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 Formulary Chapter 15: Anaesthesia - Full Chapter
15.01  General anaesthesia
15.01  Anaesthesia, sedation and resuscitation in dental practice
15.01  Gas cylinders
15.01.01  Intravenous anaesthetics
15.01.01  Barbiturates to top
Thiopental
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Thiopental should only be used when the patient is under the supervision of an Anaesthetist.
 
   
15.01.01  Other intravenous anaesthetics
Etomidate (Etomidate-Lipuro)
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Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Etomidate (Hypnomidate)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Ketamine injection
(Anaesthetic)
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Formulary
GP - Red

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Lidocaine injection
(Anaesthesia)
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Restricted Drug Restricted
GP - Red

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • The use of lidocaine (lignocaine) 2% cartridge, bupivacaine 0.0625% infusion andropivacaine is restricted to theatres only.
 
   
Propofol
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.01.02  Inhalational anaesthetics
15.01.02  Volatile liquid anaesthetics
Desflurane
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Isoflurane
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Sevoflurane
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.01.02  Nitrous oxide
Nitrous oxide
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Procedure for the Administration of Entonox for Pain Relief
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.01.03  Antimuscarinic drugs to top
Atropine injection
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Atropine Minijet injection
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
Glycopyrronium injection
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Hyoscine Hydrobromide
(injection)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.01.04  Sedative and analgesic peri-operative drugs
15.01.04.01  Benzodiazepines
Diazepam
(Pre-medication)
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Formulary

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Lorazepam
(Pre-medication)
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Formulary

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Midazolam
(Pre-medication)
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Formulary

NOTE: There is more than one monograph for Midazolam, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • For paediatric sedation before procedures (including but not limited to MRI and pre-operatively). 
    • UnlicensedUnlicensed - Midazolam 2.5 mg/mL oral solution is an unlicensed product
  • UCLH:
  • WH:
    • No restriction stated
 
   
Temazepam
(Pre-medication)
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Formulary

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.01.04.01  Benzodiazepines
15.01.04.02  Non-opioid analgesics
Ketorolac
(Post-operative pain)
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Restricted to anaesthetics
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Ketorolac tablets are not available
 
   
Parecoxib
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Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Non-formulary
 
   
15.01.04.03  Opioid analgesics to top
Alfentanil
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Fentanyl
(Injection)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Restricted Only on the recommendation of the Pain Team for patients intolerant to or with contraindications to morphine and oxycodone
  • UCLH:
  • WH:
    • No restriction stated
 
   
Remifentanil
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • For use in ICU (Intensive Care Unit) ONLY
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • CD = Controlled drug. The Misuse of Drug Regulations apply. For further details see. Prescribing Guidelines. Ideally, remifentanil should be administered as an infusion, either with a standard syringe driver or as a Target Controlled Infusion using the Minto pharmacokinetic model (with the Alaris PK pump). Remifentanil should be diluted before administration, typically to a concentration of 20 to 40 mcg/ml, though higher concentrations can be used. A recommended induction infusion rate is 0.5 mcg/kg/min or8 ng/ml target for a ventilated patient and the rate halved for maintenance and titrated to clinical need (considerably higher or lower rates may be required). Beware the elderly or those with significant comorbidity when initial rates should be reduced. A dedicated cannula or antireflux valve should be used if an IV cannula is shared with fluids or other drugs. The cannula and giving set should be flushed at the end of use to avoid boluses of remifentanil accidentally being administered postop. Boluses of remifentanil should be administered carefully, by slow injection over a period of 30 to 60seconds.
 
   
15.01.04.04  Other drugs for sedation
Dexmedetomidine injection
(Sedation in ITU)
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Formulary
GP - Red

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Approved for light sedation (RASS 0 to -3) in mechanically ventilated adult patients with CAM ICU positive agitated delirium where agitation precludes weaning and extubation only after standard sedative agents (including propofol, clonidine or a benzodiazepine) had been trialled for 48 hours. (JFC January 2019).

Provider notes

  • NMUH:
    • As per indication above
  • RFL:
    • see above indication
    • Refer to local protocol for use
  • RNOH:
  • UCLH:
  • WH:
    • As above.
 
   
15.01.05  Neuromuscular blocking drugs
15.01.05  Non-depolarising muscle relaxants
Atracurium besilate
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Store in refrigerator 
  • UCLH:
  • WH:
    • No restriction stated
 
   
Cisatracurium
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • The use of cisatracurium is restricted to theatres only.
 
   
Mivacurium
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • The use of mivacurium is restricted to theatres only
 
   
Pancuronium
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Rocuronium bromide
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Store in a refrigerator
  • UCLH:
  • WH:
    • The use of rocuronium is restricted to theatres only
 
   
Vecuronium Bromide
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.01.05  Depolarising muscle relaxants
Suxamethonium chloride
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Store in a refrigerator
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.01.06  Drugs for reversal of neuromuscular blockade to top
15.01.06  Anticholinesterases
Neostigmine metilsulfate + Glycopyrronium bromide
(Reversal of neuromuscular blockade)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Non-formulary
 
   
Neostigmine metisulfate
(Reversal of neuromuscular blockade)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.01.06  Other drugs for reversal of neuromuscular blockade
Sugammadex
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • Restricted to consultant anaesthetists only. 
  • RFL:
    • For reversal of rocuronium or vecuronium induced neuromuscular blockade when:

      • Neostmigmine / glycopyrrolate is unsuitable due to the patient’s clinical condition (e.g. history of ischaemic heart disease with proven rate-related myocardial ischaemia, atrial fibrillation/tachydysrhythmias, a-v conduction defects, brittle asthma)
      • There is residual blockade despite standard doses of neostigmine / glycopyrrolate
      • The patient is morbidly obese and there is concern of prolonged residual neuromuscular blockade
      • Immediate reversal is required in an emergency situation (e.g. when the patient cannot be ventilated).
  • RNOH:
    • Restricted for the emergency reversal of rocuronium 
  • UCLH:
  • WH:
    • For theatres use only
 
   
15.01.07  Antagonists for central and respiratory depression
Doxapram
(Anaesthesia)
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Formulary

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
    • Non-formulary
  • WH:
    • Non-formulary
 
   
Flumazenil
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Flumazenil is used to reverse the sedative effects of benzodiazepines in anaesthetic, intensive care and diagnostic procedures. It should not be used for routine benzodiazepine reversal. It has a shorter half-life than diazepam and midazolam and care is required to avoid the risk of resedation.
 
   
Naloxone
(Central and respiratory depression)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Use in accordance with the RNOH guidelines, see link below
  • UCLH:
  • WH:
    • No restriction stated
 
Link  RNOH: Naloxone Use and Administration in Opioid Toxicity
   
15.01.08  Drugs for malignant hyperthermia
Dantrolene sodium injection
(Malignant hyperthermia)
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Formulary

Provider notes

  • NMUH:
    • Check MHRA Drug Safety Update
  • RFL:
    • Stock kept in theatres on Malignant Hyperthermia trolley
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Dantrolene Injection is kept in the following locations: Main Theatres, Obstetrics Theatre
 
   
15.02  Local anaesthesia to top
15.02  Articaine
15.02  Bupivacaine
Bupivacaine
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Formulary

Approved for post-operative pain management following limb amputation for peripheral arterial disease to reduce post-operative opioid requirement (0.125% infusion via perineural stump catheter) (JFC September 2019). 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Inj 0.25% (25mg/10mL); 0.5% (50mg/10mL) only
 
   
Bupivacaine + Adrenaline
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Bupivacaine + Fentanyl
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Formulary

Provider notes

  • NMUH:
    • A ready-mixed bag of Fentanyl + Bupivicaine is available from Pharmacy
  • RFL:
    • Theatres: Bupivacaine 0.125% + Fentanyl 4micrograms/mL in NaCl 0.9% 480mL epidural bag
    • Labour: Bupivacaine 0.1% + Fentanyl 2micrograms/mL in NaCl 0.9% 15mL epidural syringe
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
Bupivacaine + Glucose (Marcain Heavy)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
15.02  Levobupivacaine
Levobupivacaine
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Non-formulary
 
   
Levobupivacaine + Fentanyl
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Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • BCF: Levobupivacaine 0.125% + Fentanyl 4mcg/ml in 500ml
    • RFH: Levobupivacaine 0.1% + Fentanyl 0.0002% in 100ml
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Non-formulary
 
   
15.02  Lidocaine
Lidocaine + Adrenaline injection (Xylocaine)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • For emergency caesarean section
 
   
Lidocaine 10% spray (Xylocaine)
(Surface anaesthesia)
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Formulary

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Lidocaine 2% + Chlorhexidine 0.25% gel (Instillagel)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Lidocaine 2.5% + Prilocaine 2.5% cream (EMLA)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Lidocaine 4% cream (LMX4)
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Restricted Drug Restricted

Approved for topical anaesthetic of first-choice prior to venous cannulation or venepuncture for paediatrics (JFC July 2013)

Provider notes

  • NMUH:

    • No restriction stated
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
Lidocaine 4% solution (Laryngojet)
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Formulary

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Non-formulary
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Non-formulary
 
   
Lidocaine 5% + Phenylephrine 0.5% topical solution
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • Formulary for ENT use only
  • RFL:
    • For ENT use only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
Lidocaine 5% ointment
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Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
LAT gel (Lidocaine 4% + Adrenaline 0.1% + Tetracaine 0.5%)
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Unlicensed Drug Unlicensed
GP - Red

Approved for second-line management of pain in children requiring sutures/debridement (JFC February 2018)

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
    • No restriction stated
  • WH:
    • Non-formulary
 
   
15.02  Mepivacaine to top
15.02  Prilocaine
Prilocaine 1% injection (Citanest)
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Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Non-formulary
 
   
Prilocaine 3% + Felypressin injection (Citanest with Octapressin)
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Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • BCF use only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Prilocaine hydrochloride 2% hyperbaric solution (Prilotekal)
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Restricted Drug Restricted
GP - Red

Approved for short duration spinal anaesthesia restricted to use in day surgery setting only (JFC February 2018).

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • As above
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • For Day Surgery use only
 
   
15.02  Chloroprocaine
Chloroprocaine
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Formulary
GP - Red

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Procaine hydrochloride
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Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
15.02  Ropivacaine
Ropivacaine
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Restricted Drug Restricted
GP - Red

Approved for:

  • Infiltration anaesthesia; restricted to RFH for knee surgery only (JFC January 2013)
  • Single dose in an off-label manner as a local infiltration during total hip replacement (THR) and total knee replacement (TKR) (JFC January 2017)
  • Surgical wound infiltration via Painbuster; for post-operative management of patients undergoing live-donor nephrectomy and patients undergoing Deep Inferior Epigastric Perforators (DIEP) flap breast reconstruction (JFC July 2015)
  • Ropivacaine continuous surgical wound infiltration via Painbuster; for colorectal surgery and incisional hernia (JFC May 2016)

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Local infiltration during total hip replacement (THR) and total knee replacement (TKR).
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • The use of Lidocaine (lignocaine) 2% cartridge, bupivacaine 0.0625% infusion and ropivacaine is restricted to theatres only.
 
   
15.02  Tetracaine
Tetracaine 4% gel (Ametop)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • The use of tetracaine (Ametop) gel is restricted to Paediatrics DSU and A&E only.
 
   
15.02  Other local anaesthetics to top
Articaine hydrochloride + Adrenaline injection
View adult BNF View SPC online View childrens BNF
Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • For dental use at BCF only
  • RNOH:
    • Non-formulary
  • UCLH:
    • Non-formulary
  • WH:
    • Non-formulary
 
   
Cocaine oromucosal solution
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • 5% and 10% mouthwash available
  • RNOH:
    • Restricted - 10% available
  • UCLH:
    • Non-formulary
  • WH:
    • Non-formulary
 
   
Ethyl Chloride (Cryogesic Spray)
View adult BNF View SPC online View childrens BNF
Formulary

econdary care notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
Mepivacaine injection (Scandonest Plain)
View adult BNF View SPC online View childrens BNF
Formulary

econdary care notes

  • NMUH:
    • Non-formulary
  • RFL:
    • BCF only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
 ....
 Non Formulary Items
Benzocaine 3% cream
(Local anaesthesia)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cocaine + Adrenaline

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dermogesic spray

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dexmedetomidine injection
(Opthalmic surgery)

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

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Not approved for conscious sedation in Opthalmic surgery (May 2014)

 
Lidocaine + Tetracaine cream  (Pliaglis)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lidocaine 5% patch

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

Not approved for neuropathic pain (November 2012)

Link  NCL JFC: Position Statement - Lidocaine patch
 
Mepivacaine + Adrenaline injection  (Scandonest 2% Special)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Naloxone pre-filled syringes  (Prenoxad)

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
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

GP - 1st

Medicines suitable for first-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - 2nd

Medicines suitable for second-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - Amber

Medicines that should be initiated by a specialist. Prescribing can be transferred to primary care once the patient has been stabilised.

Shared care: For drugs with regular, ongoing need for monitoring and/or assessment of efficacy or toxicity. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the North Central London JFC.

Fact sheet: For drugs with some concerns surrounding safety or efficacy but do not require regular monitoring and/or monitoring of effectiveness/toxicity.

  

GP - Red

Medicines which should normally be prescribed by specialists only (hospital only).

For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.

  

GP - Grey

Medicines on hospital formularies which have not been reviewed for suitability in primary care.  

Black

Medicines not recommended for routine use in primary or secondary care.

Medicines, which the North Central London JFC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.

  

netFormulary