{"id":3176,"date":"2024-02-21T12:26:53","date_gmt":"2024-02-21T12:26:53","guid":{"rendered":"https:\/\/nhsdorset.nhs.uk\/medicines\/?page_id=3176"},"modified":"2026-03-27T13:32:20","modified_gmt":"2026-03-27T13:32:20","slug":"formulation","status":"publish","type":"page","link":"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/formulation\/","title":{"rendered":"Formulation\/Presentation Changes"},"content":{"rendered":"

The budget 24\/25 <\/a>and spend information pages<\/a> within the DiiS can be used to identify potential savings opportunities and to track progress against the financial indicators.<\/a><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>

Cetirizine<\/span><\/a><\/div><\/div><\/div>
Co-codamol<\/span><\/a><\/div><\/div><\/div>
Colecalciferol (vitamin D)<\/span><\/a><\/div><\/div><\/div>
Estriol<\/span><\/a><\/div><\/div><\/div>
Fluoxetine<\/span><\/a><\/div><\/div><\/div>
Gaviscon<\/span><\/a><\/div><\/div><\/div>
Generic medicines<\/span><\/a><\/div><\/div><\/div>
Ghost brand generics<\/span><\/a><\/div><\/div><\/div>
Hyloforte eye drops<\/span><\/a><\/div><\/div><\/div>
Isosorbide mononitrate MR tablets<\/span><\/a><\/div><\/div><\/div>
Levothyroxine<\/span><\/a><\/div><\/div><\/div>
Levetiracetam, pregabalin and gabapentin<\/span><\/a><\/div><\/div><\/div>
Liothyronine<\/span><\/a><\/div><\/div><\/div>
Macrogol<\/span><\/a><\/div><\/div><\/div>
Mesalazine<\/span><\/a><\/div><\/div><\/div>
Paracetamol<\/span><\/a><\/div><\/div><\/div>
Prednisolone gastro-resistant<\/span><\/a><\/div><\/div><\/div>
Prednisolone soluble<\/span><\/a><\/div><\/div><\/div>
Proton pump inhibitors (ppis)<\/span><\/a><\/div><\/div><\/div>
Rosuvastatin<\/span><\/a><\/div><\/div><\/div>
Tamsulosin MR tablets<\/span><\/a><\/div><\/div><\/div>
Tolterodine<\/span><\/a><\/div><\/div><\/div>
Ursodeoxycholic acid<\/span><\/a><\/div><\/div><\/div>
venlafaxine<\/span><\/a><\/div><\/div><\/div><\/div><\/div>

Cetirizine capsules\/branded tablets to generic tablets<\/h2><\/div>

<\/i><\/i><\/span>What are you asking me to do?<\/span><\/a><\/h4><\/div>
\n

Where cetirizine prescriptions are needed (and can\u2019t be bought OTC), prescribe as generic tablets.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Why are you asking me to do this?<\/span><\/a><\/h4><\/div>
\n

Generic cetirizine tablets are clinically equivalent to branded tablets or capsules but represent the best value for the Dorset NHS pound.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>How do I do it?<\/span><\/a><\/h4><\/div>
\n

Run the SystmONE search provided to identify any patients on repeat supplies of cetirizine capsules\/branded tablets, and if on-going supply is needed, change to generic tablets.<\/p>\n

Communicate the changes to patients involved.<\/p>\n

SystmOne has been updated so that new initiations of cetirizine capsules will be directed to tablets.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div>
\n

SystmOne search: Dorset SystmOne GPs\/PQS Finance 24 25\/F9 Formulation\/presentation changes<\/span><\/p>\n

Template patient text – NHS Dorset has asked all GP teams to review prescribing of cetirizine preparations and as such, your prescription has been changed to generic (unbranded) tablets. The packaging might be different to what you would normally expect to see, however these products are considered clinically interchangeable. If you have any questions about this change, please contact your GP\/nurse\/pharmacist.<\/span><\/p>\n

Template patient letter \u2013 Cetirizine formulation<\/span><\/a><\/p>\n

NHS England quick reference guide for healthcare professionals \u2013 conditions for which over the counter items should not routinely be prescribed in primary care<\/span><\/span><\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

Colecalciferol (vitamin D)<\/h2><\/div>

<\/i><\/i><\/span>What are you asking me to do?<\/span><\/a><\/h4><\/div>
\n

Change\u00a0<\/span>colecalciferol<\/span>\u00a0prescriptions\u00a0<\/span>of<\/span>\u00a0<\/span>unlicensed<\/span><\/span>\u00a0tablets<\/span><\/span>\u00a0to\u00a0<\/span><\/span>licensed capsule<\/span><\/span>\u00a0product<\/span>s<\/span>.<\/span><\/span>\u00a0<\/span><\/p>\n

Pr<\/span>escribe\u00a0<\/span>colecalciferol<\/span>\u00a0as per Dorset Vitamin D guidance.<\/span><\/span>\u00a0<\/span><\/p>\n\n

\n\n\n\n\n\n\n\n\n
Unlicensed product (part VIIID of drug tariff)<\/th>\n<\/tr>\n<\/thead>\n
Colecalciferol 10,000 unit tablets<\/td>\n<\/tr>\n
Colecalciferol 2,000 unit tablets<\/td>\n<\/tr>\n
Colecalciferol 20,000 unit tablets<\/td>\n<\/tr>\n
Colecalciferol 3,000 unit tablets<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Why are you asking me to do this?<\/span><\/a><\/h4><\/div>
\n

Licensed formulations<\/span><\/b>\u00a0<\/span><\/p>\n

Use of unlicensed products (not authorised by \u00a0the UK Medicines & Healthcare products Regulatory Agency (MHRA)) puts prescribers at greater liability risk for unwanted medicine effects.\u00a0<\/span><\/span><\/p>\n

As a system we aim to save over \u00a370,000 by adopting these changes.<\/span><\/span><\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>How do I do it?<\/span><\/a><\/h4><\/div>
\n

Run the\u00a0<\/span><\/span><\/span>SystmOne<\/span><\/span><\/span>\u00a0search<\/span><\/span><\/span>es<\/span><\/span><\/span>\u00a0provided to identify patients prescribed repeat unlicensed items, review prescription<\/span><\/span><\/span>\u00a0need and if required<\/span><\/span><\/span>\u00a0and change to a licensed alternative.\u00a0<\/span><\/span><\/span>\u00a0<\/span><\/p>\n

Communicate the changes to patients involved.<\/span>\u00a0<\/span><\/p>\n

Discuss prescription changes with patients as part of Structured Medication Reviews.<\/span>\u00a0<\/span><\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div>
\n

SystmOne search: Dorset SystmOne GPs\/PQS Finance 24 25\/F9 Formulation\/Presentation change<\/span><\/p>\n

Template patient text message:<\/span>\u00a0<\/span><\/p>\n

\u201c<\/span>NHS Dorset guidance has asked all GP teams to review prescribing of oral vitamin D preparations. Your prescription for tablets has been changed to capsules which have the same effect and is more cost-effective for the NHS. If you would like to discuss this change further, please contact the surgery.\u201d<\/span><\/i>\u00a0<\/span><\/p>\n

Template patient letter<\/span><\/a><\/p>\n

Patient leafl<\/span><\/span>e<\/span><\/span>t \u2013 v<\/span><\/span>itamin D self-care<\/span><\/span><\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

Co-codamol capsules to tablets<\/h2><\/div>

<\/i><\/i><\/span>What are you asking me to do?<\/span><\/a><\/h4><\/div>
\n

Where PCN teams need to prescribe co-codamol (codeine & paracetamol) capsules, please ensure that the more cost-effective generic tablets are prescribed.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Why are you asking me to do this?<\/span><\/a><\/h4><\/div>
\n

The capsules are clinically interchangeable with the more cost-effective tablets. Use of this formulation will help the Dorset NHS pound go further, and care for a greater number of patients.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>How do I do it?<\/span><\/a><\/h4><\/div>
\n

Use the SystmOne search to identify all repeat prescriptions for co-codamol (codeine & paracetamol) capsules and convert to tablets. Notify the patients involved by text or letter using the templates provided.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div>
\n

SystmOne searches: Dorset SystmOne GPs\/PQS Finance 24 25\/F9 Formulation\/Presentation changes.<\/p>\n

Template patient text message:<\/p>\n

\u201cNHS Dorset has asked all GP teams to review prescribing of co-codamol (codeine & paracetamol) capsules and convert to tablets. These are clinically interchangeable but are more cost-effective for the NHS.\u00a0 Your prescription has been updated but if you would like to discuss this change further, please contact the surgery.\u201d<\/p>\n

Template patient letter<\/a><\/p>\n

Dorset formulary codeine & paracetamol<\/a><\/p>\n

NHS Business Services Authority. Drug Tariff Online.<\/a><\/p>\n

NHSE 2024: Guidance on conditions for which over the counter items should not routinely be prescribed in primary care.<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

Estriol 0.01% vaginal cream to estriol 0.1% vaginal cream<\/h2><\/div>

<\/i><\/i><\/span>What are you asking me to do?<\/span><\/a><\/h4><\/div>
\n

Identify patients prescribed estriol 0.01% vaginal cream and switch to estriol 0.1% vaginal cream.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Why are you asking me to do this?<\/span><\/a><\/h4><\/div>
\n

Estriol 0.1% vaginal cream delivers the same dose (0.5mg) per applicator as the estriol 0.01% vaginal cream but is more cost-effective and does not contain arachis oil & can therefore be used in peanut allergy.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>How do I do it?<\/span><\/a><\/h4><\/div>
\n

Use the SystmOne search to identify all repeat prescriptions for estriol 0.01% vaginal cream and convert to estriol 0.1% vaginal cream. Notify the patients involved by text or letter using the templates provided.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div>
\n

SystmOne searches: Dorset SystmOne GPs\/PQS Finance 24 25\/F9 Formulation\/Presentation changes.<\/p>\n

Template patient text message:<\/p>\n

\u201cNHS Dorset has asked all GP teams to review prescribing of estriol 0.01% vaginal cream and convert to 0.1% vaginal cream. These are clinically interchangeable but are more cost-effective for the NHS.\u00a0 Your prescription has been updated but if you would like to discuss this change further, please contact the surgery.\u201d<\/p>\n

Template patient letter<\/a><\/p>\n

Dorset formulary<\/a><\/p>\n

PrescQIPP bulletin 299: Menopause 202.<\/a><\/p>\n

NICE. Menopause: diagnosis and management. NICE guideline [NG23]. Published November 2015, last updated December 2019.\u00a0<\/a><\/p>\n

NHS Business Services Authority. Drug Tariff Online.<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

Fluoxetine 20mg\/5ml oral solution to dispersible tablets<\/h2><\/div>

<\/i><\/i><\/span>What are you asking me to do?<\/span><\/a><\/h4><\/div>
\n

Identify patients prescribed fluoxetine 20mg\/5ml oral solution. Where a whole dose in multiples of 20mg is required and the patient does not have dysphagia, switch to fluoxetine 20mg dispersible tablets.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Why are you asking me to do this?<\/span><\/a><\/h4><\/div>
\n

The fluoxetine oral solution and dispersible tablets are clinically interchangeable for oral use, and the dispersible tablets are suitable for patients without dysphagia. The dispersible tablets are more cost effective. Use of this formulation will help the Dorset NHS pound go further, and care for a greater number of patients.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>How do I do it?<\/span><\/a><\/h4><\/div>
\n

Use the SystmOne search to identify all repeat prescriptions for fluoxetine 20mg\/5ml oral solution. Where deemed clinically and dose appropriate, convert to fluoxetine 20mg dispersible tablets for oral use. Notify the patients involved by text or letter using the templates provided.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div>
\n

SystmOne searches: Dorset SystmOne GPs\/PQS Finance 24 25\/F9 Formulation\/Presentation changes.<\/p>\n

Template patient text message:<\/p>\n

\u201c<\/em>NHS Dorset has asked all GP teams to review prescribing of fluoxetine 20mg\/5ml oral solution and convert to dispersible tablets for oral use. These are clinically interchangeable but are more cost-effective for the NHS. Your prescription has been updated but if you would like to discuss this change further, please contact the surgery.\u201d<\/p>\n

Template patient letter<\/a><\/p>\n

NHS Business Services Authority. Drug Tariff Online.<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

Levothyroxine capsules to licensed tablets<\/h2><\/div>

<\/i><\/i><\/span>What are you asking me to do?<\/span><\/a><\/h4><\/div>
\n

Identify patients prescribed levothyroxine capsules and convert to licensed levothyroxine tablets.<\/p>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Why are you asking me to do this?<\/span><\/a><\/h4><\/div>
\n

The levothyroxine capsules and tablets are clinically interchangeable. The tablets are more cost effective. Use of this formulation will help the Dorset NHS pound go further, and care for a greater number of patients.\n

\n\n\n\n\n\n\n\n
Category<\/th>\nAdvice for doctors<\/th>\nAEDs in category<\/th>\n<\/tr>\n<\/thead>\n
Category 1<\/td>\nPrescribers are advised to ensure that their patient is maintained on a specific manufacturer\u2019s product.<\/td>\n\n
    \n
  • Carbamazepine<\/li>\n
  • Phenobarbital<\/li>\n
  • Phenytoin<\/li>\n
  • Primidone<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Category 2<\/td>\nPrescribers are advised to use their clinical judgement (in consultation with their patient and\/or their carer) to determine whether it would be advisable for them to be maintained on a specific manufacturer\u2019s product, taking into account factors such as seizure frequency, treatment history, or patient factors such co-morbid autistic people, mental health issues, or learning disability.<\/td>\n\n
    \n
  • Clobazam<\/li>\n
  • Clonazepam<\/li>\n
  • Eslicarbazepine<\/li>\n
  • Lamotrigine<\/li>\n
  • Oxcarbazepine<\/li>\n
  • Perampanel<\/li>\n
  • Rufinamide<\/li>\n
  • Topiramate<\/li>\n
  • Valproate<\/li>\n
  • Zonisamide<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Category 3<\/td>\nPrescribers are advised that it is usually unnecessary to ensure that their patients are maintained on a specific manufacturer\u2019s product, unless there are specific concerns such as patient anxiety or risk of confusion or dosing errors (from having several packs of different appearance), or patient factors such as co-morbid autistic people, mental health issues, or learning disability.<\/td>\n\n