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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 13 - Skin 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
Links:
British Association of Dermatology (BAD) recommended list of ’specials’ 2018
13.08.01 Sunscreen preparations
13.08.01 Photodamage

Diclofenac 3% gel (Solaraze®)

GREEN
Formulary

For use in actinic keratosis

 

Entry reviewed: November 2023

BNF BNFc SPC

Fluorouracil 5% cream (Efudix®)

GREEN
Formulary

Entry reviewed: November 2023

BNF BNFc SPC

Imiquimod 3.75% cream (Zyclara®)

GREEN
Formulary

For actinic keratosis

 

Entry reviewed: November 2023

BNF BNFc SPC

Imiquimod 5% cream (Aldara®)
(For photodamage)

GREEN
Formulary

• Small superficial basal cell carcinomas (sBCCs) in adults.

• Clinically typical, nonhyperkeratotic, nonhypertrophic actinic keratoses (AKs) on the face or scalp in immunocompetent adult patients when size or number of lesions limit the efficacy and/or acceptability of cryotherapy and other topical treatment options are contraindicated or less appropriate.

 

Entry reviewed: November 2023

BNF BNFc SPC

Salicylic acid, fluorouracil cutaneous solution (Actikerall®)

GREEN
Formulary

For actinic keratosis

 

Entry reviewed: November 2023

BNF BNFc SPC
Non formulary items

Ingenol mebutate (Picato®) (Gel)

 
Non Formulary

The Marketing Authorisation for Picato has been suspended whilst the concerns on the possible risk of skin malignancy are investigated. Previously Red on Formulary.

DISCONTINUED 

 

Entry reviewed: November 2023

BNF BNFc SPC
MHRA Drug Safety Update: Ingenol mebutate gel (Picato¥): suspension of the licence due to risk of skin malignancy (February 2020) MHRA Drug Safety Update: Ingenol mebutate gel (Picato¥): increased incidence of skin tumours seen in some clinical studies (October 2019)

Methyl-5-Aminolevulinate (Metvix®)

 
Non Formulary
BNF BNFc SPC

Tirbanibulin cream (Klisyri cream ®)

 
Non Formulary

Considered for inclusion at Formulary Group November 2023 - no usage across BLMK therefore not added.

 

Entry reviewed: November 2023

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.