NHS Logo
Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 7 - Obstetrics, Gynaecology, and urinary-tract disorders 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
07.02.01 Preparations for vaginal and vulval changes
07.02.01 Topical HRT & ospemifene

Estradiol 10microgram pessaries

GREEN
Formulary

 Prescribe generically (most cost-effective)

 

Entry reviewed: October 2023

BNF BNFc SPC

Estriol 0.01% vaginal cream

GREEN
Formulary

0.01% Cream
Gynest brand has been discontinued, only available as generic

BNF BNFc SPC

Estriol 1mg vaginal cream

GREEN
Formulary

0.1% Vaginal Cream

Formerly available as Ovestin (no longer an available brand-prescribe generically)

Entry reviewed: September 2022

BNF BNFc SPC

Ospemifene 60mg tablet (Senshio®)

Amber SPA
Formulary

Restricted Item Restricted to those unwilling or unable to apply local vaginal products or as a last line therapy where all other options have failed

 

Entry reviewed: September 2022

BNF BNFc SPC

Estradiol Hemihydrate vaginal ring (Estring®)
(7.5 micrograms estradiol over 24 hours over a period of 90 days.)

GREEN
Formulary

For Atrophic Vaginitis: An alternative option to the cream and pessary for patients struggling with administration as it requires replacement every 3 months.

Entry reviewed: November 2025

BNF BNFc SPC
07.02.01 Non-hormonal preparations
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.