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 Formulary Chapter 5: Infections - Full Chapter
Notes:
This chapter of the formulary is not an antibiotic prescribing guide and is not intended to guide treatment choice.

Please refer to the relevant Pennine Acute policies (e.g. the Antibiotic Policy for Adult Patients, or Antibiotic Guidelines for Paediatrics) when making treatment choices.
 Details...
05.01  Antibacterial drugs
05.01.01  Penicillins
05.01.01.01  Benzylpenicillin and phenoxymethylpenicillin
Benzylpenicillin
(Penicillin G)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection
 
   
Phenoxymethylpenicillin
(Penicillin V)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Oral Solution 
   
05.01.01.02  Penicillinase-resistant penicillins
Flucloxacillin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Oral Solution
Injection 
Link  UKMI Q&A: Can 2g flucloxacillin be given as a slow IV
   
Temocillin (Negaban®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary

Intravenous injection

For use in hospital-acquired UTIs in paediatrics - see policy

Restricted Item Restricted in adults - contact Microbiology for advice

 
Link  Paediatric Antibiotic policy
   
05.01.01.03  Broad-spectrum penicillins to top
Amoxicillin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Oral Suspension
Sachets
Injection 
   
Co-Amoxiclav
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Oral Suspension
Injection

Restricted Item Co-amoxiclav is only recommended as first line treatment in specific indications. Refer to Antibiotic Policy.

The risk of acute liver toxicity is 6 times greater with co-amoxiclav than with amoxicillin. Cholestatic jaundice is more common in patients above the age of 65 and in males. The duration of treatment should not normally exceed 14 days.

Co-amoxiclav is a recognised cause of Clostridium difficile infections and its use should be restricted.  
   
05.01.01.04  Antipseudomonal penicillins
Piperacillin and Tazobactam
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
Ticarcillin with Clavulanic Acid (Timentin®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
05.01.01.05  Mecillinams
Pivmecillinam Hydrochloride (Selexid®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
05.01.02  Cephalosporins, carbapenems and other beta-lactams
05.01.02.01  Cephalosporins
 note  Cephalosporins can only be prescribed (for adults) following discussion with the Consultant Microbiologist or ID Physician, unless their use is clearly indicated in the Antibiotic Policy.
Cefalexin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Tablets
Oral Suspension 
   
Cefixime
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Oral Suspension 
   
Cefotaxime
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
Ceftazidime
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
Ceftriaxone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
Cefuroxime (Zinacef®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection
Tablets
Oral Suspension 
   
05.01.02.02  Carbapenems to top
Meropenem
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection

Restricted Item Can only be prescribed following discussion with the Consultant Microbiologist or ID Physician 
   
Ertapenem
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Intravenous Infusion

Restricted Item Not for inpatient use 
   
05.01.02.03  Other beta-lactam antibiotics
Aztreonam
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection

Restricted Item Can only be prescribed following discussion with the Consultant Microbiologist or ID Physician 
   
05.01.03  Tetracyclines
Doxycycline
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Dispersible Tablets 
   
Lymecycline
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules 
   
Oxytetracycline
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Tetracycline
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
05.01.03  Tigecycline
Tigecycline
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Intravenous Infusion

Restricted Item Can only be prescribed following discussion with the Consultant Microbiologist or ID Physician 
   
05.01.04  Aminoglycosides
Gentamicin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection
 
   
Amikacin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection

Restricted Item Can only be prescribed for intravenous use following discussion with the Consultant Microbiologist or ID Physician
 
   
Tobramycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Injection
Dry powder inhaler ("'Podhaler'")
Nebuliser solution

Restricted Item Can only be prescribed for intravenous use following discussion with the Consultant Microbiologist or ID Physician
Restricted Item Injection solution can be nebulised in non-CF bronchiectasis; at the request of a Consultant Respiratory Physician only
 
Link  NICE TA276: Cystic fibrosis (pseudomonas lung infection) - colistimethate sodium and tobramycin (TA276)
   
Neomycin Sulphate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
05.01.05  Macrolides to top
Clarithromycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Oral Suspension
Intravenous Infusion
 
   
Erythromycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Tablets
Oral Suspension
Intravenous Infusion 
Link  UKMI Q&A: Erythromycin and Statin Interaction
   
Azithromycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Tablets
Oral Suspension 
   
05.01.06  Clindamycin
Clindamycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Injection 
   
05.01.07  Some other antibacterials
05.01.07  Chloramphenicol
Chloramphenicol
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection
(Oral preparations are non-formulary) 
   
05.01.07  Fosfomycin
05.01.07  Fusidic acid to top
Sodium fusidate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 1
Tablets
Oral Suspension
Injection Restricted Item ID/microbiologist recommendation only 
   
05.01.07  Vancomycin and teicoplanin
Vancomycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 1
Capsules
Injection


Green Traffic Light  Green1 for severe or recurrent C.diff only. To be used on advice of microbiology for other indications

 
   
Teicoplanin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
05.01.07  Daptomycin
Daptomycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Intravenous Infusion
Restricted Item Can only be prescribed following discussion with the Consultant Microbiologist or ID Physician 
   
05.01.07  Linezolid
Linezolid
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets
Suspension
Intravenous Infusion

Restricted Item Can only be prescribed following discussion with the Consultant Microbiologist or ID Physician 
   
05.01.07  Polymyxins
Colistimethate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Intravenous injection
Injection for nebulisation (Colomycin® brand)
Powder for nebuliser solution

GMMMG RAG status when nebulised:

Red Traffic Light  RED for cystic fibrosis patients

Amber Traffic Light  AMBER for non-cystic fibrosis patients

 
   
05.01.07  Rifaximin to top
Rifaximin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 3
Restricted Item Gastroenterologists only

Initial 2 weeks supply provided by secondary care. 
Link  NICE TA337: rifaximin for preventing episodes of hepatic encephalopathy
   
05.01.07  Fidaxomicin
Fidaxomicin (Dificlir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 2
Tablets

Restricted Item Can only be prescribed following discussion with the Consultant Microbiologist or ID Physician 
Link  GMMMG IPNTS Recommendation: Fidaxomicin (Dificlir®▼) for the Treatment of Clostridium Difficile Infection
   
05.01.08  Sulphonamides and trimethoprim
Trimethoprim
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Oral Suspension

 
   
Co-trimoxazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 2
Tablets
Oral Suspension
Intravenous Infusion

 
   
Sulfadiazine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

Restricted Item  Can only be prescribed following discussion with ID Physician. See BHIVA Guidelines
 
Link  BHIVA Guidelines for the Treatment of Opportunistic Infection in HIV-seropositive Individuals 2011
   
05.01.09  Antituberculosis drugs
 note  All TB treatment must be initiated by a specialist in treating TB infection
Rifampicin, isoniazid, pyrazinamide and ethambutol (Voractiv®)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green 3
Tablets 
Rifampicin and Isoniazid and Pyrazinamide (Rifater®)
View adult BNF View SPC online View childrens BNF  Track Changes
Second Choice
Green 3
Tablets

2nd line option with a 4th agent 
   
Ethambutol
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 3
Tablets 
   
Pyrazinamide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 3
Tablets 
   
Rifampicin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 3
Capsules
Tablets
Syrup
Intravenous Infusion

No restrictions on use for non-tuberculosis indications.  
   
Rifampicin and Isoniazid (Rifinah®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 3
Tablets

For continuation (maintenance) phase of treatment 
   
Isoniazid
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 3
Tablets
Injection 
   
Pyridoxine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
 
   
Rifabutin (Mycobutin®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 3
Capsules

Restricted Item Can only be prescribed following discussion with an ID Physician 
   
Bedaquiline (Sirturo®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Restricted ItemCan only be prescribed after discussion with an ID physician 
Link  NHS England Commissioning Policy
   
Capreomycin (Capastat®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Intramuscular Injection

Restricted Item Can only be prescribed following discussion with an ID physician 
   
Delamanid (Deltyba®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Restricted ItemCan only be prescribed following discussion with an ID physician
 
Link  NHS England Commissioning Policy
   
Prothionamide
(Protionamide)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets


unlicensedunlicensed

Restricted Item Can only be prescribed following discussion with an ID physician 
   
Streptomycin Sulphate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Intramuscular Injection

Restricted Item Can only be prescribed following discussion with an ID physician.  
   
Cycloserine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules

Restricted Item Can only be prescribed following discussion with an ID physician 
   
P-aminosalicylic acid (Paser®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Sachets

unlicensedunlicensed

Restricted Item Can only be prescribed following discussion with an ID physician 
Link  A UK based resource to support the monitoring and safe use of anti-tuberculosis drugs and second line treatment of multidrug-resistant tuberculosis
   
Thioacetazone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary unlicensedunlicensed

Restricted Item Can only be prescribed following discussion with an ID physician
 
Link  A UK based resource to support the monitoring and safe use of anti-tuberculosis drugs and second line treatment of multidrug-resistant tuberculosis
   
05.01.10  Antileprotic drugs
Clofazimine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules

Restricted Item Can only be prescribed following discussion with an ID physician 
   
Dapsone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 2
Tablets 
   
Thalidomide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets

Restricted Item Approved for use by ID physicians only for patients who have steroid dependent Immune Reconsitution Syndrome (IRIS) secondary to HIV related opportunistic infection or meningeal tuberculosis in a non-HIV patient. unlicensedunlicensed use 
   
05.01.11  Metronidazole and tinidazole to top
Metronidazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Oral suspension
Suppositories
Intravenous Infusion
 
   
Tinidazole (Fasigyn®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
05.01.12  Quinolones
 note  Quinolones should be used with caution in patients with a history of epilepsy or conditions that predispose to seizures.

Tendon damage (including rupture) has been reported in patients receiving quinolones. Tendon rupture may occur within 48 hours of starting treatent; cases have also been reported several months after stopping a quinolone. (BNF)
Ciprofloxacin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Oral Suspension
Intravenous Infusion: Restricted Item requires microbiology/ID consultant approval, unless use is in line with antibiotic policy 
   
Levofloxacin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Intravenous Infusion 
   
Moxifloxacin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Intravenous Infusion

Restricted Item Can only be prescribed following discussion with Microbiology or an ID physician  
   
Ofloxacin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

(Intravenous infusion is non-formulary) 
   
05.01.13  Urinary-tract infections
Nitrofurantoin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Capsules
M/R capsules
Oral Suspension

 
Link  MHRA Drug Safety Update: Nitrofurantoin in GFR<45mls/min
   
Trimethoprim
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary See section 5.1.8. 
   
Fosfomycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 2
Granules for oral suspension
Injection

Restricted Item Injection - Microbiology / ID recommendation only; for the treatment of carbapenemase-producing enterobacteriaceae

 
   
05.02  Antifungal drugs
05.02.01  Triazole antifungals
Fluconazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Oral Suspension
Intravenous Infusion 
   
Itraconazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Oral Liquid
Intravenous Infusion

Itraconazole is associated with liver damage and should no be given to patients with a history of liver disease.

Following reports of heart failure, caution is advised when prescribing itraconazole to patients at high risk of heart failure (BNF).
 
   
Posaconazole (Noxafil®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Suspension
Tablets

Restricted Item Specialist (haematology) or ID consultant initiation only. See links
For AML inpatients only. Not to be supplied on discharge 
Link  BHIVA Guidelines for the Treatment of Opportunistic Infection in HIV-seropositive Individuals 2011
Link  MHRA Safety Update: Posaconazole tablets and oral suspension not interchangeable
   
Voriconazole (Vfend®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets
Oral Suspension
Intravenous Infusion

Restricted Item Can only be prescribed following discussion with the Consultant Microbiologist, ID Physician or Haematologist 
   
05.02.02  Imidazole antifungals to top
05.02.03  Polyene antifungals
 note  Prescriptions for amphotericin products must specify brand to avoid mis-selection and administration of the wrong formulation.

NPSA Rapid Response Report (Sept 2007): Risk of confusion between non-lipid and lipid formulations of injectable amphotericin.

Non-lipid and lipid injectable amphotericin - Rapid Response Report supporting information
Amphotericin (AmBisome®)
(Lipid formulation)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Intravenous Infusion

Prepared by pharmacy aseptics during working hours. Liaise with pharmacy.  
   
05.02.04  Echinocandin antifungals
Caspofungin (Cancidas®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Intravenous Infusion

Restricted Item Can only be prescribed following discussion with the Consultant Microbiologist or ID Physician 
   
05.02.05  Other antifungals
Terbinafine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

Restricted Item Dermatology only 
   
Flucytosine (Ancotil®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Intravenous Infusion

Restricted Item ID consultant initiation only 
   
05.03  Antiviral drugs
05.03.01  HIV infection to top
05.03.01  Nucleoside reverse transcriptase inhibitors
Abacavir (Ziagen®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Emtricitabine (Emtriva®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Lamivudine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets
Oral Solution 
   
Tenofovir Disproxil (Viread®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE CG165: Hepatitis B (chronic) - incorporates TA173
Link  NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
   
Zidovudine (Retrovir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Capsules
Oral Solution
Injection 
Link  PAHT: HIV in Pregnancy
   
Abacavir and Lamivudine (Kivexa®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
   
Abacavir and Lamivudine and Zidovudine (Trizivir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Emtricitabine 200mg, Rilpivirine 25mg and Tenofovir 245mg (Eviplera®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Tenofovir 245mg, Efavirenz 600mg and Emtricitabine 200mg (Atripla®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Tenofovir alafenamide and Emtricitabine (Descovy®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Restricted ItemRequires MDT discussion with ID team
 
   
Tenofovir alafenamide, Emtricitabine and Rilpivirine (Odefsey®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablet

Restricted ItemRequires MDT discussion with ID team 
   
Tenofovir alafenamide, Emtricitabine, Elvitegravir and Cobicistat (Genvoya®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablet

Restricted ItemRequires MDT discussion with ID team 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
   
Tenofovir and Emtricitabine (Truvada®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE Evidence Summary: Pre-exposure prophylaxis of HIV in adults at high risk: Truvada
   
Tenofovir, cobicistat, elvitegravir & emtricitabine (Stribild®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets

Restricted Item Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
Link  NHS England Commissioning Policy
   
Zidovudine and Lamivudine (Combivir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Didanosine (Videx®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets
Capsules

Restricted Item Only for patients already established on this treatment.  
   
Stavudine (Zerit®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Capsules
Oral Solution

Restricted Item Only for patients already established on this treatment 
   
05.03.01  Protease inhibitors
Atazanavir (Reyataz®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Atazanavir and Cobicistat (Evotaz®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
   
Darunavir (Prezista®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Darunavir and Cobicistat (Rezolsta®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
   
Fosamprenavir (Telzir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Lopinavir and Ritonavir (Kaletra®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  MHRA Safety Alert: interaction with levothyroxine
Link  MHRA Safety Alert: Ritonavir coadministration with a corticosteroid
   
Ritonavir (Norvir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  MHRA Safety Alert: interaction with levothyroxine
Link  MHRA Safety Alert: Ritonavir coadministration with a corticosteroid
   
Tipranavir (Aptivus®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
05.03.01  Non-nucleoside reverse transcriptase inhibitors
Rilpivirine hydrochloride (Edurant®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Efavirenz (Sustiva®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Etravirine (Intelence®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Nevirapine (Viramune®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
05.03.01  Other antiretrovirals
Enfuvirtide (Fuzeon®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Maraviroc
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Raltegravir (Isentress ®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Dolutegravir (Tivicay ®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
   
Dolutegravir and Abacavir and Lamivudine (Triumeq ®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
05.03.01  Pharmacokinetic enhancers of antiretrovirals to top
Cobicistat (Tybost®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Cobicistat coadministration with a corticosteroid
Link  NHS England Commissioning Policy: cobicistat as a booster in treatment of HIV positive patients
   
05.03.02  Herpesvirus infections
05.03.02.01  Herpes simplex and varicella-zoster infection
Aciclovir
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Suspension
Intravenous Infusion 
   
Valaciclovir (Valtrex®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

Restricted Item Can only be prescribed on advice of ID physician or virologist 
   
05.03.02.02  Cytomegalovirus infection
Cidofovir (Vistide®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Foscarnet Sodium (Foscavir®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary  
   
Ganciclovir (Cymevene®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red



Prepared by pharmacy aseptics during working hours. Liaise with pharmacy.  
   
Valganciclovir (Valcyte®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
05.03.03  Viral hepatitis
05.03.03.01  Chronic hepatitis B to top
Peginterferon Alfa
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Red
Injection 
Adefovir Dipivoxil (Hepsera®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE CG165: Hepatitis B (chronic) - incorporates TA96
Link  NICE TA96: Hepatitis B (chronic) - adefovir dipivoxil and pegylated interferon alpha-2a
   
Entecavir (Baraclude®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE CG165: Hepatitis B (incorporates TA153)
Link  NICE TA153: Hepatitis B (chronic) - etecavir
   
Tenofovir Disoproxil (Viread®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
Link  NICE CG165: Hepatitis B (chronic) - incorporates TA173
Link  NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
   
Lamivudine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets
Oral Solution 
   
05.03.03.02  Chronic hepatitis C
Peginterferon Alfa
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Injection 
Link  NICE TA106: Peginterferon alfa and ribavirin for the treatment of mild chronic hepatitis C
Link  NICE TA200: Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C
Link  NICE TA300: Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people
   
Ribavirin (Copegus®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets 
Link  NICE TA106: Hepatitis C - peginterferon alfa and ribavirin
Link  NICE TA200: Hepatitis C - peginterferon alfa and ribavirin
Link  NICE TA75: Hepatitis C - pegylated interferons, ribavirin and alfa interferon
   
Daclatasvir (Daklinza®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
Link  MHRA Safety Alert: Risk of severe bradycardia or heart block when taken with amiodarone
   
Dasabuvir (Exviera®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
   
Elbasvir/Grazoprevir (Zepatier® 50mg/100mg)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item Requires MDT discussion with ID team 
Link  NICE TA413: Elbasvir–grazoprevir for treating chronic hepatitis C
   
Ledipasvir/Sofosbuvir (Harvoni® 90mg/400mg)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
Link  MHRA Safety Alert: Risk of severe bradycardia or heart block when taken with amiodarone
   
Ombitasvir/Paritaprevir/Ritonavir (Viekirax® 12.5mg/75mg/50mg)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  MHRA Safety Alert: interaction with levothyroxine
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
Link  MHRA Safety Alert: Ritonavir coadministration with a corticosteroid
   
Sofosbuvir (Sovaldi®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  MHRA Safety Alert: Risk of hepatitis B reactivation with interferon-free regimens
Link  MHRA Safety Alert: Risk of interaction with vitamin K antagonists
Link  MHRA Safety Alert: Risk of severe bradycardia or heart block when taken with amiodarone
Link  NICE TA330: Sofosbuvir for treating chronic hepatitis C
   
Sofosbuvir / Velpatasvir (Epclusa®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  NICE TA430: Sofosbuvir–velpatasvir for treating chronic hepatitis C
   
Sofosbuvir / Velpatasvir / Voxilaprevir (Vosevi®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Tablets

Restricted Item  Requires MDT discussion with ID team 
Link  NICE TA507: Sofosbuvir–velpatasvir–voxilaprevir for treating chronic hepatitis C
   
Simeprevir (Olysio®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine

Requires MDT discussion with ID team

For resistant cases only

 
Link  MHRA Safety Alert: Risk of severe bradycardia or heart block when taken with amiodarone
Link  NICE TA331: Simeprevir in combination with peginterferon alfa and ribavirin for treating genotypes 1 and 4 chronic hepatitis C
   
05.03.04  Influenza
Oseltamivir (Tamiflu®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Oral Suspension 
Link  UKMI Q&A: Can mothers breastfeed after taking oseltamivir and zanamivir
Link  UKMI Q&A: Can oseltamivir be used in adult patients with renal impairment?
   
Zanamivir inhalation (Relenza®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Dry powder for inhalation 
Link  UKMI Q&A: Can mothers breastfeed after taking oseltamivir and zanamivir
   
05.03.05  Respiratory syncytial virus
Palivizumab (Synagis®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
Injection 
Link  PAT: Guideline for the use of Palivizumab (Synagis)
   
05.04  Antiprotozoal drugs
05.04.01  Antimalarials to top
 note  Drugs for malaria prophylaxis are not prescribable on the NHS.
Chloroquine and proguanil are available 'over the counter' whereas mefloquine and Malarone® require a private prescription.

05.04.01  Treatment of malaria
Artemether with lumefantrine (Riamet®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Chloroquine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Syrup 
   
Doxycycline
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary See section 5.1.3. 
   
Mefloquine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Primaquine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Proguanil Hydrochloride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Proguanil Hydrochloride with Atovaquone (Malarone®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Pyrimethamine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Quinine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Injection 
   
05.04.01  Prophylaxis against malaria
 note  Drugs for malaria prophylaxis are not prescribable on the NHS.
05.04.02  Amoebicides
Metronidazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary See section 5.1.11 
   
Tinidazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary See section 5.1.11 
   
Diloxanide Furoate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
05.04.03  Trichomonacides
05.04.04  Antigiardial drugs to top
05.04.05  Leishmaniacides
Sodium Stibogluconate (Pentostam®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
Pentamidine Isetionate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
05.04.06  Trypanocides
05.04.07  Drugs for toxoplasmosis
Pyrimethamine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Sulfadiazine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

Restricted Item Can only be prescribed following discussion with an ID physician 
   
Clindamycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Injection 
   
Calcium Folinate
(Calcium leucovorin)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets
Injection 
   
05.04.08  Drugs for pneumocystis pneumonia
Atovaquone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 2
Oral suspension 
   
Clindamycin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Capsules
Injection 
   
Co-trimoxazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green 2
See section 5.1.8. 
   
Dapsone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets 
   
Pentamidine Isetionate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Injection 
   
05.05  Anthelmintics to top
05.05.01  Drugs for threadworms
Mebendazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Chewable tablets
Oral suspension 
   
Albendazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed 
   
05.05.02  Ascaricides
LEVAMISOLE Tablets 50 mg
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed 
   
05.05.03  Drugs for tapeworm infections
Albendazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed 
   
Niclosamide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed 
   
PRAZIQUANTEL Tablets 500 mg
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed
 
   
05.05.04  Drugs for hookworms
Mebendazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary See section 5.5.1 
   
Albendazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary See section 5.5.1. 
   
05.05.05  Schistosomicides to top
PRAZIQUANTEL Tablets 500 mg
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed
 
   
05.05.06  Filaricides
Diethylcarbamazine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed


 
   
Ivermectin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed
 
   
05.05.07  Drugs for cutaneous larva migrans
Albendazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed 
   
Ivermectin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed
 
   
TIABENDAZOLE 500mg tabs
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablet

unlicensedunlicensed 
   
05.05.08  Drugs for strongyloidiasis
Albendazole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed 
   
Ivermectin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Tablets

unlicensedunlicensed
 
   
 ....
 Non Formulary Items
Aciclovir  (Zovirax®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aciclovir lauriad  (Sitavig)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Amphotericin  (Abelcet®)
(Lipid formulation)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary Intravenous Infusion
 
Amphotericin  (Fungizone®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary Intravenous infusion
 
Ampicillin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Amprenavir  (Agenerase®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Anidulafungin

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
 
Aztreonam nebuliser solution  (Cayston®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
 
Boceprevir  (Victrelis®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
High Cost Medicine
Link  NICE TA253: Boceprevir for the treatment of genotype 1 chronic hepatitis C
 
Cefaclor

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cefadroxil

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cefpodoxime

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cefradine

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ceftaroline  (Zinforo®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Co-Fluampicil

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Colistimethate  (Promixin®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Amber
 
Colistimethate inhaler  (Colobreathe®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  NICE TA276: Cystic fibrosis (pseudomonas lung infection) - colistimethate sodium and tobramycin (TA276)
 
Demeclocycline

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary Non-formulary for treatment of infection.
For hyponatraemia (SIADH), see section 6.5.2.
 
Doripenem

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
 
Famciclovir  (Famvir®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
 
Griseofulvin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Griseofulvin  (Fulsovin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Imipenem with Cilastatin  (Primaxin®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
 
Indinavir  (Crixivan®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Inosine Pranobex  (Imunovir®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ketoconazole (oral)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Black
GMMMG Do Not Prescribe: There is sufficient concern over safety that it is inappropriate for this drug to be prescribed for oral use in any situation. EMEA CHMP: “The risk of liver damage outweighs the benefits and alternative anti-fungal treatments are available”
 
Mepacrine Hydrochloride

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Methenamine Hippurate  (Hiprex®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Micafungin  (Mycamine®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
 
Minocycline

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nalidixic Acid  (Uriben®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nelfinavir  (Viracept®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Netilmicin  (Netillin®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
 
Norfloxacin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ofloxacin
(intravenous)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
 
Piperazine

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary DISCONTINUED
 
Ribavirin  (Rebetol®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
 
Ribavirin  (Virazole®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
 
Rifampicin and Isoniazid  (Rimactazid® 300)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Saquinavir  (Invirase®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
 
Telaprevir  (Incivo®)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Red
High Cost Medicine
Link  NICE TA252:Telaprevir for the treatment of genotype 1 chronic hepatitis C
 
Telithromycin  (Ketek®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Zanamivir Injection

View adult BNF View SPC online View childrens BNF
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.   

netFormulary