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File name: Respiratory System Formulary BNF Section 3

Original date of issue: 31/11/2005

Last Reviewed: 01/05/2012

Version:4

Page 1 of 7

Department: Pharmacy

Review Date:01/05/2014

Authorised: Drug and Therapeutics Committee

3: Respiratory system 3.1 Bronchodilators 3.1.1 3.1.1. 1 First line

Second line

Formulary status C

3.1.1.2 NIL

Adrenoceptor agonists Selective beta2 agonists Product Salbutamol Inhaler (100micrograms) Salbutamol Accuhaler (200micrograms) Salbutamol Nebuliser Solution (2.5mg/2.5ml, 5mg/2.5ml) Salbutamol Injection (500micrograms/1ml) Terbutaline Turbohaler 100 dose (500mcg) Terbutaline Injection (500mcg/ml, 2.5mg/5ml) Salmeterol Accuhaler (50micrograms)

Comments

Product

Restriction

Formoterol 6micrograms, 12micrograms Turbohaler (60-dose)

Consultant Respiratory / Paediatrician use only as an alternative to salmeterol

Other adrenoceptor agonists


File name: PHA_Form_Respiratory system BNF Section 3

Date of issue: 31/11/05

Review Date: 01/05/12

Version: 2

Department: Pharmacy

Author: Linda Stewart

Authorised: Linda Stewart

3.1.2

Antimuscarinic bronchodilators Product Ipratropium Inhaler (20micrograms) Ipratropium Nebuliser Solution (250micrograms/1ml, (500microgramsmicrograms/2ml) Tiotropium Handihaler and Capsules (18micrograms) Tiotropium Respimat (2.5micrograms)

3.1.3

Comments

NOTE: Different tiotropium devices have different doses. For patients unable to use Handihaler device. NOTE: Different tiotropium devices have different doses.

Theophylline

Aminophylline MR Tablets (225mg Phyllocontin),(350mg Phyllocontin Forte) Aminophylline injection 250mg /10ml Theophylline MR Tablets (125mg Nuelin), (175mg Nuelin SA), (200mg Uniphyllin), (250mg Nuelin SA), (300mg, 400mg Uniphyllin Continus)

3.1.4

Compound bronchodilator preparations

Ipratropium bromide 500mcg and salbutamol sulphate 2.5mg Nebuliser Solution (Ipramol)

3.1.5

Page:2 of 7

Peak flow meters, inhaler devices and nebulisers

Spacer devices Aerochamber (infant with mask, standard) Volumatic Volumatic with paediatric mask Compliance aid Haleraid (120-dose, 200-dose) Nebuliser kit with adult mask Nebuliser kit with mouthpiece


File name: PHA_Form_Respiratory system BNF Section 3

Date of issue: 31/11/05

Review Date: 01/05/12

Version: 2

Department: Pharmacy

Author: Linda Stewart

Authorised: Linda Stewart

3.2

Page:3 of 7

Corticosteroids

Beclometasone CFC-free Inhaler (Qvar) (50micrograms, 100micrograms) Beclometasone CFC-free inhaler (Clenil Modulite) (50micrograms, 100micrograms, 200micrograms, 250micrograms) Beclometasone CFC-free Autohaler (Qvar) (50micrograms, 100micrograms) Beclometasone CFC-free Easi-Breathe (Qvar) (50micrograms, 100micrograms) Beclometasone Inhaler (250micrograms, 200micrograms, 50micrograms) Beclometasone (easibreath) Inhaler (100micrograms, 250micrograms, 50micrograms) Budesonide Turbohaler (100micrograms, 200microgram) Fluticasone Accuhaler (50micrograms, 100micrograms, 250micrograms, 500micrograms) Fluticasone Inhaler (50micrograms, 250micrograms) Fluticasone Inhaler CFC-free (125micrograms) Seretide Accuhaler 100 (fluticasone propionate 100mcg, salmeterol 50mcg) Seretide Accuhaler 250 (fluticasone propionate 250mcg, salmeterol 50mcg) Seretide Accuhaler 500 (fluticasone propionate 500mcg, salmeterol 50mcg) Seretide Evohaler 50 (fluticasone propionate 50mcg, salmeterol 25mcg) Seretide Evohaler 125 (fluticasone propionate 125mcg, salmeterol 25mcg) Seretide Evohaler 250 (fluticasone propionate 250mcg, salmeterol 25mcg) Symbicort Turbohaler (100/6, 200/6, 400/12) All Beclometasone CFC-free need to be prescribed by brand name. Formulary Product status R Budesonide Repsules (500micrograms/2ml, 1mg/2ml)

C

R

Restriction

Reserved for patients in whom inhaled steroids are unsuitable or ineffective. Under recommendation of Consultant Paediatrician Ciclesonide inhaler (80 micrograms, Respiratory Consultant use only. 160micrograms) For patients who develop local adverse effects with other inhaled corticosteroids Flutiform (fluticasone + formoterol) Metered For use as an alternative to Dose Inhaler Seretide速 Evohaler for patients (125mcg/5mcg,50mcg/5mcg,250mcg/10mcg) with chronic asthma in whom treatment with an inhaled corticosteroid and a long-acting beta-2 agonist in a combination device is considered appropriate.


File name: PHA_Form_Respiratory system BNF Section 3

Date of issue: 31/11/05

Review Date: 01/05/12

Version: 2

Department: Pharmacy

Author: Linda Stewart

Authorised: Linda Stewart

3.3

Cromoglicate, related therapy and leukotriene receptor antagonists

3.3.1

Cromoglicate and related therapy

Formulary Product status S Sodium Cromoglicate Inhaler (5mg 112-dose)

3.3.2

Restriction For paediatric patients only

Leukotriene receptor antagonists

Formulary Product status C Montelukast 4mg, 5mg Chewable Tablets Montelukast 10mg Tablets Montelukast Granules (4mg)

Restriction For Respiratory Consultant’s patients only where other treatments have failed. For use by paediatricians in children with severe asthma.

3.4

Antihistamines, hyposensitisation, and allergic emergencies

3.4.1

Antihistamines

Non-sedating antihistamines First line

Page:4 of 7

Product Loratadine Syrup (5mg/5ml) Loratadine Tablets (10mg) Cetirizine SF Solution (5mg/5ml) Cetirizine Tablets (10mg)

Comments


File name: PHA_Form_Respiratory system BNF Section 3

Date of issue: 31/11/05

Review Date: 01/05/12

Version: 2

Department: Pharmacy

Author: Linda Stewart

Authorised: Linda Stewart

Page:5 of 7

Sedating antihistamines First line

Second line

Product Chlorphenamine Injection (10mg/1ml) Chlorphenamine Tablets (4mg) Chlorphenamine Syrup (2mg/5ml)

Comments

Alimemazine Syrup (7.5mg/5ml, 30mg/5ml) Alimemazine Tablets (10mg) Hydroxyzine Tablets (10mg, 25mg) Hydroxyzine Syrup (10mg/5ml) Promethazine Hydrochloride Elixir (5mg/5ml) Promethazine Hydrochloride Tablets (10mg, 25mg) Promethazine Hydrochloride Injection (25mg/1ml)

3.4.2

Allergen Immunotherapy

Formulary Product status C Omalizumab Injection (75mg, 150mg pre-filled syringes)

3.4.3

Restriction For use by Respiratory Consultants for the treatment of severe persistent asthma for patients initiated on treatment in Leeds.Supported for use in-line with NICE TA133 Nov 2007

Allergic emergencies

Adrenaline Injection (1:1,000) 1mg in 1ml ampoule Adrenaline Injection (1:1,000) 1mg in 1ml syringe (MINIJECT) Adrenaline Injection 300microgram/0.3ml autoinjector for adults (EPIPEN) Adrenaline Injection 150microgram/0.3ml autoinjector for children (EPIPEN JR)


File name: PHA_Form_Respiratory system BNF Section 3

Date of issue: 31/11/05

Review Date: 01/05/12

Version: 2

Department: Pharmacy

Author: Linda Stewart

Authorised: Linda Stewart

3.5

Respiratory stimulants and pulmonary surfactants

3.5.1

Respiratory stimulants

Page:6 of 7

Caffeine citrate Solution (50mg/5ml) Caffeine citrate Injection (10mg/ml) Doxapram Injection (100mg/5ml)

3.5.2

Pulmonary surfactants

Formulary Product status C Poractant Alfa Suspension (Curosurf) (120mg/1.5ml, 240mg/3ml) C Acetylcysteine Capsules (600mg)

3.6 Product Size D E F G PD CD ZX

3.7

NIL

Consultant Paediatrician use only

Respiratory Consultants use only

Oxygen Product Volume 340L 680L 1360L 3400L 300L 460L 3040L

Mucolytics

Carbocisteine Capsules (375mg) Carbocisteine Syrup (250mg/5ml)

3.8

Restriction

Aromatic inhalers

Comments Require a regulator to be attached

Include integral regulators


File name: PHA_Form_Respiratory system BNF Section 3

Date of issue: 31/11/05

Review Date: 01/05/12

Version: 2

Department: Pharmacy

Author: Linda Stewart

Authorised: Linda Stewart

3.9

Cough preparations

3.9.1

Cough suppressants

Codeine Linctus (15mg/5ml)

3.9.2

Expectorant and demulcent cough preparations

Simple Linctus (SF)

3.10 NIL

Systemic nasal decongestants

Page:7 of 7


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