Tablets 20mg, 50mg, 70mg, 100mg, 150mg

Females of childbearing potential should use highly effective contraception during treatment and for at least 1 week after last treatment.

Tablets 210mg (equivalent to 69 mg elemental iron), 322mg (equivalent to 106 mg elemental iron)
Oral solution 140mg/5ml (equivalent to 9 mg/mL elemental iron)

Iron Deficiency Anaemia in Adult Patients with Inflammatory Bowel Disease.

Tablets ferrous fumarate 322 mg (equivalent to 106 mg elemental iron) and folic acid 350 microgram

Injection 50mg/mL

First line choice. Follow Trust protocols.

For use in patients with asthma or eczema.
For use when total dose infusion is needed.

Follow Trust protocols.

Injection 100mg/5mL

Second line choice. Follow Trust protocols.

For intravenous use only.

Do not use in patients with asthma or eczema.

Injection 1mg/1mL

1st line treatment in vitamin B12 deficiency.

Following gastric bypass or sleeve gastrectomy.

Tablets 1mg

Treatment of non-dietary vitamin B12 deficiency when hydroxocobalamin injection is inappropriate or cannot be administered, and in dietary related deficiency only until B12 levels are replete, at which point patients are encouraged to self-care with 50-150mcg tablets daily purchased over the counter. 

  Maintenance therapy of dietary related insufficiency. Patients are advised to self-care by purchase of 50mcg tablets over the counter. 

Tablets 400 microgram, 5mg
Liquid 2.5mg/5mL

Should never be given alone for pernicious anaemia or other megaloblastic anaemias caused by vitamin B12 deficiency (may precipitate subacute combined degeneration of the spinal cord).

Solution for injection 340mg/2ml

Specialist initiation only.

Concentrate for solution for infusion 300mg/3mL, 1,100mg/11mL

Tertiary centre use only for treating paroxysmal nocturnal haemoglobinuria.

Specialist initiation only.

Rituximab is recommended as an alternative treatment for adults with autoimmune haemolytic anaemia (AIHA) where patients are contraindicated to or fail to respond to standard active treatments (e.g corticosteroids).  (Unlicensed)

Treatment requires initiation and continuation by specialist haematology services.

All anti-lymphocyte monoclonal antibodies should be given under the supervision of an experienced specialist, in an environment where full resuscitation facilities are immediately available.

Capsules 150mg, 300mg

Injection prefilled syringe 10micrograms, 30micrograms, 50micrograms
Injection prefilled syringe and SureClick 20micrograms, 40micrograms, 60micrograms, 80micrograms, 100micrograms.

Consultant initiation only

 Dialysis-induced anaemia.

Injection prefilled syringe 10,000units, 40,000units

Consultant initiation only.

 Dialysis-induced anaemia.

**For use in Blackpool Teaching Hospitals NHS Foundation Trust only**

Tablets 500mg

Consultant haematologist only.

Tablets 90mg, 180mg, 360mg

Consultant haematologist only.

Capsules 500 micrograms

Specialist initiation only.

Effective contraception required during treatment.

Tablets 20mg

Specialist initiation only.

Solution for injection 10mg

Specialist initiation only.

Tablets 25mg, 50mg

Specialist initiation only.

Ensure effective contraception during treatment.

Film coated tablets, 100mg, 150mg

Specialist initiation only.

Manufacturer advises effective contraception during and for at least 1 month after stopping treatment in females of childbearing potential.

Film coated tablets 3mg

Specialist initiation only.

Injection 250 micrograms

Specialist initiation only.

Off-label use for the treatment of idiopathic thrombocytopenia in adults.

For use as an alternative 2nd line treatment in adults with ITP following failure of corticosteriod treatment or when corticosteroids and thrombopoietin receptor agonists are contraindicated

Treatment requires initiation and continuation and continuation by specialist haematology services.

All anti-lymphocyte monoclonal antibodies should be given under the supervision of an experienced specialist, in an environment where full resuscitation facilities are immediately available.

Injection 12 million units in 0.2mL prefilled syringe, 30 million units & 48 million units in 0.5mL prefilled syringe

Specialist initiation only.

Injection 6mg in 0.6mL prefilled syringe

Specialist initiation only.

Modified-release tablets 600mg (potassium 8mmol)

Avoid unless effervescent tablets or liquid preparations inappropriate.

Unlicensed potassium chloride oral solutions manufactured within the UK are available via Specials manufacturers, lead times vary.

Powder for oral or rectal suspension 99.934% w/w calcium polystyrene sulfonate

Oral powder sachets 8.4g, 16.8g

Oral powder sachets 5g, 10g

Modified release tablets 600mg (10mmol)

Dioralyte® sachets
ORS Hydration tablets

Capsules 500mg (approx 6 mmol each of Na+ and HCO3-)

Chewable tablets calcium carbonate 1.25 g (calcium 500 mg or Ca2+ 12.5 mmol)
Chewable tablets calcium carbonate 1.5 g (calcium 600 mg or Ca2+ 15 mmol)
Effervescent tablets calcium carbonate 1.25mg (calcium 500 mg or Ca2+ 12.5 mmol)

Effervescent tablets calcium 1000mg (25mmol)

Injection 10mmol/10mL amp
Injection 6.8mmol/10mL prefilled syringe (1g in 10mL)

Injection 10% (calcium 2.25mmol/10mL)10mL amp
Injection 10% 50mL vial

Tablets 30mg, 60mg

Consultant endocrinologist initiation only.

Injection

Oral powder sachets 10mmol

Tablets 4mmol

First line magnesium replacement choice in patients with a bowel stoma.

Tablets 4mmol
Oral solution 1mmol/1ml -Unlicensed

Injection 50% (magnesium 2mmol/mL) 

Intravenous infusion (phosphate 50mmol/500mL) 500mL

Oral solution phosphate 0.98mmol/ml (sodium 0.76 mmol per 1mL) 

For paediatric use only.
Available from special order manufacturers.

Phosex® tablets contain calcium acetate 1 g (equivalent to calcium 250 mg or Ca2+ 6.2 mmol).
Renacet® tablets contain calcium acetate 475 mg (equivalent to calcium 120.25 mg or Ca2+ 3 mmol).

Calcium acetate 435mg (equivalent to 110 mg calcium), Magnesium carbonate heavy 235mg (equivalent to 60 mg magnesium)

Chewable tablets 500mg, 750mg, 1000mg

Tablets 800mg
Oral powder sachets 2.4g

Caution when prescribing - Do not confuse with sevelamer hydrochloride 

Toothpaste 5000ppm (Duraphat®)

On the advice of a secondary care specialist, in patients who have had surgery, radiotherapy and/or chemotherapy, who are unable to access a primary care dentist.

Prophylaxis of dental caries. clinicians other than dentists working in primary care should not prescribe high strength fluoride toothpaste where dentists could reasonably treat the patient.

Effervescent tablets 125mg (45mg zinc)

Zinc inhibits the absorption of copper, thereby reducing copper levels and potentially causing copper deficiency. The risk of copper deficiency is greater with higher doses of zinc and with long-term treatment, particularly if zinc deficiency is no longer present. Signs of copper deficiency include neurological and haematological symptoms.

Capsules (vitamin A 4000 IU, vitamin D3 1500 IU, vitamin E 150 IU, vitamin K 5 mg)
Liquid (vitamins A, D, E and K)

Vitamin supplement in cystic fibrosis on the specific recommendation of a cystic fibrosis specialist.

Paravit CF liquid is only available as an option for patients with swallowing difficulties or young children.

Reimbursable on FP10.

Vitamin A 4000 units and vitamin D 400 units

 Unlicensed.

Prescribing only following specialist initiation or recommendation.

100,000 units / 2 ml

 Unlicensed.

Tablets 10mg, 50mg

Prolonged use of pyridoxine in a dose of 10 mg daily is considered safe but the long-term use of pyridoxine in a dose of 200  mg or more daily has been associated with neuropathy. The safety of long-term pyridoxine supplementation with doses above 10 mg daily has not been established.

Tablets 50mg, 100mg

Intravenous high potency concentrate for solution for infusion (5ml+5ml)
Intramuscular high potency solution for injection (5ml+2ml)

Re-feeding syndrome in line with NICE CG32 (Vitamin B compound strong tablets)

 Post-gastric bypass

All other indications

Capsules 250 nanograms, 500 nanograms, 1 microgram
Oral drops 2 micrograms/mL (1 drop contains approximately 100 nanograms alfacalcidol)

For patients with severe renal impairment requiring vitamin D therapy.

Secondary care prescribers initiating treatment should clearly outline monitoring requirements when transferring prescribing responsiblity to primary care.

Capsules 250 nanograms

Colecalciferol 400 units is equivalent to 10 micrograms.

For recommendations on the use of vitamin D please consult the LSCMMG Vitamin D position statement.

**Product choices to be confirmed with ICB. To be updated when resolved**

Injection 300,000 units/1ml

For the correction of deficiency and insufficiency in high-risk, symptomatic patients as a short-course treatment.

Ergocalciferol 400 units is equivalent to 10 micrograms.

Plastic syringes can be used 'off label' providing the injection is administered immediately after being drawn up into the syringe.

Contact Trust pharmacy for advice on product choice and local protocols.

Tablets 10mg

Water soluble preparation for the prevention of vitamin K deficiency in malabsorption syndromes.

Injection 10mg/1mL (for IV injection only, not for IM injection).
Injection 2mg/0.2mL (may be administered by mouth, by IM injection or by IV injection - see Trust guidance for administration of vitamin K to neonates).
Capsules 1mg (Neokay, neonatal use only) 
Tablets 10mg (Phyto-K)  

Tablets vitamins B and C

Dietary management of water-soluble vitamin deficiency in renal failure patients on dialysis. Not suitable for use in children.
Initiation by a renal consultant/SpR.

Oral drops vitamins A, B group, C and D

The vitamin concentrations of Abidec® and Dalivit® vary, consult product literature for more information.

Capsules

Forceval® Capsules, Forceval® Soluble, Forceval® Soluble Junior
Forceval® is a nutritionally complete multivitamin.

Suitable for prescribing when recommended by a dietician and/or hospital nutrition team (except in Pennine Lancashire).
Following gastric bypass surgery.
Following an adjustable gastric band or sleeve gastrectomy.

Forceval Soluble® on dieticians request only, for patients with swallowing difficulties or enteral feeding tubes.

Forceval® is in Pennine Lancashire for refeeding syndrome.

Ketovite® tablets, Ketovite® liquid
Ketovite® is not nutritionally complete and does not contain trace elements.

Patients on haemodialysis.

Taurine deficiency in CF liver disease

Solution for injection

Tertiary Centre Only.

Powder for concentrate for solution for infusion 100mg

Under expert supervision.

Solution for infusion 2.8 × 1011 vector genomes (vg)/0.5 mL

Tertiary Centre Only.

Solution for injection 45 mg/0.8 ml

Solution for injection  94.5mg/0.5mL

Tertiary Centre Only.

Concentrate for solution for infusion 20mg/10ml, 5mg/2.5ml

Under expert supervision.

Solution for injection pre-filled syringe 25mg/0.5ml 

Under expert supervision.

Females of childbearing potential should use effective contraception during treatment; if conception is planned, vutrisiran and vitamin A supplementation should be stopped and vitamin A levels monitored - consult product literature.

Tablets 125mg, 250mg

Injection 1g in 5mL
Capsules 500mg
Oral solution paediatric 1.5g/5ml