North Central London Formulary


	North Central London Joint Formulary

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Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter

07.06

Unlicensed Medicines / Significant off-label use

Acetylcysteine
(Renal protection)

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:
- Non-formulary
RNOH:
- Non-formulary
UCLH:
WH:
- Non-formulary

Botulinum toxin Type A
(Botox^®, Dysport^®, Xeomin^®)
(Urinary retention)

Restricted

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)

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:
- 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)

Formulary

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)

Non-formulary

Metformin
(Polycystic ovaries syndrome)

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:

Gynaecology and Endocrinology only

RNOH:

Non-formulary

UCLH:
- No restriction stated
WH:

No restriction stated

Methotrexate injection
(Ectopic pregnancy)

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:

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)

Formulary

Provider notes

NMUH:

Non-formulary

RFL:

Approved for calciphylaxis (off-label use)

RNOH:

Non-formulary

UCLH:
WH:

Non-formulary

Etilefrine

Unlicensed

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

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)

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

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs

Homecare

Traffic Light Status Information

Status	Description
	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.
	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
	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.