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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 12 - Ear, nose and oropharynx 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
12.03.02 Oropharyngeal anti-infective drugs
12.03.02 Oropharyngeal Fungal infections

Nystatin 100,000units/mL
(Oral Suspension )

GREEN
First Choice

 

  • Pharmacies should ensure their system orders generic nystatin suspension, not Nystan (the brand) as it has been discontinued.
  • Prescribers should prescribe as generic nystatin suspension, not Nystan, as pharmacies will be unable to dispense prescriptions for branded Nystan.
  • Pharmacies can contact the UK distributor (Zydus) directly to arrange supplies if their wholesaler has problems. Zydus’ customer services number is: 01604 504 166.

Entry reviewed May 2025

BNF BNFc SPC

Miconazole 2%
(Oral gel)

GREEN
Formulary

Beware of drug interactions due to inhibitition of cytochrome P450 isoenzymes CYP2C9 and CYP3A4. Miconazole is absorbed systemically from the oral gel preparation and has the potential to raise plasma levels of drugs metabolised by these isoenzymes, increasing the risk of adverse effects.

 

BNF BNFc SPC
MHRA Drug Safety Update (June 2016) - Topical miconazole, including oral gel: reminder of potential for serious interactions with warfarin MHRA Drug Safety Update (Sept 2017): Miconazole (Daktarin): over-the-counter oral gel contraindicated in patients taking warfarin
Non formulary items

Miconazole (Loramyc®)

 
Non Formulary
BNF BNFc SPC
12.03.02 Oropharyngeal Viral infections
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.