC

6mg in 0.6ml injection in prefilled syringes

Commissioner: NHS England – in accordance with Cancer Network Guidelines

Filgrastim (G-CSF)▼
BNF | BNFC | SPC

300 microgram (30 million units) injection in 0.5ml syringes and 1ml vials
480 microgram (48 million units) injection in 0.5ml syringes – available as Neupogen (original brand) and Ratiograstim – a biosimilar product

Commissioner: NHS England – in accordance with Cancer Network Guidelines

Lenograstim (G-CSF)
BNF | BNFC | SPC

263 microgram (33.6 million units) injection vials

Commissioner: NHS England – in accordance with Cancer Network Guidelines

Lipegfilgrastim
BNF | BNFC | SPC

6 mg solution for injection in pre-filled syringe

Plerixafor
BNF | BNFC | SPC

24mg in 1.2ml injectiom

Commissioner: NHS England - Policy - B04/P/c

Only if recommended by a specialist
If required pharmacy need notice to obtain

Drug protocol: hypokalaemia (CDDFT intranet access only)

Drug protocol: hyperkalaemia (CDDFT intranet access only)

Potassium Chloride Liquid
BNF | BNFC | SPC

Liquid - (Kay-Cee-L) 1mmol/ml

Sando-K
BNF | BNFC | SPC

Tablets Effervescent - 12mmol/Tablet

Calcium Resonium
BNF | BNFC | SPC

Potassium Removal Polystyrene Sulphonate Resin

Powder (Calcium polystyrene sulphonate)

 

Resonium A
BNF | BNFC | SPC

Potassium Removal Polystyrene Sulphonate Resins

Powder (Sodium polystyrene sulphonate)

Sorbisterit®
BNF | BNFC | SPC

Potassium Removal Polystyrene Sulphonate Resin

Powder (Calcium polystyrene sulphonate)

Sorbisterit® provides an alternative to the existing proprietary product at a lower cost. The dose of Sorbisterit® and the existing proprietary product differ as the strength of the active ingredient varies slightly.

Sodium chloride MR Tablets 600mg
BNF | BNFC | SPC

MR Tablets - 600mg

Approx. 10 mmol sodium & chloride per tablet

Oral rehydration powder – Dioralyte
BNF | BNFC | SPC

Sachets

Sodium 12 mmol, potassium 4 mmol, chloride 12 mmol, citrate 2 mmol & glucose 18 mmol (3.56g) / sachet

Sodium Chloride Oral Solution
BNF | BNFC | SPC

1mmol / ml oral solution
Treatment should only be initiated with the advice of a specialist

St Marks solution
BNF | BNFC | SPC

Use in patients with a short bowel. 

Sodium Bicarbonate
BNF | BNFC | SPC

Capsules - 600mg (Approx. 6 mmol each of sodium and bicarbonate)


1mmol/ml oral solution u

Contact Pharmacy for Information

Please refer to County Durham & Darlington Gluten Free Guidelines 

 

Sapropterin
BNF | BNFC | SPC

Commissioner: NHS England - Policy - E12/P/a

Tetrahydrobiopterin
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Cod Liver Oil Capsules
BNF | BNFC | SPC

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

Gamolenic acid/starflower oil
BNF | BNFC | SPC

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

Vitamin and mineral supplements should only be prescribed in line with an
ACBS indication, i.e. only in the management of actual vitamin or mineral deficiency; they are not to be
prescribed as dietary supplements or as a general “pick-me-up”. If patients still want to take vitamins and minerals for dietary supplementation or as a “pick-me-up” they should be advised that they can be
purchased as selfcare over-the-counter.
Some patients may be eligible for NHS Healthy Start vitamins which are specifically designed for pregnancy, breastfeeding and growing children. They are available free of charge from local distribution points. More information is available on the Healthy Start Vitamins website.

Drug protocol: hypocalcaemia (CDDFT intranet access only)

Calcium Carbonate Effervescent 1.25g (Cacit)
BNF | BNFC | SPC

Tablets Effervescent - 1.25g (Cacit)

Calcium Carbonate Suspension
BNF | BNFC | SPC

500mg in 5ml suspensionu

Sandocal Tablets
BNF | BNFC | SPC

Sandocal 1000 tablets (calcium lactate gluconate, calcium carbonate & citric acid providing 1000mg, 25 mmol calcium)

Alliance Calcium Syrup
BNF | BNFC | SPC

Each 5ml contains 2.5mmol of calcium (in form of calcium lactate and calcium gluconate 20.4mg of soluble calcium or 0.51mmol of calcium per ml)u

Calcium Gluconate Injection
BNF | BNFC | SPC

10% 10ml injection (approx. 2.2mmol, 89mg calcium)

Calcium Chloride Injection
BNF | BNFC | SPC

5 mmol in 5ml & 10 mmol in 10ml injections

Calcium chloride more irritant than gluconate
Only to be given quickly in emergencies (cardiac resuscitation)

Drug protocol: hypercalcaemia (CDDFT intranet access only)

Disodium Pamidronate
BNF | BNFC | SPC

30mg injection

Zoledronic Acid
BNF | BNFC | SPC

4mg injection
- for hypercalcaemia of malignancy and the prevention of skeletal
events in patients with metastatic breast cancer.

Prescribe by brand name (Zometa®) to avoid confusion with a different strength product used to treat osteoporosis and Paget’s disease.

Sodium Clodronate
BNF | BNFC | SPC

520mg or 800mg tablets

For use on oncology patients only

Calcitonin (Salmon)/ Salcatonin Injection
BNF | BNFC | SPC

400 units in 2ml injection

Cinacalcet
BNF | BNFC | SPC

Tablets - 30mg, 60mg, 90mg

Shared care agreement for primary hyperparathyroidism

CDDFT intranet link

 Tees - Shared Care Protocol (Endocrinology) 

Tertiary centre indication:

For the treatment of secondary hyperparathyroidism in patients with end stage renal disease on maintenance haemodialysis where parathyroid gland surgery has failed or is inappropriate. Also for short term use to control symptoms prior to a second attempt at more definitive surgery.

NICE TA117

Commissioner: NHS England - NICE TA117

Etelcalcetide
BNF | BNFC | SPC

2.5 mg/0.5ml, 5mg/1ml and 10mg/2ml solution for injection


To be used as per NICE TA448 for treating secondary hyperparathyroidism in adults with chronic kidney disease on haemodialysis.

NHSE Commissioned

Secondary hyperparathyroidism

Approved: NICE TA448

Drug protocol: hypomagnesaemia (CDDFT intranet access only)

Magnesium-L-aspartate (Magnaspartate)
BNF | BNFC | SPC

6.5g (10 mmol) sachets
-first line for the treatment and prevention of magnesium deficiency

Magnesium Sulphate
BNF | BNFC | SPC

50% 2ml (4 mmol), 50% 10ml (20 mmol) & 10% 10ml (4
mmol) injections

MHRA Drug Safety Update (May 2019): Magnesium sulfate: risk of skeletal adverse effects in the neonate following prolonged or repeated use in pregnancy

Drug protocol: hypophosphatemia (CDDFT intranet access only)

Phosphate Sandoz
BNF | BNFC | SPC

Effervescent tablets (phosphate 16.1 mmol, sodium 20.4 mmol & potassium 3.1 mmol / tablet)

Phosphate Polyfusor
BNF | BNFC | SPC

500ml intravenous infusion containing 50mmol phosphate per 500ml (PO4 3- 100mmol, K+ 19mmol, and Na+ 162mmol/litre)

Calcium Acetate
BNF | BNFC | SPC

Phosex®
1g tablets (containing 250mg, 6.2mmol of calcium)
Renacet®
475mg (containing 120.25mg, 3mmol of calcium) &
950mg tablets (containing 240.5mg, 6mmol of calcium)

Calcium Carbonate
BNF | BNFC | SPC

1.25g & 2.5g chewable tablets (Calcichew)

Use after calcium carbonate and calcium acetate, but before the much more expensive sevelamer and lanthanum.

Sevelamer Hydrochloride
BNF | BNFC | SPC

800mg f/c tablets

Lanthanum
BNF | BNFC | SPC

500mg, 750mg & 1g chewable tablets
- for 3rd line use

Lanthanum (Renal Dialysis indications)
BNF | BNFC | SPC

Red when used for indications related to renal dialysis (NHS England funded)

Sevelamer (Renal Dialysis indications)
BNF | BNFC | SPC

Red when used for indications related to renal dialysis (NHS England funded)

Dental products should only be prescribed by dentists and GPs should not accept requests to prescribe medicines that the dentist could reasonably prescribe themselves, nor accept requests from patients to issue FP10 prescriptions for items prescribed on a private prescription by their dentist.  Patients should be advised of self-care measures and signposted to purchase over the counter remedies for dental conditions where appropriate.

PrescQIPP bulletin 95: Medicines for dental conditions on FP10

Duraphat® Toothpaste
BNF | BNFC | SPC

Duraphat®
2800 ppm s Sodium fluoride 0.619% (75ml)
Duraphat®
5000 ppm s Sodium fluoride 1.1% (51g)

Dental products should only be prescribed by dentists and GPs should not accept requests to prescribe medicines that the dentist could reasonably prescribe themselves, nor accept requests from patients to issue FP10 prescriptions for items prescribed on a private prescription by their dentist.  Patients should be advised of self-care measures and signposted to purchase over the counter remedies for dental conditions where appropriate.

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

Sodium Monofluorophosphate
BNF | BNFC | SPC

Dental products should only be prescribed by dentists and GPs should not accept requests to prescribe medicines that the dentist could reasonably prescribe themselves, nor accept requests from patients to issue FP10 prescriptions for items prescribed on a private prescription by their dentist.  Patients should be advised of self-care measures and signposted to purchase over the counter remedies for dental conditions where appropriate.

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

Stannous Fluoride
BNF | BNFC | SPC

Dental products should only be prescribed by dentists and GPs should not accept requests to prescribe medicines that the dentist could reasonably prescribe themselves, nor accept requests from patients to issue FP10 prescriptions for items prescribed on a private prescription by their dentist.  Patients should be advised of self-care measures and signposted to purchase over the counter remedies for dental conditions where appropriate.

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

Zinc sulphate monohydrate
BNF | BNFC | SPC

Tablets Effervescent - 125mg (Solvazinc®)

Selenium
BNF | BNFC | SPC

50 microgram/ml oral solution

50 microgram/ml injection

For use on ITU only. NOT FOR PRESCRIBING IN PRIMARY CARE.

Ensure that all prescribing is in-line with an ACBS approved indication.

If patients still want to take a vitamin and mineral preparation for dietary supplementation or as a "pickme-up" they should be advised that they can be purchased as self care over-the-counter with the support of the community pharmacist.

Do not initiate new prescriptions for vitamin and mineral preparations unless they are in-line with an ACBS approved indication.

Some patients may be eligible for NHS Healthy Start vitamins rather than receiving a prescription. They are specifically designed for pregnancy, breastfeeding and growing children and available free of charge from local distribution points.

Vitamin and mineral supplements should only be prescribed in line with an
ACBS indication, i.e. only in the management of actual vitamin or mineral deficiency; they are not to be
prescribed as dietary supplements or as a general “pick-me-up”. If patients still want to take vitamins and minerals for dietary supplementation or as a “pick-me-up” they should be advised that they can be
purchased as selfcare over-the-counter.
Some patients may be eligible for NHS Healthy Start vitamins which are specifically designed for pregnancy, breastfeeding and growing children. They are available free of charge from local distribution points. More information is available on the Healthy Start Vitamins website.

Vitamins A & D
BNF | BNFC | SPC

Capsules

Thiamine
BNF | BNFC | SPC

Tablets - 50mg, 100mg

NICE clinical guideline 100

Pyridoxine
BNF | BNFC | SPC

Tablets - 10mgu , 50mg

Liquid - 10mg/5ml (special)

Vitamin B compound strong
BNF | BNFC | SPC

Tablets

NICE clinical guideline 100

CD&D APC Grey List: Should only be used in secondary care to prevent "re-feeding syndrome".

Not to be used for alcohol related disorders.

Vitamin B & C Injection (Pabrinex® )
BNF | BNFC | SPC

IVHP injection (ascorbic acid 500mg, nicotinamide 160mg, pyridoxine
hydrochloride 50mg, riboflavin 4mg & thiamine hydrochloride 250mg &
1g anhydrous glucose / pair of ampoules)

Pyridoxal Phosphate
BNF | BNFC | SPC

25mg tablets and 50mg capsulesu

Vitamin B Compound
BNF | BNFC | SPC

The County Durham & Darlington or Tees DO NOT PRESCRIBE List can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durhamdarlington or 
https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

The County Durham & Darlington or Tees GREY List – items to be prescribed in certain specific circumstances only can be accessed online at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington or https://medicines.necsu.nhs.uk/guidelines/tees-guidelines/

Ascorbic Acid
BNF | BNFC | SPC

Tablets - 50mg, 500mg

County Durham and Darlington  APC - Guidance for the treatment of Vitamin D insufficiency and deficiency – June 2015

County Durham and Darlington  APC - Adult Vitamin D Guideline – Quick Reference Guide Guidance for the treatment of Vitamin D insufficiency and deficiency – September 2017

Colecalciferol (Fultium D3) Capsules
BNF | BNFC | SPC

Available as 800 IU, 3200 IU and 20,000 IU capsules

Vitamin D use the most cost-effective product currently as per the Drug Tariff.

Colecalciferil (Desunin) tablets
BNF | BNFC | SPC

Available as 800 IU tablets

Vitamin D use the most cost-effective product currently as per the Drug Tariff.

Colecalciferol (Aviticol) capsules
BNF | BNFC | SPC

Vitamin D use the most cost-effective product currently as per the Drug Tariff.

Colecalciferol (Plenachol) capsules
BNF | BNFC | SPC

Vitamin D use the most cost-effective product currently as per the Drug Tariff.

Alfacalcidol
BNF | BNFC | SPC

250 nanogram & 1 microgram capsules
2 microgram/ml sugar-free oral drops – one drop
containing approx. 100 nanograms of alfacalcidol
1 microgram in 0.5ml & 2 micrograms in 1ml injections

Ergocalciferol (Calciferol) Injection
BNF | BNFC | SPC

7.5mg (300,000 units) in 1ml injection

Invita-D3 oral solution
BNF | BNFC | SPC

For use when an oral liquid preparation is required.

Fultium D3 oral drops
BNF | BNFC | SPC

For use when an oral liquid preparation is required

For use in primary care:
• Accrete D3
• Evacal

For use in secondary care:
• Adcal D3 tablets and caplets
• Calcichew D3 Forte® tablets
(alternative to Adcal D3)

1.5g (600mg Ca) 400 units

Alternatives
• Calfovit D3 sachets
Calcium phosphate 3.1g (1.2g calcium) & Vitamin D3 800 units
• Calcium & Ergocalciferol Tablets:
Calcium lactate 300mg, calcium phosphate 150mg (Ca 97mg, 2.4 mmol) & ergocalciferol 10 micrograms (400 units)

Accrete D3
BNF | BNFC | SPC

Film coated tablet containing calcium carbonate 1.5g and colecalciferol 10 micrograms (400 units)

Calcium + Vitamin D use the most cost-effective product currently as per the Drug Tariff.

Evacal
BNF | BNFC | SPC

Chewable tablets containing calcium carbonate 1.5g and
colecalciferol 10 micrograms (400 units)
-approved as a chewable option and also to be used in patients with
peanut and soya allergy

Calcium + Vitamin D use the most cost-effective product currently as per the Drug Tariff.

Adcal D3
BNF | BNFC | SPC

Tablets and Caplets - for use in secondary care

Calcium + Vitamin D use the most cost-effective product currently as per the Drug Tariff.

Calcichew D3 Forte
BNF | BNFC | SPC

Tablets - for use in secondary care

Calcium + Vitamin D use the most cost-effective product currently as per the Drug Tariff.

Calcium Phosphate & Vitamin D (Calfovit D3 ®)
BNF | BNFC | SPC

Powder in sachets – calcium phosphate 3.1g (1.2g calcium) &
Vitamin D3 800 units

Calcium and Ergocalciferol Tablets
BNF | BNFC | SPC

Tablets – calcium lactate 300mg, calcium phosphate 150mg (Ca 97mg,
2.4 mmol) & ergocalciferol 10 micrograms (400 units)

Calcium 500mg / colecalciferol 200units
BNF | BNFC | SPC

e.g. Calcichew D3, Calcium and ergocalciferol tablets

A daily dose of 800 units of vitamin D is required to prevent fractures

Alpha Tocopheryl Acetate
BNF | BNFC | SPC

Suspension - 500mg/5ml

Menadiol sodium phosphate
BNF | BNFC | SPC

Tablets - 10mg

Water soluble derivative of vitamin K for use in patients with fat malabsorption, especially in hepatic disease or biliary obstruction including cystic fibrosis patients.

Phytomenadione (Vitamin K1)
BNF | BNFC | SPC

- 50 microgram in 0.25ml drops (NeoKay®)u
- 1mg capsule = Preferred product for use in neonates
- 10mg in 1ml injectionu
- 2mg in 0.2ml mixed micelles injection (Konakion® MM Paediatric) N.B. May be taken by mouth as well as being given by IM or IV injection


N.B. Phytomenadione 10mg tabs now discontinued

Drug protocol: administration of vitamin K (CDDFT intranet access only)

Flowchart for Neonatal Vitamin K prophylaxis (CDDFT intranet access only)

Abidec
BNF | BNFC | SPC

DropsOTC

Drops containing in each 0.6ml dose ascorbic acid 50mg, ergocalciferol 400 units, nicotinamide 5mg, pyridoxine HCL 500micrograms, riboflavine 400 micrograms, thiamine 1mg & vitamin A 1,333 units- To be used in children and adults.

Multivitamin
BNF | BNFC | SPC

TabletsOTC

Vitamins BPC
Capsules containing ascorbic acid 15mg, nicotinamide 7.5mg, riboflavine 500 micrograms, thiamine HCl 1mg, vitamin A 2,500 units, & vitamin D 300 units

Forceval
BNF | BNFC | SPC

Capsules & junior capsulesOTC
-For limited use as a vitamin and mineral supplement in patients with
phenylketonuria The capsules are also approved as an oral supplement
in burns patients with malnutrition or alcohol dependency and patients
with major burns after discontinuation of IV therapy, and have also been
approved for use in patients with severe anorexia nervosa and in patients with re-feeding syndrome.. Treatment initiated with specialist advice.


SolubleOTC
- approved for short term use in patients who are unable to swallow Forceval capsules

Ketovite
BNF | BNFC | SPC

  Tablets and liquid OTC - see BNF for details of content

Dalivit
BNF | BNFC | SPC

DropsOTC containing in each 0.6ml dose ascorbic acid 50mg, ergocalciferol 400 units, nicotinamide 5mg, pyridoxine HCl 500 micrograms, riboflavine 400 micrograms, thiamine 1mg & vitamin A 5,000 units).

Dalivit drops are to be retained for use in patients requiring a full supplement of vitamin A.

Multivitamin (Renavit® )
BNF | BNFC | SPC

Initiated on specialist advice only
Renal dialysis patients only

Penicillamine
BNF | BNFC | SPC

125mg & 250mg tablets

Trientine Dihydrochloride
BNF | BNFC | SPC

Capsule

Tariff-Excluded

NHSE Commissioned

Zinc Acetate
BNF | BNFC | SPC
Carnitine
BNF | BNFC | SPC

30% oral solution
1g in 5ml injection

Commissioner: NHS England – via specialist services only

Agalsidase alfa
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Agalsidase Beta
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Algucosidase alfa
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Betaine
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Approved for paediatric patients with homocysteine remethylation defect. Liquid product is unlicensed

Calcium Levomefolate
BNF | BNFC | SPC

Prefolic®

Approved for paediatric patients with homocysteine remethylation defect. Product not licensed in UK

 

Carglumic Acid
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Sodium Phenylbutyrate
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Arginine
BNF | BNFC | SPC

Infusion solution 21.07% 20ml

For paediatric metabolic disorders on specialist advice only

Sodium Benzoate
BNF | BNFC | SPC

Injection 1 g in 5mL
Oral solution 500mg in 5ml (on drug tariff specials list)

For paediatric metabolic disorders on specialist advice only

Oral not routinely stocked at STHFT

Galsulfase▼
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Idursulfase▼
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Laronidase▼
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Imiglucerase
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Velaglucerase Alfa
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Migalastat▼
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Nitisinone
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Mercaptamine
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Human Arginate
BNF | BNFC | SPC

Commissioner: NHS England – via specialist services only

Only to be used in patients with a diagnosis confirmed by a specialist
Discussed with patients specialist before administration

Ubidecarenone
BNF | BNFC | SPC

Initiated by Neurology consultant only
Unlicensed liquid avaibale for use in named patient basis for paediatrics