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7. Obstetrics, Gynaecology and Urinary-Tract Disorders

Guidelines

NICE CG30: Long-acting reversible contraception

Medroxyprogesterone Acetate (Sayana Press)
BNF | BNFC | SPC

Only in selected patients who have been identified as able to self-administer, as per practice protocol.

Ulipristal (Ellaone)
BNF | BNFC | SPC

NTAG Recommendation: Ulipristal for post-coital (up to 120 hours) contraception 9/9/14 - Recommended as the preferred drug treatment option for post-coital contraception for patients who present between 72 and 120 hours following unprotected intercourse. 

Alfuzosin
BNF | BNFC | SPC

2.5mg tablets, 10mg XL tablets

Indoramin
BNF | BNFC | SPC

20mg Tablets

Tamsulosin
BNF | BNFC | SPC

400microgram MR Capsules

Darifenacin
BNF | BNFC | SPC
Desmopressin (Noqdirna)
BNF | BNFC | SPC

Treatment of nocturia due to idiopathic nocturnal polyuria in adults.

This drug is Amber (to be initiated in secondary care), but there is no Shared Care protocol to follow.  Consultant initiation and review to be carried out after 3 months before transfer to primary care if stable.

 

 

Fesoterodine
BNF | BNFC | SPC

Not Approved NICE TA206

Mirabegron
BNF | BNFC | SPC

Tablets 25mg, 50mg

Only in patients intolerant of anticholinergics, or where these are contraindicated or ineffective

Mirabegron for treating symptoms of overactive bladder: NICE TA290

Oxybutynin
BNF | BNFC | SPC

Tablets 2.5mg, 3mg, 5mg

XL Tablets 5mg, 10mg

Solifenacin
BNF | BNFC | SPC

Tablets 5mg, 10mg

Solifenacin / Tamsulosin
BNF | BNFC | SPC

Vesomni 6mg/400mcg

Rejected by JCUH D&T 5/11/14 due to lack of evidence of benefit, and debate over cost savings. Darifenacin's patent expires Feb 2015

Tolterodine
BNF | BNFC | SPC

Tablets 1mg, 2mg

Trospium
BNF | BNFC | SPC

Tablets 20mg

XL capsules 60mg

Alprostadil
BNF | BNFC | SPC

Injection 5 microgram, 10 microgram, 20 microgram, 40 microgram

Urethral Application (MUSE) 250 microgram, 500 microgram, 1mg

This drug is Amber (to be initiated in secondary care), but there is no Shared Care protocol to follow

Sildenafil
BNF | BNFC | SPC

Tablets 25mg, 50mg, 100mg

Treatment of pulmonary hypertension (in accordance with NHSE commissioning policy) and secondary Raynaud’s disease is specialist prescribing only

Tadalafil Once Daily
BNF | BNFC | SPC

2.5mg, 5mg - 28 tablets

Tees Do Not Prescribe/Grey List

Prescribing of tadalafil once daily is not supported by Hartlepool & Stockton-on-Tees CCGs.

Tadalafil once daily is not recommended as not cost-effective in most patients. ‘On demand’ tablets taken when required are the preferred option, generic sildenafil is currently the least costly option.

NTAG Decision Summary February 2018: Daily vs on-demand PDE-5 inhibitors for management of erectile dysfunction following treatment for prostate cancer. Not Recommended

Dapoxetine
BNF | BNFC | SPC

NTAG Rejection: Dapoxetine for premature ejaculation 3/6/14 - Rejected due to lack of long term safety data and evidence of cost effectiveness