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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

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24.06  Expand sub section  Endocrine system (paediatric)
Burosumab (Crysvita®)
(paediatrics)
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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)
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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)
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Formulary  
Link  PICU Prescribing and Administration Guide (dexamethasone)
   
Endocrine Tests for Children
(paediatrics)
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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)
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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)
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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)
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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)
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Formulary  
   
Glimepiride
(paediatrics)
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Formulary  
   
Glucagon (Endocrine test)
(paediatrics)
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Restricted Drug Restricted  
Link  Anterior Pituitary Function Tests for Children - Glucagon Stimulation Test
   
Gonadorelin (Endocrine test)
(paediatrics)
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Formulary  
Link  Gonadotrophin Releasing Hormone (GnRH) test for children
   
Hydrocortisone (generic; Alkindi® granules in capsules for opening)
(paediatrics)
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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)
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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)
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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)
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Restricted Drug Restricted
Amber 2
 
Link  Tresiba (paediatrics) : Amber 2 guidance
   
Octreotide
(paediatrics)
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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)
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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)
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Formulary  
Link  Protocol for children on pamidronate infusions
   
Prednisolone
(paediatrics)
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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
       
     ....
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Green

    Medicines which are appropriate for initiation and ongoing prescribing in both primary and secondary care.  

    Amber 1

    Amber Level 1- Specialist Recommendation
    These medicines are considered suitable for GP prescribing following specialist recommendation.
     
    There is no requirement for full Amber Drug Guidance. Generic Amber Level 1 Drug Guidance detailing responsibilities and information sources is available here
      

    Amber 2

    Amber Level 2- Specialist Initiation but no monitoring requirements
    These medicines are considered suitable for GP prescribing following specialist initiation, including titration of dose and assessment of efficacy.
    Some Amber Level 2 products will have an associated Amber Level 2 Drug Guidance document, available by clicking on the traffic light symbol to the right of the drug name. If this is not available, generic Amber Level 2 Drug Guidance is available here  

    Amber 3

    Amber Level 3- Specialist Initiation with ongoing monitoring requirements (Full Amber Drug Guidance required)
    Medicines that should be initiated by a specialist, and which require significant monitoring on an ongoing basis. Full agreement to share the care of each specific patient must be reached under the amber drug agreement, and Amber Drug Guidance must be provided to the GP (available by clicking on the traffic light symbol to the right of the drug name).   

    Red

    Guidance on the responsibilities for Red Drugs can be found here. Red Drugs would usually by prescribed by the hospital for the duration of the course. Primary care prescriber initiation or continuation of treatment not recommended except by Specialist GP and community paediatric prescribing.   

    Grey

    Grey Drugs are locally-agreed medicines which are only recommended for restricted use within the Leeds Health Economy.   

    Black

    These drugs are not recommended for use within the Leeds Health Economy  

    Multiple

    Products shown as blue have different Traffic Light List classifications dependent on indication. See the accompanying text next to the product for further information the indications for which it has a Traffic Light List classification.  

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