Gel 100mg/1g

 Hidradenitis Suppurativa 

Ointment

Cream
Oatmeal cream
Ointment
Isomol gel
Excetra cream

Do not prescribe Epimax® ointment for use on the face. 

Ointment

Ointment

Cream

Aqueous cream, sodium lauryl sulfate free.

Cream
Lotion

Contains antimicrobials.

Cream

Prescribing restricted to the treatment of CKD-associated Pruritus, in line with the Enhanced Supportive Kidney Care Guideline.

 Cream 10% (Flexitol®)

 Cream 10% (Hydromol® Intensive)

 Heel balm 25% (Flexitol®) - Use restricted to diabetic patient's only

Emollient 5%

Cream

Spray barrier film

Ointment

Paediatric use only.
Tissue viability nurse authorisation required for use in adult patients.

Ointment

For excoriated skin.

Cream

Cream

For paediatric use only.

Cream 10%

Cream 0.5%, 1%, 2%, 5%

Solution for injection 50micrograms/mL

Under expert supervision.

Cream 1%
Ointment 1%

Consider OTC/Self care.

Mild corticosteroid.

Cream hydrocortisone 1%, clotrimazole 1% 

Consider OTC/Self care.

Mild corticosteroid.

Cream hydrocortisone acetate 1%, fusidic Acid 2%

Preparations containing fusidic acid should not be used in secondary care for in-patients.

Mild corticosteroid.

Cream hydrocortisone 0.5%, nystatin 100000 unit per 1 g, benzalkonium chloride 0.2%, dimeticone '350' 10% 

Mild corticosteroid.

Cream 0.05% (Eumovate®)
Ointment 0.05%

Moderate corticosteroid.

Cream clobetasone 0.05%, nystatin 100000 unit per 1 gram, oxytetracycline 3%

Moderate corticosteroid.

Cream 0.025%, 0.1%
Ointment 0.025%, 0.1%
Scalp application 0.1%
Foam 0.1% (Bettamousse®)

Potent corticosteroid.

Ointment betamethasone 0.05%, salicylic acid 3%
Scalp application betamethasone 0.05%, salicylic acid 2%

Potent corticosteroid.

Cream betamethasone 0.1%, fusidic acid 2%

Preparations containing fusidic acid should not be used in secondary care for in-patients.

Potent corticosteroid.

Cream betamethasone 0.064% , clotrimazole 1%

Potent corticosteroid.

Gel 0.025% (Synalar®)

For scalp use only.

Potent corticosteroid.

Tape 4micrograms/square cm,  7.5cm

Potent corticosteroid.

Cream 0.1%
Ointment 0.1%

Potent corticosteroid.

 Cream 0.05%, Ointment 0.05%
 Cutaneous foam 0.05% (Clarelux®)
 Shampoo 0.05% (Etrivex®)

Very potent corticosteroid.

Cream 0.05%

For use post urology surgery.

Potent corticosteroid.

Capsules 10mg, 30mg

Prescribed by or under supervision of a consultant dermatologist.

Contra-indicated in patients with hypersensitivity to peanuts or soya (capsule filling contains soya-bean oil).

Neuropsychiatric reactions have been reported in patients taking oral retinoids. The MHRA advises patients and carers to seek medical attention if changes in mood or behaviour occur.

Patients should avoid excessive exposure to UV light (including sunlight, solariums)—sunscreen with a high protection factor should be applied.

 Bandage 7.5cm x 6m (Ichthopaste®)
 Ointment zinc oxide 15% and ichthammol 1% in yellow soft paraffin (Special ointment No1) 

Bandage 7.5cm x 6m (Viscopaste®)

Tablets 30mg, 120mg

The MHRA recommends that patients and their carers should be counselled on the risk of progressive multifocal leukoencephalopathy and advised to seek immediate medical attention if symptoms develop.

Injection pre-filled pen 80mg/1ml
Injection pre-filled syringe 80mg/1ml

Under expert supervision.

Solution for infusion 450mg/7.5ml

Under expert supervision.

Ointment 4micrograms/g

Ointment 50micrograms/g

Gel calcipotriol 0.005%, betamethasone dipropionate 0.05%
Cutaneous foam calcipotriol 0.005%, betamethasone dipropionate 0.05% (Enstilar®)

Potent corticosteroid.

 Lotion - Coal tar 5% (Exorex®)
 Scalp Ointment - Coal tar 1%, salicylic acid 2%, precipitated sulfur 4% (Sebco®)
  Ointment BP - Coal tar 2%, salicylic acid 2%   - For scalp use only
 Ointment - Coal tar, emulsifying ointment  

Not all coal tar products are routinely stocked by pharmacy departments. If the product has to be obtained from a specials manufacturing unit there may be a delay of up to 4 weeks.

Paste zinc oxide 24%, salicylic acid 2%, starch 24%, white soft paraffin 50%

Ointment 2%, 5%, 10%

10%
(0.1%, 0.25%, 0.5%, 1%, 2%, 4%, 6%, 8% dilutions available from pharmacy)
Not all dithranol products are routinely stocked by the pharmacy departments. If the product has to be obtained from a specials manufacturing unit there may be a delay for up to 4 weeks.

Capsules 10mg, 25mg

Prescribed by or under supervision of a consultant dermatologist.

Neuropsychiatric reactions have been reported in patients taking oral retinoids. The MHRA advises patients and carers to seek medical attention if changes in mood or behaviour occur.

Tablets 50mg, 100mg, 200mg

S/C injection 40mg pre-filled syringe, pre-filled pen

Tertiary centre only for hidradenitis suppurativa.

Commissioned in accordance with LSCMMG biologics pathways.
NHSE commissioned for some indications.
Consult chapter links for more details.

Tablets 10mg, 20mg, 30mg

Tablets 25mg, 50mg

Some indications are unlicensed . Please consult product literature for licensing information.

Consultant dermatologist or specialist initiation only.

Film-coated tablets 2mg, 4mg

 Treatment of atopic dermatitis

 Treatment of alopecia areata

Solution for injection pre-filled pen 160mg/1ml, 320mg/2ml
Solution for injection pre-filled syringe 160mg/1ml, 320mg/2ml

Solution for injection pre-filled syringes 210mg/1.5ml 

Solution for injection pre-filled pens 200mg/1ml
Solution for injection pre-filled syringes 200mg/1ml
Solution for injection in a dose-dispenser cartridge 200mg/1ml

Commissioned in accordance with LSCMMG biologics pathways.
Consult chapter links for more details.

Capsules 10mg, 25mg, 50mg, 100mg
Oral solution 100mg/ml

Consultant dermatologist or specilaist initiation only.

Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration.

Film coated tablets 6mg

It is not known whether deucravacitinib, an inhibitor of tyrosine kinase 2 (TYK2), is associated with the adverse reactions of Janus kinase (JAK) inhibition. Risks that have been identified as a class effect of JAK inhibitors include major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality.  

Solution for injection pre-filled pens 300mg/2ml, 200mg/1.14ml
Solution for injection pre-filled syringes 300mg/2ml, 200mg/1.14ml

 NICE TA955: Dupilumab for treating moderate to severe prurigo nodularis

S/C injection 50mg pre-filled syringe, pre-filled pen

Solution for injection in pre-filled pen 100mg/1ml

Solution for injection pre-filled pen 120 mg/1ml 

Adequate resuscitation facilities must be available when infliximab is used.

Solution for injection pre-filled pens 250mg/2ml
Solution for injection pre-filled syringes 250mg/2ml

The MHRA has reviewed the risk of dry eye and serious ocular side-effects associated with dupilumab, an inhibitor of interleukin-4 and interleukin-13 signalling. Lebrikizumab, which similarly inhibits interleukin-13, is also associated with ocular side-effects.

Tablets 2.5mg
Prefilled syringes and pens (various strengths)

Methotrexate should be prescribed once weekly as a single dose on the same day each week.
If oral methotrexate is prescribed only use the 2.5 mg strength.
See hospital policy for prescribing and supply of oral methotrexate.

Methotrexate subcutaneous injection may be supplied through a homecare arrangement.

30 mg powder and solvent for solution for injection in pre-filled pen

Solution for injection pre-filled pens 75mg/0.5ml, 150mg/1ml, 300mg/2ml
Solution for injection pre-filled syringes 75mg/0.5ml, 150mg/1ml, 300mg/2ml

 Unlicensed use of omalizumab for severe chronic inducible urticarias.

Cream 1% 

Consultant dermatologist or specilaist initiation only.

Solution for injection pre-filled syringes 150mg/mL
Solution for injection pre-filled pen 150mg/mL
Solution for injection cartridges 180mg/1.2ml, 360mg/2.4ml

Capsules 50mg

Solution for injection pre-filled pens 150mg/1ml, 300mg/2ml
Solution for injection pre-filled syringes 75mg/0.5ml, 150mg/1ml

 NHSE commissioned for some indications.

Approved by LSCMMG for palmoplantar psoriasis 

Ointment 0.03%, 0.1%

Psoriasis.

Consultant dermatologist or specilaist initiation only.

Solution for injection pre-filled syringes 100mg/1ml

Solution for injection pre-filled syringes 150mg/1ml
Solution for injection pre-filled pens 300mg/2ml

The MHRA has reviewed the risk of dry eye and serious ocular side-effects associated with dupilumab, an inhibitor of interleukin-4 and interleukin-13 signalling. Tralokinumab, which similarly inhibits interleukin-13, is also associated with ocular side-effects.

Prolonged release tablets 15mg, 30mg, 45mg

Solution for injection pre-filled syringes 45mg/0.5ml, 90mg/1ml

Consultant dermatologist or specialist initiation only.

Gel 3mg/g

Restricted to use in patients with moderate to severe, persistent facial erythema of rosacea.

Gel 15% (Finacae®)
Cream 20% (Skinoren®)

Gel 5%

If sun exposure is unavoidable, an appropriate sunscreen or protective clothing should be used.

Gel benzoyl peroxide 5%, clindamycin 1% 

If sun exposure is unavoidable, an appropriate sunscreen or protective clothing should be used.

Lotion erythromycin 40mg/ml, zinc acetate 12mg/ml

Lotion 1%
Gel 1% (Zindaclin®)

Cream 0.1%
Gel 0.1%

The MHRA advises females of childbearing potential should use effective contraception.

Contraindicated during pregnancy.

Gel adapalene 0.1%, benzoyl peroxide 2.5% 

The MHRA advises females of childbearing potential should use effective contraception.

Contraindicated during pregnancy.

Gel clindamycin 1%, tretinoin 0.025%

The MHRA advises females of childbearing potential should use effective contraception.

Contraindicated during pregnancy.

Cream 50micrograms/g

Acne vulgaris of the face and/or the trunk in patients from 12 years of age and older, when many comedones, papules and pustules are present.

The MHRA advises females of childbearing potential should use effective contraception.

Contraindicated during pregnancy.

Capsules 50mg, 100mg
Dispersible tablets 100mg

Tablets e/c 250mg
Suspension 125mg/5mL, 250mg/5mL

Tablets cyproterone 2mg / ethinylestradiol 35 micrograms

Capsules 5mg, 10mg, 20mg

Consultant dermatologist or specialist only.

As a RED drug, isotretinoin should be supplied by secondary care. Local exceptions to this are for patients under the care of the consultant-led integrated community dermatology service, OMNES.  

 Community pharmacies can dispense FP10s for isotretinoin from OMNES where it is clear that the prescription has been issued within the context of a Pregnancy Prevention Programme. Do not dispense 7 days beyond issue date of FP10. Please refer the pharmacy checklist and  Isotretinoin (Roaccutane▼): introduction of new safety measures, including additional oversight of the initiation of treatment for patients under 18 years of age 

Contra-indicated in patients with hypersensitivity to peanuts or soya (capsule filling contains soya-bean oil).

Neuropsychiatric reactions have been reported in patients taking oral retinoids. The MHRA advises patients and carers to seek medical attention if changes in mood or behaviour occur.

Patients should avoid excessive exposure to UV light (including sunlight, solariums)—sunscreen with a high protection factor should be applied.

Paint 10mL

Solution 26%

Caustic applicator 75%

for Warts
 for over-granulating wounds

Cream 5%

External genital warts.

Cream 0.15%
Solution 0.5%

Sunscreen Lotion SPF 50+

For ACBS conditions only, otherwise self care.

Gel 3%

Ointment 10 mg/g

Cream 5%

 Treatment of superficial pre-malignant skin lesions (e.g. actinic keratosis) - Prescribers should refer patients with skin lesions suggestive of skin cancers using the principles of the NICE suspected cancer guideline. Patients must be counselled in full on the correct use of fluorouracil 5% Cream, its risks and side effects.
 Treatment of small superficial basal-cell carcinomas in adults - Only to be prescribed by skin cancer specialists or a suitably qualified GP with specialist interest (GPwSI) with demonstrable clinical skills and competencies, training and experience.

Gel 78mg/g

 Cream 5% (Aldara®) Treatment of actinic keratosis
 Cream 5% (Aldara®) Treatment of small superficial basal-cell carcinomas in adults - Only to be prescribed by skin cancer specialists or a suitably qualified GP with specialist interest (GPwSI) with demonstrable clinical skills and competencies, training and experience.
 Cream 3.75% (Zyclara®) Treatment of Actinic Keratosis
ial basal cell carcinoma in adults

Cream 160 mg/g

Solution fluorouracil 0.5%, salicylic acid 10%

For treating non-segmental vitiligo in people 12 years and over

Shampoo

Consider OTC/Self care.

Shampoo coal tar distilled 10mg per 1gram, Coconut oil 10mg per 1gram, Salicylic acid 5mg per 1gram

Consider OTC/Self care.

Shampoo 2%

Consider OTC/Self care.

Cream 2%

Cream 1%

Cream 2%
Ointment 2%

To avoid the development of resistance, fusidic acid should not be used for longer than 10 days and local microbiology advice should be sought before using it in hospital.

Gel 0.75%

Cream 0.75%

Cream 1%

Consider OTC/Self care.

Cream 2%

Consider OTC/Self care.

Cream 1%

Consider OTC/Self care.

Cream 5%

Consider OTC/Self care.

Lotion 4%

Consider OTC/Self care.

Liquid 0.5%

Consider OTC/Self care.

Cream 5%

Consider OTC/Self care.

Antimicrobial wash

 Cleansing solution 4% (Hibiwash®)
 Cream 1% (Hibitane Obstetric®)

Cream 1%

**RAG position and advisory notes currently under review. Follow local protocols. Contact your local medicines management team if futher advice is required.**

Solution tablets 400mg

Available to order for named patients.

Powder for solution for injection
Preparations are not interchangeable.

For treatment of primary idiopathic hyperhidrosis and secondary hyperhidrosis.

- as an option for the management of severe primary idiopathic hyperhidrosis of the axillae, which does not respond to self-care strategies and topical treatment, and where the cause is NOT due to social anxiety.

- as an option for the management of severe secondary hyperhidrosis of the axillae, which does not respond to self-care strategies and topical treatment, where the cause is NOT due to social anxiety and where the primary condition has been optimally managed as far as reasonable to alleviate the hyperhidrosis.

In order to reduce the potential for antibody formation which reduces the effectiveness of treatment, inject the lowest effective dose at the longest clinically indicated interval.