Medicines Formulary - Chapter 3.7: Mucolytics

Chapters

Drug name	NICE TAs	Comments
Acetylcysteine tablets		On consultant advice only
Amoxicillin nebulised		Hospital only
Amphotericin (Fungizone)		Hospital only
Azathioprine		To be administered in conjunction with prednisolone (plain tablets). Supported by ESCA.
Azithromycin tablets		RICaD
Carbocisteine
Ceftazidime nebulised		Hospital only
Cefuroxime nebulised		Hospital only
Colistimethate sodium	TA276 - Colistimethate sodium and tobramycin dry powders for inhalation for treating pseudomonas lung infection in cystic fibrosis	Amber: Existing patients (initiated prior to April 2013) Promixin® - Powder for nebuliser solution Colomycin® Injection may be used for nebulisation; administer required dose in 2-4 mL of sodium chloride 0.9%, (or water for injections) or a 1:1 mixture of sodium chloride 0.9% and water for injection Colobreathe® - Dry powder for inhalation, hard capsule (NICE TA276)
Colistimethate sodium (Colomycin® inhalation)		Paediatric non-CF patients
Colistimethate sodium	TA276 - Colistimethate sodium and tobramycin dry powders for inhalation for treating pseudomonas lung infection in cystic fibrosis	NHS England commissioned for cystic fibrosis only. Red for new patients.
Colomycin nebulised		NHS England Commissioned for Cystic Fibrosis only. Existing patients - initiated prior to April 2013
Colomycin nebulised		NHS England Commissioned for Cystic Fibrosis only, new patients
Dornase alpha nebuliser solution (Pulmozyme)
Dornase alpha nebuliser solution (Pulmozyme)		NHS England commissioned for cystic fibrosis only
Erdosteine (Erdotin)		Hospital only
Gentamicin nebulised		Hospital only
Mannitol inhalation (Bronchitol®)	TA266 - Mannitol dry powder for inhalation for treating cystic fibrosis	Hospital only
Meropenem nebulised		Hospital only
Methotrexate		ILD - ESCA
N-Acetylcysteine nebulised
Nebulised hypertonic sodium chloride (Resp-Ease)		Resp-Ease (Sodium Chloride 7% nebuliser solution) for CF patients
Pirfenidone	TA282 - Pirfenidone for treating idiopathic pulmonary fibrosis	Hospital only
Prednisolone		Plain tablets
Tobramycin nebulised		NHS England Commissioned for Cystic Fibrosis only. Existing patients - initiated prior to April 2013
Tobramycin nebulised		NHS England Commissioned for Cystic Fibrosis only, new patients

Drug status key

Formulary drugs are allocated a traffic light status. This provides guidance on where clinical and prescribing responsibilities lie in regard to the initiation and maintenance of prescribing.

Grey

Positive NICE TA and/or awaiting local clarification on place in therapy. Please contact your medicines optimisation team for more information.

Red

Initiation and maintenance of prescribing by specialists only.

Amber

Initiation and maintenance of prescribing by specialists and transfer to primary care prescribing when appropriate, or in primary care following a specialists recommendation. Prior to initiation some medicines may require committee agreement or a framework to support safe transfer and maintenance.

Green

Initiation and maintenance of prescribing by specialists, GPs and other qualified clinicians.

Blue

Under review at University Hospitals Birmingham NHS Foundation Trust.