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Other - Cost: £666,290,687.47 Trimbow - Cost: £10,172,611.00 Atorvastatin - Cost: £11,064,539.20 Empagliflozin (Jardiance) - Cost: £12,771,927.20 Beclometasone / Formoterol MDI (Fostair) - Cost: £14,092,775.28 Rivaroxaban - Cost: £18,290,736.00 FreeStyle Libre 2 Sensor  - Cost: £18,939,025.00 Edoxaban (Lixiana) - Cost: £19,891,604.25 Dapagliflozin (Forxiga) - Cost: £22,821,013.30
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Notes for: Skin
Last edited [01/05/2024 14:02:15]

Emollient prescribing guidelines 2023

Bath emollients support document 2023

Moisture Associated Skin Damage (MASD) Pathway

Emollient pathway

Fire risk with emollients - advice to Health Care professionals


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 (i.e. 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 mainly for prescribing by secondary care.



 

Cornwall Joint Formulary Recommended Choices     (...Top)
Displaying 7 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
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Antibiotics Antibiotics

NameTariffBNF Sub Paragraph
Ostomy skin protectives (Zerolon)
28 gm barrier cream Pack of 1
£2.33PCT FORMULARY STATUSFirst Line Drugs Barrier PreparationsView BNF Article on 'Ostomy skin protectives'View SPC on 'Ostomy skin protectives'View PIL on 'Ostomy skin protectives'
Dimeticone + Benzalkonium (Conotrane cream)
500 g Pack of 500
£3.51PCT FORMULARY STATUS: First Line Drugs Barrier PreparationsView BNF Article on 'Dimeticone + Benzalkonium'View SPC on 'Dimeticone + Benzalkonium'View PIL on 'Dimeticone + Benzalkonium'
Dimeticone Lotion (Hedrin Lotion)
4 % lotion Pack of 50
£4.36PCT FORMULARY STATUS: First Line Drugs Barrier Preparations
View BNF Article on 'Dimeticone Lotion'View SPC on 'Dimeticone Lotion'View PIL on 'Dimeticone Lotion'
Ostomy skin protectives (Zerolon)
92 gm barrier cream Pack of 1
£5.06PCT FORMULARY STATUSFirst Line Drugs Barrier PreparationsView BNF Article on 'Ostomy skin protectives'View SPC on 'Ostomy skin protectives'View PIL on 'Ostomy skin protectives'
Zinc & Castor Oil Ointment
500 g unit Pack of 500
£5.15PCT FORMULARY STATUS: First Line Drugs [Notes:] contains peanut oil Barrier PreparationsView BNF Article on 'Zinc & Castor Oil Ointment'View SPC on 'Zinc & Castor Oil Ointment'View PIL on 'Zinc & Castor Oil Ointment'
contains peanut oil
Drapolene Cream
100 g tube Pack of 100
£2.81PCT FORMULARY STATUS: Second Line Drugs Barrier PreparationsView BNF Article on 'Drapolene Cream'View SPC on 'Drapolene Cream'View PIL on 'Drapolene Cream'
Titanium Barrier Ointment (Metanium)
30 g Unit Pack of 30
£3.34PCT FORMULARY STATUS: Second Line Drugs Barrier PreparationsView BNF Article on 'Titanium Barrier Ointment'View SPC on 'Titanium Barrier Ointment'View PIL on 'Titanium Barrier Ointment'

 
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