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 Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
07.04.02  Expand sub section  Drugs for urinary frequency, enuresis, and incontinence
07.04.02  Expand sub section  Urinary incontinence
Duloxetine (Yentreve)
(Urinary incontinence)
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Duloxetine (Yentreve) is FORMULARY for use in women with moderate to severe urinary stress incontinence. Duloxetine (Yentreve) should be used as a second line option for urinary stress incontinence, as an alternative to surgical treatment, as per NICE guidance.
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Mirabegron
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Formulary
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See NICE TA for eligibility criteria

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • Check MHRA Drug Safety Update
  • RFL:
    • For overactive bladder as per NICE TA
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Pharmacological management of Overactive Bladder (OAB) Syndrome in Primary Care
Link  NICE TA290: Mirabegron for overactive bladder
Oxybutynin immediate release
(Urinary incontinence)
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Formulary
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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:
    • First line for urinary incontinence.
  • RFL:
    • No restriction stated (liquid not available)
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Please refer to NCL JFC guidelines for the pharmacological management of overactive bladder (OAB) syndrome in primary care
 
Link  NCL JFC: Pharmacological management of Overactive Bladder (OAB) Syndrome in Primary Care
Oxybutynin modified release
(Urinary incontinence)
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Formulary
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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:
    • Non-formulary
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Oxybutynin patch
(Kentera)
(Urinary incontinence)
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Formulary
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Only to be used in patients who are unable to take oral medications Review effective treatment annually (or every 6 months in patient ≥ 75 years old) and consider a 4 week ‘drug free holiday’ to avoid chronic adverse effects. (NCL JFC May 2016)
 
Link  NCL JFC: Pharmacological management of Overactive Bladder (OAB) Syndrome in Primary Care
Propantheline
(Hyperhidrosis; Adult enuresis)
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Formulary
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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:
  • WH:
    • No restriction stated
 
Solifenacin
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • As per guidance link below for the treatment of overactive bladder
  • RFL:
    • As per JFC guidance on the treatment of overactive bladder
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Pharmacological management of Overactive Bladder (OAB) Syndrome in Primary Care
Tolterodine immediate release
(Urinary incontinence)
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Formulary
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Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Due to its increased cost, the use of tolterodine is reserved for those patients unable to tolerate oxybutynin
 
Link  NCL JFC: Pharmacological management of Overactive Bladder (OAB) Syndrome in Primary Care
Tolterodine modified release
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Formulary
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Pharmacological management of Overactive Bladder (OAB) Syndrome in Primary Care
Trospium
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Formulary
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: Pharmacological management of Overactive Bladder (OAB) Syndrome in Primary Care
Botulinum toxin Type A
(Botox)
(Neurogenic detrusor overactivity, Overactive bladder)
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Restricted Drug Restricted
GP - Red
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NOTE: There is more than one monograph for Botulinum toxin type A, click here to search for formulary status and its use for other indications. 

Approved for neurogenic bladder dysfunction for patients refractory to oral therapies (JFC January 2013)

Provider notes

  • NMUH:
    • Botox brand only
    • Restricted to consultants Dr Yoong, Mr Nair and Mr Godbole for use in Overactive Bladder (OAB) only
  • RFL:
    • Restricted to urology only
  • RNOH:
    • Restricted to Consultant Urologists only for neurogenic detrusor overactivity
  • UCLH:
  • WH:
    • See Botulinum Toxin Management Algorithm Diagram for direction of use
 
07.04.02  Expand sub section  Nocturnal enuresis
 ....
 Non Formulary Items
Darifenacin

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Non Formulary
Fesoterodine modified release

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Non Formulary
Black

Not approved for overactive bladder (October 2012)

Flavoxate

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Non Formulary
Oxybutynin Intra-vesical
(5mg/30ml)

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Non Formulary
Propiverine

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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
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Homecare
Homecare

Traffic Light Status Information

Status Description

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

  

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.

  

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