{"id":4329,"date":"2026-03-05T11:08:30","date_gmt":"2026-03-05T11:08:30","guid":{"rendered":"https:\/\/nhsdorset.nhs.uk\/medicines\/?page_id=4329"},"modified":"2026-04-20T15:26:16","modified_gmt":"2026-04-20T14:26:16","slug":"pinh-additional","status":"publish","type":"page","link":"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/pinh-additional\/","title":{"rendered":"PINH additional (optional) financial stewardship measures"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p><span class=\"TextRun SCXW192722263 BCX8\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW192722263 BCX8\">Best value preferred dipeptidylpeptidase-4 inhibitor (DPP4i or gliptin)<\/span><\/span><\/p>\n<\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-4329-1\"><div class=\"fusion-panel panel-default panel-2ff51f8889189777a fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_2ff51f8889189777a\"><a aria-expanded=\"false\" aria-controls=\"2ff51f8889189777a\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-1\" data-target=\"#2ff51f8889189777a\" href=\"#2ff51f8889189777a\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What work is required?<\/span><\/a><\/h4><\/div><div id=\"2ff51f8889189777a\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_2ff51f8889189777a\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">Generic\u00a0Sitagliptin\u00a0is\u00a0the first line, best value DPP4i in Dorset.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">NHS\u00a0Dorset is asking PCN teams to switch\u00a0patients on\u00a0the below DPP4 inhibitors to generic Sitagliptin:<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"5\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Alogliptin (Vipidia)<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"5\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Linagliptin (Trajenta)<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"5\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Saxagliptin\u00a0(Onglyza)<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"5\" data-list-defn-props=\"{\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Vildagliptin (Galvus)\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"5\" data-list-defn-props=\"{\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">Januvia brand of sitagliptin<\/span><span data-contrast=\"none\">\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">Clinical appropriateness should always be considered, and any switches should be discussed and agreed with patients through shared decision-making.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-aa7813d1bed13cb93 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_aa7813d1bed13cb93\"><a aria-expanded=\"false\" aria-controls=\"aa7813d1bed13cb93\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-1\" data-target=\"#aa7813d1bed13cb93\" href=\"#aa7813d1bed13cb93\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why are you asking me to do this?<\/span><\/a><\/h4><\/div><div id=\"aa7813d1bed13cb93\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_aa7813d1bed13cb93\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Sitagliptin has comparable efficacy and similar or better tolerability to other DPP4i medicines<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">NICE recommends that the medicine of lowest acquisition cost should be used\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Generic sitagliptin is 90% less expensive than other DPP4i medicines\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"4\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Switching to generic Sitagliptin will help PCN\u202fteams<\/span><span data-contrast=\"auto\">\u00a0care for patients within their NHS England financial envelope and hence, release funds to improve care for unmet needs.\u00a0<\/span><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"4\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">Early switching is recommended to maximise cumulative\u202fin year\u202fcost savings.\u202f<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-ccbde2954a911be96 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_ccbde2954a911be96\"><a aria-expanded=\"false\" aria-controls=\"ccbde2954a911be96\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-1\" data-target=\"#ccbde2954a911be96\" href=\"#ccbde2954a911be96\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"ccbde2954a911be96\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_ccbde2954a911be96\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">Notify community pharmacy colleges of the intention to switch to the best value DPP4i generic sitagliptin.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Work with community pharmacy colleagues to ensure sufficient stock is available to support the switching programme and minimise disruption to patients,\u00a0GP\u00a0and community pharmacy teams.\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Run the SystmOne searches provided to\u00a0identify\u00a0existing patients\u00a0prescribed a DPP4i other than generic sitagliptin:\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Dorset SystmOne GPs>PINH 26 27 \/ F5 Other finance options \/ PINH 2627 DPP4i RPT with T2DM (excluding <18years) consider switch to sitagliptin <\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">A risk management approach should be taken, to any batch-switching arrangement, which includes safeguards which enable patients to have a review, should they have any queries or changes to their condition.<\/span><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Agree a patient-centred process for switching patients within the practice<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Exclusion criteria\u00a0in SystmOne<\/span><\/b><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">< 18 years of age<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">Any\u00a0indication\u00a0other than type 2 diabetes<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<p><b><span data-contrast=\"none\">Exclusion criteria which will require clinical review<\/span><\/b><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Renal transplant or dialysis patients<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"none\">Current or recent acute kidney injury (AKI) in last 6 months<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"none\">Pregnancy and breastfeeding\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"none\">Concomitant use\u00a0of digoxin\u00a0(<\/span><a href=\"https:\/\/cks.nice.org.uk\/topics\/diabetes-type-2\/prescribing-information\/dpp-4-inhibitors\/\"><span data-contrast=\"none\">CKS states monitor for digoxin toxicity<\/span><\/a><span data-contrast=\"none\">)<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"7\" data-aria-level=\"1\"><span data-contrast=\"none\">Severe hepatic impairment<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"8\" data-aria-level=\"1\"><span data-contrast=\"none\">Previous\u00a0intolerance or allergy to sitagliptin or its excipients<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"9\" data-aria-level=\"1\"><span data-contrast=\"none\">Previous\u00a0treatment failure or contraindication to sitagliptin<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<p><b><span data-contrast=\"none\">Special considerations:<\/span><\/b><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">When making any change to a medication, please ensure:<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"8\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Any potential drug interactions,\u00a0cautions\u00a0and contraindications are considered.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"8\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">All relevant clinical monitoring parameters have been taken in the last 12 months\u00a0(last 6 months for renal function)\u00a0and reviewed, note poorly controlled diabetes should be highlighted for review.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"8\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Any necessary dose adjustments have been made.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"8\" data-list-defn-props=\"{\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"none\">Any necessary follow up tests \/ appointments booked.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">Where clinically\u00a0appropriate, after a shared decision-making process with patients, switch patient to generic sitagliptin.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">How to communicate this to patients:<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"8\" data-list-defn-props=\"{\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">Use the template patient text message and letter in SystmOne to notify patients of the change. Ensure patient is counselled appropriately.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-5b4d68a250cd3b8b3 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_5b4d68a250cd3b8b3\"><a aria-expanded=\"false\" aria-controls=\"5b4d68a250cd3b8b3\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-1\" data-target=\"#5b4d68a250cd3b8b3\" href=\"#5b4d68a250cd3b8b3\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"5b4d68a250cd3b8b3\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_5b4d68a250cd3b8b3\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">Patient text message:<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"\">\u00a0<\/span><span data-contrast=\"none\">\"NHS Dorset has asked GP teams to change prescriptions for\u00a0<\/span><span data-contrast=\"auto\">Alogliptin, Linagliptin,\u00a0Saxagliptin,\u00a0Vildagliptin\u00a0or\u00a0Januvia,\u00a0<\/span><span data-contrast=\"none\">to sitagliptin\u00a0tablets, which\u00a0are from the same class of medicines\u00a0(DDP4i's),\u00a0offer\u00a0the same effect and safety as your current prescription but is\u00a0the\u00a01<\/span><span data-contrast=\"none\">st<\/span><span data-contrast=\"none\">\u00a0choice in Dorset.\u00a0\u00a0Please read the label and patient information leaflet before starting this new\u00a0medication. Finish\u00a0your old supply\u00a0before starting\u00a0sitagliptin and\u00a0take the 1<\/span><span data-contrast=\"none\">st<\/span><span data-contrast=\"none\">\u00a0dose of sitagliptin when the next dose of your\u00a0previous\u00a0medication would have been due.\u00a0If you have any questions speak to your community pharmacist or GP.\"<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Template patient letter:\u00a0In the SystmOne communications annexe.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng28\"><span data-contrast=\"none\">Overview | Type 2 diabetes in adults: management | Guidance | NICE<\/span><\/a><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.dorsetformulary.nhs.uk\/chaptersSubDetails.asp?FormularySectionID=6&SubSectionRef=06.01.02.03&SubSectionID=B100&drugmatch=352#352\"><span data-contrast=\"none\">Dorset Formulary<\/span><\/a><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-2\"><p>Adoption of generic famotidine as best value H2-antagonist in Dorset<\/p>\n<\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-4329-2\"><div class=\"fusion-panel panel-default panel-89cbfd2d61e593280 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_89cbfd2d61e593280\"><a aria-expanded=\"false\" aria-controls=\"89cbfd2d61e593280\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-2\" data-target=\"#89cbfd2d61e593280\" href=\"#89cbfd2d61e593280\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What is the ICB contracting me to do?<\/span><\/a><\/h4><\/div><div id=\"89cbfd2d61e593280\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_89cbfd2d61e593280\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">Generic Famotidine is the best value, preferred H2 antagonist in Dorset<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">NHS\u00a0Dorset is asking PCN teams to switch\u00a0patients on\u00a0Nizatidine\u00a0to the best value\u00a0H2 antagonist\u00a0generic\u00a0Famotidine.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Clinical appropriateness should always be considered, and any switches should be discussed and agreed with patients through shared decision-making.\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Where it is not\u00a0clinically\u00a0appropriate to\u00a0switch a patient from Nizatidine to Famotidine, please ensure the best value strength of Nizatidine is prescribed. For\u00a0patients\u00a0prescribed 300mg Nizatidine, please switch the total daily dose of Nizatidine to use multiples of the\u00a0better value\u00a0150mg preparation.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-0c0de91826e90f032 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_0c0de91826e90f032\"><a aria-expanded=\"false\" aria-controls=\"0c0de91826e90f032\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-2\" data-target=\"#0c0de91826e90f032\" href=\"#0c0de91826e90f032\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why are you asking me to do this?<\/span><\/a><\/h4><\/div><div id=\"0c0de91826e90f032\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_0c0de91826e90f032\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Famotidine\u00a0has comparable efficacy and similar\u00a0tolerability to other\u00a0H2 antagonist\u00a0medicines<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">NICE recommends that the medicine of lowest acquisition cost should be used\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Generic\u00a0Famotidine is\u00a0considerably\u00a0less\u00a0expensive than\u00a0Nizatidine<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"4\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Switching to generic\u00a0Famotidine\u00a0will help PCN\u202fteams<\/span><span data-contrast=\"auto\">\u00a0care for patients within their NHS England financial envelope and hence, release funds to improve care for unmet needs.\u00a0<\/span><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"4\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">Early switching is recommended to maximise cumulative\u202fin year\u202fcost savings.\u202f<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-1cc3b26edb96b0837 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_1cc3b26edb96b0837\"><a aria-expanded=\"false\" aria-controls=\"1cc3b26edb96b0837\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-2\" data-target=\"#1cc3b26edb96b0837\" href=\"#1cc3b26edb96b0837\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"1cc3b26edb96b0837\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_1cc3b26edb96b0837\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">Notify community pharmacy colleges of the intention to switch to the best value H2 antagonist generic famotidine and w<\/span><span data-contrast=\"none\">ork with community pharmacy colleagues to ensure sufficient stock is available to support the switching programme, minimising disruption to patients, GP and community pharmacy teams. <\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Run the SystmOne searches provided to\u00a0identify\u00a0existing patients\u00a0prescribed\u00a0Nizatidine:\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><span data-contrast=\"none\">Dorset SystmOne GPs>PINH\u00a026 27 \/\u00a0F5 Other finance options \/ PINH 2627\u00a0Nizatidine RPT\u00a0consider\u00a0switch to\u00a0Famotidine\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">A risk management approach should be taken, to any batch-switching arrangement, which includes safeguards which enable patients to have a review, should they have any queries or changes to their condition.<\/span><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Agree a patient-centred process for switching patients within the practice<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Exclusion criteria\u00a0in SystmOne<\/span><\/b><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">< 18 years of age<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<p><b><span data-contrast=\"none\">Exclusion criteria for clinical review<\/span><\/b><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">Previous\u00a0intolerance or allergy to\u00a0Famotidine\u00a0or its excipients<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Previous\u00a0treatment failure,\u00a0contraindication\u00a0or adverse reaction\u00a0to\u00a0Famotidine<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"6\" data-list-defn-props=\"{\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"none\">Unable to tolerate tablet formulation<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<p><b><span data-contrast=\"none\">Special considerations:<\/span><\/b><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">When making any change to a medication, please ensure:<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"8\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Any potential drug interactions,\u00a0cautions\u00a0and contraindications are considered.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"8\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">All relevant clinical monitoring parameters have been taken in the last 12 months\u00a0(last 6 months for renal function)\u00a0and reviewed.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"8\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Any necessary dose adjustments have been\u00a0made.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">Where clinically\u00a0appropriate, after a shared decision-making process with patients, switch patient to generic\u00a0famotidine.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-facbf79e05f2acb4a fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_facbf79e05f2acb4a\"><a aria-expanded=\"false\" aria-controls=\"facbf79e05f2acb4a\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-2\" data-target=\"#facbf79e05f2acb4a\" href=\"#facbf79e05f2acb4a\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"facbf79e05f2acb4a\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_facbf79e05f2acb4a\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">Patient text message:<\/span><span data-ccp-props=\"\"> \u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Switch to Famotidine<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"5\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">\"NHS Dorset has asked GP teams to change prescriptions for\u00a0Nizatidine and switch to<\/span><span data-contrast=\"auto\">\u00a0Famotidine\u00a0<\/span><span data-contrast=\"none\">tablets, which\u00a0are from the same class of medicines\u00a0(H2 antagonists),\u00a0offer\u00a0the same effect and safety as your current prescription but is\u00a0the\u00a01<\/span><span data-contrast=\"none\">st<\/span><span data-contrast=\"none\">\u00a0choice in Dorset.\u00a0\u00a0Please read the label and patient information leaflet before starting this new\u00a0medication. Finish\u00a0your old supply\u00a0before starting\u00a0Famotidine\u00a0and\u00a0take the 1<\/span><span data-contrast=\"none\">st<\/span><span data-contrast=\"none\">\u00a0dose of\u00a0Famotidine\u00a0when the next dose of your\u00a0Nizatidine\u00a0would have been due.\u00a0If you have any questions speak to your community pharmacist or GP.\"<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">Switch to best value Nizatidine 150mg preparation<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">NHS Dorset has asked all GP teams to review prescribing of Nizatidine 300mg capsules. Your total daily dose of Nizatidine\u00a0remains\u00a0the same, but your capsule strength has been changed to 150mg capsules, which have the same effect and are more cost-effective for the NHS.\u00a0\u00a0Please follow the amended dosing instructions. If you\u00a0have any questions about this change, please discuss with your Community Pharmacy or GP.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Template patient letter:\u00a0In the SystmOne communications annexe.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.dorsetformulary.nhs.uk\/chaptersSubDetails.asp?FormularySectionID=1&SubSectionRef=01.03.01&SubSectionID=A100&drugmatch=32#32\"><span data-contrast=\"none\">Dorset Formulary<\/span><\/a><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/cks.nice.org.uk\/topics\/dyspepsia-proven-gord\/prescribing-information\/h2-receptor-antagonists\/\"><span data-contrast=\"none\">H2-receptor antagonists | Prescribing information | Dyspepsia \u2013 proven GORD | CKS | NICE<\/span><\/a><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-3\"><p>Medication formulation \/ Branded to generic recommended switching<\/p>\n<\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-4329-3\"><div class=\"fusion-panel panel-default panel-8267b5ab3ade617f0 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_8267b5ab3ade617f0\"><a aria-expanded=\"false\" aria-controls=\"8267b5ab3ade617f0\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-3\" data-target=\"#8267b5ab3ade617f0\" href=\"#8267b5ab3ade617f0\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What are you asking me to do?<\/span><\/a><\/h4><\/div><div id=\"8267b5ab3ade617f0\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_8267b5ab3ade617f0\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>NHS Dorset is asking PCN teams to review the brand and prescribed formulation of medicines, where multiple brands \/ formulations exist.<\/p>\n<p>A table of suggested switches can be found in the resources section.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-a4ac1c8a0df4c3397 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_a4ac1c8a0df4c3397\"><a aria-expanded=\"false\" aria-controls=\"a4ac1c8a0df4c3397\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-3\" data-target=\"#a4ac1c8a0df4c3397\" href=\"#a4ac1c8a0df4c3397\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why are you asking me to do this?<\/span><\/a><\/h4><\/div><div id=\"a4ac1c8a0df4c3397\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_a4ac1c8a0df4c3397\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>Some brands and formulations of the same medicine offer no clinical advantage, at an increased cost. The potential savings achieved through formulation switching, can enable the NHS budget to be used to greater benefit the Dorset population.<\/p>\n<p>A table of suggested switches can be found in the resources section.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-29587be1253c64312 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_29587be1253c64312\"><a aria-expanded=\"false\" aria-controls=\"29587be1253c64312\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-3\" data-target=\"#29587be1253c64312\" href=\"#29587be1253c64312\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"29587be1253c64312\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_29587be1253c64312\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>Review the table of proposed medication switches in the resources section, to identify appropriate switches.<\/p>\n<p>Run SystmOne searches to help PCN teams identify patients suitable for product switch within the PCN:<\/p>\n<p>Dorset SystmOne GPs&gt; PINH Finance 2627&gt;Optional medication changes&gt;<\/p>\n<p>Switch patients to the NHS Dorset recommended formulations, taking into consideration any dosage instruction changes which may be required because of the formulation change.<\/p>\n<p>As with all product switches, not all patients will be appropriate for switch.<\/p>\n<p>Where patients are not eligible for product switch, this should be recorded in the patient record e.g. where increasing tablet\/capsule burden is not appropriate, patients requiring specific products due to visual impairment, licensing, contraindication, drug interaction, intolerance\/allergy to excipients, dietary preference, religious grounds, swallowing issues etc.<strong>\u00a0<\/strong><\/p>\n<p>Note, where a formulation switch requires a tablet formulation to be halved, the patient&#8217;s ability to half a tablet must be considered. Patients are able to purchase a pill cutter form their Community Pharmacy.<strong>\u00a0<\/strong><\/p>\n<p>Communicate the change to patients using the Template patient letters and text messages within SystmOne:<\/p>\n<p>Template text messages can be found within SystmOne&gt;Msg presets&gt; Medication Management&gt;Formulation&gt; specific template for each product listed<\/p>\n<p>Template Letters can be found within SystmOne&gt;Word letter templates&gt;Dorset CCG&gt; Medicines Management&gt; Formulation&gt; specific template for each product listed<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-49e0343d8c0d1f73a fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_49e0343d8c0d1f73a\"><a aria-expanded=\"false\" aria-controls=\"49e0343d8c0d1f73a\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4329-3\" data-target=\"#49e0343d8c0d1f73a\" href=\"#49e0343d8c0d1f73a\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"49e0343d8c0d1f73a\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_49e0343d8c0d1f73a\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-content\/uploads\/sites\/3\/2026\/04\/Table-of-optional-additional-formulation-prescribing-changes-savings-1.docx\">Table of optional additional formulation prescribing changes savings<\/a><\/p>\n<p><a href=\"https:\/\/www.dorsetformulary.nhs.uk\/\">Dorset formulary<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":29,"featured_media":0,"parent":3067,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-4329","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4329","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/comments?post=4329"}],"version-history":[{"count":24,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4329\/revisions"}],"predecessor-version":[{"id":4550,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4329\/revisions\/4550"}],"up":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/3067"}],"wp:attachment":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/media?parent=4329"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}