Hydrocortisone

BNF:
6.3, 1.5.2
Status:
Do Not Prescribe (DNP), Grey - after consultant/specialist initiation, Red, Green
Decision Date:
November 2012
 

Comments

GREEN:

  • Mild potency steroid  0.5%, 1% cream, ointment (15g, 30g, 100g)

DO NOT PRESCRIBE (DNP):

  • Plenadren MR tablets

GREY consultant/specialist initiation:

  • Alkindi granules, only to be used in patients whose hydrocortisone must otherwise be individually prepared by manipulation in order to produce an age-appropriate dose, or if hydrocortisone is given as off-label buccal tablets. (Decision  date  - Feb 2019)
  • MHRA (February 2021) Alkindi (hydrocortisone granules): risk of acute adrenal insufficiency in children when switching from hydrocortisone tablet formulations to granules

RED: 

  • Hydrocortisone MR (Efmody) for treatment of congenital adrenal hyperplasia (CAH). (Decision date - June 2023) 
If specialist provides an APC approved SCP or the specialist is working to the out of area APC classification, GP can consider accepting on-going prescribing as per out of area SCP. 

Do Not Prescribe (DNP) Drug Classifications

  • 1: Are classified by the BNF as 'less suitable for prescribing', and includes anti-malarials (where a private prescription may be provided). Have a lack of data on effectiveness compared with standard therapy
  • 5: Less cost-effective than current standard therapy

Red Drug Classifications

  • 1: Requiring specialist assessment to enable patient selection, initiation and ongoing treating
  • 2: Requiring long term on-going monitoring of efficacy by a specialist and not suitable for shared care

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Derby and Derbyshire ICB

Derby and Derbyshire ICB

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