Page content

Page breadcrumb

17. Miscellaneous Preparations

First line drugs Second line drugs Specialist drugs Secondary care drugs
Recommended in both primary and secondary care Alternatives (often in specific conditions) in both primary and secondary care; Where a specialist input is needed (see introduction for definition) Prescribing principally within secondary care only

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only
  • Double Red: These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.

 

The preparations in this chapter are those stocked, but which do not currently sit in one of the BNF chapters. They will generally be preparations used exclusively within the hospital.

 

Burosumab

  • Injectable solution in single-dose vials 10mg/mL, 20mg/mL, 30mg/mL

Note:

 

 

Caffeine citrate   U  

  • Solution for infusion 20mg/mL (Peyona®)

Note:

  • Off label use for low pressure headaches
  • For Hospital Consultant Neurologist recommendation and / or initiation only.
  • Typical IV dose - Caffeine 500mg in 500ml normal saline over 2 hours stat

 

Ferucarbotran (Resovist®)  U

  • Pre-filled syringes 1.4 ml

 

 

Flutter® Device  (Amber 3)

Note: For Hospital initiation only for adult non-CF bronchiectasis patients managed through MKHFT. GPs may be asked to issue prescriptions for continuing therapy.

 

 

Holoclar®

(Ex vivo expanded autologous human corneal epithelial cells containing stem cells)

  • 79,000 - 316,000 cells/cm2 living tissue equivalent  

NICE TA467: Holoclar for treating limbal stem cell deficiency after eye burns (August 2017)  

 

 

Mannitol 2.5% & Carob bean gum 0.2% U

  • Oral solution 500ml

Note: For use by Radiology for outlining the small bowel for MRI scans

 

 

Methacholine Chloride U

  • 60 micrograms/ml, 125 micrograms/ml, 250 micrograms/ml, 500 micrograms/ml, 1 mg/ml, 2 mg/ml, 4 mg/ml, 8 mg/ml, 16 mg/ml

 

 

Methylthioninium Chloride (Methylene blue) U

  • Injection 1%, 10mL
  • Sterile solution 1%, 10mL

 

 

Misoprostol  (Amber 2)

  • Tablets 200 micrograms

 

 

Osmohale®  U

  • Mannitol, diagnostic kit

 

 

Penicillin allergenic determinants (Dap Kit®)

 

 

Haemofiltration

Calcium-free dialysate solutions  U    

  • Prism0cal® B22 dialysate solution
  • Prismocitrate® 18/0 sterile solution

Notes:

  • Prism0cal and Prismocitrate are calcium-free dialysate solutions for haemofiltration   
  • Restricted - to prescribing by Consultant Anaesthetists only, for critically ill patients who require continuous renal replacement therapy (CRRT) and
  • are not contraindicated for RCA and
  • in accordance with Continuous Renal Replacement Therapy (CRRT) using Citrate - Secondary Care guideline

 

 

Secretin (Secrelux®)  U

  • 100 unit vials

 

 

Sodium Citrate

  • Oral Solution 0.3M, 30mL bottle

Notes:
For In-patient maternity use only for prophylaxis against acid aspiration syndrome in obstetric patients undergoing caesarean section. Used as a single dose.

 

Strimvelis®  

  • Dispersion for infusion

Notes:

Use as per NICE HST7 Strimvelis for treating adenosine deaminase deficiency-severe combined immunodeficiency (Feb 2018)

Strimvelis is currently only administered in one specialist centre in the world; Ospedale San Raffaele in Milan, Italy. Patients travel to the hospital in Milan for treatment, and stay as an inpatient, and subsequently as an outpatient, for a number of months in Milan

 

 

Sugammadex

  • Injection 100mg/ml

Note: Sugammadex has been added for restricted us for the immediate reversal of rocuronium or vecuronium-induced neuromuscular blockade in adult patients in cannot intubate and ventilate situations.

 

Talc (Sterile)   U

  • Powder 2g (Restricted for pleurodesis)
  • Spray Powder 3g in an aerosol can (restricted for Thoracoscopic Pleurodesis)

 

 

TheraBite®

  • Jaw Motion Rehabilitation System™

Note: A specialist maxillo-facial device for hospital supply only.

 

Trans-anal Irrigation systems  (Amber 3)

NICE guidelines CG49: Faecal incontinence in adults - management (June 2007)

Royal College of Surgeons. Commissioning guide: faecal incontinence 2014

Note:

1. Before you consider recommending or prescribing a trans-anal irrigation device, refer to the flow chart which can be found here.

2. The recommended Trans-anal Irrigation system products can be found here

3. Specialists must not initiate prescriptions or requests directly to suppliers

4. GPs should NOT be asked to prescribe trans-anal irrigation systems unless and until a review has been undertaken as outlined in the flow chart linked to '1' above

 

Trisodium Citrate 46.7% (Citra-Lock®)

  • For use by the Oxford Renal Unit based on MKUH site only

 

 

 

 

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only

 

Last updated by: Dupe Fagbenro on 13-03-2019 10:27