BNF Chapter 5

1. Gastro-Intestinal System | 2. Cardiovascular System | 3. Respiratory System | 4. Central Nervous System | 5. Antimicrobials | 6. Endocrine System | 7. Obstetrics, Gynaecology & Urology | 8. Malignant Disease & Immunosuppression | 9. Nutrition & Blood | 10. Musculoskelatal & Joint Diseases | 11. Opthalmology | 12. Ear, Nose & Oropharynx | 13. Dermatology | 14. Immunology & Vaccines | 15. Anaesthetics |  GP Centre Home


Antimicrobials

Please click here for the SaSH Microguide

Please click here for the CCG Antimicrobial Guidelines

2 Bacterial Infection
AMINOGLYCOSIDESNOTES
AMIKACIN Injection 500mg in 2ml, paediatric 100mg in 2ml

 

RESTRICTED

May be prescribed when recommended on Microguide or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

Therapeutic Drug Monitoring Required Treatment of serious Gram ve infections resistant to gentamicin . Amikacin – Therapeutic drug monitoring

GENTAMICIN Injection 80mg in 2ml, 20mg in 2ml (paediatric)

Intrathecal injetion 5mg in 1ml

Therapeutic Drug Monitoring Required, refer to SaSH guideline

Consult with MICRO/CLINICAL PHARMACIST in any of the following : Renal Impairment, Abnormal serum levels, continued therapy (more than 2 doses) and patients not suitable for once daily dosing* (pregnancy, infants<6months, endocarditis, CF patients & burns patients) .

When should gentamicin levels be taken after once daily administration?

NEOMYCIN500mg tabletsRESTRICTED

Colorectal surgery prophylaxis only

MICRO Approval Required for all other indications.

TOBRAMYCIN80mg/2ml injection

260mg/6ml injection

RESTRICTED

Prescribing by paediatric and respiratory clinicians for CF patients (adults and paediatrics) on the advice of the Royal Bromton only.

MICRO Approval Required for all other indications.

CARBAPENEMSNOTES
ERTAPENEM Injection 1gRESTRICTED

May be prescribed when recommended on Microguide (proven or suspected multi-resistant Gram ve infections) or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

IMIPENEM + CILASTIN Injection IM 500mg, IV 500mgRESTRICTED

May be prescribed when recommended on Microguide (proven or suspected multi-resistant Gram ve infections) or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

MEROPENEM Injection 500mg, 1gRESTRICTED

May be prescribed when recommended on Microguide (proven or suspected multi-resistant Gram ve infections) or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

CEPHALOSPORINS – first generationNOTES
Medicines Q&A – Is there a 10% cross-sensitivity between penicillins and cefalosporins?

Is there a 10% cross-sensitivity between penicillins and cephalosporins?

CEFALEXIN Capsules 250mg, 500mg

Suspension 125mg in 5ml, 250mg in 5ml, 500mg in 5ml

1st line oral cephalosporin of choice
CEPHALOSPORINS – second generationNOTES
CEFUROXIME Injection 250mg, 750mg, 1.5g1st line IV cephalosporin of choice
CEPHALOSPORINS – third generationNOTES
CEFIXIMETablets 200mgRESTRICTED

May be prescribed when recommended on Microguide (gram -ve infection when other agents are unsuitable, stat dose in uncomplicated gonorrhoea (unlicensed – GUM only), MICRO Approval Required for all other indications.

British Association for Sexual Health and HIV guidelines

UK national guideline for the management of gonorrhoea in adults, 2011 (BASHH)

CEFOTAXIME Injection 250mg, 500mg, 1gRESTRICTED

May be prescribed when recommended on Microguide (bacterial meningitis, severe bacterial pneumonias) or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

CEFTAZIDIME Injection 250mg, 500mg, 1g, 2gRESTRICTED

May be prescribed when recommended on Microguide  or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

CEFTRIAXONE Injection 250mg, 1g, 2gRESTRICTED

May be prescribed when recommended on Microguide (bacterial meningitis, biliary sepsis, PID, gonorrhoea, community IV programme) or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

UK national guideline for the management of gonorrhoea in adults, 2011 (BASHH)

GLYOCOPEPTIDESNOTES
DALBAVANCINInjection 500mgMICROBIOLOGIST & senior pharmacist approval required

RESTRICTED for treatment of the following conditions to facilitate earlier  discharge in vulnerable adults for whom an IV long line is not appropriate:

  1. Acute bacterial skin and skin structure infections (ABSSSI)
  2. Bone & joint infections (off-label use)
TEICOPLANIN Injection 200mg, 400mgRESTRICTED for treatment of the following conditions:

  1. Treatment of MRSA
  2. Penicillin allergy in gram +ve infections
  3. Community IV Programme TDM & blood levels maybe required : consult with MICRO or CLINICAL PHARMACIST
VANCOMYCIN Capsules 250mg

Injection 500mg, 1g

Therapeutic drug monitoring required for IV therapy refer to SaSH microguide

CONSULT with MICRO / CLINICAL PHARMACIST in any of the following cases 1) Renal Impairment 2) Abnormal serum levels3)Continued therapy

ORAL VANCOMYCIN
Infection Control and Antimicrobial Stewardship (CDI)

CDI change of treatment Jan 2017 

CONTINUOUS INFUSION I/V VANCOMYCIN [CRITICAL CARE SETTING]
Continous vancomycin [Critical Care] May 2014

LINCONSAMIDESNOTES
CLINDAMYCIN Capsules 150mg

Suspension 150mg in 5ml

Injection 300mg in 2ml

RESERVED For patients allergic to penicillin who fall into any of these 4 groups : 1) Staph. aureus infection of bone or soft tissue 2) Human or animal bites 3) SBE 4) Group B streptococcal prophylaxis in maternity patients 5) Clindamycin is also used in bacterial vaginosis Side-Effects (ie diarrhoea) limit use of this drug
MACROLIDESNOTES
AZITHROMYCIN Capsules 250mg

Suspension 200mg in 5ml

MICRO Approval Required RESTRICTED Use GUM & PAEDS are exempt from MICRO approval for treatment of the following: 1)  GUM : Chlamydia & related STIs 2) PAEDIATRICS : URTI & LRTI 3 day course
CLARITHROMYCIN Tablets 250mg, 500mg

Suspension 125mg in 5ml, 250mg in 5ml

Injection 500mg

Annotations on use of Clarithromycin 1) Preferred macrolide for LRTI (erythromycin is macrolide of choice for URTI) 2)  Macrolide of choice for (hospitalised) uncomplicated community acquired pneumonias (combined with either benzylpenicillin, co-amoxiclav or amoxicillin) 3)  Also used for atypical mycobacterial infections 4)  Also used for Helicobacter pylori eradication 7 day course         (combined with omeprazole + metronidazole or amoxicillin) 5)   Clarithromycin IV reserved for severe community acquired pneumonia 6) Clarithromycin IV is monitored by a Pharmacy Stop Order to limit the use to approved indications
ERYTHROMYCIN STEARATE Tablets 250mg, 500mg

SF Suspension 125mg in5ml, 250mg in 5ml, 500mg in 5ml

Injection 1g

Annotations on use of Erythromycin 1) Macrolide of choice for uncomplicated community acquired pneumonias (not requiring hospitalisation) when patient is allergic to penicillin 2) Used in bacterial tonsillitis & pharyngitis in patients allergic to penicillin 3) Used in otitis media & sinusitis (bacterial) if allergic to b-lactams 4) Treatment of Campylobacter enteritis when advised by MICRO 5) Erythromycin IV should be given as an infusion over 30-60 minutes.

Is there an interaction between erythromycin and statins?

NITROIMIDAZOLE DERIVATIVESNOTES
METRONIDAZOLE Tablets 200mg, 400mg

Suspension 200mg in 5ml

Suppositories 500mg

Injection 500mg in 100ml

Annotations on use of Metronidazole 1) General use anaerobic infections 2) Also used for treatment of necrotising fasciitis, intra-abdominal/biliary sepsis & bacterial vaginosis 3) Use for UNCOMPLICATED Clostridium difficile infection Choice of treatment varies upon severity, use algorithms (I&II) below I Clostridium difficile Treatment Algorithm II Clostridium difficile Bristol Stool Chart 4) Optional agent as part of triple therapy against Helicobacter pylori (omeprazole + clarithromycin + either metronidazole or amoxicillin) 7 day course
PENICILLINS – Antipseudomonal with beta lactamase inhibitorNOTES
TAZOCIN [Piperacillin + Tazobactam] Injection 2.25g, 4.5gRESTRICTED

May be prescribed when recommended on Microguide or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

(CONTAINS PENICILLIN)

PENICILLINS – Beta-lactamase sensitiveNOTES
Medicines Q&A – What is the clinical significance of the interaction between methotrexate and penicillins?

What is the clinical significance of the interaction between methotrexate and penicillins?

BENZYLPENICILLIN Injection 600mg, 1.2gUKMi How do you treat syphilis with parenteral benzylpenicillins
PENICILLIN V (phenoxymethypenicillin)Tablets 125mg, 250mg

Syrup 125mg/5ml, 250mg/5ml

PENICILLINS – broad-spectrum NOTES
AMOXICILLIN Capsules 250mg, 500mg

Syrup 125mg/5ml, 250mg/5ml, 125mg in 1.25ml (restricted to paediatrics/neonatal)

Injection 250mg, 500mg, 1g

Sachets (SF) 3g

PENICILLINS – broad-spectrum with beta-lactamase inhibitorNOTES
CO-AMOXICLAV [Amoxicillin/Clavulanic acid] Tablets 375mg, 625mg

Suspension 125/31mg in 5ml SF, 250/62mg in 5ml SF, 400/75mg in 5ml (Paeds only)

Injection 600mg, 1.2g

PENICILLINS – mecillinam-typeNOTES
PIVMECILLINAM Tablets 200mg

MICRO Approval Required (CONTAINS PENICILLIN) RESTRICTED
1) Reserved for treatment of ESBL UTI

eMC Medicines Compendium

PENICILLINS – penicillinase-resistant NOTES
FLUCLOXACILLIN Capsules 250mg, 500mg

Syrup 125mg/5ml, 250mg/5ml

Injection 500mg, 1g


TEMOCILLIN
 Injection 1g ** New Agent Added for Empirical Treatments ** see
POLYMYXINSNOTES
COLISTIMETHATE SODIUM500,000 units Vial, 1,000,000 units VialRESTRICTED

MICROBIOLOGY CONSULTANT approval Required.

COLOMYCIN injection 1 million units, 2 million units, suitable for nebulisationRESTRICTED

May be prescribed when recommended on Microguide (paediatrics, serious gram -ve infections and Pseudomonas. Also inhaled via nebulised route in CF) or were susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

QUINOLONESNOTES

MHRA WARNING: FLUOROQUINOLONES

CIPROFLOXACIN Tablets 100mg, 250mg, 500mg

Suspension 250mg/5ml

Infusion 100mg/50ml, 200mg/100ml

Microbiology Policy on Ciprofloxacin Notes on use of Oral Ciprofloxacin 1) Ciprofloxacin should NOT be used for empirical treatment of lower UTI 2) Ciprofloxacin may be used in conjunction with gentamicin for patients allergic to b-lactams to treat the following conditions : UTI, acute prostatitis, gram ve sepsis & neutropenic fever 3) For treatment of Salmonella enteritis, Campylobacter enteritis, bacillary dysentery (Shigella) on MICRO advice
LEVOFLOXACIN Tablets 250mg, 500mg

Infusion 500mg/100ml

RESERVED for treatment of community acquired pneumonias in patients allergic to b-lactams
MOXIFLOXACIN Tablets 400mgRESTRICTED USE MICRO approval or RESPIRATORY CONSULTANT use only.
NORFLOXACINTablets 400mgReserved for propyhlaxis of spontaneous bacterial peritonitis
OFLOXACINTablets 200mg, 400mgReserved for treatment of PID (in conjunction with metronidazole)
SULPHONAMIDESNOTES
CO-TRIMOXAZOLE Tablets 480mg, 960mg

Suspension 240mg/5ml, 480mg/5ml

Injection 96mg/ml

CO-TRIMOXAZOLE contains a mixture of trimethoprim 1 part to sulfamethoxazole 5 parts RESERVED for treatment of: 1. bacillary dysentery 2. PCP 3. disease due to Stenotrophomonas maltophilia, e.g. ventilator-associated pneumonia . UKMi How to administer intravnous co-trimoxazole in fluid restricted patients
SULFADIAZINE Tablets 500mg

250mg / ml Injection (4ml vial)

Used for toxoplasmosis
TETRACYCLINESNOTES
DEMECLOCYCLINECapsules 150mgUsed for treatment of inappropriate secretion of antidiuretic syndrome
DOXYCYCLINECapsules 50mg, 100mg

Tablets soluble 100mg

1) Doxycycline also used in genital Chlamydia infection 2) Doxycycline also recommended for treatment of suspected PID (in conjunction with metronidazole) 3) Doxycycline also used for treatment of mild skin/soft tissue infections due to MRSA . UK national guideline for the management of Pelvic Inflammatory Disease in adults, 2011 (BASHH)
MINOCYCLINETablets 50mg, 100mg

SR Capsules 100mg

Minocycline also used for treatment of mild skin/soft tissue infections due to MRSA. APC traffic light status: AMBER

Ance APC traffic light status: BLACK  Minocycline is non-formulary for acne treatment.

APC Policy Statement: Minocycline for acne APC policy statement – Minocycline no-acne indications – June 2019

NICE Clinical Knowledge summary: Acne

OXYTETRACYCLINE Tablets 250mg
TETRACYCLINE500 mg Intravenous Injection
TIGECYCLINEInjection 50mgRESTRICTED

MICROBIOLOGY CONSULTANT Approval Only

1) Treatment of skin & soft tissue infections (excluding diabetic foot ulcers) 2) Treatment of complicated intra-abdominal infections 3) Unlicensed use for community acquired pneumonia & hospital acquired pneumonia 4) Treatment of multi-drug resistant infections

ANIBACTERIALS – OtherNOTES
CHLORAMPHENICOLCapsules 250mg

Injection 1g

0.5% drops, 1% ointment (see chapter 11: Eye)

MICRO Approval Required For treatment of serious / life threatening infections & resistant cases; also used to treat Haemophilus influenza
DAPTOMYCIN Injection 350mg, 500mgRESTRICTED

MICROBIOLOGY CONSULTANT APPROVAL REQUIRED

Treatment of resistant gram+ve bacteria (where 1st/2nd line antibiotics have failed/or not appropriate)

FIDAXOMICIN Tablets 200mgMICRO Approval required RESTRICTED
1st line treatment for toxin positive haematology patients and severe/recurrent cases (on microbiology advice)CDI change of treatment Jan 2017 *NICE Summary – Clostridium difficile infection [ESNM1] Fidaxomicin SMC approval* Updated Microbiology Guidelines to follow
FOSFOMYCIN3g Oral Sachet[ESBL UTI] Unlicensed Use
DOSE FEMALES = 1x 3g sachet stat 
DOSE MALES = 2x 3g sachet (one stat & one in 3 days – provide full course on discharge) 
Tx for ESBL UTI does not require MICRO approval. Approval required for all other indications.
40mg/ml Powder for SolutionRESTRICTED USE MICRO approval
1. Multi-resistant organisms
2. ESBL
3. Carbapenum resistant organisms
eMC Compendium
SODIUM FUSIDATE (fusidic acid) Tablets 250mg

Suspension 250mg in 5ml

Injection 500mg

LINEZOLID Tablets 600mg

Injection 600mg in 300ml

RESTRICTED

MICROBIOLOGY CONSULTANT Approval Required

For treatment of serious gram +ve infections with no suitable alternative

TRIMETHOPRIM Tablets 100mg

Suspension 50mg in 5ml

100 mg in 5ml Injection

Note: interaction with methotrexate – do not co-prescribe

Also used in lower UTI & prostatitis

 RIFAMYCINS NOTES
RIFABUTINCapsules 150mgRESTRICTED USE
Requires MICRO or RESP approval
RIFAXIMIN  Tablets 550mgGASTRO / LIVER Consultant Restricted For treatment of hepatic encephalopathy

APC traffic light status: AMBER

APC Statement – Rifaximin for prevention of hepatic encephalopathy

NICE Guidance Rifaximin for preventing episodes of overt hepatic encephalopathy [TA 337]

2.2 Leprosy
ANTIMYCOBACTERIALSNOTES
DAPSONE Tablets 50mg
2.5 Tuberculosis
ANTIMYCOBACTERIALS – rifamycinsNOTES
VORACTIV (ethambutol + Isoniazid + Pyrazinamide + Rifampicin)Tablets [Ethambutol 275 mg, Isoniazid 75 mg, Pyrazinamide 400 mg, Rifampicin 150 mg]RESTRICTED USE

Requires MICRO or RESP approval

To be used only when alternative options are unavailable.

RIFAMPICINCapsules 150mg, 300mg

Syrup 100mg in 5ml

Injection 600mg

RESTRICTED USE
Requires MICRO or RESP approval
RIFINAH (Rifampicin + Isoniazid) 150 Tablets [Rifampicin 150mg + Isoniazid 100mg ] 

300 Tablets [Rifampicin 300mg + Isoniazid 150mg]

RESTRICTED USE
Requires MICRO or RESP approval
RIFATER  (Rifampicin + Isoniazid + Pyrazinamide) Tablets Rifampicin 120mg + Isoniazid 50mg + Pyrazinamide 300mg]RESTRICTED USE
Requires MICRO or RESP approval
 
ANTIMYCOBACTERIALS – otherNOTES
CAPREOMYCIN1g Injection (1MU)RESTRICTED USE
Requires MICRO or RESP approval
CYCLOSERINE250mg CapsulesRESTRICTED USE
Requires MICRO or RESP approval
ETHAMBUTOLTablets 100mgRESTRICTED USE
Requires MICRO or RESP approval
.Use Voractiv if unavailable if  shortage of Ethambutol.
ISONIAZID Tablets 100mg

Injection 25mg/ml

RESTRICTED USE
Requires MICRO or RESP approval
PYRAZINAMIDETablets 500mgRESTRICTED USE
Requires MICRO or RESP approval
2.1 Urinary tract infections
NITROFURANTOIN Capsules 50mg
3 Fungal Infection
ANTIFUNGALS – echinocandin antifungalsNOTES
CASPONFUNGIN 50mg, 70mg vialsRESCRICTED to prescribing by Microbiology, ICU and Haematology clinicians and other clinical departments on the advice of Microbiology.

  • 1st line – candidaemia / invasive candidiasis
  • 3rd line – invasive aspergillosis –for patients who are refractory to / intolerant of voriconazole and ambisome.
  • 1st line – Empirical treatment for presumed fungal infections (e.g. Candida or Aspergillus) in febrile neutropenic patients
ANTIFUNGALS – polyene antifungalsNOTES
AMPHOTERICIN B (LIPOSOMAL)

(AMBISOME)

 Injection 50mgRESTRICTED

May be prescribed when recommended on Microguide (Haematology/oncology). MICRO Approval Required for all other indications.

MHRA – Parenteral amphotericin B: fatal overdose risk due to confusion between lipid-based and non-lioid-based formulations

NYSTATINSuspension 100,000 units/mloral thrush – see chapter 12
ANTIFUNGALS – triazole antifungalsNOTES
FLUCONAZOLECapsules 50mg

Suspension 50mg in 5ml

Infusion 2mg/ml

ITRACONAZOLECapsules 100mg

Liquid 10mg/ml

POSACONAZOLE  Tablets 100mg

Suspension 40mg/ml

RESTRICTED

May be prescribed when recommended on Microguide (haematology/oncology) or where susceptibility testing results preclude other choices. MICRO Approval Required for all other indications.

 

SASH Guideline for the management of neutropenic sepsis, antifungal treatment, and prophylaxis.

HIGH COST DRUG (PBR excluded)

MHRA Drug Safety Update – posaconazole tablets and suspension are not directly interchangeable

VORICONAZOLETablets 50mg, 200mg

Suspension 40mg/5ml

Infusion 200mg

RESTRICTED

May be prescribed when recommended on Microguide  or where susceptibility testing results preclude other choices. MICRO Approval Required for all other indications except if haemotology.

 Microguide Antifungal guideline

HIGH COST DRUG (PBR excluded)

FLUCYTOSINE Tablets 500mg (unlicensed)

Injection 2.5g in 250ml

MICRO APPROVAL REQUIRED

Use for the treatment of Cryptococcal meningitis on advice of GUM Physician is exempt from MICRO approval.

GRISEOFULVINTablets 500mg
4 Helminth Infection
 ANTHELMINTICS  NOTES
SASH Antimicrobial GuidelinesAntimicrobial prescribing – Guidelines and Policy
ALBENDAZOLE200mg and 400mg tabletsMicrobiology consultant approval required. (Unlicensed product)
IVERMECTIN3mg tabletsMicrobiology approval required. (Unlicensed product)
MEBENDAZOLE 100 mg Tablets

100 mg in 5ml Suspension

RESERVED for treatment of threadworm, roundworm (ascaris) & hookworm
PRAZIQUANTEL150mg, 500mg and 600mg tablets.Schistosome infections. Microbiology approval required. (Unlicensed product)
5 Protozoal Infection
5.2 Malaria
ANTIPROTAZOALS – antimalarialsNOTES
ARTEMETHER +LUMEFANTRINE20mg / 120mgFirst-line treatment of Uncomplicated Falciparum malaria
ARTESUNATE 60mg injectionFirst-line treatment of Complicated Falciparum malaria

Unlicensed product ‘named patient’

CHLOROQUINE SULPHATE 200mg in 5mL InjectionTreatment of benign malaria (vivax)
MEFLOQUINE 250 mg TabletsTreatment of malaria (falciparum & vivax)
PRIMAQUINE 7.5mg TabletsRESTRICTED USE Adjunt treatment of benign malaria (plasmodium vivax & plasmodium ovale)
PROGUANIL 100 mg TabletsChemoprophylaxis of malaria
QUININE SULPHATE200mg & 300 mg TabletsTreatment of malaria falciparum
QUININE DIHYDROCHLORIDE 300 mg /mL InjectionRESTRICTED USE Treatment malaria falciparum
5.2 Toxoplasmosis
ANTIPROTAZOALSNOTES
PYRIMETHAMINE 25 mg TabletsRESTRICTED USE. Treatment of toxoplasmosis
6. Viral Infection
6.2a Chronic hepatitis B
ANTIVIRALS – nucleoside analoguesNOTES
ENTECAVIRTablets 500micrograms, 1mgNICE TA 153

NHS England Funded

TENOFOVIR DISOPROXIL245 mg TabletsVIREAD
ADEFOVIR DIPIVOXIL10mg TabletsHIGH COST DRUG Payment by Results Excluded Restricted to Consultant prescribing only Download Authorisation Form
PEGINTERFERON ALFA(Pegasys) 180 microgramme / 0.5ml pre-filled syringeHIGH COST DRUG Payment by Results Excluded Restricted to Consultant prescribing only Download Authorisation Form
6.2b Chronic hepatitis C
ANTIVIRALS – nucleoside analoguesNOTES
RIBAVIRIN200 mg TabletsHIGH COST DRUG Payment by Results Excluded Restricted to Consultant prescribing only Download Authorisation Form
 6g for Inhalation (Virazole) (reconstitute 6g with 300ml water for injections)Restricted to Paediatric Consultant prescribing only
6.3 Herpesvirus infections
HERPES SIMPLEX AND VARICELLA-ZOSTERNOTES
ACICLOVIR Tablets 200mg, 400mg, 800mg

Suspension 200mg in 5ml

Injection 250mg, 500mg

FAMCICLOVIR Tablets 125mg, 250mg
VALACICLOVIR Tablets 500mg
6.3a Cytomegalovirus
ANTIVIRALS – Nucleoside analoguesNOTES
GANCICLOVIR500 mg Intravenous InfusionRESTRICTED USE 1) GUM : Patients with CMV infection under care of GUM physician 2) Patients under HAEM & ONCOLOY 3) All other use under MICRO advice
ANTIVIRALS – OtherNOTES
FOSCARNET24mg/ml Intravenous Infusion
6.4 HIV Infection
NON-NUCLEOSIDE REVERSE TRANSCRIPTASE  INHIBITORSNOTES
EFAVIRENZ600 mg Tablets
NEVIRAPINE NEVIRAPINE200 mg Tablets

50 mg in 5ml Suspension

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORSNOTES
All Nuceloside Reverse Transcriptase Inhibitors are only prescribable for patients with HIV under the care of GUM Physicians
ABACAVIRZIAGEN 300 mg Tablets
ABACAVIR + LAMIVUDINE  + ZIDOVUDINETRIZIVIR 300mg / 150mg / 300mg Tablets
DIDANOSINE (ddI)VIDEX-EC 125 mg, 200mg, 250mg, 400mg  Gastro-Resistant Capsules
 TENOFOVIR  + EMTRICITABINE + EFAVIRENZATRIPLA Tablets 600mg / 200mg / 245mg
EMTRICITABINEEMTRIVA 200mg Capsules

EMTRIVA 10mg/ml Oral Solution

 EMTRICITABINE  + TENOFOVIRTRUVADA 200mg / 245mg Tablets
LAMIVUDINE (3TC)EPIVIR 150 mg, 300mg Tablets
STAVUDINE (d4T)ZERIT 15 mg, 20mg, 40mg Capsules
ZIDOVUDINE (AZT)RETROVIR 100mg, 250mg Capsules

RETROVIR 50 mg in 5mL Syrup

 ZIDOVIDINE  + LAMIVUDINECOMBIVIR 300mg + 150mg Tablets 
PROTEASE  INHIBITORSNOTES
All Protease Inhibitors are only prescribable for patients with HIV under the care of GUM Physicians
ATAZANIVIRREYETAZ100mg, 150mg, 200mg, 300mg Capsules
DARUNAVIRPERZISTA 300 mg Tablets
 LOPINAVIR + RITONAVIRKALETRA 200mg/50mg tablet
RITONAVIR100 mg Capsules

400 mg in 5mL Oral Solution

NORVIR
SAQUINAVIR200 mg Capsules
6.5 Influenza
 INFLUENZA – Neuraminidase inhibitorsNOTES
Public Health England Guidance (2016)PHE guidance – antiviral agents for treatment and prophylaxis of influenza
OSELTAMIVIR [TAMIFLU] Capsules 75mgAmantadine, oseltamivir and zanamivir for the treatment of influenza [TA168]
Amantadine, oseltamivir (review) and zanamivir for the prophylaxis of influenza [TA158]
ZANAMIVIR Inhalation Disks 5mg/blister (Relenza)

Aqueous solution for injection or nebulisation (Unlicensed, available on ‘named patient basis’ from company)

All requests through Chief Pharmacist

Amantadine, oseltamivir and zanamivir for the treatment of influenza [TA168]
Amantadine, oseltamivir (review) and zanamivir for the prophylaxis of influenza [TA158]

BNF CODE – 5.3.5
RESPIRATORY SYNCYTIAL VIRUSNOTES
Date of revisionSections ReviewedReviewer
8/2/17Tania Beadling

1. Gastro-Intestinal System | 2. Cardiovascular System | 3. Respiratory System | 4. Central Nervous System | 5. Antimicrobials | 6. Endocrine System | 7. Obstetrics, Gynaecology & Urology | 8. Malignant Disease & Immunosuppression | 9. Nutrition & Blood | 10. Musculoskelatal & Joint Diseases | 11. Opthalmology | 12. Ear, Nose & Oropharynx | 13. Dermatology | 14. Immunology & Vaccines | 15. Anaesthetics |  GP Centre Home