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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 3 - Respiratory system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
Links:
BLMK ICB Guidance: Chronic obstructive pulmonary disease guidelines for primary care BLMK ICB Guidance: Review of Inhaled Corticosteroids (ICS) in patients with COPD BLMK Paediatric Wheeze and Asthma Guidelines (Children Age 16 and under), Oct 2024 NICE NG115: COPD guideline NICE NG78: Cystic fibrosis: diagnosis and management. October 2017 Right Breathe Inhaler Prescribing Information
03.04.01 Antihistamines
03.04.01 Non-sedating antihistamines
03.04.01 Sedating antihistamines

Alimemazine
(Syrup)

RED
Restricted Drug Restricted

For paediatric dermatology patients where no alternative is effective.

30mg/5mL 
7.5mg/5mL 

N.B. GP's will no longer prescribe this due to availability of alternatives and high cost of preparation.

 

Entry check: July 2025

BNF BNFc SPC

Alimemazine 10mg
(Tablets)

RED
Restricted Drug Restricted

For paediatric dermatology patients where no alternative is effective.

N.B. GP's will no longer prescribe this due to availability of alternatives and cost.

BNF BNFc SPC

Chlorphenamine (Oral)

GREEN
Formulary

Consider Self care if clinically appropriate

At all hospital trusts- review indication and check whether continued use is needed during inpatient hospital stay before ordering from pharmacy

4mg Tablets 
2mg in 5mL Oral Solution

BNF BNFc SPC

Chlorphenamine 10mg/ 1mL
(Injection )

RED
Formulary
BNF BNFc SPC

Hydroxyzine (Oral)

GREEN
Formulary
10mg & 25mg Tablets
10mg in 5mL Syrup

Following concerns over the risk of possible cardiovascular adverse effects, the European Medicines Agency's (EMA) PRAC has completed a review of, and issued guidance on, medicines containing hydroxyzine. See links below:
BNF BNFc SPC
EMA Pharmacovigilance Risk Assessment Committee (PRAC) - Hydroxyzine Review UKMi Safety Alert - Hydroxyzine

Promethazine Hydrochloride
(Oral)

GREEN
Formulary

10mg, 25mg tablets
5mg/5mL Elixir

 

Promethazine must not be used in children less than six years of age due to the potential for fatal respiratory depression, psychiatric and CNS events (Source: SPC)

BNF BNFc SPC

Promethazine Hydrochloride 25mg/ 1mL
(Injection)

RED
Formulary
BNF BNFc SPC
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.