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 Formulary Chapter 5: Infections - Full Chapter
Notes:

Prescribing of systemic antimicrobials is 'protected'. All prescribing MUST be in accordance with the Trust Antimicrobial Policy and in conjunction with local antimicrobial guideline:

 Details...
05.03.01  Expand sub section  HIV infection
Atazanavir + cobicistat (Evotaz®)
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Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be initiated by Consultants in HIV Medicine only
  • RFL:
    • HIV Medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
   
Cobicistat
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Second line protease inhibitor booster for HIV for confirmed ritonavir intolerance (March 2016)

Provider notes

  • NMUH:
    • To be initiated by Consultants in HIV Medicine only
    • See MHRA Drug Safety Updates
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Rilpivirine + emtrictabine + tenofovir alafenamide (Odefsey®)
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red

 Secondary care notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NHSE 16043/P: Tenofovir Alafenamide for treatment of HIV 1 in adults and adolescents
   
Tenofovir alafenamide + Elvitegravir + Cobicistat + Emtricitabine (Genvoya®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be initiated by consultants in HIV medicines only
    • See MHRA Drug Safety Update
    • See link below
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NHSE 16043/P: Tenofovir Alafenamide for treatment of HIV 1 in adults and adolescents
   
05.03.01  Expand sub section  Nucleoside reverse transcriptase inhibitors
Abacavir
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • For TB / HIV clinic only
 
   
Abacavir + Lamivudine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be prescribed as per BHIVA Guidelines by the HIV team only
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • For TB / HIV clinic only
 
   
Abacavir + Lamivudine + Zidovudine (Trizivir®)
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
Emtricitabine
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be prescribed as per BHIVA Guidelines by the HIV team only
    • Patients currently benefiting from FTC in their combination therapy, who either accessed FTC in studies or move to London with FTC as part of their existing regimen, should continue to receive FTC without interruption
    • For patients who have previously not received 3TC, the decision to prescribe 3TC or FTC to be made by the clinician and patient after discussion and consideration of relevant factors
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • For TB / HIV clinic only
 
   
Emtricitabine + Rilpivirine + Tenofovir disoproxil (Eviplera®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • NHSE approval required
    • Initiation restricted to Consultants HIV Medicine
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
   
Emtricitabine + Tenofovir alafenamide (Descovy®)
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NHSE 16043/P: Tenofovir Alafenamide for treatment of HIV 1 in adults and adolescents
   
Lamivudine
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Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • Epivir brand only approved for HIV patients
    • Zeffix brand approved for HIV and Hepatitis B patients
  • RFL:
    • 150mg & 300mg approved for HIV patients
    • 100mg approved for Hepatitis B patients
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Epivir brand on formulary
 
   
Rilpivirine
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
   
Stavudine
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Tenofovir disoproxil + Cobicistat + Elvitegravir + Emtricitabine (Stribild®)
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • See MHRA Drug Safety Update
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • For TB / HIV clinic only
 
Link  NHSE B06/P/x: Stribild® for the treatment of HIV-1 infection in adults
   
Tenofovir disoproxil + Efavirenz + Emtricitabine
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be prescribed by the HIV team only, in line with the BHIVA Guidelines
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • For TB / HIV clinic only
 
   
Tenofovir disoproxil + Emtricitabine
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be prescribed by the HIV team only, in line with the BHIVA Guidelines
  • RFL:
    • HIV medicine only
  • RNOH:
    • Restricted for use in accordance with RNOH Sharps Policy and Inoculation Management (see policy)
  • UCLH:
  • WH:
    • No restriction stated
 
Link  RNOH: Sharps Policy and Inoculation Management
   
Tenofovir disproxil
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Approved for HIV
    • Approved for Hepatitis B - see NICE TA
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
   
Zidovudine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Zidovudine infusion is for use by Women’s Health only
    • Caps 100mg, 250mg; Infusion 200mg/2 ml only  
 
   
Zidovudine + Lamivudine
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • No restriction stated 
 
   
05.03.01  Expand sub section  Protease inhibitors
Atazanavir
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Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be prescribed as per BHIVA Guidelines by HIV team only
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • No restriction stated
 
   
Darunavir
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Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be prescribed as per BHIVA Guidelines by the HIV team only
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • For TB / HIV clinic only
 
   
Darunavir + Cobicistat (Rezolsta®)
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be initiated by Consultants in HIV Medicine only
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
   
Darunavir + Cobicistat + Emtricitabine + Tenofovir alafenamide (Symtuza®)
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Formulary
GP - Red

Approved for HIV infection in line with NHSE commissioning policy F03/P/b (JFC January 2019)

 Provider notes

  • NMUH:
    • To be prescribed by the HIV team only, as per the clinical commissioning policy - see link below.
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NHSE F03/P/b: Use of cobicistat as a booster in treatment of HIV infection (all ages)
   
Fosamprenavir
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • No restriction stated
 
   
Lopinavir + Ritonavir
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • Check Drug Safety Update
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • For TB / HIV clinic only
 
   
Ritonavir
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • For TB / HIV clinic only
 
   
Saquinavir
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Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • No restriction stated
 
   
Tipranavir
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be prescribed as per BHIVA Guidelines by the HIV team only
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
   
05.03.01  Expand sub section  Non-nucleoside reverse transcriptase inhibitors
Efavirenz
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • No restriction stated
 
   
Etravirine
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be prescribed as per BHIVA Guidelines by the HIV team only
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
   
Nevirapine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • For TB/HIV clinic & Womens Health
 
   
05.03.01  Expand sub section  Other antiretrovirals to top
Dolutegravir
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NHSE B06/P/a: Dolutegravir for treatment of HIV1 in adults and adolescents
   
Dolutegravir + Abacavir + Lamivudine (Triumeq®)
View adult BNF View SPC online View childrens BNF
Formulary
GP - Red
High Cost Medicine

Approved for HIV in line with NHSE Commissioning Policy B06/P/a.

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NHSE B06/P/a: Dolutegravir for treatment of HIV1 in adults and adolescents
   
Enfuvirtide
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • To be used in accordance with the London HIV consortium BHIVA guidelines
    • For HIV team only
    • Patients currently benefiting from enfuvirtide in their combination therapy should continue to receive enfuvirtide without interruption. Current benefit is defined as patients whose viral load is either undetectable or remaining below their pre-enfuvirtide baseline level. Patients whose current viral load has substantially rebounded or returned to their baseline level when their first used enfuvirtide and who have a strong CD4 count, are likely to have developed or be developing resistance to enfuvirtide. Enfuvirtide is also unlikely to be having antiretroviral activity, and these patients should consider stopping the enfuvirtide in their combination, with close monitoring BHIVA Guidelines - Treatment of HIV-1 infected adults with antiretroviral therapy
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
   
Maraviroc
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Non-formulary
 
   
Raltegravir
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • HIV medicine only
  • RNOH:
    • Restricted for use in accordance with RNOH Sharps Policy and Inoculation Management (see policy)
  • UCLH:
  • WH:
    • For TB / HIV clinic and post-exposure prophylaxis
 
Link  RNOH: Sharps Policy and Inoculation Management
   
 ....
 Non Formulary Items
Doravirine + Lamivudine + Tenofovir disoproxil  (Delstrigo®)

View adult BNF View SPC online View childrens BNF
Non Formulary
GP - Red

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
Link  NHSE 190137P: Doravirine for the treatment of HIV-1 in adults
 
Doravirine tabs  (Pifeltro®)

View adult BNF View SPC online View childrens BNF
Non Formulary
GP - Red

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
Link  NHSE 190137P: Doravirine for the treatment of HIV-1 in adults
 
  
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.

See link for the complete NCL Red List https://www.ncl-mon.nhs.uk/wp-content/uploads/2017/08/ncl_red_list.pdf

  

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