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 Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
Chapter Links...
Link   County Durham and Darlington Adult Bladder and Bowel formulary First Line Prescribing Guide 2023
Link   NICE NG118: Renal and ureteric stones: assessment and management
Link   NICE NG123: Urinary incontinence and pelvic organ prolapse in women: management
Link   NICE NG126: Ectopic pregnancy and miscarriage: diagnosis and initial management
Link   North of Tyne, Gateshead and North Cumbria Urinary Continence Enablement Products and Devices Formulary Guideline (October 2024)
Link   Tees Urinary Continence Formulary February 2020
 Details...
07.03.01  Expand sub section  Combined hormonal contraceptives
Combined Hormonal Contraceptives - oral
(Standard oestrogen - 30 or 35 micrograms ethinylestradiol)
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Green

First Choice

  • Rigevidon® (ethinylestradiol 30 microgram/levonorgestrel 150microgram)

Alternatives

  • Cilique® (ethinylestradiol 35 microgram/norgestimate 250microgram)
  • Femodene® (ethinylestradiol 30 microgram/gestodene 75 microgram)
  • Femodene® ED (ethinylestradiol 30 microgram/gestodene 75 microgram)
  • Gedarel 30/150® (ethinylestradiol 30 microgram/desogestrel 150 microgram)
  • Levest® (ethinylestradiol 35 microgram/norgestimate 250microgram)
  • Lizinna® (ethinylestradiol 35 microgram/norgestimate 250 microgram)
  • Loestrin 30® (ethinylestradiol 30 microgram/ norethisterone 1.5mg)
  • Lucette® (ethinylestradiol 30 microgram/drospirenone 3mg)
  • Marvelon® (ethinylestradiol 30 microgram/desogestrel 150 microgram)
  • Microgynon® 30 (ethinylestradiol 30 microgram/levonorgestrel 150 microgram)
  • Microgynon® ED (ethinylestradiol 30 microgram/levonorgestrel 150 microgram)
  • Millinette 30/75® (ethinylestradiol 30 microgram/ gestodene 75 microgram)
  • Ovranette® (ethinylestradiol 30 microgram/levonorgestrel 150microgram)
  • Ovysmen® (ethinylestradiol 35 microgram/norethisterone 500 microgram
 
 
Combined Hormonal Contraceptives - oral
(Phased formulations - standard dose 30 microgram oestrogen)
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Green
  • Logynon®
  • Logynon® ED
  • Tri-Regol®
 
 
Combined Hormonal Contraceptive - patch (Evra)
(Standard strength)
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Green

  • Evra® are self-adhesive patches releasing approximately 20 micrograms ethinylestradiol and 150 micrograms norelgestromin/24 hours.

    • Approved for use by a small number of women with gastrointestinal absorption problems or with compliance issues.



 
 
Estradiol valerate plus dienogest  (Qlaira®)
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Green plus

  • Each wallet (28 film-coated tablets) contains in the following order:
    2 dark yellow tablets each containing 3 mg estradiol valerate
    5 medium red tablets each containing 2 mg estradiol valerate and 2 mg dienogest
    17 light yellow tablets each containing 2 mg estradiol valerate and 3 mg dienogest
    2 dark red tablets each containing 1 mg estradiol valerate

  • Approved for
    • women who need HRT as well as contraceptive pill, and
    • for heavy menstrual bleeding (HMB)
 
 
Ethinylestradiol and drospirenone (Eloine®)
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Green
  • 20mcg ethinylestradiol and 3mg drospirenone
 
 
Syreniring®
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Green plus

  • Ethinylestradiol 2.7 mg, Etonogestrel 11.7 mg vaginal ring

 
 
Co-Cyprindiol 2000/35 - cyproterone Acetate 2mg with ethinylestradiol 35micrograms
(Standard oestrogen)
View adult BNF View SPC online View childrens BNF 		Formulary
Green
  • Co-cyprindiol should be reserved for those women requiring treatment for the androgenic conditions such as severe acne or moderately severe hirsutism. It is recommended that treatment be withdrawn 3 to 4 cycles after the androgenic condition(s) has/have completely resolved and that it is not continued solely to provide oral contraception. Venous thromboembolism occurs more frequently in women taking co-cyprindiol than those taking a low-dose combined oral contraceptive. Repeat courses may be given if the androgen-dependent condition(s) recur.
  • Note: generic co-cyprindiol is much cheaper than Dianette®
 
 
 link Link    FSRH Standards & Guidance
 link Link    MHRA Drug Safety Update (March 2014): Combined hormonal contraceptives: risk of venous thromboembolism
 link Link    NICE CG30: Long-acting reversible contraception
 link Link    MHRA Drug Safety Update (March 2014):  St John’s wort: interaction with hormonal contraceptives, including implants
07.03.01  Expand sub section  Emergency contraception
 link Link    FSRH emergency contraception guidelines
07.03.01.02  Expand sub section  Co-cyprindiol
07.03.01.03  Expand sub section  Phased formulations – standard dose 30 micogram oestrogen
07.03.01.04  Expand sub section  Low dose oestrogen – 20 microgram ethinylestradiol to top
07.03.01.05  Expand sub section  Transdermal (standard strength)
07.03.01.06  Expand sub section  Vaginal rings (low strength
07.03.01.07  Expand sub section  Copper intra-uterine devices
 link Link    MHRA Drug Safety Update (June 2015): Intrauterine contraception: uterine perforation—updated information on risk factors
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
 Display tracking information
click to search medicines.org.uk
 Link to adult BNF
click to search medicines.org.uk
 Link to children's BNF
click to search medicines.org.uk
 Link to SPCs
Cytotoxic Drug
 Cytotoxic Drug
CD
 Controlled Drug
High Cost Medicine
 High Cost Medicine
NHSE
 NHS England
Homecare
 Homecare
CCG
 CCG

Traffic Light Status Information

Status Description

Red

 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.  

Amber

 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.  

Green plus

 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.  

Green

 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.  

Black

 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.   

Brown

 UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review.  

Not Recomended

 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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