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 Formulary Chapter 24: Leeds Children's Hospital Formulary - Full Chapter
Notes:

The Leeds Children's Hospital Formulary is laid out in BNF chapter order. There are custom indexes for the following specialist areas:

Paediatric Intensive Care Unit (PICU)
Neonatal Intensive Care Unit (NICU)
Paediatric Cardiology

Chapter Links...
 Details...
24.01  Expand sub section  Gastro-intestinal system (paediatric)
 note  The neonatal formulary has moved here
Azathioprine
(paediatrics)
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Formulary
Amber 3
 
Link  Amber guidance for IBD and rheumatology in children (azathioprine)
Link  Azathioprine PIL for IBD
Link  Azathioprine: patient information leaflet - children and young people with rheumatological conditions
Link  Azathioprine-Mercaptopurine PIL for IBD
   
Balsalazide
(paediatrics)
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Formulary  
   
Budesonide
(paediatrics)
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Formulary  
   
Erythromycin
( paediatrics)
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Formulary  
Link  Leeds Cystic Fibrosis guidelines: gastric stasis only
   
Esomeprazole
(paediatrics)
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Restricted Drug Restricted
Red
  • Injection only
 
Link  Paediatric intravenous prescribing and administration monograph - esomeprazole
   
Gaviscon Infant
( )
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Formulary
Green
 
   
Glycopyrronium Bromide (Glycopyrrolate) (e.g. Robinul®, Sialanar®)
(paediatrics)
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Formulary
Amber 1
  • For hyperhidrosis in children, dermatology and vascular patients (unlicensed use)
  • For drooling and hypersalivation in children with a neurological disorder
  • Glycopyrronium oral solution (licensed) and tablets (unlicensed) supported for the management of drooling and hypersalivation in children
 
Link  Amber Guidance: Glycopyrronium for Hypersalivation in Children and adults
Link  Paediatric Prescribing and Administration Guideline (glycopyrronium)
   
Hyoscine butylbromide
(paediatrics)
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Formulary  
Link  LTHT Medication Safety Alert (June 17) - patients with underlying cardiac disease - practical guidance
Link  MHRA Drug Safety Update (Feb 17): risk of serious adverse effects in patients with underlying cardiac disease
Link  National Paediatric IV Administration Guide (Medusa) - hyoscine butylbromide
   
Lansoprazole
(paediatrics)
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Formulary  
Link  BNFC dosing (lansoprazole)
Link  Leeds Cystic Fibrosis guidelines
Link  Paediatric Prescribing and Administration guideline (lansoprazole)
   
Mercaptopurine
(paediatrics)
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Formulary
Multiple

Amber3 - IBD

Red - cancer

 
Link  Amber Drug Guidance: Mercaptopurine for IBD
Link  Azathioprine-Mercaptopurine PIL for IBD
Link  Patient information leaflet: mercaptopurine for inflammatory bowel disease in children and young people
Link  UK guidelines: IBD in children
   
Mesalazine
(paediatrics)
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Formulary
Amber 3
 
Link  Amber Drug Guidance: Inflammatory Bowel Disease in Children
Link  Aminosalicylates-5-asas PIL for IBD
Link  Mesalazine Foam Enema PIL for IBD
Link  Mesalazine Liquid Enema PIL for IBD
Link  Mesalazine oral PIL for IBD
Link  Mesalazine suppositories PIL for IBD
Link  UK Guidelines: IBD in children
   
Olsalazine
(paediatrics)
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Formulary  
   
Omeprazole
(paediatrics)
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Formulary
  • Omeprazole liquid preparations are not used at LTHT - use omeprazole MUPS
  • IV - use esomeprazole (see above for monograph) 
  • Link  BNFC dosing (omeprazole)
    Link  Leeds Cystic Fibrosis guidelines
    Link  omeprazole dispersible tablets preferred to unlicensed liquid
       
    Ranitidine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  BNFC dosing (ranitidine)
    Link  Leeds Cystic Fibrosis guidelines: adults and children
       
    Sulfasalazine
    (paediatrics)
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    Formulary  
       
    Ursodeoxychloic acid
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Leeds Cystic Fibrosis guidelines (adults and children)
       
    Vedolizumab
    ( paediatrics)
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    Formulary
    Red
    • For use in line with NICE TA 342 and TA 352 (under the  NHSE Children's Policy)
    • For use in pre-pubertal children, refer to the DTG application (Dec 19) 
     
       
    24.02  Expand sub section  Cardiovascular system (paediatric)
    Adenosine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (adenosine)
    Link  National Paediatric IV Administration Guide (Medusa) - adenosine
       
    Adrenaline
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration guide (adrenaline)
       
    Alprostadil
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Paediatric cardiology and Neonatal Unit Prescribing and Administration guide (alprostadil)- network guideline
       
    Alteplase
    (paediatrics)
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    Formulary
    Red
     
    Link  Guideline - management and use of antithrombotics in children (NHS access only)
    Link  National Paediatric IV Administration Guide (Medusa) - alteplase
       
    Amiodarone
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Paediatric cardiology and PICU Prescribing and Administration guide (amiodarone)
    Link  Paediatric cardiology supporting information (amiodarone)
    Link  BNFc oral dosing information (amiodarone)
       
    Aspirin
    (paediatrics)
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    Formulary  
    Link  Paediatric cardiology Anticoagulation Guidelines
       
    Atenolol
    (paediatrics)
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    Formulary  
    Link  BNFc oral dosing information (atenolol)
       
    Captopril
    (paediatrics)
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    Formulary
    Green
    • March 2014: Licensed liquid now available - 5mg/5mL and 25mg/mL. Use in preference to unlicensed specials which have considerable price volatility in primary care
     
    Link  BNFc oral dosing information (captopril)
    Link  Paediatric ACE inhibitor information
       
    Carvedilol
    (paediatrics)
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    Formulary  
    Link  Paediatric cardiology supporting information (carvedilol)
    Link  BNFc oral dosing information (carvedilol)
       
    Dinoprostone
    (paediatrics)
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    Formulary
    Red
    • Alprostadil used first line - dinoprostone for restricted use only
    • Oral dinoprostone may be considered in extreme circumstances as an alternative to continuous intravenous infusion of alprostadil if intravenous access is lost. Before commencing this must be discussed with a paediatric cardiology and or neonatal consultant. Dosage and administration guidance is available on L51 HDU drug file
     
       
    Disopyramide
    (paediatrics)
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    Formulary  
    Link  Paediatric cardiology patient information leaflet
       
    Dobutamine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU administration monograph (dobutamine)
    Link  Paediatric cardiology administration monograph (dobutamine)
       
    Dopamine
    (paediatrics)
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    Formulary  
    Link  PICU administration monograph (dopamine)
    Link  Paediatric cardiology administration monograph (dopamine)
    Link  National Paediatric IV Administration Guide (Medusa) - dopamine
       
    Dornase alfa
    (paediatrics)
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    Formulary  
    Link  PICU Prescribing and Administration guide (dornase)
    Link  Leeds Cystic Fibrosis inhaled therapy guidelines
       
    Enoximone
    (paediatrics)
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    Formulary  
       
    Epoprostenol
    (paediatrics)
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    Formulary
    Red
    • Pulmonary hypertension and digital ischaemia
     
    Link  PICU Prescribing and Administration Guide (epoprostenol)
       
    Furosemide
    (paediatrics)
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    Formulary  
    Link  PICU Prescribing and Administration guide (furosemide)
    Link  National Paediatric IV Administration Guide (Medusa) - furosemide
       
    Heparin
    (paediatrics)
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    Formulary  
    Link  PICU administration monograph (heparin)
    Link  Paediatric cardiology administration monograph (heparin)
    Link  Paediatric cardiology Anticoagulation Guidelines
    Link  Guideline for the use of anti-thrombotic treatment in children (NHS access only)
    Link  LTHT chart - heparin (paediatric)
       
    Hydralazine
    (paediatrics)
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    Formulary
    • Oral - follow BNFc
    • IV - follow prescribing and administration guide
     
    Link  PICU Prescribing and Administration guide (hydralazine)
    Link  BNFc oral dosing information (hydralazine)
       
    Isoprenaline
    (paediatrics)
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    Formulary
    Red
     
    Link  Paediatric cardiology and PICU Prescribing and Administration guide (isoprenaline)
    Link  National Paediatric IV Administration Guide (Medusa) - isoprenaline
       
    Levosimendan
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration guide (levosimendan)
    Link  Levosimendan paediatric patient information leaflet (LTHT access only)
       
    Lisinopril
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  BNFc oral dosing information (lisinopril)
    Link  Paediatric ACE inhibitor information
       
    Metaraminol
    (paediatrics)
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    Formulary
    Red
     
    Link  PICU Prescribing and Administration Guide (metaraminol)
       
    Milrinone
    (paediatrics)
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    Formulary  
    Link  PICU administration monograph (milrinone)
    Link  Paediatric cardiology administration monograph (milrinone)
       
    Noradrenaline
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration guide (noradrenaline)
       
    Phenylephrine
    (paediatric)
    View SPC online View childrens BNF
    Formulary  
    Link  Paediatric cardiology and PICU Prescribing and Administration guide (phenylephrine)
       
    Potassium canrenoate
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration guide (potassium canrenoate)
       
    Propranolol
    (paediatrics)
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    Formulary

    Amber1 - paediatric migraine

     
    Link  BNFc information (propranolol)
    Link  Shared care guidance: propranolol in paediatric migraine
       
    Sildenafil (Revatio®)
    (paediatrics)
    View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    • For use in liaison with Great Ormond Street Hospital
     
    Link  Paediatric cardiology supporting information (sildenafil)
    Link  Drug Safety Update (Nov 18) Sildenafil (Revatio and Viagra): reports of persistent pulmonary hypertension of the newborn (PPHN) following in-utero exposure in a clinical trial on intrauterine growth restriction
       
    Tinzaparin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Feb 2019: tinzaparin shortage - change in guidance
    Link  Paediatric cardiology Anticoagulation Guidelines
    Link  Guideline for the use of anti-thrombotic treatment in children (NHS access only)
       
    Tranexamic acid
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  National Paediatric IV Administration Guide (Medusa) - tranexamic acid
       
    Urokinase
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  CVC unblocking protocol (urokinase)
    Link  Stock shortage of urokinase - memo (2019)
       
    Warfarin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Paediatric cardiology Anticoagulation Guidelines
    Link  Guideline for the use of anti-thrombotic treatment in children
       
    Warfarin INR monitoring (CoagUCheck®)
    (paediatrics)
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    Restricted Drug Restricted
    Grey
    • Use only supported in the Leeds Paediatric Anticoagulant service as a process is in place to ensure the testing machines are calibrated and a six monthly venous blood sample is taken.
     
       
    24.03  Expand sub section  Respiratory system (paediatric)
    Aminophylline
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (aminophylline)
    Link  Acute asthma guideline (IV aminophylline guide embedded in guideline) (NHS access only)
       
    Caffeine citrate
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
  • Caffeine should be prescribed as citrate in paediatric areas
  • Further information: BNF-c
  • Always prescribe as citrate. Levels are not required unless there is evidence of toxicity or ongoing apnoeas
  • Caffeine citrate 10mg/1ml mixture is an unlicensed preparation 
  • Link  BNFC dosing (caffeine)
       
    Hydroxychloroquine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2
    • There are several indications for hydroxychloroquine: please see here for other indications.
     
    Link  Amber Drug Guidance: Interstitial Pneumonitis in Children
       
    Magnesium sulphate (acute asthma)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Paediatric acute asthma guideline (magnesium IV guide embedded in guideline) (NHS access only)
       
    Omalizumab (Xolair®)
    (paediatrics)
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    Formulary In line with NICE TA133, by respiratory specialists in accordance with asthma clinic protocols 
    Link  Omalizumab guidelines (NHS access only)
       
    Oxygen
    (paediatrics)
    Formulary
  • LTHT: treat as a medicine and ensure it is prescribed on drug chart 
  • Link  Guidelines
    Link  LTHT Quality and Safety Matters: oxygen and air (May 18)
       
    Salbutamol
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (salbutamol)
    Link  Paediatric acute asthma guideline (salbutamol IV guide embedded in guideline) (NHS access only)
       
    Salbutamol (for SMA II and III)
    (paediatrics)
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    Formulary
    Red
  • In addition to licensed uses, supported for the management of spinal muscular atrophy II and III - see link below (for SMA II and III - RED
  • Link  DTG submission - salbutamol for SMA II and III
       
    24.04  Expand sub section  Central nervous system (paediatric)
    Acrivastine
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
  • See choice of antihistamines in children (link below)  
  •    
    Alimemazine (Vallergan®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
  • See choice of antihistamines in children (link below)
  • Alimemazine costs approx. £226/month compared with hydroxyzine (£1.20/month), chlorphenamine and promethazine (approx. £3/month). Prescribers are asked to consider whether there is significant clinical benefit in choosing this agent 
  •    
    Aprepitant
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
    • For the management of cyclical vomiting in children
    • For chemotherapy induced nausea and vomiting (CINV) in children
     
       
    Ataluren (Translarna®)
    (suspension)
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    Formulary
    Red
    • for the treatment of Duchenne muscular dystrophy in specific children in line with NICE HST3 and NHSE SSC 1633
     
    Link  NICE HST3: treating Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene
       
    Cannabidiol (Epidyolex®)
    (paediatrics)
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    Formulary For use in line with NICE guidance and NHSE commissioning position 
    Link  NICE TA614: Cannabidiol with clobazam for treating seizures associated with Dravet syndrome
    Link  NICE TA615: Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome
       
    Carbamazepine (paediatrics)
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    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
    Link  Drug Safety Update (Dec 12): risk of serious skin reactions
    Link  LTHT: avoid switching between brands of antiepileptics
       
    Cetirizine
    (paediatrics)
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    Formulary
    Green
  • See choice of antihistamines in children (link below)  
  •    
    Chloral hydrate
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU oral and rectal sedation pescribing and administration guide
    Link  BNFC dosing (chloral hydrate)
       
    Chlorpheniramine
    (paediatrics)
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    Formulary
    • See choice of antihistamines in children (link below)
     
    Link  National Paediatric IV Administration Guide (Medusa) - chlorpheniramine
       
    Chlorpromazine
    (paediatrics)
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    Formulary  
       
    Clobazam
    (paediatrics)
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    Formulary
    Amber 2
  • Licensed liquids are listed in the BNFC. These should be used in preference to unlicensed products 
  • Link  Amber Drug Guidance - antiepileptics in children
    Link  BNFC dosing (clobazam)
    Link  NICE TA614: Cannabidiol with clobazam for treating seizures associated with Dravet syndrome
    Link  NICE TA615: Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome
       
    Clonazepam (paediatrics)
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    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
       
    Clonidine (sedation)
    (paediatrics)
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    Formulary

    Green - tablets

    Grey - oral liquid - restricted for patients unable to swallow solid dosage forms

     
    Link  PICU oral and rectal sedation pescribing and administration guide
       
    Codeine
    (paediatrics)
    View SPC online View childrens BNF
    Restricted Drug Restricted
  • Note MHRA warnings and contraindications for use in paediatric patients - restricted use in children
     
  • Link  BNFC dosing (codeine)
    Link  Drug Safety Update (Apr 15): codeine contraindated for cough/cold in childern
       
    Cyclizine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  National Paediatric IV Administration Guide (Medusa) - cyclizine
       
    Controlled Drug Diamorphine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
  • MMPS:use of Ayendi intranasal spray in LTHT A&E - see MiDatabank 147233 
  • Link  National Paediatric IV Administration Guide (Medusa) - diamorphine
       
    Domperidone
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Drug Safety Update (Dec 2019) Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents
    Link  Drug Safety Update (June 2014) - risks of cardiac side effects
    Link  NPPG interim position statement on the use of domperidone
       
    Eslicarbazepine (paediatrics)
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    Formulary
    Amber 2
     
       
    Ethosuximide (paediatrics)
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    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
       
    Fentanyl
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  MHRA Drug Safety Update (Oct 18): Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure, particularly in children
    Link  PICU Prescribing and Administration Guide (fentanyl)
       
    Fexofenadine
    (paediatrics)
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    Formulary
    Green
  • See choice of antihistamines in children (link below)  
  •    
    Fosaprepitant
    (paediatrics)
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    Formulary
    Red
    • For chemotherapy induced nausea and vomiting (CINV) in children
     
       
    Gabapentin (paediatrics)
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    Formulary
    Amber 2
     
    Link  MHRA: Drug safety Update (Apr 19) Pregabalin (Lyrica), gabapentin (Neurontin) and risk of abuse and dependence: new scheduling requirements from 1 April
    Link  Amber Drug Guidance - antiepileptics in children
    Link  LTHT: CD prescribing and available pack sizes
    Link  MHRA Drug Safety Update: risk of severe respiratory depression (Oct 17)
       
    Hydroxyzine
    (paediatrics)
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    Formulary
    Green
  • See choice of antihistamines in children (link below)  
  •    
    Ketamine
    (paediatrics)
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    Formulary
    Red

    Red - Chronic Pain

    Red - Cancer Pain

     
       
    Lacosamide
    (paediatrics)
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    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
       
    Lamotrigine (paediatrics)
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    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
       
    Levetiracetam
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2

    Red - intravenous for status epilepticus

     
    Link  Amber Drug Guidance - antiepileptics in children
    Link  National Paediatric IV Administration Guide (Medusa) - levetiracetam
    Link  Levetiracetam: Leeds CCG commissioning statement
       
    Levomepromazine
    (paediatrics)
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    Formulary  
       
    Loratadine
    (paediatrics)
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    Formulary
    Green
    • See choice of antihistamines in children (link below)
     
       
    Lorazepam
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU oral and rectal sedation pescribing and administration guide
    Link  Caution in use: lorazepam injection (April 2019)
       
    Melatonin
    (paediatrics)
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    Formulary
    Amber 2
    Amber2 - Melatonin and Melatonin CR for the treatment of sleep disorders in children and adolescents (link to guidance below)
  • adult indications are listed in Chapter 4 
  • Link  Amber Drug Guidance: Melatonin in Children and Adolescents
    Link  https://www.medicinesforchildren.org.uk/melatonin-sleep-disorders
       
    Controlled Drug Methylphenidate hydrochloride (all brands)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
     
    Link  Amber Drug Guidance - methylphenidate (children and adolescents)
       
    Metoclopramide
    (paediatrics)
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    Formulary
    Grey
  • Prescribe in line with guidelines and/or Drug Safety Update 
  • Link  MHRA Drug Safety Update (Aug 13); risk of neurological adverse effects
    Link  National Paediatric IV Administration Guide (Medusa) - metoclopramide
       
    Mexiletine (NaMuscla® 167mg capsules)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • For use in children with non-dystrophic myotonic disorders in line with NHSE SSC2001
    • This is an unlicensed use of a licensed medicine
     
       
    Mexiletine Hydrochloride (Mexitil® ULM)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 3
    • Unlicensed.
    • For the treatment of chloride channel myotonias (e.g. Thomsen's disease and Becker's generalized myotonia) and sodium channel myotonias (e.g. Paramyotonia congenital). For initiation by paediatric neurology.
     
    Link  Unlicensed medicine: SPC and ULM assessments
       
    Controlled Drug Midazolam (Buccolam® (buccal))
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2
  • From 3 March 2014, Buccolam® will be the product of choice at LTH
  • For further information, contact Medicines Information on ext 65377 (MiDatabank 135935) 
  • Link  Buccal midazolam training package
    Link  How to administer Buccolam syringes
       
    Controlled Drug Midazolam (intravenous)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (midazolam)
       
    Controlled Drug Morphine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (morphine)
    Link  Medication Safety Alert: mis-selection of morphine (July 19) (LTHT access only)
       
    Nabilone
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
     
       
    Nusinersen (Spinraza®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • For use in line with NICE guidance below
     
    Link  NICE TA588: Nusinersen for treating spinal muscular atrophy
    Link  MHRA Drug Safety Update (Sep 18) Nusinersen (Spinraza): reports of communicating hydrocephalus; discuss symptoms with patients and carers and investigate urgently
       
    Ondansetron
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Drug Safety Update (Jan 2020) small increased risk of oral clefts following use in the first 12 weeks of pregnancy
       
    Oxcarbazepine (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
    Link  Drug Safety Update (Dec 12): risk of serious skin reactions
       
    Paracetamol
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    • Note: risk of error with IV preparations - see guidance below
     
    Link  Warning: Paracetamol, Metronidazole and Sodium Chloride infusions look very similar (Oct 17)
    Link  LTHT Paediatric Acute Pain Management manual
    Link  Paediatric IV paracetamol dosing table (practice within LTHT)
    Link  IV paracetamol in paediatrics - Medicines Safety Alert (LTHT access only)
    Link  May 2014: paediatric paracetamol dosing in acute pain - memo
    Link  The Safe Use of Paracetamol
       
    Perampanel (paediatrics)
    (tablets, oral liquid)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
       
    Phenobarbital
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2
    • Phenobarbital oral elixir 15mg/5mL contains 38% alcohol - not suitable for children
    • LTHT use an alcohol free 50mg/5mL unlicensed preparation
    • Please ensure the correct dose is prescribed for the child and parents/carers and child are made aware if any changes to the strength being prescribed are made by primary care
     
    Link  PICU Prescribing and Administration Guide (phenobarbital)
    Link  Amber Drug Guidance - antiepileptics in children
    Link  BNFc (phenobarbital)
    Link  LTHT: avoid switching between brands of antiepileptics
       
    Phenytoin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2
    • LTHT Oct-Dec 2018: supply shortage of Epanutin suspension - neurology colleagues will assist with appropriate switch if required
     
    Link  PICU Prescribing and Administration Guide (phenytoin)
    Link  Phenytoin Prescribing and Administration Guide (general paediatric medicine)
    Link  Medication Safety Alert: Risk of death and severe harm from error with injectable phenytoin (LTHT access only)
    Link  Amber Drug Guidance - antiepileptics in children
    Link  BNFC dosing (phenytoin)
    Link  LTHT: avoid switching between brands of antiepileptics
    Link  phenytoin infatabs, capsules and liquid have different bioavailabilities
       
    Pregabalin
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  MHRA: Drug safety Update (Apr 19) Pregabalin (Lyrica), gabapentin (Neurontin) and risk of abuse and dependence: new scheduling requirements from 1 April
    Link  Amber Drug Guidance - antiepileptics in children
    Link  LTHT: CD prescribing and available pack sizes
       
    Primidone
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
    Link  LTHT: avoid switching between brands of antiepileptics
       
    Procyclidine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
       
    Promethazine
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  PICU oral and rectal sedation pescribing and administration guide
       
    Promethazine
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    • see choice of antihistamines in children (link below)
     
       
    Rufinamide
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2
  • For the management of seizures associated with Lennox-Gastaut syndrome in chilren 4 years and over 
  • Link  Amber Drug Guidance - antiepileptics in children
       
    Rupatadine
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    • See choice of antihistamines in children (link below)
     
       
    Sodium Valproate (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
    • Epilim LIQUID is sugar free
    • Epilim syrup contains sugar
    • Generic brands - please check
     
    Link  MHRA: Drug safety Update (Apr 19) Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme
    Link  MHRA: Valproate medicines: are you in acting in compliance with the pregnancy prevention measures? (Dec 2018)
    Link  Valproate Pregnancy Prevention Programme: actions required now from GPs, specialists, and dispensers (Sep 18)
    Link  MHRA: Valproate medicines (Epilim, Depakote): Pregnancy Prevention Programme materials online (May 18)
    Link  MHRA: Valproate contraindicated in wormen and girls unless conditions met (Apr 18)
    Link  MHRA: Valproate patient leaflet for women and girls (Apr 18)
    Link  Medication Safety Alert - Sodium Valproate (July 18)
    Link  Resources to support female patient safety with valproate
    Link  LTHT: Alternatives for patients with swallowing difficulties
    Link  LTHT: avoid switching between brands of antiepileptics
    Link  MHRA: Carbapenems: concomitant use with valproate not recommended (May 2010)
       
    Stiripentol (capsules/ sachets)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
  • sachets and capsules are not bioequivalent - patients need to be maintained on the same preparation
  • some patients open the capsules and dissolve the contents in water; this practice is unlicensed and pre-dates the availability of the sachets
  • if a switch of formulations is required, this should be done under clinical supervision - see amber drug guidance below
     
  • Link  Amber Drug Guidance - stiripentol
    Link  https://www.medicinesforchildren.org.uk/search-for-a-leaflet/stiripentol-for-preventing-seizures
       
    Sumatriptan
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 1
     
    Link  Amber Drug Guidance - sumatriptan (paediatrics)
       
    Tiagabine (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
       
    Tizanidine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2
    • Non-formulary for the treatment of cerebral palsy spasticity in children (unlicensed use)
     
    Link  Amber Drug Guidance - tizanidine
       
    Topiramate (migraine)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Multiple
    • First line: capsules
    • Second line: capsules opened and sprinkled (where licensed)
    • Third line: oral liquid (Rosemont)

    Amber1 - paediatric migraine

    Amber2 - epilepsy in children

     
    Link  Amber Drug Guidance - antiepileptics in children
    Link  Amber Drug Guidance - topiramate (paediatric migraine)
       
    Vigabatrin (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
    Link  Drug Safety Update (Nov 09): use in infantile spasms: risk of movement disorders and MRI abnormalities
       
    Zolmitriptan
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 1
     
    Link  Amber Drug Guidance - zolmitriptan for paediatric migraine
       
    Zonisamide
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  Amber Drug Guidance - antiepileptics in children
       
    24.05  Expand sub section  Infections (paediatric) to top
    Aciclovir
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    • Oral - follow BNFc
    • IV - follow dosing and administration guide
     
    Link  PICU Prescribing and Administration Guide (aciclovir)
    Link  BNFc oral dosing information (aciclovir)
    Link  National Paediatric IV Administration Guide (Medusa) - aciclovir
       
    Amikacin (Amikin®)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Leeds Cystic Fibrosis inhaled therapy guidelines (adults and children)
    Link  Leeds Cystic Fibrosis IV antibiotics (adults and children)
       
    Amoxicillin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    • Oral - follow BNFc
    • IV - follow prescribing and administration guide
     
    Link  PICU Prescribing and Administration Guide (amoxicillin)
    Link  BNFc oral dosing information (amoxicillin)
    Link  LTHT Cystic Fibrosis Oral Antibiotics guidelines (adults and children)
    Link  National Paediatric IV Administration Guide (Medusa) - amoxicillin
       
    Amphotericin (liposomal) (AmBisome®)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
     
    Link  Drug Safety Update (July 2018): Parenteral amphotericin B: reminder of risk of potentially fatal adverse reaction if formulations confused
    Link  PICU Prescribing and Administration Guide (AmBisome)
    Link  LTHT Cystic Fibrosis Inhaled therapy (adults and children)
    Link  LTHT Cystic Fibrosis IV Antibiotic guidelines (adults and children)
       
    Azithromycin
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Leeds Cystic Fibrosis oral antimicrobial guidelines
       
    Aztreonam
    (paediatrics)
    View SPC online View childrens BNF
    Formulary

    Aseptics product available:

    • 5mg to 20mg per mL in sodium chloride 0.9% bag (cystic fibrosis) (preparation risk rating: amber)
    • 100mg per mL in water for injections (general paediatrics) (preparation risk rating: amber)
    • Severe shortages: Fully restricted antimicrobial.
    • Microbiology codes not required for cystic fibrosis patients (June 2017)
     
    Link  Ongoing supply shortage - alternatives
    Link  LTHT aseptics order form (paediatric CF)
    Link  LTHT Cystic Fibrosis Inhaled Therapy (adults and children)
    Link  LTHT Cystic Fibrosis IV Antibiotic guidelines (adults and children)
       
    Benzylpenicillin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  BNF-C dosing: benzylpenicillin
    Link  Paediatric IV Guide - benzylpenicillin
       
    Caspofungin
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    Cefaclor
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Leeds Cystic Fibrosis Oral antimicrobial guidelines
       
    CefoTAXime
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  BNFC dosing (cefoTAXime)
       
    cefOXITin
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    CefTAZidime
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (cefTAZidime)
    Link  BNFc dosing (cefTAZidime)
    Link  CVC infection guideline for children on TPN
    Link  LTHT Cystic Fibrosis IV antibiotics guidelines (adults and children)
       
    CefTRIAXone
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  BNFC dosing (cefTRIAXone)
    Link  IM administration guidance (cefTRIAXone)
       
    CeFUROXime
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (cefuroxime)
    Link  LTHT Cystic Fibrosis IV antibiotics guideline (adults and children)
    Link  National Paediatric IV Administration Guide (Medusa) - cefuroxime
       
    Cidofovir (Vistide®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
  • Adenovirus and BK virus in children 
  • Link  LTH Paed Oncology guidance: adenovirus and polyoma BK virus
       
    Ciprofloxacin
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Drug Safety Update (Mar 2019) Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects
    Link  Leeds Cystic Fibrosis Oral antimicrobial guidelines
    Link  UK Guidelines: IBD in children
       
    Clarithromycin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
  • Oral - BNFc
  • IV - follow prescribing and administration guide 
  • Link  PICU Prescribing and Administration Guide (clarithromycin)
    Link  BNFc oral dosing information (clarithromycin)
    Link  LTHT Cystic Fibrosis Oral antimicrobial therapy (adults and children)
       
    Clindamycin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  National Paediatric IV Administration Guide (Medusa) - clindamycin
    Link  LTHT Cystic Fibrosis Oral antimicrobial therapy (adults and children)
       
    Co-amoxiclav
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  LTHT Cystic Fibrosis Oral antimicrobial therapy (adults and children)
    Link  National Paediatric IV Administration Guide (Medusa) - co-amoxiclav
       
    Co-trimoxazole
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Leeds Cystic Fibrosis Oral antimicrobial guidelines (adults and children)
       
    Daptomycin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  National Paediatric IV Administration Guide (Medusa) - daptomycin
       
    Doxycycline
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted  
    Link  Leeds Cystic Fibrois Oral antimicrobial guidelines (adults and children from age 8)
       
    Ethambutol
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Leeds Cystic Fibrosis Oral antimicrobial guidelines (adults and children)
       
    Flucloxacillin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    • Oral - follow BNFc
    • IV - follow prescribing and administration guide
     
    Link  PICU Prescribing and Administration Guide (flucloxacillin)
    Link  BNFc oral dosing information (flucloxacillin)
    Link  National Paediatric IV Administration Guide (Medusa) - flucloxacillin
    Link  LTHT Cystic Fibrosis IV antibiotics guideline (adults and children)
    Link  LTHT Cystic Fibrosis Oral antibiotics guideline (adults and children)
    Link  LTHT: Cardiac Surgery in Children - Guideline for antimicrobial prophylaxis
       
    Fluconazole
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    • Oral - follow BNFc
    • IV - follow prescribing and administration guide
     
    Link  PICU Prescribing and Administration Guide (fluconazole)
    Link  BNFc oral dosing information (fluconazole)
    Link  LTHT Cystic Fibrosis IV Antimicrobial doses (adults and children)
       
    Fosfomycin
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    Fusidic acid (Sodium fusidate)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Leeds Cystic Fibrosis Oral antimicrobial guidelines (adults and children)
       
    Gentamicin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Green
     
    Link  Gentamicin Charts Poster - take care you are using the right chart
    Link  National Paediatric IV Administration Guide (Medusa) - gentamicin
    Link  Paediatric cardiac surgery prophylactic antibiotics guidline
       
    Glecaprevir - Pibrentasvir (Maviret®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • For the treatment of Hepatitis C in line with NHSE commissioning policy
     
       
    HIV formulary
    (paediatrics)
    View SPC online View childrens BNF
    Restricted Drug Restricted
    High Cost Medicine
  • See link below for further information on available products, administration advice and other guidance

  • Includes: abacavir, atazanavir, cobicistat, co-trimoxazole, darunavir, didanosine, dolutegravir, efavirenz, elvitegravir, emtricitabine, enfuviritide, etravirine,fosamprenavir, lamivudine, lopinavir, maraviroc, nevirapine, raltegravir, rilpivirine, ritonavir, stavudine, tenofovir, zidovudine

  • Includes combination products: Atripla, Combivir, Descovy, Eviplera, Evotaz, Genvoya, Kivexa, Odefsy, Rezolsta, Stribilid, Triumeq, Trizivir, Truvada  
  • Link  Paediatric HIV Formulary guidance
    Link  Post exposure prophylaxis guideline (NHS access only)
    Link  HIV drug interactions checker (Liverpool Uni)
       
    Imipenem (with cilastatin) (Primaxin®)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    Itraconazole
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary

    Leeds Cystic Fibrosis Oral antimicrobial guidelines (adults and children)

     
       
    Ledipasvir - Sofosbuvir (Harvoni®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • For the treatment of Hepatitis C in line with NHSE commissioning policy
     
       
    Linezolid
    (paediatrics)
    View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    • weekly full blood counts required, including post-discharge (see guideline)
     
    Link  National Paediatric IV Administration Guide (Medusa) - linezolid
    Link  Linezolid - antimicrobial prescribing guidelines
    Link  LTHT Cystic Fibrosis Oral antimicrobial therapy (adults and children)
       
    Meropenem
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (meropenem)
    Link  BNFc dosing (meropenem)
    Link  LTHT Cystic Fibrosis Inhaled therapy (adults and children)
    Link  LTHT Cystic Fibrosis IV antimicrobial guidance (adults and children)
       
    Metronidazole
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  BNFC dosing (metronidazole)
    Link  National Paediatric IV Administration Guide (Medusa) - metronidazole
    Link  UK Guidelines: IBD in children
    Link  Warning: Metronidazole, Paracetamol and Sodium Chloride infusions look very similar
       
    Minocycline (cystic fibrosis)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    Moxifloxacin
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary

    Red - When used for tuberculosis / cystic fibrosis

     
    Link  MHRA Drug Safety Update: Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects
       
    Piperacillin-tazobactam
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    Posaconazole (Noxafil®)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    • Treatment of invasive fungal infections including aspergillosis in patients who are refractory or intolerant to amphotericin B or itraconazole
    • Note significant differences in bioavailability between liquids and tablets - briefing includes dosing advice (LTHT access only)
     
    Link  Leeds Cystic Fibrosis Oral antimicrobial guidelines
    Link  MHRA Drug Safety Update (Sep 16): tablets and liquids are not interchangeable
       
    Ribavirin (Rebetol®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    •             Life threatening viral infections
     
       
    Rifampicin
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    Teicoplanin
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    • May 2018 - some teicoplanin in LTHT is distributed without water for injection. Please see Caution in Use below, and use ward stock water for injection to reconstitute
     
    Link  LTHT Cystic Fibrosis IV antimicrobial guidelines (adults and children)
    Link  May 2018 Caution in Use - some product distributed without water for injection
    Link  National Paediatric IV administration monograph - teicoplanin
    Link  Paediatric cardiac surgery antibiotic prophylaxis guideline
       
    Temocillin
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
     
       
    Temocillin
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
       
    Tigecycline
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
     
    Link  LTHT Cystic Fibrosis IV antimicrobial guidelines (adults and children)
    Link  National Paediatric IV Administration Guide (Medusa) - tigecycline
       
    Tuberculosis medicines
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
     
    Link  Tuberculosis drug monographs (external link)
       
    Vancomycin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  LTHT prescription chart - vancomycin (paediatric)
    Link  National Paediatric IV Administration Guide (Medusa) - vancomycin
    Link  Paediatric vancomycin prescribing guidance
    Link  CVC infection guideline for children on TPN
    Link  LTHT Cystic Fibrosis Inhaled Therapy (adults and children)
    Link  LTHT Cystic Fibrosis IV antimicrobial guidelines (adults and children)
       
    Vancomycin (Intrathecal)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  CSF Shunt Infections in children
       
    Voriconazole (Vfend®)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
    Link  MHRA Drug Safety Update (Dec 14): Voriconazole: reminder of risk of liver toxicity, phototoxicity, and squamous cell carcinoma
       
    24.06  Expand sub section  Endocrine system (paediatric)
    Burosumab (Crysvita®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
     
       
    Chorionic Gonadotrophin (e.g. Pregnyl) (Endocrine test)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Gonadotrophin Releasing Hormone (GnRH) test for children
       
    Clonidine (Endocrine test)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Clonidine Growth Hormone Stimulation Test for Children
       
    Desmopression (DDAVP®) (Endocrine test)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Water Deprivation test for suspected Diabetes Insipidus in children
       
    Dexamethasone
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (dexamethasone)
       
    Endocrine Tests for Children
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Anterior Pituitary Function Test for Children (Glucagon Stimulation Test)
    Link  Clonidine GH Stimulation Test for Children
    Link  Corticotrophin Releasing Hormone (CRH) Test in children
    Link  Cortisol profile test in children
    Link  Gonadotrophin Releasing Hormone (GnRH) test for children
    Link  Human chorionic gonadotropin (hCG) stimulation test for children
    Link  Low dose (1 microgram) Synacthen test for suspected adrenal insufficiency in children
    Link  Multiple Endocrine Neoplasia (MEN) 2a screening for children
    Link  Oral glucose tolerance test for the diagnosis of Diabetes Mellitus in children
    Link  Oral glucose tolerance test for the diagnosis of Growth Hormone excess in children
    Link  Standard Synacthen test for Congenital Adrenal Hyperplasia in children
    Link  Water Deprivation test for suspected Diabetes Insipidus in children
       
    Estradiol valerate (Progynova)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 1
    • Pubertal induction in girls (unlicensed use)
    • Female pubertal induction under the Gender Identity Service (unlicensed use)
     
    Link  Amber Drug Guidance: Estradiol Valerate Tablets for Sexual Maturation and Maintenance in Females
    Link  BSPED: Hormone Supplementation For Pubertal Induction In Girls
    Link  PIL - estradiol valerate (Gender Identity Service) (LTHT access only)
       
    Gender Identity Development Service
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    • estradiol valerate
    • ethinylestradiol
    • gonadotropin releasing hormone (GnRH) agonists (Decapeptyl, Gonapeptyl)
    • oestrogen (Evorel)
    • testosterone
     
    Link  NHSE: Medical care for gender variant children and young people
    Link  Northern Gender Identity Development Service - info for GPs
    Link  PIL - estradiol valerate (Gender Identity Service) (LTHT access only)
    Link  PIL - ethinylestradiol (Gender Identity Service) (LTHT access only)
    Link  PIL - Decapeptyl (Gender Identity Service) (LTHT access only)
    Link  PIL - Gonapeptyl (Gender Identity Service) (LTHT access only)
    Link  PIL - oestrogen patches (Evorel) (Gender Identity Service) (LTHT access only)
    Link  PIL - testosterone (Gender Identity Service) (LTHT access only)
    Link  Testosterone gel: alternatives during shortage (Mar 18)
       
    Glibenclamide (ULM)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary

    Neonatal diabetes mellitus: LTHT use glibenclamide oral suspension 2.5mg/5mL (Specials Laboratory); this is an unlicensed medicine. 

    The licensed product was considered by LTHT Drug and Therapeutics Group (Nov 2019). It will not be used due to significant patient safety concerns.

     
       
    Gliclazide
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    Glimepiride
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
       
    Glucagon (Endocrine test)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted  
    Link  Anterior Pituitary Function Tests for Children - Glucagon Stimulation Test
       
    Gonadorelin (Endocrine test)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Gonadotrophin Releasing Hormone (GnRH) test for children
       
    Hydrocortisone (generic; Alkindi® granules in capsules for opening)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Multiple

    ◾10mg hydrocortisone tablets are generally scored and will be used for patients on doses of 5mg and 10mg

    ◾For doses between 1mg and 4mg hydrocortisone granules in capsules for opening (Alkindi®) can be prescribed.

     
    Link  Amber Drug Guideline: hydrocortisone oral for paediatric adrenal insufficiency (tablets/Alkindi granules)
    Link  MHRA: Hydrocortisone muco-adhesive buccal tablets: should not be used off-label for adrenal insufficiency in children due to serious risks (Dec 2018)
       
    Insulin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Charts and administration guides
    Link  PICU Prescribing and Administration Guide (insulin)
    Link  LTHT chart - multiple daily dose insulin (paediatric)
    Link  LTHT Chart - Paediatiric Insulin Standard Sliding Scale
    Link  National Paediatric IV Administration Guide (Medusa) - insulin
    Link  Guidelines
    Link  Management of DKA in paediatric patients (NHS access only)
    Link  Management of hyperglycaemia in non-diabetic critically ill children
    Link  Peri-operative management of insulin (paediatrics) (NHS access only)
    Link  Sick days and diabetes (NHS access only)
    Link  Information
    Link  Guidance on adding 50% glucose to iv fluids to increase glucose concentrations
    Link  Newsletter - insulin use in paediatric patients (information) (LTHT access only)
       
    Insulin aspart (Fiasp®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    • Rapid acting human insulin analogue manufactured by Novo Nordisk
    • 10mL vial, FlexTouch® 3mL prefilled pen, Penfill® 3mL cartridges
     
       
    Insulin degludec (Tresiba®)
    (paediatrics)
    View SPC online View childrens BNF
    Restricted Drug Restricted
    Amber 2
     
    Link  Tresiba (paediatrics) : Amber 2 guidance
       
    Octreotide
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Paediatric cardiology supporting information (octreotide)
    Link  BNFc (octreotide)
       
    Oestrogen  (Evorel® patches)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 1
    • Pubertal induction in girls (unlicensed use)
    • Female pubertal induction under the Gender Identity Service (unlicensed use)
     
    Link  Amber Drug Guidance: Evorel® for Sexual Maturation and Maintenance in Females (Children)
    Link  BSPED: Hormone Supplementation For Pubertal Induction In Girls
    Link  PIL: oestrogen patches (Gender Identity Service) (LTHT access only)
       
    Oral Glucose (Rapilose®) (Endocrine test)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Oral glucose tolerance test for the diagnosis of Diabetes Mellitus in children
    Link  Oral glucose tolerance test for the diagnosis of Growth Hormone excess in children
       
    Pamidronate
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Protocol for children on pamidronate infusions
       
    Prednisolone
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary First choice: use standard tablets
  • If unable to swallow standard tablets or dose is greater than 30mg, refer to formulation guide below
     
  • Link  LTH access only: Oral prednisolone formulation guide
    Link  Patient information leaflet: prednisolone in paediatric rheumatology and dermatology
    Link  Steroids PIL for paediatric IBD
    Link  UK Guidelines: IBD in children
       
    Somatropin (various brands, including Genotropin, Humatrope, Norditropin, NutropinAq, Omnitrope, Saizen Zomacton)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
    Amber1 - see link below for amber guidance in children 
    Link  Amber guidance for somatropin in children
    Link  NICE TA188: growth failure in children
       
    Stilboestrol (Endocrine test)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted  
    Link  Anterior Pituitary Function Tests for Children Glucagon Stimulation Test - priming dose of stilboestrol
       
    Tetracosactide (Synacthen®) (Endocrine test)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary

    Currently there are limited supplies of this product. All prescribing needs to be on the request of a consultant endocrinologist only

     
    Link  Low dose (1 microgram) Synacthen test for suspected adrenal insufficiency in children
    Link  Standard Synacthen test for Congenital Adrenal Hyperplasia in children
       
    Triptorelin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Amber drug guidance: adolescent gender dysphoria
       
    Zoledronic Acid Infusion
    (paediatrics)
    View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
  • restricted for consultant use only for the management of children with low bone density and fragility fractures 
  • Link  Protocol for children on zoledronic acid infusions
       
    24.07  Expand sub section  Obstetrics, Gynaecology, and urinary-tract disorders (paediatric)
    24.08  Expand sub section  Malignant disease and immunosuppression (paediatric)
    Adalimumab (Amgevita®, Humira®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • Amgevita® is the brand of choice at LTHT
     
    Link  Adalimumab PIL for paediatric IBD
    Link  Paediatric Rheumatology prescribing guidance - Adalimumab
    Link  PIL: biosimilar adalimumab (children) (LTHT access only)
       
    Azathioprine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
  • There are a number of different indications for azathioprine. Please see here for other indications. 
  • Link  Azathioprine Amber Drug Guidance - paediatric autoimmune hepatitis and solid organ transplant
    Link  Azathioprine Amber Drug Guidance - paediatric inflammatory bowel disease or rheumatological conditions
    Link  LTHT Patient Information Leaflet
       
    Basiliximab (Simulect®)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red

    In line with NICE TA482 (below)

     
    Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
       
    Ciclosporin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
    • There are a number of different indications for ciclosporin.
     
    Link  Ciclosporin Amber Drug Guidance - paediatric nephrotic syndrome
       
    Dinutuximab (Qarziba®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • For use in line with NICE guidance and NHSE commissioning position
     
    Link  NICE TA538: high-risk neuroblastoma in people aged 12 months and over
       
    Dupilumab (Dupixent®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • For severe atopic dermatitis (adolescents) in line with NICE TA534/SSC2082
     
    Link  NICE TA534: Dupilumab for treating moderate to severe atopic dermatitis
       
    Everolimus (Votubia® dispersible tablets)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • NHSE commission for refractory focal onset seizures associated with Tuberous Sclerosis Complex (TSC)
    • Dispersible tablets are not bioequivalent to standard tablets and are not interchangeable
     
       
    Gemtuzumab ozogamicin (Mylotarg®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • For use in line with NICE TA545: untreated acute myeloid leukaemia
     
       
    Infliximab (Inflectra®, Remicade®, Remsima®)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    • Prescribe by brand name: Inflectra® is the current biosimilar of choice at LTHT
     
    Link  Paediatric rheumatology administration guide (infliximab)
    Link  Patient information leaflet: infliximab infusions for juvenile arthritis and uveitis in children and young people
    Link  Infliximab PIL for paediatric IBD
    Link  Paediatric Infliximab dose banding
    Link  Paediatric Rheumatology prescribing guidance: Infliximab
    Link  PIL: biosimilar infliximab (children) (LTHT access only)
    Link  UK Guidelines: IBD in children
    Link  MHRA Drug Safety Update Apr 2014: Tumour necrosis factor alpha inhibitors: risk of tuberculosis—screen all patients before starting treatment and monitor them closely
       
    Inotuzumab ozogamicin (Besponsa®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • For use in line with NICE TA541: treating relapsed or refractory B-cell acute lymphoblastic leukaemia
     
    Link  NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia
       
    Lanadelumab (Takhzyro®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
  • For preventing recurrent attacks of hereditary angioedema in line with NICE TA606 
  • Link  NICE TA606: Lanadelumab for preventing recurrent attacks of hereditary angioedema
       
    Leflunomide
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
  • for juvenile idiopathic arthritis (JIA) and chronic uveitis associated with JIA 
  •    
    Methotrexate
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3

    Amber3 - oral
    Red - injection

     
    Link  Amber Drug Guidance - non-oncology indications in paediatrics
    Link  LTHT Paediatric Rheumatology Intravenous Methotrexate administration guide
    Link  Paediatric Rheumatology prescribing guidance: methotrexate IV
    Link  Paediatric Rheumatology prescribing guidance: methotrexate SC
    Link  Patient Information Leaflet: methotrexate IV for non-oncology indications in children
    Link  Patient Information Leaflet: methotrexate oral for non-oncology indications in children
    Link  Patient Information Leaflet: methotrexate SC for non-oncology indications in children
    Link  PIL: Methotrexate in inflammatory bowel conditions
    Link  PIL: methotrexate in inflammatory bowel conditions - a guide for young people
    Link  UK Guidelines: IBD in children
       
    Mycophenolate mofetil
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
  • Where Amber Drug Guidance is available, AMBER 3, otherwise RED
    Amber3 - Prevention of relapse in frequently Relapsing Nephrotic Syndrome
    Amber3 - Rheumatological conditions in children 
  • Link  Amber Drug Guidance - mycophenolate mofetil (Auto-Immune Hepatitis in children)
    Link  Amber Drug Guidance - mycophenolate mofetil (Frequently Relapsing Nephrotic Syndrome in Paediatrics)
    Link  Amber Drug Guidance - mycophenolate mofetil (paediatric renal transplant)
    Link  Amber Drug Guidance - mycophenolate mofetil (paediatric rheumatology)
    Link  Drug Safety Update: high rate of serious birth defects and increased risk of spontaneous abortion (Dec 15)
    Link  Drug Safety Update: new pregnancy-prevention advice for women and men (Feb 18)
    Link  Drug Safety Update: risk of hypogammaglobulinaemia and risk of bronchiectasis (Jan 2015)
    Link  Patient information leaflet: mycophenolate mofetil in paediatric rheumatological conditions (LTHT only)
       
    Rasburicase (Fasturtec®)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  LHP: Tumour lysis syndrome in adults with malignant disease
    Link  LHP: Tumour lysis syndrome in children with malignant disease
       
    Tacrolimus
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
  • Prescribe by brand name 
  • Link  Amber Drug Guidance - tacrolimus (liver transplant)
    Link  Amber Drug Guidance - tacrolimus (nephrotic syndrome)
    Link  Amber Drug Guidance - tacrolimus (post renal transplant)
    Link  Drug Safety Update: prescribe by brand name (Nov 17)
       
    Ustekinumab (Stelara®)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red

    for children with Crohn's Disease 

       
    24.09  Expand sub section  Nutrition and blood (paediatric)
    Abidec
    (paediatrics)
    View SPC online View SMC online View childrens BNF
    Formulary  
    Link  BNFc oral dosing information (Abidec)
    Link  Nutritional supplementation in the newborn (guideline)
       
    Arginine
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary

    June 2017: Caution: change in strength (now 10%) - see new monograph

     
    Link  PICU prescribing and administration guide (arginine)
       
    Calcium
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Paediatric IV calcium monograph (acute replacement - not for use on PICU)
    Link  Paediatric IV calcium monograph (maintenance - not for use on PICU)
    Link  PICU electrolytes guidance (calcium gluconate)
    Link  Paediatric calcium oral administration monograph
       
    Calcium resonium
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  BNFC dosing (calcium resonium)
       
    Carnitine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  Amber Drug Guidance (carnitine)
       
    Colecalciferol
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Amber Drug Guidance: Colecalciferol 300,000 units IM Injection for the Treatment of Vitamin D Deficiency or Insufficiency in Children
    Link  Leeds Paediatric Vitamin D Guideline ( under 18 years ) for Primary and Secondary Care
       
    Copper Sulphate (injection )
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
  • unlicensed product
  • for use as an additional component for parenteral nutrition 
  •    
    Cosmofer (iron dextran)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
  • See link below to paediatric dose calculator 
  • Link  National Paediatric IV Administration Guide (Medusa) - iron dextran
    Link  Paediatric IV iron calculator (LTHT access only)
       
    Dalavit
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Nutritional Supplementation in the newborn infant (NHS access only)
       
    Fluids
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
  • See guidance below for appropriate ways to increase glucose concentrations in standard infusion fluids 
  • Link  LTHT: Intravenous Fluid Therapy in Term Neonates, Children and Young People in Hospital
    Link  Guidance on adding glucose 50% to infusion fluids
    Link  LTHT Paediatrics: Sodium Choride 2.7% (see below) - For the management of Severe Symptomatic Hyponatraemia ONLY
       
    Fruti-Vits®
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Green
  • nutritional supplement for children 3-10 years on restrictive therapeutic diets (replaces Phlexyvits which have been discontinued) 
  •    
    Glycerol phenylbutyrate (Ravicti® oral liquid)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary Commissioned by NHSE (July 2018) for metabolic disorders 
       
    Human albumin solution
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    • Non-pharmacy product - supplied from blood bank
     
    Link  National Paediatric IV Administration Guide (Medusa) - human albumin solution
       
    Human Albumin Solution (HAS)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration guide (human albumin solution)
       
    Ketogenic Dietary Products
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 1

    For epilepsy

    • Beta Quik
    • Carb Zero
    • Fruitivits
    • Ketocal
    • Ketoclassic
    • Keyo
    • Liquigen
    • MCT oil and MCT procal
     
    Link  Ketogenic Diet Prescribable Products
       
    Magnesium
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU electrolytes guidance (magnesium)
    Link  Paediatric Magnesium IV monograph
    Link  Paediatric Magnesium ORAL monograph
       
    Paravit CF® (ULM) (capsules, oral liquid )
    (Vitamins A, D, E, K)
    View adult BNF View SPC online
    Formulary
    Amber 1
    • Liquid: for children with Cystic Fibrosis or cholestatic liver disease
    • Capsules: for patients with Cystic Fibrosis, cholestatic liver disease, malabsorption following bariatric surgery (e.g. duodenal switch)
     
    Link  Paravit CF capsules - patient leaflet
       
    Phosphate
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU electrolytes guidance (phosphate)
    Link  BNFc information (oral phosphate)
    Link  Paediatric Phosphate IV monograph
    Link  Paediatric Phosphate ORAL monograph
       
    Controlled Drug Potassium chloride
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
  • All additions of potassium to intravenous fluids must be made by a pharmacy aseptic unit
  • For oral potassium chloride use Kay-Cee-L syrup 7.5% (1mL of Kay-Cee-L syrup contains 1mmol potassium chloride - see BNFc link below)
  • High strength potassium (1mmol/mL) available from pharmacy aseptics. Managed as a controlled drug 
  • Link  PICU electrolytes guidance (potassium)
    Link  BNFc information (oral potassium)
       
    Sodium benzoate
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (sodium benzoate)
       
    Sodium bicarbonate
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Paediatric IV prescribing and administration guide - sodium bicarbonate
       
    Sodium Chloride Intravenous (2.7% for severe symptomatic hyponatraemia ONLY)
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
  • treated as a controlled drug at LTHT 
  • Link  Paediatric Formulary: For the management of Severe Symptomatic Hyponatraemia ONLY
       
    Sodium Chloride oral solution 1mmol/L
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 1
  • Amber1 - supplementation in cystic fibrosis in children 
  •    
    Sodium phenylbutyrate
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (sodium phenylbutyrate)
       
    Sytron
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  https://www.medicinesforchildren.org.uk/search-for-a-leaflet/sytron-sodium-feredetate-for-prevention-of-anaemia
    Link  Nutritional Supplementation in the newborn infant (NHS access only)
       
    Thickeners (Resource Thicken Up Clear, Thick and Easy, Carobel)
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    • Resource Thicken Up Clear for children 3 years and above
    • Carobel for younger children
     
    Link  Neonatal guideline - management of suspected GORD
       
    24.10  Expand sub section  Musculoskeletal and joint diseases (paediatric) to top
    Abatacept
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
     
    Link  LTHT: patient information leaflet (abatacept)
    Link  Paediatric rheumatology administration guide (abatacept)
    Link  Paediatric Rheumatology prescribing guidance: abatacept
       
    Anakinra
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • treatment of cytokine release syndrome following CAR-T therapy
     
    Link  Paediatric Rheumatology prescribing guidance - Anakinra
       
    Azathioprine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
    • There are a number of different indications for azathioprine. Please see here for other indications.
     
    Link  Amber drug guidance: azathioprine in children with rheumatological conditions
       
    Baclofen
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
     
       
    Canakinumab
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
    Link  Paediatric Rheumatology prescribing guidance - canakinumab
       
    Ciclosporin
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
  • There are a number of different indications for ciclosporin. Please see here for other indications. 
  • Link  Amber Drug Guidance for paediatric rheumatology (ciclosporin)
    Link  LTHT Patient Information Leaflet - paediatric rheumatology
       
    Cyclophosphamide
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
     
    Link  Paediatric Rheumatology administration guide: cyclophosphamide
    Link  Paediatric Rheumatology prescribing guidance: Cyclophosphamide IV
    Link  Patient Information Leaflet: cyclophosphamide non-oncology indications
       
    Etanercept
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
    Link  Paediatric Rheumatology prescribing guidance: Etanercept
    Link  PIL: biosimilar etanercept (children) (LTHT access only)
       
    Hydroxychloroquine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 2

    There are several indications for hydroxychloroquine; please see here for further indications.

     
    Link  Amber Drug Guidance - for rheumatological conditions in children
    Link  LTHT PIL: hydroxychloroquine in children
       
    Methylprednisolone
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  Paediatric rheumatology administration guide (methylprednisolone)
       
    Rituximab (and biosimilars) (MabThera®, Rixathon®, Truxima®)
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    • There are multiple indications for rituximab. Contact a specialist pharmacist for further details

      LTHT use biosimilar rituximab for children:
    • Truxima® for all paediatric patients (also used for adult non-haematology patients)
    • Rixathon® (for adult haematology)
       

     

    • NHSE commission for anti-NMDAR autoimmune encephalitis (all ages): SSC1625
     
    Link  Paediatric rheumatology administration guide (rituximab)
    Link  Paediatric Rheumatology prescribing guidance: Rituximab
    Link  PIL: biosimilar rituximab (children) (LTHT access only)
       
    Sulfasalazine
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
     
    Link  Amber Drug Guidance - sulfasalazine (paediatric rheumatology)
    Link  LTHT: sulfasalazine - interference with ALT assay (updated Oct 17)
    Link  Patient Information leaflet: sulfasalazine in juvenile idiopathic arthritis in children and young people
       
    Tocilizumab
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    • treatment of cytokine release syndrome following CAR-T therapy
     
    Link  Paediatric rheumatology administration guide (tocilizumab)
    Link  Paediatric Rheumatology prescribing guidance: tocilizumab
    Link  Tocilizumab for Takayasu arteritis (through Children’s Policy)
       
    Triamcinolone
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PIL: Corticosteroid injections for juvenile arthritis: Information for Parents/Carers/Young People
       
    24.11  Expand sub section  Eye (paediatric)
    24.12  Expand sub section  Ear, Nose and oropharynx (paediatric)
    24.13  Expand sub section  Skin (paediatric)
    24.14  Expand sub section  Immunological products and vaccines (paediatric)
    Icatibant (Firazyr®)
    ( paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
     
       
    Immunoglobulins
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
  • Follow guidance available on LTHT intranet 
  • Link  Immunoglobulin prescribing information (LTHT access only)
    Link  LTHT Tetanus Algorithm
       
    Vaccines - Primary Immunisation Course
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
  • June 2013: Changes to meningitis C schedule
  • July 2013: Rotavirus immunisation added 
  • Link  Association of Paediatric Anaesthetists of Great Britain and Ireland - vaccinations and surgery
    Link  NRLS alert - risk of omitting Hib in primary immunisation schedule
    Link  Primary Immunisation Schedule (Dept of Health)
    Link  LTHT Tetanus Algorithm
       
    24.15  Expand sub section  Anaesthesia (paediatric) to top
    Atracurium
    (paediatrics)
    View SPC online View childrens BNF
    Formulary  
    Link  PICU Prescribing and Administration Guide (atracurium)
    Link  National Paediatric IV Administration Guide (Medusa) - atracurium
       
    Dexmedetomidine
    (paediatrics)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
  • For buccal and intranasal use (unlicensed use) for sedation in theatres for children with difficult airways where respiratory depression would be significant 
  •    
    Rocuronium
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Red
     
    Link  PICU Prescribing and Administration Guide (rocuronium)
       
    24.16  Expand sub section  Neonatal Formulary
     note 

    Pharmacy contact details (neonatal / obstetric wards)

    Abidec
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNFc preterm neonate
  • Administration: BNF-c
  • July 2013 - intermittent supply problems. Use Dalivit in line with local guidelines if Abidec is unavailable 
  • Link  Neonatal Guideline - nutritional supplements
       
    Acetylcysteine (IV, oral, bowel irrigation)
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    • IV dose and administration for acute liver injury: see prescribing and administration monograph
    • Oral and rectal dose and administration: see meconium ileus monograph
     
    Link  Neonatal BNF-c monograph (oral)
    Link  Neonatal Prescribing and Administration Monograph - acute liver injury (IV)
    Link  Neonatal Prescribing and Administration monograph - meconium ileus (oral and rectal administration)
       
    Aciclovir
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c 
  • Link  Neonatal BNF-c monograph (oral)
    Link  Neonatal Prescribing and Administration Monograph (IV)
       
    Adenosine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph 
  • Link  Neonatal prescribing and administration monograph
       
    Adrenaline
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: Neonatal guideline
  • Administration: Neonatal guideline 
  • Link  Neonatal Guideline - Management of Preterm Infants Born before 28 weeks
    Link  Neonatal prescribing and administration monograph when used as an inotrope
    Link  Resuscitation Council (UK) - Newborn Life Support
       
    Alphatocopheryl (vitamin E)
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Neonatal monograph - supplements in cholestasis
       
    Alprostadil
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    • Follow neonatal unit & paediatric cardiology prescribing and administration monograph (link below) 
     
    Link  Neonatal unit (& paediatric cardiology) prescribing and administration guideline (alprostadil) - network guideline
       
    Amiodarone
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Follow paediatric ICU / cardiology administration guidelines 
  • Link  Paediatric cardiology and PICU administration monograph (amiodarone)
    Link  Paediatric cardiology supporting information (amiodarone)
       
    Amoxicillin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c 
  • Link  Neonatal Prescribing and Administration Monograph (IV)
    Link  Neonatal BNF-c monograph (oral)
    Link  Neonatal guideline - surgical antibiotic prophylaxis
       
    Amphotericin (liposomal) (AmBisome®)
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
  • Dose and administration: prescribing and administration monograph
  • Only available from pharmacy aseptics
  • Incompatible with sodium chloride solutions  
  • Link  Drug Safety Update (July 2018): Parenteral amphotericin B: reminder of risk of potentially fatal adverse reaction if formulations confused
    Link  Neonatal Guideline - Management of Invasive Candidiasis
    Link  Neonatal Guideline - Management of Suspected (but unproven) Invasive Candida Infection
    Link  Neonatal Prescribing and Administration Monograph
       
    Atracurium
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph 
  • Link  Neonatal Prescribing and Administration Monograph
       
    Atropine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose and administration: prescribing and administration monograph
  • Consult emergency drug prescriber

  • For oral pre-medication: BNFc (use injection orally) 
  • Link  Neonatal Prescribing and Administration Monograph
    Link  BNFc atropine monograph (oral pre-medication)
       
    BCG vaccination
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNF-c
  • Administration: BNF-c 
  • Link  Neonatal BCG immunisation protocol
    Link  Neonatal BNF-c monograph
       
    Benzylpenicillin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • See guideline for early onset sepsis
  • See guideline for syphilis

  • Product no longer available from aseptics 
  • Link  Neonatal Network Prescribing and Administration Monograph - benzylpenicillin
    Link  Neonatal Guideline - antibiotic management of early onset sepsis
    Link  Neonatal Guideline - congenital syphilis
       
    Biotin (vitamin h)
    (neonatal)
    View adult BNF View childrens BNF
    Formulary
  • Dose for seizures is as per BNFc advice for ’defect of biotin metabolism’ (click icon to the left)
  • 5mg tablets available. Can obtain a 5mg/1mL injection 
  •    
    Blood Products
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Not pharmacy products - order from Blood Bank 
  • Link  Use of blood products within neonates (guideline)
       
    Caffeine citrate
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • From Jan 2014, caffeine should be prescribed as citrate on the neonatal units
  • IV and oral dose and administration: prescribing and administration monograph
  • Further information: BNF-c
  • Always prescribe as citrate. Levels are not required unless there is evidence of toxicity or ongoing apnoeas
  • Caffeine citrate 10mg/1ml mixture is an unlicensed preparation 
  • Link  Neonatal Prescribing and Administration Monograph (IV)
    Link  Neonatal BNF-c monograph (oral)
       
    Calcium  (oral)
    (neonatal)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Dosing in osteopenia of prematurity (LTHT neonatal feeding supplementation guideline)
    Link  Dosing in deficiency (BNF-C: Calcium Carbonate)
    Link  Guidance on administration (LTHT)
       
    Calcium chloride
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Resuscitation Council (UK) Paediatric Advanced Life Support
       
    Calcium folinate
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose for seizures is as per BNFc advice for ’metabolic disorders leading to folate deficiency’ (click icon to the left)
  • Available as 15mg tablets and 15mg/2mL injection 
  •    
    Calcium Gluconate
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • For correction of hypocalcaemia
  • Preferably administer centrally - destructive to tissues if extravasation occurs 
  • Link  Neonatal Prescribing and Administration Monograph (IV)
    Link  Neonatal BNF-c monograph
       
    Calcium Resonium
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose and administration: BNF-c
  • Stop treatment when serum potassium reaches 5mmol/L 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal guideline - hyperkalaemia
       
    Carobel
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    Green
  • Dose: Neonatal guideline
  • Administration: See product information (packet) 
  • Link  Neonatal guideline - management of suspected GORD
       
    Cefotaxime
    (neonatal)
    View SPC online View childrens BNF
    Restricted Drug Restricted
  • Cefotaxime for any indication requires microbiology approval, including patients transferred to the unit where cefotaxime has already been initiated

  • Cefotaxime is not stocked on the neonatal units and will need ordering from pharmacy

  • The network administration guide below is for guidance. All use requires approval from microbiology
  • Link  Neonatal guideline - management of conjunctivitis
    Link  Yorkshire and Humber Neonatal Network Guideline - cefotaxime administration monograph
    Link  Neonatal BNFc monograph
       
    Ceftazidime
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Long term supply shortage (May 2017): for any guideline that includes this antibiotic please contact microbiology for advice.

  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph 
  • Link  Neonatal Prescribing and Administration Monograph
    Link  Neonatal BNF-c monograph
    Link  Neonatal guideline - long line sepsis
       
    Cefuroxime
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph 
  • Link  Neonatal Prescribing and Administration Monograph
       
    Chloral hydrate
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNF-c
  • Administration: BNF-c
  • Oral or rectal administration 
  • Link  Neonatal BNF-c monograph
       
    Chloramphenicol
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNF-c
  • Administration: BNF-c 
  • Link  Neonatal BNF-c monograph (eye drops)
    Link  Neonatal guideline - management of conjunctivitis
       
    Chlorothiazide
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNF-c
  • Administration: BNF-c
  • Diuretic dose used in guidelines is 12.5mg/kg twice a day (within BNF-c dosing guidance)

  • Unlicensed medicine
  • LTHT QC approved product: Diuril 250mg/5mL oral suspension; manufacturer: Perrigo, USA; LTHT QC reference: QA1502001
     
  • Link  Neonatal BNF-c monograph (chronic hypoglycaemia)
    Link  Neonatal BNF-c monograph (diuretic)
    Link  Neonatal guideline - diuretics for infants at risk of chronic lung disease
       
    Clarithromycin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c 
  • Link  Neonatal Prescribing and Administration Monograph (IV)
    Link  Neonatal BNF-c monograph (oral)
       
    Clonidine
    (neonatal)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  Neonatal prescribing and administration monograph
       
    Co-amoxiclav
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Oral dosing for chest infections in neonates without IV access (providing there have been no previous resistant gram negative bacteria isolated): dose as per BNFc (click icon to the left). When prescribed ensure the concentration (125/31) is clearly written on the prescription.
  • IV dosing on the recommendation of microbiology only: dose as per BNFc (click icon to the left), administration as per Paediatric Medusa IV Guide (see link below) 
  • Link  Paediatric Medusa IV administration guide - co-amoxiclav
       
    Dalivit
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNF-c (use child 1-18 year dose for liver patients)
  • Administration: BNF-c 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal guideline - nutritional supplements
    Link  Neonatal guideline - supplements in cholestasis
       
    Dexamethasone
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c monograph
  • Available from pharmacy aseptics (100micrograms/mL) 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal Guideline - use of dexamethasone in the ventilator dependant preterm infant
    Link  Neonatal Prescribing and Administration Monograph
       
    Dobutamine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph 
  • Link  Neonatal Network Prescribing and Administration Monograph - dobutamine
    Link  Neonatal guideline - management of hypotension
       
    Dopamine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph 
  • Link  Neonatal Network Prescribing and Administration Monograph - dopamine
    Link  Neonatal guideline - management of hypotension
       
    Dornase alfa (DNase®)
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
    • Dose: BNF-c (use half the recommended dose for 5-18 years)
    • Administration: BNF-c
     
    Link  Neonatal BNF-c monograph
       
    Doxapram
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNF-c
  • Administration: BNF-c
  • Use caffeine as first line treatment 
  • Link  Neonatal BNF-c monograph (2010-2011)
       
    Drugs in lactation resources
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Information in the following resources is for babies who are well and born at term. Professional interpretation must be used for babies who are unwell or who are born prematurely
  • Drugs During Pregnancy and Lactation (C Schaefer) - paper copies available on the neonatal units
  • Further guidance available from neonatal pharmacists, or Medicines Information on ext 65377 
  • Link  LactMed
    Link  UKMI q+a’s - medicines in lactation
       
    Erythromycin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Oral dose and administration (GORD): BNF-c
  • Oral/IV dose and administration (infection): BNF-c 
  • Link  Neonatal BNF-c monograph (gastrointestinal stasis)
    Link  Neonatal BNF-c monograph (infection)
    Link  Neonatal guideline - management of conjunctivitis
    Link  Neonatal guideline - management of suspected GORD
       
    Extravasation
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • See guideline below 
  • Link  Neonatal extravasation guideline
       
    Fentanyl
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph 
  • Link  MHRA Drug Safety Update (Oct 18): Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure, particularly in children
    Link  Neonatal Prescribing and Administration Monograph
       
    Flucloxacillin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
  • Only use on microbiology advice or if culture and sensitivity results indicate
  • For use in cystic fibrosis, contact paediatric pharmacist

    Products available:
  • 250mg injection powder for reconstitution
  • 50mg/mL syringes in water for injection available from pharmacy aseptics 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal Network Prescribing and Administration Monograph - flucloxacillin
       
    Fluconazole
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
  • From November 2011, nystatin will be the first line antifungal for the prophylaxis of invasive candida. Fluconazole will remain a second line choice - see guideline below
     
  • Link  Neonatal BNF-c monograph (oral)
    Link  Neonatal Guideline - Management of Invasive Candidiasis
    Link  Neonatal Guideline - Management of Suspected (but unproven) Invasive Candida Infection
    Link  Neonatal guideline - prophylaxis of candida infection
    Link  Neonatal Network Prescribing and Administration Monograph (fluconazole)
       
    Flucytosine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNF-c
  • Administration: BNF-c
  • Made in pharmacy aseptics 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal Guideline - Management of Invasive Candidiasis
       
    Fluids
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Fluids available on neonatal units
    Link  Guidance on adding glucose 50% to infusion fluids
    Link  LTHT: Intravenous Fluids and How to Prescribe them on Neonatal Unit
    Link  Potassium-containing fluids available within LTHT
       
    Furosemide
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
     
  • Link  Neonatal BNF-c monograph (oral)
    Link  Neonatal guideline - diuretics for infants at risk of chronic lung disease
    Link  Neonatal guideline - patent ductus arteriosus
    Link  Neonatal guideline - use of blood products
    Link  Neonatal Prescribing and Administration monograph (IV)
       
    Gentamicin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    • Dose and administration: prescribing and administration monograph
    • Neonatal gentamicin is prescribed on emeds (neonatal units, transitional care units, postnatal wards and delivery suites only)
    • All other wards at Leeds Childrens Hospital will continue to use paper copies of the gentamicin prescription chart
     
    Link  Sepsis - Antibiotics for Early Onset Sepsis in the Newborn
    Link  Late Onset ( after 72 hours ) Neonatal Sepsis
    Link  Neonatal gentamicin prescribing guideline
    Link  Neonatal guideline - surgical antibiotic prophylaxis
       
    Heparin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose and administration (arterial line patency): prescribing and administration monograph
  • Note: May 2012 - concentration and diluent used for arterial line patency has changed - see monograph below.
  • Note: May 2014 - concentration used for thrombosis has changed - see monograph below
     
  • Link  LTHT guideline - anti-thrombotic treatment in children
    Link  Neonatal Prescribing and Administration Monograph (arterial line patency)
    Link  Neonatal Prescribing and Administration Monograph (thrombosis)
       
    Hepatitis B vaccine and immunoglobulin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose: BNF-c
  • Administration: BNF-c
  • Supply: Hepatitis B immunoglobulin is not stocked by pharmacy. It is pre-ordered via the HPA and held on the relevant delivery suite in anticipation. If an unanticipated patient presents, an emergency supply can be obtained from virology. The product is not supplied by pharmacy and is not stocked. See neonatal guideline link below for more detail. 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal guideline - infants at risk of Hepatitis B infection
       
    Hydralazine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: Neonatal BNF-c monograph 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal prescribing and administration monograph
       
    Hydrocortisone
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    • IV dose and administration: prescribing and administration monograph for NEONATES on the NEONATAL unit
    • Oral dose and administration: neonatal BNF-c monograph
    • <LTHT aseptics - 10mg/mL in sodium chloride 0.9%
     
    Link  MHRA: Hydrocortisone muco-adhesive buccal tablets: should not be used off-label for adrenal insufficiency in children due to serious risks (Dec 2018)
    Link  Neonatal BNF-c monograph (oral dosing)
    Link  Neonatal guideline - management of hypotension in the newborn
    Link  Neonatal prescribing and administration monograph
       
    Ibuprofen
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Aug 2015 - product change to Pedea. Take care to use the correct monograph
  • Dose and administration: prescribing and administration monograph 
  • Link  Neonatal guideline - patent ductus arteriosus
    Link  Neonatal prescribing and administration monograph
       
    Immunisations
    (neonatal)
    View SPC online View childrens BNF
    Formulary See vaccines (below) 
       
    Immunoglobulins (Octagam®)
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
  • To request immunoglobulin, a clinician request form (see link below) needs to be completed before discussion with pharmacy
  • Approved indications: haemolytic disease of the newborn (red), alloimmune thrombocytopenia (red). Other indications require immunology and funding approval before use
  • Octagam monograph below (2g vials usually used)
  • Prescribe on immunoglobulin prescription chart (available from pharmacy)(see example below)
  • Other immunoglobulin brands can also be used - contact your pharmacy team
  • Dose: see DoH guidance (see link below)
  • An additional 0.15micron filter is not required for Octagam 
  • Link  LTHT Immunoglobulins information (forms / guidance / DMP)
    Link  LTHT Neonatal Monograph: Octagam (Human Immunoglobulin)
    Link  LTHT NNU: Octagam prescribing example
       
    Insulin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose and administration: prescribing and administration monograph 
  • Link  Neonatal guideline - hyperglycaemia
    Link  Neonatal prescribing and administration monograph
       
    Isoniazid
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • For treatment of congenital tuberculosis see BNFc 
  • Link  Neonatal BNF-c monograph (tuberculosis treatment)
    Link  Neonatal guideline - infants exposed to maternal tuberculosis
       
    Isoprenaline
    (neonatal)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
    Link  Paediatric cardiology and PICU Prescribing and Administration guide (isoprenaline)
       
    Lamivudine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
  • Lamivudine 10mg/mL liquid expires 1 month after first opening. To prevent wastage transfer opened bottle with the patient from delivery suite.
  • Stocked in LGI and SJUH delivery suites 
  • Link  Neonatal guideline - management of infants born to to mothers known to be HIV positive
       
    Levetiracetam
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    • IV and enteral dose and administration - see monograph below
     
    Link  Neonatal levetiracetam - prescribing and administration monograph
       
    Levothyroxine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose and administration: neonatal BNF-c monograph 
  • Link  Neonatal BNF-c monograph
       
    Lidocaine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Infiltration anaesthesia: BNFc 
  • Link  Drug Safety Update (Dec 18) Oral lidocaine-containing products for infant teething: only to be available under the supervision of a pharmacist
    Link  Neonatal BNFc monograph
       
    Liothyronine
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Neonatal BNF-c monograph
       
    Loperamide
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose and administration: neonatal BNF-c monograph
  • Do not use liquid, disperse the contents of 1 x 2mg capsule in 2mL of water to give a 1mg/mL solution and give the appropriate proportion 
  • Link  Neonatal BNF-c monograph
       
    Magnesium sulphate
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose and administration: prescribing and administration monograph 
  • Link  MHRA: Drug Safety Update (May 19) Magnesium sulfate: risk of skeletal adverse effects in the neonate following prolonged or repeated use in pregnancy
    Link  Drug Safety Update (Sep 17): serious cardiac adverse reactions with high doses of loperamide associated with abuse or misuse
    Link  Neonatal Prescribing and Administration Monograph
       
    Meningococcal group C conjugate vaccine
    (neonatal)
    View SPC online View childrens BNF
    Formulary June 2013 - change to primary immunisation schedule
  • One dose of Menjugate Kit® or Neisvac-C® should be used for primary course (Neisvac-C® stocked at LTHT)
  • Meningitec® should not be used for one-dose schedule
  • If Meningitec® used at 3 months (e.g. if vaccination initiated abroad, or if used in error), the child will require an additional dose at least one month after the first injections 
  • Link  Neonatal immunisation protocol
       
    Meropenem
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Dose and administration: prescribing and administration monograph 
  • Link  Neonatal prescribing and administration monograph
    Link  Neonatal sepsis guideline
       
    Metanium
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Neonatal BNF-c monograph
       
    Metronidazole
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: Neonatal BNF-c monograph 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal guideline - surgical antibiotic prophylaxis
    Link  Neonatal Network prescribing and administration monograph - metronidazole
    Link  Warning: Metronidazole, Paracetamol and Sodium Chloride infusions look very similar
       
    Miconazole oral gel / topical cream (Daktarin®)
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Drug Safety Update (Sept 17): risk of bleeding (possibly fatal) with warfarin
    Link  Drug Safety Update (June 2016): reminder of potential for serious interaction with warfarin
    Link  Neonatal BNF-c monograph (oral AND topical application)
    Link  Neonatal guideline - management of superficial candidiasis
       
    Controlled Drug Midazolam
    (neonatal)
    View SPC online View childrens BNF
    Formulary Products available:
  • 5mg in 5mL injection
  • 5mg, 10mg and 20mg in 50mL glucose 10% available from pharmacy aseptics
     
  • Link  Neonatal Network Prescribing and Administration Monograph - midazolam
    Link  Neonatal guideline - hypoxic ischaemic encephalopathy
    Link  Neonatal guideline - neonatal convulsions
    Link  Neonatal guideline - sedation of mechanically ventilated infants
       
    Milrinone
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • For prescribing and administration, follow paediatric cardiology information linked below 
  • Link  Paediatric cardiology prescribing and administration monograph (milrinone)
       
    Controlled Drug Morphine sulphate
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Neonatal Prescribing and Administration Monograph
    Link  Neonatal guideline - neonatal abstinence syndrome
    Link  Neonatal guideline - sedation of mechanically ventilated infants
    Link  Medication Safety Alert: mis-selection of morphine (LTHT access only)
       
    Naloxone
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Neonatal BNF-c monograph
       
    Nevirapine
    (neonatal)
    View SPC online View childrens BNF
    Formulary
    High Cost Medicine
  • Nevirapine 10mg/mL liquid expires 6 months after first opening. To prevent wastage transfer opened bottle with the patient from delivery suite
  • Stocked in LGI and SJUH delivery suites. 
  • Link  Neonatal guideline - management of infants born to to mothers known to be HIV positive
       
    Noradrenaline
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • IV dose and administration: prescribing and administration monograph
     
  • Link  Neonatal prescribing and administration monograph
       
    Nystatin
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Topical cream discontinued (follow guideline below for alternative)
  • Oral drops available
  • From November 2011, nystatin will be the first line antifungal for the prophylaxis of invasive candida - see guideline below 
  • Link  Neonatal guideline - prophylaxis of invasive candida
    Link  Neonatal guideline - superficial candidiasis
       
    Octenisan
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Use daily as a wash from 28 weeks of age 
  •    
    Octreotide
    (neonatal)
    View SPC online View childrens BNF
    Formulary  
    Link  Neonatal Prescribing and Administration Monograph - octreotide
    Link  Paediatric cardiology supporting information (octreotide)
       
    Omeprazole
    (neonatal)
    View SPC online View childrens BNF
    Formulary
  • Losec brand IV injection has been withdrawn from the market. There is no IV omeprazole product suitable for use in neonates - if indicated, consider IV esomeprazole (see paediatric monograph for dosing information)
  • Oral dose and administration: neonatal BNFc monograph 
  • Link  Neonatal BNF-c monograph
    Link  Neonatal guideline - management of suspected GORD
       
    Controlled Drug Oxycodone
    (neonatal)
    View adult BNF View SPC online View childrens BNF
    Formulary
  • For use in line with paediatric pain team advice 
  • Link  Neonatal prescribing and administration monograph
       
    Palivizumab
    (neonatal)