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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 9 - Nutrition and blood 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
Links:
BLMK ICB: Oral nutritional supplements guidance Vitamin and Mineral Supplementation Post Bariatric Surgery Guideline
09.02.01.03 Oral bicarbonate

Sodium Bicarbonate

GREEN
First Choice

500mg Capsules

BNF BNFc SPC

Sodium hydrogen carbonate (Nephrotrans®)
(500mg gastro-resistant capsules)

Amber SPIS
Restricted Drug Restricted

For treatment and maintenance of metabolic acidosis in adults with chronic kidney disease. Reserved for patients who cannot tolerate other sodium bicarbonate preparations due to gastric side effects.

Recommended for initiation by specialists and after an assessment of tolerability and efficacy following stabilisation of therapy has been made by the specialists, ongoing prescribing in primary care. 

For existing patients, primary care may consider switching from sodium bicarbonate 600mg tablets to sodium bicarbonate 500mg capsules or sodium hydrogen carbonate gastro-resistant 500mg capsules (Nephrotrans®). If previous intolerance to standard capsules, seek advice and guidance from specialist team to support clinical decision making as appropriate. On the advice of local specialists, switching between sodium bicarbonate formulations is a 1:1 switch with no additional monitoring required.

BNF BNFc SPC
Non formulary items

Potassium Bicarbonate

 
Non Formulary
BNF BNFc SPC

Sodium bicarbonate (600mg tablet)

DNP
Non Formulary

For existing patients, primary care may consider switching from sodium bicarbonate 600mg tablets to sodium bicarbonate 500mg capsules or sodium hydrogen carbonate gastro-resistant 500mg capsules (Nephrotrans®). If previous intolerance to standard capsules, seek advice and guidance from specialist team to support clinical decision making as appropriate. On the advice of local specialists, switching between sodium bicarbonate formulations is a 1:1 switch with no additional monitoring required.

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.