Harrogate & Rural District Formulary Formulary

	Harrogate & Rural District Formulary
	Harrogate & District NHS Foundation Trust Harrogate & Rural District Clinical Commissioning Group

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Formulary Chapter 1: Gastro-intestinal system - Full Chapter

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01.03

Antisecretory drugs and mucosal protectants

01.03

Helicobacter pylori infection

Recommended regimen for eradication of Helicobacter pylori

First line
Omeprazole 20mg bd +
Clarithromycin 500mg bd +
Amoxicillin 1g bd

Duration of treatment: 7 days

Alternative regimen
Omeprazole 20mg bd +
Clarithromycin 250mg bd
Metronidazole 400mg bd

Duration of treatment: 7 days

• Following eradication and healing, long term therapy with a PPI is usually not necessary.
• Patients remaining symptomatic should be treated with a H2RA (ranitidine) or the lowest dose of a PPI to control symptoms.
• After 6-8 weeks confirm Helicobacter pylori eradication . If negative try off all therapy. If positive, re-treat and repeat breath test.

01.03

NSAID-associated ulcers

01.03.01

H2-receptor antagonists

Ranitidine

Formulary

Tablets 150mg, 300mg; Liquid 75mg/5ml

Ranitidine IV

Formulary

Injection 50mg/2ml

01.03.02

Selective antimuscarinics

01.03.03

Chelates and complexes

Sucralfate (Antepsin^®)

Formulary

Unlicensed preparation approved for use by the gastroenterology consultants only.

Approved as a Red Drug until the licensed preparation is available again.

01.03.04

Prostaglandin analogues

01.03.05

Proton pump inhibitors (PPIs)

Omeprazole

Formulary

Capsules 10mg 20mg

Omeprazole IV

Formulary

HDFT Intravenous Omeprazole Prescription Chart

Lansoprazole

Restricted

FasTabs 15mg 30mg for administration down enteral feeding tubes only

Lansoprazole

Formulary

Capsules 15mg 30mg;

01.03.06

Other ulcer-healing drugs

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Non Formulary Items

Cimetidine

Non Formulary

Cimetidine (Dyspamet^®)

Non Formulary

diabact UBT

Non Formulary

Esomeprazole

Non Formulary

Famotidine

Non Formulary

Famotidine (Pepcid^®)

Non Formulary

Helicobacter Test Hp-Olus

Non Formulary

Helicobacter Test INFAI

Non Formulary

Misoprostol (Cytotec^®)

Non Formulary

Drug Safety Update: Misoprostol vaginal delivery system (Mysodelle): reports of excessive uterine contractions (tachysystole) unresponsive to tocolytic treatment

Nizatidine

Non Formulary

Nizatidine (Axid^®)

Non Formulary

Pantoprazole (Protium^®)

Non Formulary

Pylobactell

Non Formulary

Rabeprazole Sodium (Pariet^®)

Non Formulary

Ranitidine Bismuth Citrate (Pylorid^®)

Non Formulary

Tripotassium Dicitratobismuthate

Non Formulary

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG

Traffic Light Status Information

Status	Description
	Medicines which are suitable to be prescribed in primary care only after specialist recommendation. Ongoing prescribing by primary care includes titration of dose and assessment of efficacy. There is no need for ongoing monitoring other than for general adverse effects as listed in the BNF & SPC.
	Medicines which are suitable to be prescribed in primary care only after specialist recommendation only under a shared care protocol once the patient has been stabilised. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must be approved by the Harrogate & Rurual District Area Prescribing Committee (HaRD APC).
	Medicines which the Harrogate & Rural District Area Prescribing Committee (HaRD APC) has reviewed and does not recommend for use at present based on a review of clinical and/or cost effectiveness data.
	Medicines suitable for routine use and can be prescribed within primary care within their licensed indication in accordance with nationally recognised formularies e.g. BNF, BNF for Children, Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.
	Medicines which the Harrogate & Rural District Area Prescribing Committee (HaRD APC) have not yet reviewed.
	Medicines for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician. The drug should be supplied by the hospital for the duration of the treatment course. Primary care prescriber initiation or continuation of treatemnt is not recommended.