KCC Referral
Management System
Shared Care
Guidelines
Care Home
Resources
Local Resource
Packs
Chronic Pain
in Cornwall
Diabetes Resources
Respiratory Resources
Flu Resource Pack
Patient Group Direction (PGD)
Palliative Care Resources
Search   
        Click to View ALL BNF
 >>  >> 
   (Click to View Drug List)


Cost
Packs
Items
Other - Cost: £661,463,212.92 Influenza vaccine  (Adjuvanted trivalent ) - Cost: £9,449,685.05 Empagliflozin (Jardiance) - Cost: £9,723,815.36 FreeStyle Libre 2 Sensor  - Cost: £11,098,185.00 Dapagliflozin (Forxiga) - Cost: £11,311,066.17 Edoxaban (Lixiana) - Cost: £11,546,869.25 Beclometasone / Formoterol MDI (Fostair) - Cost: £16,266,120.28 Rivaroxaban - Cost: £20,149,499.70 Apixaban - Cost: £36,117,187.03
Formulary Notes (BNF Chapter)
Formulary Notes (BNF Section)
NICE Guidance (1)
Other Links (1)
Important Local Documents (3)
Notes for: Skin
Last edited [09/11/2022 16:06:43]

NHS Kernow emollient prescribing guideline September 2021

NHS Kernow moisture associated skin damage pathway September 2021

Fire risk with paraffin-containing products


Management of skin conditions
With skin disease it is extremely important to consider patient acceptability of a product to maximise patient compliance. There is a wide range of products available and patient acceptance of individual products is very variable.
Where a consultant or GP with specialist interest asks a GP to prescribe a non-formulary agent they should check that formulary agents have been tried and not tolerated by the patient

Greasy preparations (ointments) are often preferable to creams in most circumstances because:

  • They contain fewer skin sensitisers
  • They are more hydrating (i.e. water retaining)
  • There is better penetration of active ingredients

However, patient preference or activity may necessitate a combination of ointments and creams, for example, patients may prefer to apply creams during the day and use ointments at night, or different preparations on different parts of the body.

Application technique: It is important to educate patients with the correct application technique. Ointments and creams should be applied down the direction of hair growth. They should also be smeared on and not rubbed in.

Pot Hygiene: When supplying patients with pots of emollient, it is important to educate them about the hygiene required. Patients should be advised to decant from the pot onto plate/bowl etc. using a spoon or a spatula. Hands should not be put into the pot as this will lead to the introduction of foreign particles.

In many cases generic prescribing will be difficult because products contain a combination of active ingredients. In this chapter brand names are used for products which should not be prescribed generically.

Extemporaneous preparations: A product should only be extemporaneously prepared when there is no product with a marketing authorisation available. Depending on the formulation this may be done in a pharmacy, or by a specials manufacturer, usually depending on the formulation. Where a specials manufacturer prepares the product, additional charges will be incurred. The cost can, and usually does, exceed £100 for a cream. The cost is usually the same whether 500 g or 50 g of a product is ordered. Specials all have a very short shelf life with an expiry date of a maximum of 28 days from manufacture.

A range (but not all) of specials preferred by the British Association of Dermatologists has been approved for use within Cornwall mainly for prescribing by secondary care.



 

Cornwall Joint Formulary Recommended Choices     (...Top)
Displaying 36 Drugs

Key:
First Line Drugs First Line Drugs
Second Line Drugs Second Line Drugs
Specialist Initiated Drugs Specialist Initiated Drugs
Hospital Only Drugs Hospital Only Drugs
Discouraged Discouraged
No comment available No comment available
Antibiotics Antibiotics

NameTariffBNF Sub Paragraph
Betamethasone Ointment (Betnovate)
0.1 % ointment Pack of 30
£1.43PCT FORMULARY STATUS: First Line Drugs [Notes:] Potent Topical CorticosteroidsView BNF Article on 'Betamethasone Ointment'View SPC on 'Betamethasone Ointment'View PIL on 'Betamethasone Ointment'
Potent
Hydrocortisone Cream
0.5 % (15g) Pack of 15
£1.72PCT FORMULARY STATUS: First Line Drugs [Notes:] Mild Potency Topical CorticosteroidsView BNF Article on 'Hydrocortisone Cream'View SPC on 'Hydrocortisone Cream'View PIL on 'Hydrocortisone Cream'
Mild Potency
Betamethasone / Clioquinol (Betnovate-C)
30 g Cream Pack of 30
£1.76PCT FORMULARY STATUS: First Line Drugs [Notes:] Corticosteroid & Antimicrobial Combination - Potent Topical CorticosteroidsView BNF Article on 'Betamethasone / Clioquinol'View SPC on 'Betamethasone / Clioquinol'View PIL on 'Betamethasone / Clioquinol'
Corticosteroid & Antimicrobial Combination - Potent
Betamethasone / Clioquinol (Betnovate-C)
30 g Ointment Pack of 30
£1.76PCT FORMULARY STATUS: First Line Drugs [Notes:] Corticosteroid & Antimicrobial Combination - Potent Topical CorticosteroidsView BNF Article on 'Betamethasone / Clioquinol'View SPC on 'Betamethasone / Clioquinol'View PIL on 'Betamethasone / Clioquinol'
Corticosteroid & Antimicrobial Combination - Potent
Miconazole/ HC (Daktacort)
2 %: 1% cream Pack of 30
£1.82PCT FORMULARY STATUS: First Line Drugs [Notes:] Corticosteroid & Antimicrobial Combination - Mild Potency Topical CorticosteroidsView BNF Article on 'Miconazole/ HC'View SPC on 'Miconazole/ HC'View PIL on 'Miconazole/ HC'
Corticosteroid & Antimicrobial Combination - Mild Potency
Clobetasone Cream (Eumovate Cream)
0.05 % cream Pack of 30
£1.86PCT FORMULARY STATUS: First Line Drugs [Notes:] Moderate Potency Topical CorticosteroidsView BNF Article on 'Clobetasone Cream'View SPC on 'Clobetasone Cream'View PIL on 'Clobetasone Cream'
Moderate Potency
Clobetasone Ointment (Eumovate Ointment)
0.05 % oint Pack of 30
£1.86PCT FORMULARY STATUS: First Line Drugs [Notes:] Moderate Potency Topical CorticosteroidsView BNF Article on 'Clobetasone Ointment'View SPC on 'Clobetasone Ointment'View PIL on 'Clobetasone Ointment'
Moderate Potency
Hydrocortisone Cream
1 % (30g) Pack of 30
£2.40PCT FORMULARY STATUS: First Line Drugs [Notes:] Mild Potency Topical CorticosteroidsView BNF Article on 'Hydrocortisone Cream'View SPC on 'Hydrocortisone Cream'View PIL on 'Hydrocortisone Cream'
Mild Potency
Clotrimazole/ Hydrocortisone Cream (Canesten HC Cream)
1 % / 1% (30g tube) Pack of 30
£2.42PCT FORMULARY STATUS: First Line Drugs [Notes:] Corticosteroid & Antimicrobial Combination - Mild Potency Topical CorticosteroidsView BNF Article on 'Clotrimazole/ Hydrocortisone Cream'View SPC on 'Clotrimazole/ Hydrocortisone Cream'View PIL on 'Clotrimazole/ Hydrocortisone Cream'
Corticosteroid & Antimicrobial Combination - Mild Potency
Miconazole/ HC (Daktacort)
2 %: 1% ointment Pack of 30
£2.50PCT FORMULARY STATUS: First Line Drugs [Notes:] Corticosteroid & Antimicrobial Combination - Mild Potency Topical CorticosteroidsView BNF Article on 'Miconazole/ HC'View SPC on 'Miconazole/ HC'View PIL on 'Miconazole/ HC'
Corticosteroid & Antimicrobial Combination - Mild Potency
Betamethasone Cream (Betnovate-RD)
0.025 % cream Pack of 100
£3.15PCT FORMULARY STATUS: First Line Drugs [Notes:] Moderate Potency Topical CorticosteroidsView BNF Article on 'Betamethasone Cream'View SPC on 'Betamethasone Cream'View PIL on 'Betamethasone Cream'
Moderate Potency
Betamethasone / Salicylic acid (Diprosalic ointment)
0.05 % / 3% Ointment (30g Unit) Pack of 30
£3.18PCT FORMULARY STATUS: First Line Drugs [Notes:] Potent Topical CorticosteroidsView BNF Article on 'Betamethasone / Salicylic acid'View SPC on 'Betamethasone / Salicylic acid'View PIL on 'Betamethasone / Salicylic acid'
Potent
Timodine Cream
30 g tube Pack of 30
£3.37PCT FORMULARY STATUS: First Line Drugs [Notes:] Corticosteroid & Antimicrobial Combination - Mild Potency Topical CorticosteroidsView BNF Article on 'Timodine Cream'View SPC on 'Timodine Cream'View PIL on 'Timodine Cream'
Corticosteroid & Antimicrobial Combination - Mild Potency
Betamethasone Scalp Lotion (Betacap)
0.1 % Lotion Pack of 100
£3.75PCT FORMULARY STATUS: First Line Drugs Topical CorticosteroidsView BNF Article on 'Betamethasone Scalp Lotion'View SPC on 'Betamethasone Scalp Lotion'View PIL on 'Betamethasone Scalp Lotion'
Betamethasone Cream (Betnovate)
100 g Cream Pack of 100
£4.05PCT FORMULARY STATUS: First Line Drugs Topical CorticosteroidsView BNF Article on 'Betamethasone Cream'View SPC on 'Betamethasone Cream'View PIL on 'Betamethasone Cream'
Fluocinolone acetonide (Synalar)
0.025 % gel (30g tube) Pack of 1
£4.14PCT FORMULARY STATUS: First Line Drugs [Notes:] Potent Topical CorticosteroidsView BNF Article on 'Fluocinolone acetonide'View SPC on 'Fluocinolone acetonide'View PIL on 'Fluocinolone acetonide'
Potent
Hydrocortisone Ointment
1 % (30g) Pack of 30
£4.88PCT FORMULARY STATUS: First Line Drugs [Notes:] Mild Potency Topical CorticosteroidsView BNF Article on 'Hydrocortisone Ointment'View SPC on 'Hydrocortisone Ointment'View PIL on 'Hydrocortisone Ointment'
Mild Potency
Mometasone Cream
0.1 % cream Pack of 100
£8.43PCT FORMULARY STATUS: First Line Drugs Topical CorticosteroidsView BNF Article on 'Mometasone Cream'View SPC on 'Mometasone Cream'View PIL on 'Mometasone Cream'
Mometasone Ointment
0.1 % ointment Pack of 100
£10.17PCT FORMULARY STATUS: First Line Drugs Topical CorticosteroidsView BNF Article on 'Mometasone Ointment'View SPC on 'Mometasone Ointment'View PIL on 'Mometasone Ointment'
Clobetasol Cream (Dermovate Cream)
0.05 % cream Pack of 30
£2.69PCT FORMULARY STATUS: Second Line Drugs [Notes:] Very Potent Topical CorticosteroidsView BNF Article on 'Clobetasol Cream'View SPC on 'Clobetasol Cream'View PIL on 'Clobetasol Cream'
Very Potent
Clobetasol Ointment (Dermovate Ointment)
0.05 % oint Pack of 30
£2.69PCT FORMULARY STATUS: Second Line Drugs [Notes:] Very Potent Topical CorticosteroidsView BNF Article on 'Clobetasol Ointment'View SPC on 'Clobetasol Ointment'View PIL on 'Clobetasol Ointment'
Very Potent
Clobetasol Scalp (Dermovate Scalp)
0.05 % soln (30 ml unit) Pack of 30
£3.07PCT FORMULARY STATUS: Second Line Drugs [Notes:] Very Potent Topical CorticosteroidsView BNF Article on 'Clobetasol Scalp'View SPC on 'Clobetasol Scalp'View PIL on 'Clobetasol Scalp'
Very Potent
Betamethasone Lotion (Betnovate)
0.1 % Lotion Pack of 100
£4.58PCT FORMULARY STATUS: Second Line Drugs Topical CorticosteroidsView BNF Article on 'Betamethasone Lotion'View SPC on 'Betamethasone Lotion'View PIL on 'Betamethasone Lotion'
Fusidic Acid - HC Cream (Fucidin H Cream)
30 g tube Pack of 30
£6.02PCT FORMULARY STATUS: Second Line Drugs [Notes:] Mild Potency Topical CorticosteroidsView BNF Article on 'Fusidic Acid - HC Cream'View SPC on 'Fusidic Acid - HC Cream'View PIL on 'Fusidic Acid - HC Cream'
Mild Potency
Fusidic Acid / Betamethasone Cream (FuciBET)
30 g tube Pack of 30
£6.38PCT FORMULARY STATUS: Second Line Drugs [Notes:] Corticosteroid & Antimicrobial Combination - Potent Topical CorticosteroidsView BNF Article on 'Fusidic Acid / Betamethasone Cream'View SPC on 'Fusidic Acid / Betamethasone Cream'View PIL on 'Fusidic Acid / Betamethasone Cream'
Corticosteroid & Antimicrobial Combination - Potent
Betamethasone Scalp (Bettamousse)
0.1 % scalp mousse Pack of 100
£9.75PCT FORMULARY STATUS: Second Line Drugs [Notes:] Potent Topical CorticosteroidsView BNF Article on 'Betamethasone Scalp'View SPC on 'Betamethasone Scalp'View PIL on 'Betamethasone Scalp'
Potent
Betamethasone/ Salicylic Acid Scalp (Diprosalic Scalp Application)
100 ml Pack of 100
£10.10PCT FORMULARY STATUS: Second Line Drugs [Notes:] Potent Topical CorticosteroidsView BNF Article on 'Betamethasone/ Salicylic Acid Scalp'View SPC on 'Betamethasone/ Salicylic Acid Scalp'View PIL on 'Betamethasone/ Salicylic Acid Scalp'
Potent
Clobetasone + Oxytetracycline + Nystatin (Trimovate Cream)
30 g tube Pack of 30
£12.45PCT FORMULARY STATUS: Second Line Drugs [Notes:] Corticosteroid & Antimicrobial Combination - Moderate Potency Topical CorticosteroidsView BNF Article on 'Clobetasone + Oxytetracycline + Nystatin'View SPC on 'Clobetasone + Oxytetracycline + Nystatin'View PIL on 'Clobetasone + Oxytetracycline + Nystatin'
Corticosteroid & Antimicrobial Combination - Moderate Potency
Hydrocortisone 17 Butyrate (Locoid)
0.1 % ointment (30g tube) Pack of 30
£1.60PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Potent Topical CorticosteroidsView BNF Article on 'Hydrocortisone 17 Butyrate'View SPC on 'Hydrocortisone 17 Butyrate'View PIL on 'Hydrocortisone 17 Butyrate'
Potent
Betamethasone / Clotrimazole Cream (Lotriderm)
30 g cream Pack of 30
£6.34PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Potent Topical CorticosteroidsView BNF Article on 'Betamethasone / Clotrimazole Cream'View SPC on 'Betamethasone / Clotrimazole Cream'View PIL on 'Betamethasone / Clotrimazole Cream'
Potent
Fludroxycortide (Haelan)
7.5 x 50cm Fludroxycortide Tape Pack of 1
£21.25PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Moderate Potency Topical CorticosteroidsView BNF Article on 'Fludroxycortide'View SPC on 'Fludroxycortide'View PIL on 'Fludroxycortide'
Moderate Potency
Fludroxycortide (Haelan)
7.5 x 200cm Fludroxycortide Tape Pack of 1
£24.95PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Moderate Potency Topical CorticosteroidsView BNF Article on 'Fludroxycortide'View SPC on 'Fludroxycortide'View PIL on 'Fludroxycortide'
Moderate Potency
Clobetasol/ Neomycin/ Nystatin
30 g Cream Pack of 30
£100.12PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Very Potent Topical CorticosteroidsView BNF Article on 'Clobetasol/ Neomycin/ Nystatin'View SPC on 'Clobetasol/ Neomycin/ Nystatin'View PIL on 'Clobetasol/ Neomycin/ Nystatin'
Very Potent
Hydrocortisone Ointment
2.5 % (15g) Pack of 15
£24.46PCT FORMULARY STATUS: Discouraged [Notes:] Mild Potency Topical CorticosteroidsView BNF Article on 'Hydrocortisone Ointment'View SPC on 'Hydrocortisone Ointment'View PIL on 'Hydrocortisone Ointment'
Mild Potency
Hydrocortisone Ointment
0.5 % (15g) Pack of 15
£44.00PCT FORMULARY STATUS: Discouraged [Notes:] Mild Potency Topical CorticosteroidsView BNF Article on 'Hydrocortisone Ointment'View SPC on 'Hydrocortisone Ointment'View PIL on 'Hydrocortisone Ointment'
Mild Potency
Hydrocortisone Cream
2.5 % (15g) Pack of 15
£55.85PCT FORMULARY STATUS: Discouraged [Notes:] Mild Potency Topical CorticosteroidsView BNF Article on 'Hydrocortisone Cream'View SPC on 'Hydrocortisone Cream'View PIL on 'Hydrocortisone Cream'
Mild Potency

 
© Kernow Clinical Commissioning Group 2022 - All Rights Reserved
The Sedgemoor Centre, Priory Road, St Austell, Cornwall, PL25 5AS