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Nottinghamshire Area Prescribing Committee  
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 Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
07.04.02  Expand sub section  Drugs for urinary frequency, enuresis, and incontinence
07.04.02  Expand sub section  Urinary incontinence
Oxybutynin
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First Choice
Green

Tablets, patches.

 
Tolterodine
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First Choice
Green

Tablet (1mg and 2mg)

 
Trospium
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Second Choice
Amber 3

Tablet

 
   
Darifenacin (Emselex®)
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Second Choice
Amber 3

Tablet

 
Link  Link to reviews
   
Fesoterodine (Toviaz®)
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Second Choice
Amber 3

Tablet

 
Link  Link to reviews
   
Propiverine (Detrunorm®)
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Second Choice
Amber 3

Tablets

 
Link  Link to reviews
   
Solifenacin (Vesicare®)
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Second Choice
Amber 3

Tablets

 
Link  Link to reviews
   
Mirabegron (Betmiga®)
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Third Choice
Amber 3

Tablets

 
Link  Click here for independent drug reviews
Link  MHRA: risk of severe hypertension and associated CV events with mirabegron
Link  NICE: TA290 - Mirabegron for overactive bladder
   
Duloxetine (Yentreve®)
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Formulary
Amber 2
Capsules
  • On recommendation of stress incontinence team.
  • If needed capsules can be opened and beads mixed with water (do not crush). More Info
     
  • Link  Link to reviews
       
    Oxybutynin Intra-vesical
    (5mg/30ml)
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    Restricted Drug Restricted
    Red
    Unlicensed, named patient use- secondary care only 
       
    07.04.02  Expand sub section  Nocturnal enuresis
    07.04.02  Expand sub section  antimuscarinics
     ....
     Non Formulary Items
    Flavoxate  (Urispas 200®)

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    Non Formulary
    Grey
     
    Imipramine

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    Non Formulary
    Grey
    Tablet
     
    Propantheline

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    Non Formulary
    Grey
     
    Solifenacin and Tamsulosin  (Vesomni®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
  • Reviewed and rejected as not thought to offer significant benefits for the health community. Oxybutynin and tolterodine are first line anticholinergics and should be used as per the LUTS guideline. (APC May 2014)
  • Link  Link to reviews
     
    Trospium  (Regurin® XL )

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    Non Formulary
    Grey
  • Modified release preparation, classified as
  • See above for normal release formulary entry
  •  
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Grey

    Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
    Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
    Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
      

    Red

    Medicines which should normally be prescribed by specialists only. eg hospital only.
    For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
      

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
    Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
      

    Amber 2

    Medicines suitable to be prescribed in primary care after specialist* recommendation or initiation.
    A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
    *Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
      

    Amber 3

    Primary care/ non specialist may initiate as per APC guideline.
    The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
      

    Green

    Medicines suitable for routine use within primary care.
    Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

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