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 Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
07.06  Expand sub section  Unlicensed Medicines / Significant off-label use
Acetylcysteine
(Renal protection)
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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:
    • No restriction stated
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Botulinum toxin Type A
(Botox, Dysport, Xeomin)
(Urinary retention)
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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 urinary retention secondary to Fowlers Syndrome (JFC February 2020).

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Restricted to urology only (Botox®)
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Ephedrine tablets
(Priapism in sickle cell disease)
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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:
    • Approved for use for priapism (unlicensed use).
    • See Trust Sickle Cell guidelines via intranet
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Indometacin suppositories
(Tocolytic)
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Formulary
GP - Red
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Approved for tocolytic therapy during pre-natal repair of myelomeningocele, a serious form of spina bifida (UCLH only; JFC February 2018)

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
    • As tocolytic therapy during pre-natal repair of myelomeningocele (fetal spina bifida) (UMC Dec 2017)
  • WH:
    • Non-formulary
 
Metformin
(Polycystic ovaries syndrome)
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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:
    • No restriction stated
  • RFL:
    • Gynaecology and Endocrinology only
  • RNOH:
    • Non-formulary
  • UCLH:
    • No restriction stated
  • WH:
    • No restriction stated
 
Methotrexate injection
(Ectopic pregnancy)
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Formulary
GP - Red
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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:
    • Zlatal is stocked. This is a licensed preparation, but it is not licensed for use in ectopic pregnany
  • RFL:
    • See local protocol
  • RNOH:
    • Non-formulary
  • UCLH:
    • Approved for ectopic pregnancy (UCLH only; UMC September 2020)
  • WH:
    • No restriction stated
 
Sodium thiosulfate inj
(Calciphylaxis)
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Formulary
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Approved for calciphylaxis (off-label use)
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Etilefrine
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Unlicensed Drug Unlicensed
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Provider notes

  • NMUH:
    • For treatment of priapism in patients with sickle cell disease
    • Etilefrine 25mg Tablets, available from ‘special-order’ manufacturers or specialist importing companies
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Tiopronin
(Urological stones)
Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Approved for urological stones in patients with cysteine urea
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
 ....
 Non Formulary Items
Domperidone
(Lactation stimulation)

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Non Formulary

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

  
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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Link to adult BNF
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Link to children's BNF
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Link to SPCs
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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