- 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)
- Tablets - 5mg & 10mg (Decision date - June 2024)
DO NOT PRESCRIBE (DNP):
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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