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 Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
12.01  Drugs acting on the ear
 note  Please refer to the GMMMG Formulary Chapter 12 for treatment advice.
12.01.01  Otitis externa
12.01.01  Astringent preparations
Acetic Acid 2% (Earcalm )
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Formulary Ear Spray 
   
12.01.01  Anti-inflammatory preparations
Betamethasone drops
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First Choice Ear/eye/nose drops

 
Hydrocortisone Acetate 1% with Gentamicin 0.3% (Gentisone HC)
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First Choice Ear drops

 
Flumetasone 0.02% with Clioquinol 1% (Locorten-Vioform)
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Formulary Ear drops

 
   
Betamethasone 0.1% with Neomycin 0.5% drops (Betnesol N)
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Formulary Ear/eye/nose drops 
   
Dexamethasone with Antibacterial (Otomize)
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Formulary Ear Spray 
   
Dexamethasone with Antibacterial (Sofradex)
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Formulary Eye/ear drops

Not on GMMMG formulary 
   
Hydrocortisone with Antibactrial (Otosporin)
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Formulary Ear drops 
   
12.01.01  Anti-infective preparations to top
Flumetasone 0.02% with Clioquinol 1% (Locorten-Vioform)
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First Choice Ear drops

 
Clotrimazole (Canesten)
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Formulary 1% solution 
   
Betamethasone 0.1% with Neomycin 0.5% drops (Betnesol N)
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Formulary Ear/eye/nose drops 
   
Gentamicin (Genticin)
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Formulary Ear/eye drops

Not on GMMMG formulary 
   
Neomycin Sulphate with corticosteroids (Otosporin)
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Formulary Ear drops

Not on GMMMG formulary
 
   
Trimacinolone, neomycin, gramidicin and nystatin ointment (Otocomb Otic)
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Formulary  
   
12.01.02  Otitis media
12.01.03  Removal of ear wax
Olive Oil Ear Drops
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First Choice Ear drops

 
Sodium Bicarbonate
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Formulary Ear drops 
   
Cerumol
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Formulary Ear drops

Not on GMMMG Formulary 
   
12.02  Drugs acting on the nose
12.02.01  Drugs used in nasal allergy
12.02.01  Antihistamines to top
12.02.01  Corticosteroids
Beclometasone Dipropionate
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First Choice Nasal Spray 
Mometasone Furoate (Nasonex)
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Formulary Nasal Spray 
   
Fluticasone Propionate
(Flixonase / Nasofan)
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Formulary 50mcg/metered dose Nasal Spray 
   
Betamethasone drops
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Formulary Eye/ear/nose drops 
   
12.02.01  Cromoglicate
12.02.02  Topical nasal decongestants
Sodium Chloride 0.9% Nose Drops
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Formulary Nose drops 
   
12.02.02  Sympathomimetics
Xylometazoline (Otrivine)
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First Choice Nasal drops 
Ephedrine
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Formulary Nasal drops

Restricted Item Licensed for over 12 years of age only 
   
12.02.02  Antimuscarinic to top
Ipratropium Bromide (Rinatec)
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Formulary  
Link  UKMI Q&A: Drug induced hypersalivation
   
12.02.03  Nasal preparations for infection
12.02.03  Nasal Staphylococci
Chlorhexidine Hydrochloride 0.1%, Neomycin Suphate 0.5% (Naseptin)
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Formulary Cream

note Contains PEANUT oil 
   
Mupirocin 2% in White Soft Paraffin (Bactroban Nasal)
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Formulary Nasal ointment

Restricted Item For MRSA eradication only 
   
12.03  Drugs acting on the oropharynx
12.03.01  Drugs for oral ulceration and inflammation
Benzydamine (Difflam)
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First Choice

Mouthwash
Oromucosal Spray

note To only be prescribed in paediatrics with consultant approval

 
Hydrocortisone (Corlan)
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Formulary Oromucosal tablets 
   
Benzocaine
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Formulary Anaesthetic gel 
   
Carmellose Sodium (Orabase)
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Formulary Oral paste 
   
Carmellose Sodium (Orahesive)
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Formulary Powder 
   
Choline Salicylate (Bonjela Adult)
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Formulary Oral gel

Restricted Item For over 16 years of age only 
   
Gelclair
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Formulary Sachets 
   
Lidocaine
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Formulary 10% mouth spray
5% ointment 
   
12.03.02  Oropharyngeal anti-infective drugs to top
12.03.02  Oropharyngeal Fungal infections
Fluconazole
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First Choice Capsules
 
Nystatin (Nystan)
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Second Choice Oral suspension 
   
Miconazole (Daktarin)
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Formulary Oral Gel 
Link  MHRA Safety Alert: serious interactions with warfarin
   
12.03.02  Oropharyngeal Viral infections
12.03.03  Lozenges and sprays
12.03.04  Mouthwashes, gargles, and dentifrices
Chlorhexidine Gluconate
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First Choice Mouthwash
Dental gel
Oral spray 
Hydrogen Peroxide
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Formulary Mouthwash 
   
Sodium Chloride Mouthwash, Compound BP
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Formulary Mouthwash 
   
Tranexamic Acid Mouthwash
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Formulary unlicensedunlicensed 
   
12.03.05  Treatment of dry mouth to top
12.03.05  Local Treatment
Glandosane
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First Choice Aerosol spray 
Biotene Oralbalance
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Formulary Saliva replacement gel  
   
BioXtra
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Formulary Gel 
   
12.03.05  Systemic treatment
 ....
 Non Formulary Items
ACETIC ACID 5% solution in IMS

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Non Formulary
 
Aciclovir

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Non Formulary
 
Almond Oil

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Non Formulary
 
Amphotericin Lozenges  (Fungilin)

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Non Formulary
 
Antacid with Oxetacaine

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Non Formulary
 
AS saliva Orthana

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Non Formulary
 
Azelastine and fluticasone  (Dymista)

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Non Formulary
 
Azelastine Hydrochloride  (Rhinolast)

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Non Formulary Nasal spray
 
Betamethasone

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Non Formulary Soluble tablets
 
Betamethasone Sodium Phosphate 0.1% with Neomycin Sulphate 0.5%

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Non Formulary
 
Betamethasone Sodium Phosphate with Antibacterial  (Vista-Methasone N)

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Non Formulary DISCONTINUED
 
Budesonide  (Rhinocort Aqua)

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Non Formulary Nasal spray
 
Caphosol

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Non Formulary
 
Cetylpyridinium, Chlrocresol, Lidocaine  (Anbesol)

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Non Formulary
 
Chloramphenicol

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Non Formulary Ear drops

Not on GMMMG Formulary
 
Chlorhexidine Gluconate 0.1% with Chlorobutanol 0.5%  (Eludril)

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Non Formulary
 
Chlorhexidine Mouthwash

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Non Formulary
 
Docusate Sodium 0.5%  (Waxsol)

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Non Formulary
 
Doxycycline

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Non Formulary
 
Doxycycline  (Periostat®)

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Non Formulary
 
Exterol

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Non Formulary
 
Flunisolide  (Syntaris)

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Non Formulary Nasal spray
 
Flurbiprofen lozenge

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Non Formulary
 
Fluticasone furoate  (Avamys)

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Non Formulary Nasal spray

Formulary application rejected Sept 2010
 
Fluticasone Propionate  (Flixonase Nasule)

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Non Formulary Nasal drops
 
Hydrocortisone with Antibacterial  (Neo-Cortef)

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Non Formulary DISCONTINUED
 
Lidocaine and Cetylpyridinium  (Dentinox Teething Gel)

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Non Formulary
 
Lidocaine and Phenylephrine  (Cophenalcaine)

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Non Formulary
 
Luborant

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Non Formulary
 
Miconazole  (Loramyc)

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Non Formulary
 
Molcer

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Non Formulary
 
Neomycin Sulphate with corticosteroids  (Neo-Cortef)

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Non Formulary DISCONTINUED
 
Otex

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Non Formulary
 
pilocarpine Hydrochloride  (Salagen®)

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Non Formulary
 
Prednisolone 0.5% with Neomycin 0.5%  (Predsol-N)

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Non Formulary DISCONTINUED
 
Prednisolone drops  (Predsol)

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Non Formulary Ear/eye drops

Not on GMMMG formulary for use in the ear
 
Salicylates - Salicylic acid  (Pyralvex®)

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Non Formulary
 
Salinum

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Non Formulary
 
Saliveze

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Non Formulary
 
Salivix

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Non Formulary
 
Sodium Cromoglicate  (Rynacrom)

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Non Formulary Nasal spray
 
Sodium Cromoglicate  (Vividrin)

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Non Formulary Nasal Spray DISCONTINUED
 
SST

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Non Formulary
 
Triamcinolone with Antibacterial  (Tri-Adcortyl Otic)

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Non Formulary
 
Triamcinolone Acetonide  (Nasacort)

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Non Formulary Nasal spray
 
Triamcinolone Acetonide 0.1% in Adhesive Basis  (Adcortyl in Orabase)

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Non Formulary
 
Xerotin(r)  (Xerotin®)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Amber

Drugs designated amber are suitable for shared care arrangements under a shared care protocol. Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.   

Black

These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products.  

Green

Not used   

Green 1

Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

Green 2

Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required.  

Green 3

Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required.  

Grey

Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient.   

Red

Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.   

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