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Black Traffic Light Drugs (Not Recommended for Use)

Black Traffic Light Drugs                            (Not Recommended for Use)

These are medicines that have been reviewed and have been deemed less suitable for prescribing, and are therefore not recommended in primary or secondary care. This may be due to the lack of good clinical evidence, or due to the availability of more suitable alternatives.

These medicines are not included in the East Lancashire Joint Formulary and are not available within secondary care.

Template letters have been developed to aid GP's in the Blackburn with Darwen and East Lancashire CCG areas refer BLACK lighted drugs back to the prescriber for review.

Eculizumab -    

Generic Name 

Brand Name



Abatacept  Orencia® Psoriatic arthritis after DMARDs NICE TA568
appraisal terminated.
NOT recommended for prescribing on the NHS in Lancashire
Formulary BNF 10.1.3
ActiPatch®  ActiPatch®  Chronic pain (presence of pain lonfer than 3 months) associated with knee osteoarthritis and plantar fasciitis  Forumlary BNF 4.7
Actos® Actos® Generic prescribing only  Formulary BNF 6.1
ACWY vaccine   Travel vaccination  See Position   Statement
Afatininb    Locally advanced or metastatic squamous non-small-cell lung cancer after platinum-based chemotherapy Appraisal Terminated   Formulary BNF 8.1
Aflibercept Zaltrap® Metastatic colorectal cancer
 Formulary BNF 8.1
Agomelatine Valdoxan® Major depression  Formulary BNF 4.3
Alectinib Alecensa® Previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer (terminated appraisal) NICE TA438  Formulary BNF 8.1

Alendronate and Vitamin D

Fosavance®  Postmenopausal osteoporosis  Formulary BNF 6.6
Alimemazine tablets and liquid  All brands  antihistamine  Formulary BNF 3.4
Aliskiren   Non-formulary in line with NHSE low priority prescribing commissioning agenda  Formulary BNF 2>5
Alpelsib Piqray NICE is unable to make a recommendation alpelisib with fulvestrant for treating hormone-receptor positive, HER2-negative, PIK3CA-positive advanced breast cancer NICE TA652 Formulary BNF 8>1
Amantadine  Lysovir®   Influenza treatment & prophylaxis
 NICE TA158, TA168
 Formulary BNF 5.3
Firdapse® Lambert-Eaton Syndrome

 Formulary BNF 10.2
Amoxycillin (nebulised)   Not licensed for use via nebulised route for bronchiectasis or any other indication  Formulary BNF 5.1
Anakinra Kineret® Rheumatoid arthritis - NICE TA72

 Formulary BNF 10.3
Anti-thymocyte globulin (Riabbit) Thymoblobuline® Immunosuppressive therapy for kidney transplant in adults NICE TA481 (adults) NICE TA482 (Children and young adults) Formulary BNF 8.2
Apremilast Otezla Moderate to severe plaque psoriasis. NICE TA368
 Formulary  BNF 10.1
Aprovel® Generic Prescribing Only

 Formulary BNF 2.5
Aricept® Aricept® Generic Prescribing Only

 Formulary BNF 4.11
Armour Thyroid Armour Thyroid Hypothyroidism.
UKMI Q&A Statement
 Statement from  British Thyroid Association
 Formulary BNF 6.2

Asenapine  Sycrest® Schizophrenia/bipolar mania

 Formulary BNF 4.2
Atezolizumab Tecentriq® Untreated advanced non-squamous non-small-cell lung cancer - Not recommended as in NICE TA618  Formulary BNF 8.1
Atorvastatin chewable tablets Lipitor chewable® Hypercholesterolaemia

 Formulary BNF 2.12
Azacitidine Vidaza® Acute myeloid leukaemia
 Formulary  BNF 8.1
Azelastine/ Fluticase Dymista® Moderate to severe allergic rhinitis

 Formulary BNF 12.2
Azilsartan Edarbi® Hypertension

 Formulary BNF 2.5
Bazedoxefine Duavive® Oestrogen deficiency symptoms. 

 Formulary BNF 6.4
BCG vaccine   Travel vaccination  See Position   Statement
Belatacept Nulojix® Immunosuppressive therapy for kidney transplant in adults NICE TA481 (adults) NICE TA482 (Children and young adults)  Formulary BNF 8.2
Bendamustine Levact® Non-Hodgkins lymphoma. NICE TA206 

Appraisal terminated.

 Formulary  BNF 8.1

Betamethasone valerate Medicated Plasters

Betesil® Severe eczema; psoriasis  Formulary BNF 13.4
Bevacizumab  Avastin® NICE is unable to make a recommendation about the use in the NHS of bevacizumab with carboplatin, gemcitabine and paclitaxel for treating the first recurrence of platinum-sensitive advanced ovarian cancer because no evidence submission was received from Roche.
 Formulary BNF 8.1
Bevacizumab Avastin® Relapsed, platinum‑resistant epithelial ovarian, fallopian tube or primary peritoneal cancer.
NICE TA353 Appraisal terminated. 
 Formulary BNF 8.1

Bevacizumab Avastin®

Monotherapy or combination chemotherapy of metastatic colorectal cancer, 2nd line NICE TA242

 Formulary BNF 8.1
Bevacizumab Avastin® Lung cancer, NSC NICE TA148

 Formulary BNF 8.1
Bevacizumab Avastin® Renal cell carcinoma NICE TA178

 Formulary BNF 8.1
Bevacizumab Avastin®

In combination with a taxane for metastatic breast cancer, 1st line NICE TA214

 Formulary BNF 8.1
Bevacizumab Avastin® Diabetic Macular Oedema

 Formulary BNF 8.1
Bevacizumab Avastin® In combination with paclitaxel and carboplatin for 1st line treatment of advanced ovarian carcinoma NICE TA284  Formulary BNF 8.1
Bevacizumab Avastin® In combination with gemcitabine and carboplatin for treating  1st recurrence of platinum-sensitive advanced ovarian carcinoma
NICE TA285  
 Formulary BNF 8.1
Bevacizumab Avastin®
EGFR mutation-positive non-small-cell lung cancer (terminated appraisal) NICE TA436             
 Formulary BNF 8.1
Bezlotuxumab Zinplava®  Preventing current clostridium difficile infection -appraisal terminated -NICE TA601 Formulary BNF
Biatain-IBU®  Biatain-IBU®  Polyurethane foam film dressing  Wound Care  Formulary 
Blinatumomab Blincyto  Previously treated Pghiladelphia-chromosome- positive acute lymphoblastic leukaemia - NICE TA686 [Appraisal terminated]  Formulary 8.2.3
Bortezomib Velcade®  Multiple myeloma after second or subsequent relapse. terminate appraisal Formulary 8.1.5
Bosutinib Bosulif Untreated chronic myeloid leukamia in adults _ NICE TA576 - appraisal terminated
NOT recommended for prescribing on the NHS in Lancashire
Formulary 8.1.5
Botulinum Type A Botulinum Type A Uncomplicated chronic anal fissure

 Formulary BNF 1.7
 Botulinum Type A   Botulinum Type A Hyperhidrosis (excessive sweating) in people with social anxiety disorder. Formulary BNF
Brentuximab vedotin Adcetris®  Untreated advanced Hodgkin lymphoma NICE TA594 - appraisal terminated.  Formulary BNF 8.1
Brimonidine Mirvaso®

Facial erythema in rosacea

 Formulary BNF 13.6
Bromfenac Yellox® Postoperative inflammation following cataract surgery  Formulary BNF 11.8
Budesonide oral capsules Entocort® 2nd line corticosteroid option in crohn's disease when conventional corticosteroid not tolerated  Formulary BNF 1.5
Buspirone  Buspar®  Anxiety (short term use)

 Formulary  BNF 4.3
Cabazitaxel Jevtana® Prostate Cancer

 Formulary BNF 8.1
Cabozantinib  Cometriq  NICE was unable to make a recommendation about the use of Cabazantinib for previously treated advanced hepatocellular carcinoma - appraisal terminated _ NICE TA582  Formulary BNF 8'1
 Cannabis based Medicinal products   Management of Chronic Pain - See Position Statement  Formulary BNF 4.7
Canabis extract
buccal spray

Spasticity in multiple  sclerosis Existing patients to be referred for review NICE CG186 

 Formulary BNF 10.2
Canakinumab Ilaris®  Gout NICE TAG281

 Formulary BNF 8.2.4
Cangrelor Kangrexal®  Reducing atherothrombotic events in people undergoing percutaneous coronary intervention or awaiting surgery requiring interruption of anti-platelet therapy. Appraisal terminated  NICE TA351
 Formulary BNF 2.9

Capsaicin 179 mg (8%) Patches  Qutenza® Peripheral neuropathic pain in non-diabetic patients  Formulary BNF 10.3
Carmustine implant Gliadel® Recurrent glioblastoma multiforme  NICE TA149 
Appraisal terminated.
 Formulary BNF 8.1
Casodex® Casodex® Generic Prescribing Only

 Formulary BNF 8.3
Cenegermin Oxervate  Not recommended, within its marketing authorisation, for treating moderate to severe neurotrophic keratitis in adults - NICE TA532  Formulary BNF 11
Cetuximab Erbitux®

Metastatic colorectal cancer 2nd line, (montherpay or combination chemo) NICE TA242

 Formulary BNF 8.1
 Cholestyramine 10% in  cetomacrogol   Refer patient back to original prescriber  Formulary BNF 13

Intermittent claudication              NICE TA223

 Formulary BNF 2.6
Clarithromycin Straws  Clarosip®  Discontinued 

 Formulary  BNF 5.1
Clarithromycin XL  Klaricid XL®  Respiratory tract infections

 Formulary BNF 5.1
Co-aprovel® Co-aprovel® Generic Prescribing Only

 Formulary BNF 2.5

Co-careldopa Intestinal Gel

Duodopa®  Severe Parkinson's disease  Formulary  BNF 4.9
 Cobimetinib Cotellic®  Unrescetable or metastatic BRAF V600 mutation positive melanoma, in combination with vemurafenib
 Formulary BNF 8.1
Co-enzyme Q10/ Ubiquinone/ Ubidecarenone
Co-enzyme Q10 Except for mitochondrial disorders   Formulary BNF 9.8
Colesevelam Cholestagel®

Familial hypercholesterolaemia (combination or monotherapy)        

 Formulary BNF 2.12
Co-phenotrope   all brands Adjunct  to rehydration in acute diarrhoea  Formulary BNF 1.4
Co-proxamol  e.g. Cosalgesic®, Distalgesic®,                       Dolgesic®                        
Unlicensed and only available on named patient basis   Formulary  BNF 4.7
Cozaar® Cozaar® Generic Prescribing Only

 Formulary BNF 2.5
Crisaborole    Mild to moderate atopic dermatitis - appraisal terminated. Not recommended for prescribing on the NHS in Lancashire. NICE TA701  Formulary BNF 13.5.3
Crizotinib Xalkori® Previously treated non-small-cell lung cancer associated with an anaplastic lymphoma kinase fusion gene - not recommended by NICE TAG296  Formulary BNF 8.1
Dapoxetine Priligy® Premature ejaculation in men 18-64 years of age.   
 Formulary  BNF 7.4
Daratumumab Daralex ®  Relapsed or refractory multiple myeloma (with dexamethasone and lenalinomide), Appraisal terminated. Formulary BNF 8.1.5
Daratumumab Daralex ®
 Daratuzumab with lenalidomide and dexamethasone for untreated multiple myeloma - appraisal terminated. NICE was unable to make a recommendation as the company did not provide an evidence submission. Formulary BNF 8.1.5
Darvadstrocel Alofisel Darvadstrocel is not recommended, within its marketing authorisation, for previously treated complex perianal fistulas in adults with non-active or mildly active luminal Crohn's disease. - NICE TA556 Formulary BNF 1.5.2
Decitabine Dacogen® Leukaemia, acute myeloid        NICE TA270. Appraisal terminated  Formulary BNF 8.1
Degludec with Liraglutide Xultophy® Type II diabetes mellitus.

 Formulary BNF 6.1
Xgeva® Bone loss in non-metastatic prostate cancer NICE TA194 Terminated appraisal.  Formulary BNF 6.6
Dexamethasone                       intravitreal implant Ozurdex® Repeat treatment for posterior uveitis.
Position Statement
Formulary  BNF 11.4
Dexibuprofen  Seractil®  Pain & inflammation  Formulary BNF 10.1
Dibotermin alfa InductOs® Non-union long bone fractures [unlicensed indication]  
Diclofenac Gel Patch  Voltarol Gel Patch®  Pain & inflammation  Formulary BNF 10.3
Diclofenac tablets All brands Non Steroidal Anti Inflammatory Drug  Formulary BNF 4.7
Dicycloverine Non-proprietary Intestinal smooth muscle relaxant  Formulary BNF 1.2
Diethylamine salicylate cream Algesal®  Rubifacient  Formulary BNF
Diovan® Diovan® Generic Prescribing Only  Formulary BNF 2.5
Dosulepin Prothiaden® Depressive illness  Formulary BNF 4.3

Diclofenac & Misoprostol

Arthrotec® Rheumatoid arthritis; osteoarthritis   Formulary BNF 10.1
Disofrol® Disofrol® Intractable cough, unlicensed import from USA  Formulary BNF 3.0
Dupilumab Dupixent® Chronic rhinosinusitis with nasal polyps NICE TA648  Formulary BNF 13
Durvalumab Durvalumab Untreated extensive-stage small-cell lung cancer [terminated appraisal] NICE TA662 Formulary BNF 8.1.
E-Cigarettes E-Cigarettes Substitute to smoking tobacco
Position statement
 Formulary BNF 4.10
Eculizumab Soliris® Refractory myasthenia gravis - NICE TA636 - terminated appraisal Formulary BNF 8.1.5
Eculizumab Soliris®

 Relapsing neuromyelitis optica - NICE TA647 appraisal terminated

Formulary BNF 8.1.
Efalizumab Raptiva® Licence currently suspended.  Formulary BNF 10.1
Elfornithine  Vaniqa®  Facial hirsutism  
Elotuzumab  Empliciti Previously treated multiple myeloma (terminated appraisal) NICE TA434  Formulary BNF 8.2.3
Eltrompobag Revolade® Severe aplastic anaemia refractory to immunosuppressive therapy - terminated appraisal. NICE TA382
 Formulary  BNF 9.1
Entocort® Prescribe as Budenofalk®  Formulary BNF 1.5
Enzalutamide   Xtandi  Hormone-relapsed non-metastatic prostate cancer - not recommended by NICE TA580  Formulary BNF
Erdosteine  Erdotin®  Acute exacerbations of chronic bronchitis  Formulary  BNF 3.7
Eribulin  Halaven® Locally advanced or metastatic (secondary) breast cancer in adults who have had only 1 course of chemotherapy - not recommended as an option in NICE TA515  Formulary BNF 8.1
Erlotinib Tarceva®

Monotherapy for maintenance treatment of non-small-cell lung cancer. NICE TA227

 Formulary BNF 8.1
Escitalopram  Cipralex® 

BLACK for Depression. GREEN for Generalised Anxiety Disorder

 Formulary BNF 4.3
Estriol 0.1% vaginal cream  Gynest® (Ortho)  Topical HRT  Formulary BNF 7.2
Everolimus Certican® Preventing organ rejection in  liver transplant. NICE TAG348
 Formulary BNF 8.1
 Everolimus Certican® Immunosuppressive therapy for kidney transplant in adults NICE TA481 (adults) NICE TA482 (Children and young adults)  Formulary BNF 8.2
 Evolocumab  Repatha®  Prevention of cardiac events on patients with CHD and a history of ACS , in combination with a statin  Formulary 2.12

Ezetimibe & Simvastatin 


Primary (heterozygous-familial & non-familial) cholesterolaemia Prescribe separately, NICE TA132

 Formulary BNF 2.12
Fampridine Fampyra® NHS England commissioned drug  Link to document
Fentanyl Lozenge  Actiq®  Severe chronic pain  Formulary  BNF 4.7
Fentanyl nasal spray Instanyl®, PecFent®  Severe chronic pain  Formulary BNF 4.7
Fentanyl sublingual Abstral®, Effentora® Severe chronic pain  Formulary BNF 4.7
 Ferric Maltol Feracrru®  Iron Deficiency Anaemia in patients with inflammatory bowel disease  Formulary BNF 9.1
Fluconazole capsules                           & suspension Diflucan® Breast ductal thrush  Formulary BNF 5.2
Fludarabine, oral  Fludara® Leukaemia, lymphocytic, 1st line monotherapy NICE TA119  Formulary BNF 8.1
Fluocinolone Acetonide         intravitreal implant Iluvien® Diabetic Macular Oedema         NICE TA271 - replaced by NICE TA301 - RED Traffic Light  Formulary BNF 11.4
Fluocinolone Acetonide         intravitreal implant  Iluvien®  Chronic diabetic macular oedema that has inadequately responded to previous therapy, in adults whose eyes have natural lenses (phakic eyes).   NICE TA613 Formulary BNF 11.4
Fluorouracil 0.5%                                  + salicylic acid 10% Actikerall® Actinic keratosis  Formulary BNF 13.8
Fluticasone & Formoterol             inhaler Flutiform® Asthma  Formulary BNF 3.2
Fluticasone furoate/Vilanterol Relvar® Ellipta®  COPD in adults
 Link to review
 Formulary BNF  3.1
Fluticasone furoate Avamys® Nasal allergies  Formulary BNF 12.2
Forceval® Forceval® BLACK for all indications except: Malabsorption = RED  Formulary BNF 9.6
Fulvestrant Faslodex® Breast cancer, locally advanced or metastatic. NICE TA239  Formulary BNF 8.3
Locally advanced or metastatic oestrogen-receptor positive breast cancer in post menopausal women who have not had endocrine therapy before Formulary BNF 8.3
Gabapentin Liquid  Non-proprietary  Seizures, neuropathic pain Formulary BNF 4.8
Gamolenic Acid 

Efamast®  Epogam®   Evening Primrose Oil®  

Dietary supplement  
Gefitinib Iressa® Lung cancer, NSC, 2nd line.      NICE TA175 
Formulary  BNF 8.1
Gefitinib Iressa® Non-small-cell lung cancer that has progressed after prior chemotherapy. NICE TA374 


Formulary BNF 8.1

Gemcitabine infusion  Non-proprietary  In combination with carboplatin for treating the first recurrence of platinum‑sensitive ovarian cancer, as perNICE TA389  Formulary  BNF 8.1
Gentamicin & Hydrocortisone  Gentisone HC®    Eczematous inflammation in otitis externa Formulary BNF 12.1
Glasdegib with chemotherapy    Untreated acute myeloid leukaemia NICE TA646 - appraisal terminated Formulary BNF 8.1
Glucosamine Alateris®         
Osteoarthritis of the knee - NICE Do Not Do Recommendation Formulary BNF 10.1
 Gluten Free Food Products  Gluten Free Food Products  Coeliac disease or other gluten intolerances.  Link to  Commissioning  Statement
Golimumab Simponi®  BLACK for Methotrexate naive patients with Rheumatoid Arthritis. NICE TA224

RED as an option for Rheumatoid Arthritis NICE TA225, Psoriatic Arthritis NICE TA220 and Ankylosing Spondylitis NICE TA233

Formulary BNF 10.1
Golimumab  Simponi® Moderate to severe active ulcerative colitis.                   Position Statement Formulary  BNF 1.5
Grass pollen extract Grazax® 
Grass & tree pollen allergy.       New Drug Review
Formulary  BNF 3.4
 Haemophilus type b and Meningococcal group C conjugate vaccine  Menitorix  Adminstration in patients with rsepiratory conditions. Not recommended for prescribing on the NHS in Lancashire and South Cumbria. See supporting Document

Heliox® Heliox® Not commissioned for vocal chord dysfunction  
 Hepatitis B Vaccine    Travel vaccination  See Position   Statement
Hyaluronic Acid
Durolane®, Euflexxa®, Fermathron®, Hyalgan®,
Orthovisc®, Ostenil®,
Ostenil Plus®, RenehaVis®
Suplasyn®, Synocrom®, 
Synopsis®, Synvisc®,     SportVis®
Osteoarthritis (all joints) NICE CG177  (update of CG59) Formulary BNF 10.1
Hydrocortisone MR Plenadren®
Treatment of adrenal insufficiency
Formulary BNF 6.3
Hydrogen peroxide 1% cream
Skin infection, infected eczema
Formulary BNF 13.11
Ibrutinib with bendamustine and rituximab 

Relapsed or refractory chronic lymphocytic leukaemia after systemic therapy (terminated appraisal) NICE TA437

Formulary BNF 8.1.5
Ibrutinib Imbruvica 

Untreated chronic lymphocytic leukaemia without a 17p deletion or Tp53 mutation (terminated appraisal) Formulary BNF 8.1.5
Ibrutinib [with rituximab] Imbruvica Untreated chronic lymphocytic leukaemia (appraisal terminated) Not recommended for prescribing on the NHS in Lancashire NICE TA703 Formulary BNF 8.1.5
Ibrutinib [with obinutuzumab]
Imbruvica Untreated chronic lymphocytic leukaemia and small lymphocytic lymphoma in adults. (appraisal terminated) NICE TA702  Formulary BNF 8.1.5
Ibrutinib [with rituximab] Imbruvica   (with rituximab) for treating Waldenstrom's macroglobulinaemia - NICE TA608 - appraisal terminated Formulary BNF 8.1.5
Hereditary angioedema in patients with C1-esterase inhibitor deficiency.
Formulary BNF 3.4

Follicular lymphoma that is refractory to 2 prior treatments (terminated appraisal) 
Formulary BNF 8.1    
Idelalisib   Zydelic® 

 Chronic lymphocytic leukamia  Formulary BNF 8.1.5
Idelalisib  Zydelic®  Not recommended,within its marketing authorisation, for traeting Follicular lymphoma that has not responded to 2 prior lines of treatment in adults. NICE TA604 Formulary BNF 8.1
Osmotic laxative
Formulary BNF 1.6
Imatanib, high dose
GIST, unresectable/ metastatic NICE TA209
Formulary BNF 8.1
Imipramine  Non-proprietary Neuropathic Pain FormularyBNF 4.7
Imiquimod 3.75%
Actinic keratosis
Formulary BNF 13.8
Influenza Vaccine                                   (Intadermal)
9 or 15 microgram / strain
 Inositol Nicotinate   Hexopal®   Peripheral vascular disease.        NICE TA223 Formulary  BNF 2.6
 Insulin glargine/lixisenatide  Suliqua®▼  In combination with metformin for the treatment of adults with T2DM to improve glycaemic control when this has not been provided by metformin alone or metformin combined with another oral glucose lowering medicinal product or with basal insulin Formulary BNF 6.1
 Intrabeam radiotherapy system   Adjuvant treatment of early breast cancer NICE TA501  
 Japanese Encephalitis Vaccine    Travel vaccination  See Position   Statement
 Ketamine (oral)  unlicensed

 Chronic pain - limited clinical evidence. 

 Formulary BNF  4.7
Ketamine infusion    Non - fromulary  Formulary BNF  4.7
Ketotifen eye drops 0.25mg/ml Ketofall ®   Symptomatic treatment of seasonal allergic conjunctivitis   Formulary BNF 11.4 
In combination with an aromatase inhibitor for women who have been through the menopause and who have metastatic breast cancer that is hormone receptor and HER2 positive. NICE TA257
 Formulary BNF 8.1
Lenalidomide Revlimid®  Untreated multiple myeloma - appraisal terminated - NICE TA603 Formulary BNF 8.2.4
Lesinurad  Ziurampic®   Chronic hyperuricaemia in adults with gout - not recommended by NICE TA506  Formulary BNF
 Formulary  BNF 3.4
Levomepromazine tablets 6mg Non -proprietary  Pain, nausea, agitation in palliative care.  Formulary  BNF 4.6
Levothyroxine Liquid   Hypothyroidism   Formulary BNF 6.2
Lidocaine/Prilocaine Spray Fortacin®  
 Primary premature ejaculation in adult men Formulary BNF 7.4.5
Liothyronine 20mcg tablets
  Add  on treatment for refractory hypothyroidism despite adequate monotherapy with levothyroxine
 Formulary  BNF 6.2
 Liothyronine 20mcg tablets   Monotherapy for the chronic management of hypothyroidism - not licensed. Not for use by the NHS in Lancashire  
 Liothyronine 20mcg tablets    Management of resistant depression - not licensed, Not for use by the NHS in Lancashire  
Lipitor® Lipitor® Generic prescribing only  Formulary BNF 2.12
Liraglutide Saxenda▼
Adjunct to reduced-calorie diet and increased physical activity for weight management in adult patients 
 Formulary BNF 6.1
Loprazolam  Non-proprietary
Hypnotic  Formulary  BNF 4.1
Hypnotic  Formulary BNF 4.1
Losartan and                   Hydrochlorothiazide 
Cozaar Comp®
 Formulary  BNF 2.5

Generic Prescribing Only
 Formulary BNF 1.3

Acute agitation and disturbed behaviours associated with schizophrenia and bipolar disorder NICE TA286
 Formulary BNF 4.2
Cystic Fibrosis in people 12 years and older who are homozygous  for the F508del mutation
 Formulary BNF 3.7
Discontinued  Formulary  BNF 10.1

ICAPS®,                           Vitalux Plus®

Dietary supplement
 ICAPS - New Drug Review
Primary insomnia in adults 
 Formulary  BNF 4.1
Meningitis Vaccine    Travel vaccination  See Position   Statement
Relistor® Opioid-induced  bowel dysfunction in people with advanced illness receiving palliative care NICE TAG277  & NICE TA468
 Formulary BNF 1.6
 Minocycline tablet    Non-formulary - in line with NHSE low priority prescribing commissioning guidance  Formulary BNF 5.1
Minocycline MR
Acnamino®MR, Minocin MR®,  Sebomin MR®
 FormularyBNF 5.1
Generic Prescribing Only
 Formulary BNF 4.9
Modulen IBD® 
Modulen IBD® 
Food supplement
 Formulary BNF 
Mucositis from cancer therapy
 Formulary BNF 12.3 
Mycophenolate Sodium  Myfortic®, Ceptava®
Immunosuppressive therapy for kidney transplant in adults NICE TA481 (adults) NICE TA482 (Children and young adults) Formulary BNF 8.2

Naproxen & Esomeprazole

Pain & inflammation
 Formulary BNF 10.1
Naltrexone-bupropion Mysimba®    Management of overweight and obesity in adults  Formulary

Nalorex®                   Opizone®

Treatment of advanced ovarian cancer
Nebulised Amoxycillin

Not licensed for use via nebulised route for bronchiectasis or any other indication
Untreated advanced or metastatic squamous non-small-cell lung cancer. NICE TA411
 Formulary BNF 8.2
Nefopan  all brands  Non opioid analgesia  Formulary BNF 4.7
Nicotine Strips
NiQuitin Strips®
Nicotine Replacement Therapy
 Formulary BNF 4.10
Nivolumab Opdivo®  Not recommended within its marketing authorisation , for treating locally advanced unresectable or metastatic urothelial carcinoma in adults - as per NICE TA530 Formulary BNF 8.1.5
Prophylaxis of spontaneous bacterial peritonitis
 Formualry BNF 5.1
 Nortriptyline Non-proprietary Depressive illness  Formulary BNF 4.3

Chronic lymphocytic leukaemia, NICE TA202

 Formulary  BNF 8.2
 Ofatumumab   Arzerra®   Chronic lymphocytic leukaemia (with chemotherapy)   Formulary BNF8.2.3

 Olanzapine Embonate Depot  Injection

 Formulary BNF 4.2

BLACK for children under 6 . RED for adults and children over 6.  NICE TA278

 Formulary BNF 3.3
 Omalizumab   Xolair®  Chronic rhinosinusitis with nasal polyps.
 Not recommended for prescribing on the NHS   in Lancashire. NICE TA678 (Appraisal   terminated)
 Formulary BNF 3.4.
 Omega-3 acid ethyl esters
 Omacor®  Hyper-triglyceridaemia. NHS England has   identified this product as an item that should   not  be routinely prescribed in primary care. It is   available to purchase over the counter  Formulary BNF 2.12
 Omeprazole liquid  Non-proprietary  Gastro-oesophageal reflux Formulary BNF 1.3.5
 Ospemifene  Senshio® Moderate to severe symptomatic vulvar and   vaginal atrophy in post-menopausal women   who are not candidates for local vaginal   oestrogen therapy Formulary BNF 7.2.1
 Oxycodone hydrochloride/    naloxone hydrochloride
 Restless Legs Syndrome
 Formulary  BNF 4.9
 RLS Guidelines 
 Oxycodone hydrochloride/         naloxone hydrochloride
 Severe pain
 Formulary BNF 4.7
 Ozanimod  Zeposia® Relapsing–remitting multiple sclerosis in adults with clinical or imaging features of active disease. Not recommended for prescribing on the NHS in Lancashire - NICE TA706  Formulary BNF 8.2
 Omega-3 acid ethyl esters
Post Myocardial Infarction. NHS England has identified this product as an item that should  not be routinely prescribed in primary care. It is available to purchase over the counter
 Formulary BNF 2.12

Abraxane®,                   Taxol®

Breast cancer, early (NICE TA108)
 Formulary BNF 8.1
Paclitaxel as albumin-bound nanoparticles with carboplatin for untreated non-small-cell lung cancer (terminated appraisal). NICE TA362 
 Formulary BNF 8.1
Padeliporfin Tookad®  Padeliporfin is not recommended, within its marketing authorisation, for untreated, unilateral, low-risk prostate cancer in adults - NICE TA546  Formulary BNF 
Paliperidone tablets
 Formulary BNF 4.2
Panitumumab (in combination with chemotherpay)
Metastatic colon cancer (appraisal terminated)  NICE TA240 updated March 17
 Formulary  BNF 8.1
Monotherpay of metastatic colorectal cancer 2nd line (NICE TA242)
 Formulary  BNF  8.1.5
Proton pump inhibitor
 Formulary  BNF 1.3
Secondary hypoparathyroidism
 Formulary  BNF 9.6

Age-related macular degeneration, (NICE TA155)

 Formulary  BNF 11.8
Gout (NICE TA291)
 Formulary BNF 10. 
Pegylated liposomal irinotecan Onivyde  Pancreatic cancer in adults  after gencitabine (NICE TA440) Formulary BNF 8.1
Pembrolizumab Keytruda®  Not recommended as an option to treat relapsed or erfarctory classical Hodgkin lymphoma in adults who have had auologous atem cell transplant and brentuximab vedotin as per NICE TA540 Formulary BNF 8.1
 Pembrolizumab Keytruda® Recurrent or metastatic squamous cell carcinoma of the head and neck after platinum-based chemotherapy (NICE TA570) - appraisal terminated.
NOT recommended for prescribing on the NHS in Lancashire
Formulary BNF 8.1.5
 Pembrolizumab  Keytruda® Not recommended, with axitinib, for untreated advanced renal cell carcinoma NICE TA650 Formulary BNF 8.1.5
 Pembrolizumab  Keytruda®  Not recommended for prescribing on  the   NHS in Lancashire NICE TA674 [appraisal terminated]   Formulary BNF 8.1
 Pembrolizumab   Keytruda® Locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy in adults - NICE TA692 [replaces NICE TA519] Not recommended for prescribing on  the   NHS in Lancashire  Formulary BNF 8.1

Peripheral vascular disease, (NICE TA223)

 Formulary BNF 2.6
 Perindopril Arginine 
Use generic perindopril erbumine
 Formulary  BNF 2.5
 Pioglitazone15mg/                   Metformin 850mg
Type 2 diabetes mellitus
 Formulary BNF 6.1
 Pitolisant  Wakix®  Narcolepsy with or without cataplexy in adults  Formulary BNF 4.4
 Plavix®   Generic prescribing only - Plavix may be supplied against a generically written prescription.
Formulary BNF 2.9
 Pomalidomide  Imnovid®  Relapsed or refractory multiple myeloma (with bortezomib and dexamethasone) - NICE TA602 - appraisal terminated Formulary BNF 8.2.4
 Potassium hydroxide 5%  Molludab ®  Molluscum  Formulary BNF
 Prasterone Intrarosa®  Vulvar and vaginal atrophy in postmenopausal women having moderate to severe symptoms  Formulary BNF 7.2
Generic prescribing only
 Formulary BNF 2.6
 Prednisolone Soluble All brands
Suppression of inflammation and allergic disorders
 Formulary BNF 6.3
 Prednisolone 5mg EC
Use non-EC tabs, where possible, 2.5mg EC tabs remain GREEN
 Formulary BNF 6.3
Moderate to severe rheumatoid arthritis 
 Formulary BNF 6.3
Generalised Anxiety disorder       Joint Formulary for  Psychotropic Medication  LCFT
 Formulary BNF 4.3
Epilepsy only 
 Formulary BNF 4.8
Pregabalin Liquid  all brands Epilepsy, GAD, neuropathic pain   Formulary BNF 4.7
Progesterone Cream 

 Formulary BNF 6.4
Proton pump inhibitor
 Formulary BNF 1.3
Rabies vaccine   Travel vaccination  See Position   Statement
Advanced gastric cancer or gastro-oesophageal junction adenocarcinoma previously treated with chemotherapy. 
 Formulary BNF 8.3 
locally advanced or metastatic non-small-cell lung cancer , in combination with docetaxel, in adults whose disease has progressed after platinum-based chemotherapy. NICE TA403 
 Formulary BNF 8.1
With erlotinib for untreated EGFR-positive metastatic non-small-cell lung cancer NICE TA635 - terminated appraisal Formulary BNF 8.1.5
Ramucirumab Cyramza® Unresectable hepatocellular carcinoma in adults who have had sorafenib - NICE TA609 - terminated appraisal Formulary BNF 8.1
Ranibizumab Lucentis®  Diabetic retinopathy - NICE TA637 - terminated appraisal Formulary BNF 11.8.2
Recombinant human parathyroid hormone    Hypoparathyroidism - appraisal terminated Formulary 6.6
Metastatic colorectal cancer after treatment for metastatic disease (terminated appraisal) NICE TA334
Formulary BNF 8.1
Regorafenib   Stivarga® Previously treated advanced hepatocellular carcinoma in adults - not recommended  as an option in NICE TA514 Formulary BNF 8.1
Black for Adjunct treatment of Hypertension
Formulary BNF 2.5
Superficial bacterial infections
Formulary BNF 13.10
Osteoporosis, primary prevention (NICE TA160)
 Formulary BNF 6.6
 Formulary BNF 8,2
Multi drug resistant, steroid dependent, frequently relapsing nephrotic syndrome
 Formulary BNF 8.2
Resistant coeliac disease
 Formulary BNF 8.2
Safinamide Xadago®
 Idiopathic Parkinson's disease
New Medicines Recommendation
 Formulary  BNF 4.9
Salbutamol SR tablets
Ventmax SR®
 Formulary BNF 3.1
Salmeterol MDI
 Formulary BNF 3.1
Sea Water nasal drops
Nasal decongestant
 Formulary BNF 12.2
Oral food supplement
Post bariatric surgery - patient to purchase own. link to Guidelines
 Formulary BNF 9.5
Selinexor [with low dose dexamethasone]   Refractory multiple myeloma in adults. Appraisal terminated. Not recommended for prescribing on the NHS in Lancashire NICE TA700  Formulary BNF 8.1.5
 Formulary BNF 4.2
Silicone Gel Sheets
Scarsil®, Silgel STC-SE®,   Dermatix®, Ciltech®,          NewGel®,  Kelocote®,        Advasil Conform ®,      Cica-Care®
Hypertrophic and keloid scarring
 Formulary  woundcare
Silk Garments

Dermasilk®,         Dreamskin®,                Skinnies Silk TM

Eczema/atopic dermatitis
 ELHE Position statement
Simeprevir in combination with sofosbuvir for treating genotype 1 or 4 chronic hepatitis C (terminated appraisal). NICE TA361
 Formulary BNF 5.3
Simvastatin Suspension
Rosemont brand
Primary hypercholesterlaemia
 Formulary BNF 2.12

Asymptomatic or minimally symptomatic metastatic hormone-relapsed prostate cancer as by NICE TA332
 Formulary BNF 8.3
Sirolimus Rapamune® Immunosuppressive therapy for kidney transplant in adults NICE TA481 (adults) NICE TA482 (Children and young adults)  Formulary BNF 8.2
Sitagliptin & Metformin

Type II Diabetes, (prescribe drugs separately)

 Formulary BNF 6.1
 Sodium Chloride nebules 0.9%    For dilution of solutions for nebulisation.  Formulary BNF 3.7
Sodium Chondroitin                 sulphate 2% bladder washout
Painful bladder syndrome
 Formulary BNF 7.4
Sodium Hyaluronate Injection
Durolane®                   Hyalgan®                        Ostenil®

BLACK for OA of the knee.           RED for all other indications

 Formulary BNF 10.1
Sodium Oxybate
Narcolepsy with cataplexy             New Medicine  Recommendation
 Formulary BNF 4.1
Solifenacin 6mg/                         tamsulosin 400mcg MR
Symptoms associated with benign prostatic hyperplasia
 Formulary  BNF 7.4
Renal cell carcinoma (NICE TA178)
 Formulary BNF 8.1

St Johns Wort (Hypericum)

 Formulary  BNF 4.3
Renal cell carcinoma (NICE TA178)
 Formulary BNF 8.1
Tacrolimus Prolonged Release Advagraf®, Envarsus  Immunosuppressive therapy for kidney transplant in adults NICE TA481 (adults) NICE TA482 (Children and young adults)  Formulary BNF 8.2
Benign prostatic hyperplasia
 (NICE TA273)
 Formulary BNF 7.4
Tadalafil once daily
Post prostatectomy
 Formulary BNF 7.4
Tadalafil 2.5, 5mg
Erectile Dysfunction
 Formulary BNF 7.4
Tafamidis Vyndaqel®
Transthyretin amyloidosis with cardiomyopathy. Not recommended for prescribing on the NHS in Lancashire.
 Formulary BNF 4.9
Tamsulosin MR Tablets
Flomaxtra XL®
Benign prostatic hyperplasia
 Formulary  BNF 7.4
Tapentadol MR
Palexia SR®
Not recommended for use as a treatment option  for intractable neuropathic pain in non-palliative care patients. Link to  Position Statement
 Formulary  BNF 4.7.2

Tapentadol MR
Palexia SR®
Not recommended for use as a treatment for non-specific pain. Link to  Position Statement
Formulary  BNF 4.7

Supplementation in Cystic Fibrosis Liver Disease

Teduglutide Revestive®   Short bowel syndrome. Appraisal terminated. Not recommended for prescribing on the NHS in Lancashire.  Formulary BNF 1.0
Chronic Hepatits B 
 Formulary BNF 5.3
Renal cell carcinoma (NICE TA178)
 Formulary BNF 8.1

Mantle Cell Lymphoma, (NICE TA207)

 Formulary BNF 8.1
Tenofovir alafenamide   Chronic hepatitis B (terminated appraisal) NICE TA 435  Formulary BNF 8.2.3

BLACK for treatment of osteoporosis in MEN at increased risk of fractures, RED for for  prevention of osteoporotic fragility fractures in postmenopausal women.(NICE TA160/161)

 Formulary BNF 6.6

Testosterone gel
Female sexual dysfunction post oophorectomy or primary ovarian failure
 LMMG new medicine assessment

Testosterone patches                        Testosterone mucoadhesive    buccal tablets.                           Testosterone gel

Striant SR®

Hypoactive sexual desire in surgically induced menopause. Link to New Drug Review
Formulary BNF 6.4

Testosterone mucoadhesive   buccal tablets

Striant SR®
 Formulary BNF 6.4

Testosterone Patches Testosterone mucoadhesive  buccal tablets

Testosterone gel


Striant SR®

Male low libido
 Formulary 6.4
Tick Borne Encephalitis vaccine    Travel vaccination  See Position   Statement
 Formulary BNF 6.5
Topotecan, IV
Lung cancer, small cell (NICE TA184)
 Formulary BNF 8.1
Topotecan, IV
Not recommended within its marketing authorisation for treating the first recurrence of platinum‑sensitive ovarian cancer. NICE TA389
 Formulary BNF 8.1
Topotecan, IV
Recurrent platinum‑resistant or platinum‑refractory ovarian cancer (not recommended) in NICE TA389
 Formulary BNF 8.1

Relapsed platinum sensitive ovarian cancer when in combination with PLDH. (NICE TA222)

 Formulary BNF 8.1
Trabectedin in combination with PLDH is not recommended within its marketing authorisation for treating the first recurrence of platinum‑sensitive ovarian cancer. NICE TA389
 Formulary  BNF 8.1
Tramadol and Paracetamol
Moderate to severe pain
 Formulary  BNF 4.7
In combination with an aromatase inhibitor for women who have been through the menopause and who have metastatic breast cancer that is hormone receptor and HER2 positive (NICE TA257)
 Formulary BNF 8.1
Triamcinolone Hexadetonide Injection

Approved for use for JIA only in ELHE - Not approved for other indications
 Formulary BNF 10.1
 Trifluridine-tipiracil  Lonsurf  Metastatic gstric cancer or gastro-oesophageal junction adenocarcinoma NICE TA669  Fomulary BNF 8.1
Trimipramine    Depressive illness/neuropathic pain  Formulary BNF 4.3
Ulipristal  Esmya®  Intermittent treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age. See MHRA Alert February 2018  Formulary 6.4
COPD  Formulary BNF 3.1
 Valsartan and Amlodipine
 Formulary  BNF 2.6
 Vandetanib  Caprelsa Vandetanib is not recommended, within its marketing authroisation , for treating aggressive and symtomatic medullary thyroid canmer in adults as in NICE TA550  Formulary BNF 8.
Those patients prescribed this before July 2012 may continue on it
 Formulary BNF 7.4
 Vernakalant  Brinavess  Rapid conversion of recent onset atrial   fibrilation to sinus rhythm in adults . Not   recommend for prescribing on the NHS in   Lancashire. NICE TA675 [appraisal terminated]  
Formulary BNF 2.3.2
Generic Prescribing Only
 Formulary BNF 7.4
Urothelial tract carcinoma
 Formulary BNF 8.1

Type II Diabetes / Use sitagliptin 

 Formulary  BNF 6.1
 Vismodegib  Erivedge  Basal cell carcinoma  Formulary BNF 8.1
 Vitamin D capsules
Vitamin D deficiency
 Formulary BNF 9.6
 Vitamins, minerals, supplements, herbal and homeopathic medicines without a product licence    Link to position statement  Formulary BNF 9
Yellow fever Vaccine    Travel vaccination  See Position   Statement
Oral food supplement
Post bariatric surgery - patient to purchase own
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