Lancashire and South Cumbria
Formulary
Formulary
3 Respiratory system
When prescribing inhalers the drug, device (e.g. MDI, Easibreathe, Autohaler, Accuhaler), strength (micrograms per inhalation), number of puffs per dose and frequency MUST be specified
03-07 Mucolytics
| Carbocisteine |
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Formulary
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250mg/5ml oral solution and 750mg/10ml oral solution in sachet Restriction: only to be used for those with swallowing difficulties who can't take capsules. |
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| Deutivacaftor , Tezacaftor , Vanzacaftor Alyftrek® |
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Formulary
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125 mg/50 mg/10 mg tablets
50 mg/20 mg/4 mg tablets
NHS England will commission vanzacaftor–tezacaftor–deutivacaftor during this interim access period, in line with the NICE FDG, from 15th July 2025.
NHS England will routinely commission vanzacaftor–tezacaftor–deutivacaftor for all patients from 30 days post publication of the NICE Technology Appraisal (TA) [ID6372] who are eligible, in line with the NICE TA. |
 NHSE: NHS England commissioning statement: Arrangements for access to cystic fibrosis transmembrane conductance regulator (CFTR) modulators for licensed and off-label use in patients with cystic fibrosis NICE: Vanzacaftor–tezacaftor–deutivacaftor for treating cystic fibrosis with 1 or more F508del mutations in the CFTR gene in people aged 6 years and over [ID6372] |
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| Ivacaftor Kalydeco® |
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Formulary
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Tablets 150mg |
 NHSE: Clinical Commissioning Policy: Ivacaftor for Cystic Fibrosis (named mutations) |
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| Mannitol Bronchitol® |
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Formulary
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Inhalation powder, hard capsule with device 40mg |
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NICE TA266: Mannitol dry powder for inhalation for treating cystic fibrosis |
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CapsulesLinks
- NICE TA10: Guidance on the use of inhaler systems (devices) in children under the age of 5 years with chronic asthma
- Asthma action plan child: Asthma UK
- Asthma management plan: Asthma UK
- Clinical Commissioning Policy: Ivacaftor for Cystic Fibrosis (G551D gene)
- LSCMMG: Asthma Treatment Guideline for Adults (aged 12 and over)
- LSCMMG: Asthma Treatment Guideline for Children
- LSCMMG: COPD Desktop Guideline
- MART asthma plan
- MHRA Drug Safety Update :Nebulised asthma rescue therapy in children: home use of nebulisers in paediatric asthma should be initiated and managed only by specialists
- MHRA: Ivacaftor, tezacaftor, elexacaftor (Kaftrio▼) in combination with ivacaftor (Kalydeco): risk of serious liver injury; updated advice on liver function testing
- MHRA: Ivacaftor, tezacaftor, elexacaftor (Kaftrio▼) in combination with ivacaftor (Kalydeco): risk of serious liver injury; updated advice on liver function testing
- MHRA: Ivacaftor, tezacaftor, elexacaftor (Kaftrio▼) in combination with ivacaftor (Kalydeco): risk of serious liver injury; updated advice on liver function testing
- MHRA: Kaftrio▼ (Ivacaftor, tezacaftor, elexacaftor): risk of psychological side effects
- MHRA: Pressurised metered dose inhalers (pMDI): risk of airway obstruction from aspiration of loose objects
- NHS England Clinical Commissioning Policy:Inhaled Therapy for Adults and Children with Cystic Fibrosis
- NHSE: Clinical Commissioning Policy: Ivacaftor for Cystic Fibrosis (named mutations)
- NHSE: NHS England commissioning statement: Arrangements for access to cystic fibrosis transmembrane conductance regulator (CFTR) modulators for licensed and off-label use in patients with cystic fibrosis
- NICE NG115: Chronic obstructive pulmonary disease in over 16s: diagnosis and management
- NICE NG209: Tobacco: preventing uptake, promoting quitting and treating dependence
- NICE NG78: Cystic fibrosis: diagnosis and management
- NICE NG80:Asthma: diagnosis, monitoring and chronic asthma management
- NICE TA266: Mannitol dry powder for inhalation for treating cystic fibrosis
- NICE TA38: Inhaler devices for routine treatment of chronic asthma in older children (aged 5–15 years)
- NICE TA398: Lumacaftor–ivacaftor for treating cystic fibrosis homozygous for the F508del mutation
- NICE TA988: Ivacaftor–tezacaftor–elexacaftor, tezacaftor–ivacaftor and lumacaftor–ivacaftor for treating cystic fibrosis
- NICE TA988: Ivacaftor–tezacaftor–elexacaftor, tezacaftor–ivacaftor and lumacaftor–ivacaftor for treating cystic fibrosis
- NICE TA988: Ivacaftor–tezacaftor–elexacaftor, tezacaftor–ivacaftor and lumacaftor–ivacaftor for treating cystic fibrosis
- NICE: Vanzacaftor–tezacaftor–deutivacaftor for treating cystic fibrosis with 1 or more F508del mutations in the CFTR gene in people aged 6 years and over [ID6372]