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Other - Cost: £652,109,405.62 Empagliflozin (Jardiance) - Cost: £7,788,101.39 Edoxaban (Lixiana) - Cost: £8,056,980.75 Influenza vaccine (Fluad) - Cost: £13,930,057.90 Beclometasone / Formoterol MDI (Fostair) - Cost: £17,160,087.08 Rivaroxaban (Xarelto) - Cost: £20,491,468.20 Apixaban (Eliquis) - Cost: £33,811,997.20
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Notes for: Skin
Last edited [16/11/2021 14:55:40]


NHS Kernow emollient prescribing guideline September 2021

NHS Kernow moisture associated skin damage pathway September 2021

Fire risk with paraffin-containing products


Management of skin conditions

    With skin disease it is extremely important to consider patient acceptability of a product to maximise patient compliance. There is a wide range of products available and patient acceptance of individual products is very variable.
    Where a consultant or GP with specialist interest asks a GP to prescribe a non-formulary agent they should check that formulary agents have been tried and not tolerated by the patient

    Greasy preparations (ointments) are often preferable to creams in most circumstances because:

    • They contain fewer skin sensitisers
    • They are more hydrating (ie water retaining)
    • There is better penetration of active ingredients

    However, patient preference or activity may necessitate a combination of ointments and creams, for example, patients may prefer to apply creams during the day and use ointments at night, or different preparations on different parts of the body.

    Application technique: It is important to educate patients with the correct application technique. Ointments and creams should be applied down the direction of hair growth. They should also be smeared on and not rubbed in.

    Pot Hygiene: When supplying patients with pots of emollient, it is important to educate them about the hygiene required. Patients should be advised to decant from the pot onto plate/bowl etc. using a spoon or a spatula. Hands should not be put into the pot as this will lead to the introduction of foreign particles.

    In many cases generic prescribing will be difficult because products contain a combination of active ingredients. In this chapter brand names are used for products which should not be prescribed generically.

    Extemporaneous preparations: A product should only be extemporaneously prepared when there is no product with a marketing authorisation available. Depending on the formulation this may be done in a pharmacy, or by a specials manufacturer, usually depending on the formulation. Where a specials manufacturer prepares the product, additional charges will be incurred. The cost can, and usually does, exceed £100 for a cream. The cost is usually the same whether 500 g or 50 g of a product is ordered. Specials all have a very short shelf life with an expiry date of a maximum of 28 days from manufacture.

    A range (but not all) of specials preferred by the British Association of Dermatologists has been approved for use within Cornwall & IoS mainly for prescribing by secondary care. The website also lists various clinical guidelines.



     

    Cornwall Joint Formulary Recommended Choices     (...Top)
    Displaying 8 Drugs

    Key:
    First Line Drugs First Line Drugs
    Second Line Drugs Second Line Drugs
    Specialist Initiated Drugs Specialist Initiated Drugs
    Hospital Only Drugs Hospital Only Drugs
    Discouraged Discouraged
    No comment available No comment available
    Antibiotics Antibiotics

    NameTariffBNF Sub Paragraph
    Metronidazole Gel (Metrotop Gel)
    0.8 % gel Pack of 15
    £4.59PCT FORMULARY STATUS: First Line Drugs Antibac'ial Preps Also Used SystemicallyView BNF Article on 'Metronidazole Gel'View SPC on 'Metronidazole Gel'View PIL on 'Metronidazole Gel'
    Metronidazole Cream (Rozex)
    0.75 % cream Pack of 30
    £6.60PCT FORMULARY STATUS: First Line Drugs Antibac'ial Preps Also Used SystemicallyView BNF Article on 'Metronidazole Cream'View SPC on 'Metronidazole Cream'View PIL on 'Metronidazole Cream'
    Metronidazole Gel (Rozex)
    0.75 % gel Pack of 30
    £6.60PCT FORMULARY STATUS: First Line Drugs Antibac'ial Preps Also Used SystemicallyView BNF Article on 'Metronidazole Gel'View SPC on 'Metronidazole Gel'View PIL on 'Metronidazole Gel'
    Metronidazole Gel (Anabact)
    0.75 % gel Pack of 30
    £7.89PCT FORMULARY STATUS: First Line Drugs [Notes:] Be aware of variations of indications between brands Antibac'ial Preps Also Used SystemicallyView BNF Article on 'Metronidazole Gel'View SPC on 'Metronidazole Gel'View PIL on 'Metronidazole Gel'
    Be aware of variations of indications between brands
    Metronidazole gel (Acea)
    0.75 % Gel Pack of 40
    £9.95PCT FORMULARY STATUS: First Line Drugs Antibac'ial Preps Also Used SystemicallyView BNF Article on 'Metronidazole gel'View SPC on 'Metronidazole gel'View PIL on 'Metronidazole gel'
    Fusidic Acid Ointment (Fucidin Ointment)
    2 % 15g Tube Pack of 15
    £2.68PCT FORMULARY STATUS: Second Line Drugs Antibac'ial Preps Also Used SystemicallyView BNF Article on 'Fusidic Acid Ointment'View SPC on 'Fusidic Acid Ointment'View PIL on 'Fusidic Acid Ointment'
    Fusidic Acid Cream (Fucidin Cream)
    2 % 30g Tube Pack of 30
    £3.59PCT FORMULARY STATUS: Second Line Drugs Antibac'ial Preps Also Used SystemicallyView BNF Article on 'Fusidic Acid Cream'View SPC on 'Fusidic Acid Cream'View PIL on 'Fusidic Acid Cream'
    Fusidic Acid Ointment (Fucidin Ointment)
    2 % 30g Tube Pack of 30
    £4.55PCT FORMULARY STATUS: Second Line Drugs Antibac'ial Preps Also Used SystemicallyView BNF Article on 'Fusidic Acid Ointment'View SPC on 'Fusidic Acid Ointment'View PIL on 'Fusidic Acid Ointment'

     
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