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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
13.12 Antiperspirants

Aluminium chloride hexahydrate solution (Driclor® Anhydrol Forte®)
(For hyperhidrosis)

SELF
First Choice

Self-care item - advise patients to buy over the counter for Hyperhidrosis

 

Entry reviewed: May 2025

BNF BNFc SPC

Botulinum toxin type A
(For hyperhidrosis)

RED
Restricted Drug Restricted

Hospital only prescribing as per local BLMK APC guideline.

Must be prescribed by both GENERIC and BRAND name

 

BNF BNFc SPC BlueTeq
BLMK APC Botulinum Toxin A Guidelines (for Multiple Conditions including hyperhidrosis)

Oxybutynin tablet
(For hyperhidrosis)

GREEN
Formulary

1st line off-label choice for Hyperhidrosis where anticholinergic is indicated

 

Entry reviewed: April 2022

BNF BNFc SPC

Propantheline tablet
(For hyperhidrosis)

 
Formulary

1st line licensed choice for Hyperhidrosis where anticholinergic is indicated.

 

Entry reviewed: April 2022

BNF BNFc SPC

Trospium tablet
(For hyperhidrosis)

GREEN
Formulary

Second line anticholinergic for hyperhidrosis where oxybutynin or propantheline are not tolerated

 

Entry reviewed: April 2022

BNF BNFc SPC
Non formulary items

Formaldehyde solution

DNP
Non Formulary

Assessed April 2022 - Rejected for use in Hyperhidrosis due to unacceptable rate of contact dermatitis. Also a known carcinogen.

Topical methenamine also assessed and rejected for use due to lack of robust evidence to support.

BNF BNFc SPC

Glutaraldehyde paint

DNP
Non Formulary

Assessed April 2022 for Hyperhidrosis. Rejected for use due to unacceptable skin staining.

BNF BNFc SPC

Glycopyrronium oral liquid (For hyperhidrosis)

DNP
Non Formulary

Assessed April 2022: Rejected for use in Hyperhidrosis. Oxybutynin is a more cost-effective choice with a similar evidence base.

BNF BNFc SPC

Glycopyrronium powder (For hyperhidrosis )

DNP
Non Formulary

Assessed April 2022: Rejected for use with iontophoresis due to lack of sufficient evidence to support superiority over tap water

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.