netFormulary
Data extracted : 24/07/2014
 Formulary Section 9: Nutrition and blood
 Details...
09.01 Anaemias and some other blood disorders
Link   NICE CG39: Anaemia management in chronic kidney disease
09.01.01 Iron-deficiency anaemias
09.01.01.01 Oral iron
First Choice:
Ferrous Sulphate  (200mg)
Ferrous Fumarate  (210mg)
Ferrous Gluconate  (300mg)
Sodium Feredetate  (Sytron®)
  • Liquid
  • 09.01.01.01 Iron and folic acid
    Iron and Folic Acid  (Pregaday®)
  • Ferrous fumarate equivalent to 100mg iron and folic acid 350 micrograms
  • 09.01.01.02 Parenteral iron

    Prescribe parenteral iron products by brand name - important differences between formulations

    Link   Drug Safety Update (Sept 2013): IV iron and serious hypersensitivity reactions: new advice on initial test dose
    Link   Medicines Standard (July 2011) - potential for confusion with parenteral iron preparations (LTH Access Only)
    Link   Parenteral iron dose calculator
    Iron Dextran  (CosmoFer®)
    Iron Sucrose  (Venofer)
    Restricted Drug  Ferric Carboxymaltose  (Ferinject®)
  • For renal teams in line with agreed commissioned pathway for renal anaemia
  • For obstetric teams in line with agreed pathway for the management of anaemia in pregnancy
  • For hepatology and liver transplant services
  • All other uses require agreement of funding before use

  • For use within the renal service, use the prescription chart linked below to guide dosing
  • For other indications, use the parenteral iron dose calculator at the bottom of this page
  • 09.01.02 Drugs used in megaloblastic anaemias
    Folic Acid 
    Hydroxocobalamin 
    09.01.03 Drugs used in hypoplastic, haemolytic, and renal anaemias
    Restricted Drug  Eculizumab 
  • Use in line with NHSEngland commissioned position. Seek advice from specialist pharmacists
  • 09.01.03 Erythropoietin
    For information on possible doses of epoetin used for the management of patients who refuse blood transfusion, please contact Medicines Information on ext 65377 quoting ref 123860.
    Link   NICE TA142: Anaemia (cancer-treatment induced) - erythropoietin (alpha and beta) and darbepoetin
    Darbepoetin Alfa  (Aranesp®)
  • Treatment of anaemia associated with chronic renal failure in adults and children aged 11 years and over
  • NHS Leeds Traffic Light List classification (link): AMBER 3
  • Epoetin beta  (NeoRecormon®)
  • Anaemia associated with erythropoietin deficiency in chronic renal failure
  • NHS Leeds Traffic Light List classification (link): AMBER 2
  • Methoxy Polyethylene Glycol-Epoetin Beta  (Mircera®)
  • NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only
  • Restricted Drug  Epoetin alfa  (Eprex®)
  • For haematology use only
  • Anaemia associated with erythropoietin deficiency in chronic renal failure
  • NHS Leeds Traffic Light List classification (link): AMBER 2
  • 09.01.03 Iron overload
    Desferrioxamine Mesilate 
  • Treatment of iron overload

  • NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only

  • Deferasirox  (Exjade®)
  • Treatment of chronic iron overload

  • NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only
  • Deferiprone  (Ferriprox®)
  • Treatment of iron overload

  • NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only
  • 09.01.04 Drugs used in autoimmune thrombocytopenic purpura
    Anagrelide  (Xagrid®)
  • Thrombocythaemia
  • NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only
  • Eltrombopag 
  • For use in line with TA293
  • NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only
  • 09.01.05 G6PD deficiency
    09.01.06 Drugs used in neutropenia
    Link   G-CSF guidance - use and product selection (LTHT access only)
    Filgrastim  (Neupogen®)
  • Recombinant human granulocyte-colony stimulating factor (G-CSF) - neutropenia

  • NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only


    ’Web Drug Safety Update: risk of potentially life-threatening capillary leak syndrome>
  • Filgrastim  (Zarzio®)

    ’Web Drug Safety Update: risk of potentially life-threatening capillary leak syndrome>
    Lenograstim  (Granocyte®)
  • Recombinant human granulocyte-colony stimulating factor (rHuG-CSF) - neutropenia

  • NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only
  • Pegfilgrastim  (Neulasta®)

    ’Web Drug Safety Update: risk of potentially life-threatening capillary leak syndrome
    09.01.07 Drugs used to mobilise stem cells
    Restricted Drug  Plerixafor 
  • For stem cell mobilisation in line with NHS England commissioned position - see link below
  • 09.02 Fluids and electrolytes
    09.02.01 Oral preparations for fluid and electrolyte imbalance
    09.02.01.01 Oral potassium
    Link   Hypokalaemia guideline (NHS access only)
    Link   See also intravenous potassium
    First Choice:
    Potassium Chloride  (Sando-K®)
  • soluble tablet
  • Potassium Chloride  (Kay-Cee-L®)
  • Liquid
  • Potassium Chloride  (Slow-K®)
  • Prolonged release tablet
  • BNF classes as less suitable for prescribing
  • 09.02.01.01 Potassium removal
    Link   LTHT guideline: hyperkalaemia in adults (NHS access only)
    Polystyrene Sulphonate Resins  (Calcium Resonium®)
    09.02.01.02 Oral sodium and water
    Sodium Chloride  (Slow Sodium®)
  • Prolonged release product
  • 09.02.01.02 Oral rehydration therapy (ORT)
    Oral Rehydration Salts 
    09.02.01.03 Oral bicarbonate
    Sodium Bicarbonate 
    09.02.02 Parenteral preparations for fluid and electrolyte imbalance
    09.02.02.01 Electrolytes and water
    Link   Subcutaneous fluids (hypodermoclysis) information
    09.02.02.01 Intravenous sodium
    Sodium Chloride Intravenous 
    09.02.02.01 Intravenous glucose
    Glucose Intravenous 
    09.02.02.01 Intravenous potassium
    Potassium Chloride  (intravenous)
    09.02.02.01 Bicarbonate and lactate
    Sodium Bicarbonate  (Sodium Bicarbonate Intravenous Infusion)
    09.02.02.01 Water
    Water for Injection 
    09.02.02.02 Plasma and plasma substitutes
    Human Albumin Solution 
    09.02.02.02 Plasma substitutes
    Dextran 40® 
    Dextran 70® 
    Gelatin  (Volplex®)
    09.03 Intravenous nutrition
    Link   NICE CG32: Nutrition support in adults
    Parenteral Nutrition  (adult)
    09.03 Supplementary preparations
    09.04 Oral nutrition
    Link   NICE CG32: Nutrition support in adults
    09.04.01 Foods for special diets
    09.04.02 Enteral nutrition
    Link   NICE CG32: Nutrition support in adults
    Enteral nutrition  (adult)
    09.05 Minerals
    09.05.01 Calcium and magnesium
    09.05.01.01 Calcium supplements
    Link   Calcium and vitamin D supplements that are suitable for patients with peanut allergy
    Link   Hyperkalaemia - Trust Guideline (NHS access only)
    Link   Hypocalcaemia - Trust Guideline (NHS access only)
    Link   Is there a calcium and vitamin D preparation which is suitable for vegetarians
    Link   NICE TA160: Osteoporosis - primary prevention
    Link   NICE TA161: Osteoporosis - secondary prevention including strontium ranelate
    Calcium gluconate  (intravenous)
    Calcium chloride  (intravenous)
    Calcium Salts  (oral)
  • Sandocal-1000® effervescent tablets are available.
  • Sandocal-400® have been discontinued.

  • If liquid products are unavailable contact Medicines Information on (0113 20) 65377, quoting reference number 136327 for information on administering fractional doses of Sandocal-1000® effervescent tablets
  • Calcium with vitamin D  (oral)
    Stocked at LTHT
  • Calcium carbonate 1.25g (calcium 500mg) and colecalciferol 10 micrograms (400 units) chewable tablets (Calceos®)
  • Calcium phosphate 3.1g (calcium 1.2g) and colecalciferol 20 micrograms (800 units) sachets (Calfovit D3®)

    Not stocked at LTHT, used within primary care
  • Adcal D3® chewable tablets
  • Calcichew D3 Forte® chewable tablets
  • Adcal D3® caplets
  • Calcichew D3® caplets

  • For products less suitable for use within Leeds, see non-formulary entry below
  • 09.05.01.02 Hypercalcaemia and hypercalciuria
    Link   LTH Clinical Guideline for the Treatment of Hypercalcaemia in Adults (NHS access only)
    Link   LTH Clinical Guideline for the treatment of Hypercalcaemia of Malignancy in Adults (NHS access only)
    Cinacalcet  (Mimpara®)
  • Hyperparathyroidism in patients with end stage renal disease on dialysis
  • NHS Leeds Traffic Light List classification (link): AMBER 3
  • Restricted Drug  Cinacalcet  (Mimpara ®)
  • Primary hyperparathyroidism (unlicensed use)
  • NHS Leeds Traffic Light List classification (link): AMBER 3
  • 09.05.01.03 Magnesium
    Link   Hypermagnesaemia - Trust Guideline (NHS access only)
    Link   Hypomagnesaemia Trust Guideline (NHS access only)
    First Choice:
    Magnesium Glycerophosphate 
  • Tablets 4 mmol (contains 97.2 mg Magnesium)
  • Liquid 1 mmol/1ml (contains 24.25mg Magnesium), to be used when patients are not suitable for tablets or magnesium aspartate sachets
  • First Choice:
    Magnesium aspartate 
  • Sachets 10 mmol (contains 243.12 mg magnesium)

  • Use in preference to magnesium glycerophosphate liquid
  • Restricted Drug  Magnesium Oxide 
  • Oncology and haematology use
  • Magnesium Sulphate 
  • IV
    ’Loading  Caution: NPSA RRR18 - Preventing fatalities from medication loading doses - see links below for prescribing guidance (pre-eclampsia)
  • 09.05.02 Phosphorus
    09.05.02.01 Phosphate supplements
    Link   Management of hypophosphataemia (NHS access only)
    Phosphate polyfusor 
    Phosphate supplements  (Phosphate-Sandoz®)
    09.05.02.02 Phosphate-binding agents
    Link   Costs for phosphate binding agents (September 2011) (NHS access only)
    Aluminium Hydroxide  (Alu-Cap®)
    Calcium Salts  (calcium acetate)
  • Phosex® 1g
  • Renacet® 475mg, 950mg
  • PhosLo® 667mg
  • Calcium Salts  (calcium chloride)
  • Calcichew®
  • Lanthanum  (Fosrenol ®)
  • Phosphate binder - hyperphosphataemia in patients on haemodialysis and peritoneal dialysis

  • NHS Leeds Traffic Light List classification (link): AMBER 3
  • Sevelamer  (Renagel® / Renvela®)
  • Treatment of hyperphosphataemia in dialysis patients

  • NHS Leeds Traffic Light List classification (link): AMBER 3
  • 09.05.03 Fluoride
    Restricted Drug  Fluorides  (Toothpaste)
  • NHS Leeds Traffic Light List classification (link): GREY - Restricted use only within Leeds Health Economy
  • 09.05.04 Zinc
    Zinc Sulphate 
    09.05.05 Selenium
    Restricted Drug  Selenium 
  • unlicensed tablets and injection available at LTH
  • treatment of selenium deficiency that can not be offset by food sources, usually initiated following advice by the nutrition team
  • 09.06 Vitamins
    09.06.01 Vitamin A
    Vitamins A and D 
  • unlicensed capsules in use at LTH
  • 09.06.02 Vitamin B group
    Link   Guideline - alcohol withdrawal in adults (NHS access only)
    Link   Guideline - alcohol withdrawal in older people (NHS access only)
    Nicotinamide 
    Pyridoxine Hydrochloride  (Pyridoxine)
  • unlicensed 10mg tablets available at LTH, indication and dose as per BNF
  • Thiamine 
    Thiamine  (Pabrinex®)
    09.06.02 Oral vitamin B complex preparations
    Vitamin B Tablets (Compound Strong) 
    09.06.02 Other compounds
    09.06.03 Vitamin C
    Ascorbic Acid 
    09.06.04 Vitamin D
    Link   CMO letter - importance of vitamin D supplementation in at risk groups (Feb 2012)
    Link   Q+A - vitamin D products suitable for patients with peanut/soya allergy
    Link   Q+A - vitamin D products suitable for vegetarians
    Link   Vitamin D deficiency in Adults - Primary Care Guideline (includes product sourcing information) (NHS access only)
    Alfacalcidol 
    Colecalciferol 
  • (300,000 unit/mL injection NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only)
  • High-strength colecalciferol preparations are unlicensed
  • For advice on sourcing products, see guideline link below.
  • Ergocalciferol 
  • Ergocalciferol 50,000 units capsules available at LTH is an unlicensed preparation
  • 09.06.05 Vitamin E
    Alpha Tocopheryl Acetate  (Vitamin E)
    09.06.06 Vitamin K
    Link   Available vitamin K products at LTHT (NHS access only)
    Menadiol Sodium Phosphate  (Vitamin K)
    Phytomenadione  (Vitamin K)
  • Phytomenadione tablets (Menadion) and capsules are available as unlicensed products
  • 09.06.07 Multivitamin preparations
    Multivitamin preparations  (Abidec®)
    Mutivitamin 
    Restricted Drug  Antox 
  • Antioxidant preparation for the management of pancreatitis

  • NHS Leeds Traffic Light List classification (link): AMBER 2
  • 09.06.07 Vitamin and mineral supplements and adjuncts to synthetic diets
    Renavit® 
  • Replaces Nephrovite or vitamin B co-strong / folic acid combination for patients requiring dialysis
  • ACBS approved and prescribable on FP10

  • NHS Leeds Traffic Light List classification (link): AMBER 1
  • Vitamin and mineral supplements  (Forceval®)
    Vitamin and mineral supplements  (Ketovite®)
    09.07 Bitters and tonics
    09.08 Metabolic disorders
    09.08.01 Drugs used in metabolic disorders
    09.08.01 Wilsons disease
    Penicillamine 
    09.08.01 Carnitine deficiency
    Carnitine  (Carnitor®)
  • NHS Leeds Traffic Light List classification (link): AMBER 2

    (L-acetyl carnitine for drug induced peripheral neuropathy: NHS Leeds Traffic Light List classification (link): RED - Hospital Use Only)
  • 09.08.01 Fabry's disease
    Agalsidase Alfa and Beta  (Fabrazyme®)
    09.08.01 Gaucher's disease
    09.08.01 Mucopolysaccharidosis I
    09.08.01 Pompe disease
    09.08.01 Nephropathic cystinosis
    Mercaptamine  (Cystagon®)
    09.08.01 Urea cycle disorders
    Sodium Phenybutyrate  (Ammonaps®)
    09.08.02 Acute porphyrias
    Link   Wales Medicines Information Centre - medicines in porphyria (includes link to NAPOS website)
    Haem Arginate  (Normasang®)
  • Supply is only via a designated porphyria centre - cannot be ordered directly from the manufacturer.
  • If haem arginate is required, please contact Medicines Information on ext 65377 for guidance, ref 129720
  • Administration guidance is supplied with the product. Contact Medicines Information on ext 65377 for more guidance, ref 133283
  •  ....