Formulary Chapter 14: Immunological products and vaccines - Full Chapter
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Notes: |
Please refer to the Public Health England Green Book on vaccines for the most up to date information on the recommended preparations and use.
The use of travel vaccines in primary care is not recommended in line with NHS England Guidance on items which should not routinely be prescribed in primary care |
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Details... |
14.01 |
Active immunity |
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14.01 |
Immunisation schedule |
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14.02 |
Passive immunity |
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14.03 |
Storage and use |
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14.04 |
Vaccines and antisera |
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Japanese Encephalitis Vaccine (Ixiaro®)
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Formulary
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Tuberculin Purified Protein Derivative
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Formulary
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14.04 |
Anthrax vaccine |
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14.04 |
BCG vaccines |
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BCG vaccine (Bacillus calmette-guerin vaccine)
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Formulary
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(BCG Vaccine, Dried/Tub/BCG) 1ml multidose vials containing freeze dried powder for preparing intradermal injections
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14.04 |
Botulism antitoxin |
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Botulism antitoxin
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Formulary
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1 vial of Botulism antitoxin trivalent (equine) A B& E 5000 units injection
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14.04 |
Cholera vaccine |
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14.04 |
COVID-19 vaccine |
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COVID-19 vaccines
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Formulary
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- Comirnaty® Original / Omicron BA.4-5
- Comirnaty® 10 Concentrate for children
- Comirnaty® 3 (THREE) Concentrate
- VidPrevtyn Beta®
- Spikevax® Original/Omicron BA.4-5
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MHRA Drug Safety Updates: COVID-19 Vaccines
SPS COVID-19 vaccine resources
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14.04 |
Diphtheria vaccines |
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Absorbed Diptheria Low Dose, Tetanus, and Poliomyelitis vaccine
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Formulary
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Absorbed Diptheria Low Dose, Tetanus, Pertussis and Poliomyelitis vaccine
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Formulary
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Absorbed Diptheria, Tetanus, Pertussis and Poliomyelitis vaccine
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Formulary
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14.04 |
Haemophilus influenzae type B vaccine |
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Haemophilus influenzae type B
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Formulary
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Haemophilus Influenzae type b & Meningococcal Group C Conjugate vaccine
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Formulary
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14.04 |
Hepatitis A vaccine |
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Hepatitis A vaccine
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Formulary
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Hepatitis A vaccine with Hepatitis B vaccine (Twinrix®)
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Formulary
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14.04 |
Hepatitis B vaccine |
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Hepatitis B vaccine
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Formulary
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14.04 |
Human papilloma virus vaccine |
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Human papilloma virus (HPV) vaccine
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Formulary
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14.04 |
Influenza vaccine |
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Influenza vaccine
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Formulary
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14.04 |
Measles vaccine |
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14.04 |
Measles, Mumps and Rubella (MMR) vaccine |
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Measles, Mumps and Rubella Vaccine, Live (MMR)
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Formulary
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14.04 |
Meningococcal vaccines |
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14.04 |
Mumps vaccine |
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14.04 |
Pertussis vaccine |
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14.04 |
Pneumococcal vaccines |
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Pneumococcal polysaccharide conjugate vaccine
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Formulary
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14.04 |
Poliomyelitis vaccines |
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Poliomyelitis Vaccine Inactivated (Salk) (Inactivated poliomyelitis vaccine (IPV))
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Formulary
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Poliomyelitis Vaccine Live (oral)
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Formulary
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14.04 |
Rabies vaccine |
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Rabies vaccine
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Formulary
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14.04 |
Rotavirus vaccine |
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Rotavirus vaccine (Rotarix®)
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Formulary
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14.04 |
Rubella vaccine |
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14.04 |
Smallpox vaccine |
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14.04 |
Tetanus vaccines |
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Tetanus vaccine
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Formulary
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14.04 |
Tick-borne encephalitis vaccine |
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Tick-borne encephalitis vaccine
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Formulary
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14.04 |
Typhoid vaccines |
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Typhoid vaccine
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Formulary
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14.04 |
Varicella-zoster vaccine |
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Varicella Zoster vaccine (Zostavax®)
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Formulary
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Varicella-zoster vaccine
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Formulary
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14.04 |
Yellow fever vaccine |
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Yellow fever vaccine (Live)
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Formulary
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Only available from designated Yellow Fever Vaccination Centres.
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MHRA Drug Safety Update (April 2019): Yellow fever vaccine (Stamaril) and fatal adverse reactions: extreme caution needed in people who may be immunosuppressed and those 60 years and older
MHRA Drug Safety Update (Nov 2019): Yellow fever vaccine: stronger precautions in people with weakened immunity and in those aged 60 years or older
MHRA Drug Safety Update (Nov 2021): Yellow fever vaccine (Stamaril): new pre-vaccination checklist
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14.05 |
Immunoglobulins |
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14.05 |
Normal immunoglobulin |
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14.05 |
Specific immunoglobulins |
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14.05 |
Anti-D (Rho) immunoglobulin |
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14.05 |
Interferons |
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14.05.01 |
Normal immunoglobulin |
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Normal Immunoglobulin (Cuvitru®)
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Formulary
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Normal Immunoglobulin (Flebogamma®DIF)
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Formulary
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Normal Immunoglobulin (Gammanorm®)
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Formulary
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- 16.5% - 1g, 1.65g, 2g, 3.3g, 4g & 8g
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Normal Immunoglobulin (Gammunex®)
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Formulary
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Normal Immunoglobulin (Intratect®)
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Formulary
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- 5% - 1g, 2.5g, 5g & 10g
- 10% - 1g, 5g, 10g & 20g
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Normal Immunoglobulin (Iqymune®)
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Formulary
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Normal Immunoglobulin (Kiovig®)
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Formulary
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- 10% - 1g, 2.5g, 5g, 10g, 20g & 30g
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Normal Immunoglobulin (Octagam®)
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Formulary
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- 5% - 5g & 10g
- 10% - 2g, 5g, 10g & 20g
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Normal Immunoglobulin (Privigen®)
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Formulary
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- 10% - 2.5g, 5g, 10g & 20g
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Normal Immunoglobulin (Subcuvia®)
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Formulary
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Normal immunoglobulin for Intramuscular use
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Formulary
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14.05.02 |
Disease-specific immunoglobulins |
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Hepatitis B immunoglobulin (HBIG)
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Formulary
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- 200 international units - for infant use
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Hepatitis B immunoglobulin (Hepatect CP®)
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Formulary
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Tetanus immunoglobulin
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Formulary
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Varicella-Zoster immunoglobulin (VZIG)
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Formulary
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14.05.03 |
Anti-D (Rho) immunoglobulin |
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Anti-D (Rh0) Immunoglobulin (Rhophylac®)
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Formulary
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- Approved for the prevention of RhoD sensitisation in
women in line NICE.
- Approved for use by haematologists in appropriate patients with immune thrombo-cytopenia. The 1,500 and 5,000 unit vials (WinRho) are much more expensive than the other formulations and should only be used on advice from haematologists. It is the only formulation licensed for use in immune thrombocytopaenia.
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Anti-D (Rh0) Immunoglobulin (WinRho SDF®)
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Formulary
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- Approved for the prevention of RhoD sensitisation in
women in line NICE.
- Approved for use by haematologists in appropriate patients with immune thrombo-cytopenia. The 1,500 and 5,000 unit vials (WinRho) are much more expensive than the other formulations and should only be used on advice from haematologists. It is the only formulation licensed for use in immune thrombocytopaenia.
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14.06 |
International travel |
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The use of travel vaccines in primary care is not recommended in line with NHS England Guidance on items which should not routinely be prescribed in primary care |
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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
Status |
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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