| Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
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| Chapter Links... |
 County Durham and Darlington Adult Bladder and Bowel formulary First Line Prescribing Guide 2023 |
| NICE NG118: Renal and ureteric stones: assessment and management |
| NICE NG123: Urinary incontinence and pelvic organ prolapse in women: management |
| NICE NG126: Ectopic pregnancy and miscarriage: diagnosis and initial management |
 North of Tyne, Gateshead and North Cumbria Urinary Continence Enablement Products and Devices Formulary Guideline (October 2024) |
| Tees Urinary Continence Formulary February 2020 |
| Details... |
| 07.04.04 |
Bladder instillations and urological surgery |
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Sodium hyaluronate 40mg in 50ml solution (Cystistat®)
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Formulary
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- For instillation into the bladder.
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Sodium hyaluronate (1.6%)/sodium chondroitinsulphate (2%) (Ialuril® )
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Formulary
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- Ialuril® is a 50ml solution for instillation into the bladder approved as second line treatment in patients who have failed Cystistat.
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Chondroitin sulfate (Gepan Instill®)
(Bladder Installation)
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Formulary
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- Approved the treatment of:
- Interstitial cystitis/painful bladder syndrome
- Radiation cystitis
- Recurring bacterial cystitis
- Overactive bladder
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Glycine 1.5% solution
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Formulary
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- 1.5% large volume solutions (up to 3 litres).
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Sodium chloride 0.9% solution
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Formulary
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- Large volume solutions (up to 3 litres).
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Sodium Hyaluronate (Hyacyst®)
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Formulary
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Water
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Formulary
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- Large volumes - up tp 3 litres.
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Whitmore cocktail
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 Unlicensed
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- Whitmore cocktail is a 60ml bladder installation containing hydrocortisone 100mg, heparin Sodium 10,000units, and bupivacaine 50mg in Sodium Chloride 0.9%.
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| 07.04.04 |
Urological surgery |
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| 07.04.04 |
Maintenance of indwelling urinary catheters |
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Catheter Patency Solutions
(Chlorhexidine 0.02%)
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Formulary
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- Chlorhexidine 0.02% (1 in 5,000) solution in 100ml sachets.
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Catheter Patency Solutions
(Sodium chloride 0.9%)
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Formulary
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- Sodium chloride 0.9% solution in 100ml sachets.
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Catheter Patency Solutions (Urotainer Twin Solution R®)
(Solution R)
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Formulary
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- Solution R 2 x 30ml sachets (citric acid 6%, gluconolactone 0.6%, magnesium carbonate 2.8%, disodium edetate 0.01%)
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Catheter Patency Solutions (Urotainer Twin Suby G®)
(Solution G)
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Formulary
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- Solution G 2 x 30ml sachets (citric acid 3.23%, magnesium oxide 0.38%,
sodium bicarbonate 0.7%, disodium edetate 0.01%)
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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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