| Formulary Chapter 13: Skin - Full Chapter
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| Notes: |
Specials Recommended by the British Association of Dermatologists for Skin Disease
Most prescribing uses licensed medicines whose safety and efficacy are assured. For many common dermatological diseases including psoriasis and eczema, the range of licensed medicines is limited. As a result, Dermatology prescribing may rely significantly on unlicensed creams and ointments (known as ‘Specials’) containing tars, dithranol, salicylic acid, steroids and other active constituents in a range of concentrations and bases. This is of particular concern in primary care where lack of effective price controls and a mechanism to ensure independent scrutiny of product quality has increased costs and concern about standards. To address these concerns, and help optimise quality of care, adherence to the revised British Association of Dermatologists (BAD) list of preferred Specials (2018) is encouraged. |
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| Details... |
| 13.02 |
Emollient and barrier preparations |
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| 13.02 |
Soap substitute |
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| 13.02.01 |
Emollients |
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Aqueous Cream BP
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Formulary
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- Due to the SLS content to be used as a soap substitute only.
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Aveeno® (Cream)
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Formulary
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Cetraben®
(Cream and ointment)
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Formulary
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DoubleBase®gel
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Formulary
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E45®
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Formulary
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Emulsifying Ointment BP
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Formulary
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Epaderm® emollient
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Formulary
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- Hydromol® Ointment is made to the same formula and is more cost effective.
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Epimax®
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Formulary
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 MHRA Drug Safety Update: Epimax Ointment and Epimax Paraffin-Free Ointment: reports of ocular surface toxicity and ocular chemical injury
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Hydromol® ointment
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Formulary
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- This product is also known locally as ‘Emulsifying Ointment RVI
Formula’. It is softer than emulsifying ointment BP. Epaderm ointment is
made to the same formula, but is more expensive.
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Hydrous® ointment
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Formulary
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Oilatum® cream
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Formulary
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Oilatum® Junior cream
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Formulary
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Paraffin sterile liquid
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Formulary
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QV®
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Formulary
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- Approved for used in radiotherapy only.
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ZeroAQS®
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Formulary
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- SLS free alternative to Aqueous Cream.
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Zerobase®
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Formulary
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Zerocream®
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Formulary
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- Alternative to E45® Cream.
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Zerodouble® Gel
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Formulary
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- Alternative to Doublebase gel.
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Zeroveen® cream
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Formulary
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White Soft Paraffin BP
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Formulary
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Yellow Soft Paraffin BP
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Formulary
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AquaGel lubricating jelly
(oil-free)
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Formulary
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- Approved for the relief of dryness of the nose, lips and face when a patient is using oxygen via nasal prongs, CPAP masks etc
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| 13.02.01 |
Emollients - preparations containing urea |
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Balneum® Plus cream
(Emollient preparation containing Urea)
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Formulary
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Calmurid® emollient
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Formulary
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| 13.02.01 |
Emollients - with antimicrobials |
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Dermol®
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Formulary
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Dermol® 500 Lotion
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Formulary
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| 13.02.01.01 |
Emollient bath and shower preparations |
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Bath and shower preparations for dry and pruritic skin conditions
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Formulary
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 Emollient Prescribing Guideline and Formulary North East North Cumbria
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Hydromol® bath and shower
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Formulary
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- For inpatient use only as per Trust Moisture-Associated Tissue Damage (MASD) guidelines
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| 13.02.02 |
Barrier preparations |
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Barrier preparation (Cavilon®Film)
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Formulary
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Dimeticone (Siopel®)
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Formulary
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Drapolene®
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Formulary
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Medi Derma-Pro Foam & Spray Skin Cleanser And Skin Protectant Ointment (Medi Derma-Pro Foam & Spray Skin Cleanser®)
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Formulary
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Medi Derma-S barrier film (Medi Derma-S ®barrier film)
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Formulary
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Sorbaderm® cream
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Formulary
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- 2g, 28g & 92g barrier cream, 28ml pump spray, sterile 1ml no
sting barrier film foam applicator, sterile 3ml no sting
barrier film foam applicator
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Deegan's ointment
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 Unlicensed
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Sucralfate cream
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Unlicensed
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- For limited use around gastrostomies when wound breakdown is thought to be aggravated by leakage of gastric acid.
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| 13.02.02 |
Community |
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| 13.02.02 |
Hospital |
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
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Description |
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Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment.
In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.
For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing. |
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Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement.
The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber.
If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care. |
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Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs. |
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Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care. |
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NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria. |
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UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review. |
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NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status. |
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