netFormulary
Data extracted : 24/11/2017
 Formulary Section 24: Paediatric Formulary
Notes:
Follow BNF for Children (BNFc) for Oral preparations.
 Details...
24.01 Gastro-intestinal system (paediatric)
Azathioprine 
Oral - Follow BNFc
IV - Follow CH IV monograph There are a number of different indications for azathioprine.

AMber shared care gastroenterology
Domperidone 
Oral - Follow BNFc

Note MHRA warnings
Lansoprazole 
Oral - Follow BNFc
Omeprazole 
Omeprazole liquid preparations only available on case by case basis - use omeprazole MUPS
Oral - Follow BNFc.
IV - Follow CH IV Monograph.
Ranitidine 
Oral - Follow BNFc.
IV - Follow CH IV Monograph
24.02 Cardiovascular system (paediatric)
Restricted Drug  Adenosine 
IV - Follow Paediatric Injectable Medicines Guide.
Restricted Drug  Adrenaline 
IV - Follow Paediatric Injectable Medicines Guide.
Restricted Drug  Ajmaline 
Reviewed by TAS
Amiodarone 
IV - Follow Paediatric Injectable Medicines Guide.
Atenolol 
Oral - Follow BNFc
Captopril 
March 2014: Licensed liquid now available - 25mg/5mL and 5mg/mL. Use in preference to unlicensed specials which have considerable price volatility in primary care.
Oral - Follow BNFc
Carvedilol 
Oral - Follow BNFc.
Dinoprostone 
IV - Follow Paediatric Injectable Medicines Guide.
Dobutamine 
IV - Follow Paediatric Injectable Medicines Guide.
Dopamine 
IV - Follow Paediatric Injectable Medicines Guide.
Furosemide 
IV - Follow Paediatric Injectable Medicines Guide.

Heparin 
IV - Follow Paediatric Injectable Medicines Guide.
Hydralazine 
IV - Follow Paediatric Injectable Medicines Guide.
Milrinone 
IV - Follow Paediatric Injectable Medicines Guide.
Propranolol 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Restricted Drug  Sildenafil  (Revatio®)
For use in liaison with Great Ormond Street Hospital
Oral - Follow BNFc.
Urokinase 
IV - Follow Paediatric Injectable Medicines Guide.
Warfarin 
Restricted Drug  Warfarin INR monitoring  (CoagUCheck®)
24.03 Respiratory system (paediatric)
Aminophylline 
IV - Follow Paediatric Injectable Medicines Guide.

Caffeine citrate 
Within paediatric medicine, prescribe as citrate.
Magnesium sulphate 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.

Restricted Drug  Omalizumab  (Xolair®)
In line with NICE TA278, by respiratory specialists in accordance with asthma clinic protocols.
Salbutamol 
IV - Follow Paediatric Injectable Medicines Guide.
24.04 Central nervous system (paediatric)
Restricted Drug  Aprepitant 
Restricted to paediatric oncology/haematology
Chloral hydrate 
Oral - Follow BNFc.
Clobazam 
Oral - Follow BNFc.
Licensed liquids are listed in the BNFc. These should be used in preference to unlicensed products.
Restricted Drug  Codeine 
Note MHRA warnings and contraindications for use in paediatric patients - restricted use in children
Domperidone 
Restricted Drug  Fentanyl 
IV - Follow Paediatric Injectable Medicines Guide.
Restricted Drug  Ketamine 
IV - Follow Paediatric Injectable Medicines Guide.
Restricted Drug  Levomepromazine 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Lorazepam 
IV - Follow Paediatric Injectable Medicines Guide.
Metoclopramide 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Restricted Drug  Midazolam 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Midazolam  (Buccolam® (buccal))
From 3 March 2014, Buccolam® will be the product of choice at UHL
Morphine 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Restricted Drug  Nabilone 
For specialist oncology/haematology use only.
Ondansetron 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Paracetamol 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Note: risk of error with IV preparations.
Phenytoin 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Procyclidine 
Oral - Follow BNFc.
IV - Follow Paediatric Injectable Medicines Guide.
Restricted Drug  Rufinamide 
Specialist paediatric neurology use only.
Reviewed by TAS
Restricted Drug  Stiripentol 
Specialist paediatric neurology use only.
Sumatriptan 
Topiramate  (migraine)
Restricted Drug  Zonisamide 
Specialist paediatric neurology use only.
Reviewed by TAS
24.05 Infections (paediatric)
Antimicrobial Website 
Aciclovir 
IV - Follow Paediatric Injectable Medicines Guide.
Amoxicillin 
Amphotericin (liposomal)  (AmBisome®)
IV - Follow Paediatric Injectable Medicines Guide.
Benzylpenicillin 
IV - Follow Paediatric Injectable Medicines Guide.
CefoTAXime 
IV - Follow Paediatric Injectable Medicines Guide.
CefTAZidime 
IV - Follow Paediatric Injectable Medicines Guide.
CefTRIAXone 
IV - Follow Paediatric Injectable Medicines Guide.
Cefuroxime 
IV - Follow Paediatric Injectable Medicines Guide.
Clarithromycin 
  • Oral - BNFc
  • IV - follow prescribing and administration guide
  • Flucloxacillin 
  • Oral - follow BNFc
  • IV - follow prescribing and administration guide
  • Fluconazole 
  • Oral - follow BNFc
  • IV - follow prescribing and administration guide
  • Restricted Drug  HIV formulary 
  • See link below for further information on available products, administration advice and other guidance
  • Meropenem 
    Metronidazole 
    Tuberculosis medicines 
    Vancomycin 
    Vancomycin (Intrathecal) 
    24.06 Endocrine system (paediatric)
    Dexamethasone 
    Insulin 
    Octreotide 
    Somatropin 
    Triptorelin 
    24.07 Obstetrics, Gynaecology, and urinary-tract disorders (paediatric)
    24.08 Malignant disease and immunosuppression (paediatric)
    Azathioprine 
  • There are a number of different indications for azathioprine. Please see here for other indications.
  • Ciclosporin 
  • There are a number of different indications for ciclosporin. Please see here for other indications.
  • Mycophenolate mofetil 
  • Where Amber Drug Guidance is available, AMBER 3, otherwise RED
  • Tacrolimus 
    24.09 Nutrition and blood (paediatric)
    Abidec 
    Calcium resonium 
    Calcium salts 
    Carnitine 
    Cosmofer (iron dextran) 
  • See link below to paediatric dose calculator
  • Dalavit 
    Fluids 
  • See guidance below for appropriate ways to increase glucose concentrations in standard infusion fluids
  • Parenteral nutrition  
    Sytron 
    24.10 Musculoskeletal and joint diseases (paediatric)
    Abatacept 
    Baclofen 
    Ciclosporin 
  • NHS Leeds Traffic Light List classification (link): AMBER 3 - click on the traffic light symbol to the left for Amber Drug Guidance

  • There are a number of different indications for ciclosporin. Please see here for other indications.
  • Hydroxychloroquine 
    Infliximab 
    Methotrexate 
    Methylprednisolone 
    Rituximab 
  • There are multiple indications for rituximab. Contact a specialist pharmacist for further details
  • Sulfasalazine 
  • NHS Leeds Traffic Light List classification (link): AMBER 3 - click on the traffic light symbol to the left for Amber Drug Guidance
  • Tocilizumab 
    24.11 Eye (paediatric)
    24.12 Ear, Nose and oropharynx (paediatric)
    24.13 Skin (paediatric)
    24.14 Immunological products and vaccines (paediatric)
    Immunoglobulins 
  • Follow guidance available on LTHT intranet
  • Vaccines - Primary Immunisation Course 
  • June 2013: Changes to meningitis C schedule
  • July 2013: Rotavirus immunisation added
  • 24.15 Anaesthesia (paediatric)
    Atracurium 
    24.16 Neonatal Formulary
    Abidec 
  • Dose: BNFc preterm neonate
  • Administration: BNF-c
  • July 2013 - intermittent supply problems. Use Dalivit in line with local guidelines if Abidec is unavailable
  • Acetylcysteine 
  • IV dose and administration: prescribing and administration monograph
  • Oral and rectal dose and administration: see rectal washout guideline (5% solution)
  • Aciclovir 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
  • Adenosine 
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph
  • Adrenaline (1 in 10,000) (100microgram/mL) 
  • Dose: Neonatal guideline
  • Administration: Neonatal guideline
  • Alprostadil 
  • 1/5/2013: change in strength of standard preparation
  • first line prostin
  • Follow paediatric cardiology prescribing and administration monograph
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph
  • Amiodarone 
  • Follow paediatric ICU / cardiology administration guidelines
  • Amoxicillin 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
  • Amphotericin (liposomal) (AmBisome®) 
  • Dose and administration: prescribing and administration monograph
  • Only available from pharmacy aseptics
  • Incompatible with sodium chloride solutions
  • Atracurium 
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph
  • Atropine 
  • Dose and administration: prescribing and administration monograph
  • Consult emergency drug prescriber

  • For oral pre-medication: BNFc (use injection orally)
  • BCG vaccination 
  • Dose: BNF-c
  • Administration: BNF-c
  • Benzylpenicillin 
  • IV dose and administration: prescribing and administration monograph
  • See guideline for early onset sepsis
  • See guideline for syphilis

  • If used for a prolonged course, benzylpenicillin can be made by pharmacy aseptics. If used for empirical treatment, product should be made on the unit following the prescribing and administration monograph
  • Blood Products 
  • Not pharmacy products - order from Blood Bank
  • Caffeine citrate 
  • From Jan 2014, caffeine should be prescribed as citrate on the neonatal units
  • IV and oral dose and administration: prescribing and administration monograph
  • Further information: BNF-c
  • Always prescribe as citrate. Levels are not required unless there is evidence of toxicity or ongoing apnoeas
  • Caffeine citrate 10mg/1ml mixture is an unlicensed preparation
  • Calcium chloride 
    Calcium Gluconate 
  • IV dose and administration: prescribing and administration monograph
  • For correction of hypocalcaemia
  • Preferably administer centrally - destructive to tissues if extravasation occurs
  • Calcium Resonium 
  • Dose and administration: BNF-c
  • Stop treatment when serum potassium reaches 5mmol/L
  • Carobel 
  • Dose: Neonatal guideline
  • Administration: See product information (packet)
  • Restricted Drug  Cefotaxime 
  • Cefotaxime for any indication requires microbiology approval, including patients transferred to the unit where cefotaxime has already been initiated

  • Cefotaxime is not stocked on the neonatal units and will need ordering from pharmacy
  • Only for use in gonococcal eye infection
  • Ceftazidime 
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph
  • Cefuroxime 
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph
  • Chloral hydrate 
  • Dose: BNF-c
  • Administration: BNF-c
  • Oral or rectal administration
  • Chloramphenicol 
  • Dose: BNF-c
  • Administration: BNF-c
  • Chlorothiazide 
  • Dose: BNF-c
  • Administration: BNF-c
  • Diuretic dose used in guidelines is 12.5mg/kg twice a day (within BNF-c dosing guidance)
  • Clarithromycin 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
  • Dalivit 
  • Dose: BNF-c (use child 1-18 year dose for liver patients)
  • Administration: BNF-c
  • Dexamethasone 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c monograph
  • Available from pharmacy aseptics (100micrograms/mL)
  • Dobutamine 
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph
  • Dopamine 
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph
  • Dornase Alfa (DNase®) 
  • Dose: BNF-c (use half the recommended dose for 5-18 years)
  • Administration: BNF-c
  • Doxapram 
  • Dose: BNF-c
  • Administration: BNF-c
  • Use caffeine as first line treatment
  • Drugs in lactation resources 
  • Information in the following resources is for babies who are well and born at term. Professional interpretation must be used for babies who are unwell or who are born prematurely
  • Drugs During Pregnancy and Lactation (C Schaefer) - paper copies available on the neonatal units
  • Further guidance available from neonatal pharmacists, or Medicines Information on ext 65377
  • Elfin Trial 
    Stock is provided Monday-Friday 9am-5pm only via LGI dispensary
    Erythromycin 
  • Oral dose and administration (GORD): BNF-c
  • Oral/IV dose and administration (infection): BNF-c
  • Extravasation 
  • See guideline below
  • Fentanyl 
  • Dose: prescribing and administration monograph
  • Administration: prescribing and administration monograph
  • Flucloxacillin 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
  • Only use on microbiology advice or if culture and sensitivity results indicate
  • For use in cystic fibrosis, see guideline below
  • Fluconazole 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
  • From November 2011, nystatin will be the first line antifungal for the prophylaxis of invasive candida. Fluconazole will remain a second line choice - see guideline below
  • Flucytosine 
  • Dose: BNF-c
  • Administration: BNF-c
  • Made in pharmacy aseptics
  • Fluids 
  • ’Standard’ solutions containing calcium are no longer used within LTHT

  • See guidance below for appropriate ways to increase glucose concentrations
  • Correcting glucose and electrolyte abnormalities in the neonate
    neonatal fluid calculator designer fluid calculator
  • Furosemide 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: BNF-c
  • Gentamicin 
  • Dose and administration: prescribing and administration monograph
  • Use gentamicin prescription chart
  • Heparin 
  • Dose and administration (arterial line patency): prescribing and administration monograph
  • Note: May 2012 - concentration and diluent used for arterial line patency has changed - see monograph below.
  • Note: May 2014 - concentration used for thrombosis has changed - see monograph below
  • Hepatitis B vaccine and immunoglobulin 
  • Dose: BNF-c
  • Administration: BNF-c
  • Supply: Hepatitis B immunoglobulin is not stocked by pharmacy. It is pre-ordered via the HPA and held on the relevant delivery suite in anticipation. If an unanticipated patient presents, an emergency supply can be obtained from virology. The product is not supplied by pharmacy and is not stocked. See neonatal guideline link below for more detail.
  • Hydralazine 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: Neonatal BNF-c monograph
  • Hydrocortisone 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: neonatal BNF-c monograph
  • Ibuprofen 
  • January 2014 - product change to Neoprofen (ibuprofen lysine
  • Dose and administration: prescribing and administration monograph
  • Immunisations 
    See vaccines (below)
    Immunoglobulins 
  • To request immunoglobulin, a clinician request form (see link below) needs to be completed before discussion with pharmacy
  • Approved indications: haemolytic disease of the newborn (blue), alloimmune thrombocytopenia (red). Other indications require approval before use
  • Prescribe on immunoglobulin prescription chart (available from pharmacy)
  • Octagam 2g vials usually used to reduce waste - other immunoglobulin brands can also be used
  • Dose: see DoH guidance (see link below)
  • An additional 0.15micron filter is not required for Octagam
  • Infloran®  (unlicensed medicine)
  • For use in line with guideline below
  • Insulin 
  • Dose and administration: prescribing and administration monograph
  • Isoniazid 
  • For treatment of congenital tuberculosis see BNFc
  • Lamivudine 
  • Lamivudine 10mg/mL liquid expires 1 month after first opening. To prevent wastage transfer opened bottle with the patient from delivery suite.
  • Stocked in LGI and SJUH delivery suites
  • Levothyroxine 
  • Dose and administration: neonatal BNF-c monograph
  • Lidocaine 
  • Infiltration anaesthesia: BNFc
  • Liothyronine 
    Loperamide 
  • Dose and administration: neonatal BNF-c monograph
  • Do not use liquid, disperse the contents of 1 x 2mg capsule in 2mL of water to give a 1mg/mL solution and give the appropriate proportion
  • Magnesium sulphate 
  • Dose and administration: prescribing and administration monograph
  • Meningococcal group C conjugate vaccine 
    June 2013 - change to primary immunisation schedule
  • One dose of Menjugate Kit® or Neisvac-C® should be used for primary course (Neisvac-C® stocked at LTHT)
  • Meningitec® should not be used for one-dose schedule
  • If Meningitec® used at 3 months (e.g. if vaccination initiated abroad, or if used in error), the child will require an additional dose at least one month after the first injections
  • Meropenem 
  • Dose and administration: prescribing and administration monograph
  • Metanium 
    Metronidazole 
  • IV dose and administration: prescribing and administration monograph
  • Oral dose and administration: Neonatal BNF-c monograph
  • Miconazole oral gel / topical cream (Daktarin®) 
    Midazolam 
    Morphine sulphate 
    Naloxone 
    Nevirapine 
  • Nevirapine 10mg/mL liquid expires 6 months after first opening. To prevent wastage transfer opened bottle with the patient from delivery suite
  • Stocked in LGI and SJUH delivery suites.
  • Noradrenaline 
  • IV dose and administration: prescribing and administration monograph
  • Nystatin 
  • Topical cream discontinued (follow guideline below for alternative)
  • Oral drops available
  • From November 2011, nystatin will be the first line antifungal for the prophylaxis of invasive candida - see guideline below
  • Octenisan 
  • Use daily as a wash from 28 weeks of age
  • Omeprazole 
  • IV dose and administration: neonatal prescribing and administration monograph
  • Oral dose and administration: neonatal BNFc monograph
  • Palivizumab 
  • Restricted to use for RSV prophylaxis in patients who meet the Yorkshire and Humber Specialised Commissioning Group criteria
  • Discuss with a specialist pharmacist before initiating in a new patient
  • Palliative care 
    Pancreatin  (Creon Micro®)
  • Dose: BNFc and cystic fibrosis guideline
  • Pancuronium 
  • Dose and administration: neonatal prescribing and administration monograph
  • Paracetamol 
  • Oral dosing and administration: BNFc
  • IV dosing and administration: prescribing and administration monograph
    (IV doing information in BNFc 2011-12 is different to that in previous editions. Currently, we continue to follow the previous dosing regimen at LTHT neonatal units - this is in the prescribing and administration monograph below)
  • Parenteral Nutrition 
    Phenobarbital (Phenobarbitone) 
  • Dose and administration (IV): prescribing and administration monograph
  • Use BNF-c status dose regime initially. For long term treatment consider once daily dosing
  • Oral trough level reached after 1-2 week(steady state levels not reached for 2-3 weeks)
  • Note: standard phenobarbital oral solution contains 38% alcohol - LTHT purchase an alcohol-free ’special’ containing 25mg in 5mL phenobarbital for use on the neonatal units
  • Phenylephrine 2.5% minims 
    Phenytoin 
    Potassium canrenoate 
  • 100mL bags no longer stocked on the units. Instructions for making out of hours available in the prescribing and administration monograph below
  • Potassium chloride 
  • All additions of potassium to intravenous fluids must be made by a pharmacy aseptic unit
  • For oral potassium chloride use Kay-Cee-L syrup 7.5% (1mL of Kay-Cee-L syrup contains 1mmol potassium chloride - see BNFc link below)
  • High strength potassium (1mmol/mL) available from pharmacy aseptics. Managed as a controlled drug
  • Propofol 0.5% 
  • For prescribing and administration information see links below
  • Pyridoxine 
  • unlicensed 100mg in 2ml injection available at LTH for use in neonates
  • Ranitidine 
    Salbutamol 
  • For the management of hyperkalaemia, follow local guidance (link below). If IV route is unavailable, follow guidance in BNFc (link below).
  • Sodium bicarbonate 
    Sodium chloride 
  • Oral product used at LTHT is sodium chloride 1mmol/1mL 200mL (unlicensed medicine)
  • Sodium Phosphate 
  • Use BNFc oral dosing regime (see link below)
  • Product used at LTHT is sodium phosphate (1mmol/mL phosphate). LTHT purchase from St Thomas’ Hospital, London (’St Thomas’ formula’)
  • unlicensed medicine
  • Spironolactone 
    Sucrose 24% 
  • Product has changed - see information below
  • Suxamethonium 
  • Dose and administration: prescribing and administration monograph
  • Sytron (Sodium feredetate) 
    Taurolidine  (Taurolock 2%)
  • Restricted for use in PN dependant infants after their first episode of CRBSI where lack of venous access may be life limiting
  • Tetracaine (Ametop®) 
    THAM (trometamol) 
  • IV dose and administration: prescribing and administration monograph
  • Thick and Easy 
  • Replaces Thixo-D
  • Trimethoprim 
    Vaccines - primary immunisation course 
    Valganciclovir 
  • See ToRCH screening guideline below for approved indications and durations
  • Treatment lying outside of these guidelines would need approval from the Drug and Therapeutics Group before initiation
  • Vancomycin 
  • IV dose and administration: prescribing and administration monograph (use electronic prescriber and prescribing guideline)
  • Oral vancomycin for enterocolitis.
    Dose: 5mg/kg/dose 4 times daily (as per BNFc). If requested within working hours, pharmacy can prepare a 50mg in 1mL vancomycin solution (7 day expiry, store in fridge). Alternatively vancomycin injection can be reconstituted and given orally as specified in the manufacturers information leaflet.
  • Vitamin K (phytomenadione) 
    Zidovudine 
  • Follow neonatal guideline (see below)
    To allow the first dose to be administer promptly (within 6 hours of birth):
  • Intravenous zidovudine is kept as stock on L44, L45 (LGI delivery suite), SJ03 (SJUH delivery suite) and SJ04.
  • Oral zidovudine liquid is kept as stock on L36, L44, L45 (LGI delivery suite), SJ03 (SJUH delivery suite), SJ04 and SJ05
  • Zidovudine 10mg/mL liquid expires 1 month after first opening. To prevent wastage transfer opened bottle with the patient between wards

  • Unlabelled stock bottles must not be used at discharge - all medicines leaving with the patient must be labelled with dosing instructions by pharmacy
  • 24.17 Miscellaneous (paediatric)
    Acetylcysteine 
    Restricted Drug  Atenolol  (haemangioma)
  • NHS Leeds Traffic Light List classification (link): AMBER 2 for the management of infantile haemangiomas
  • Restricted Drug  Episil 
    Paediatric Oncology for severe mucositis after chemotherapy
    Classified as a medical device
    Factor Concentrate 
    Levamisole 
  • For the management of nephrotic syndrome

  • NHS Leeds Traffic Light List classification (link): AMBER 3 - click on the traffic light symbol to the left for Amber Drug Guidance
  • unlicensed medicine
  • Metabolic Formulary 
  • See link below for further information on available products and prescribing guidance
  • Palliative Care Formulary 
  • The APPM Master Formulary is followed by Martin House
  • Also follow local policies and guidelines
  • Propranolol  (haemangioma)
    Restricted Drug  Timolol 0.5% long acting eye drops  (topical treatment of haemangioma)
  • Unlicensed use of a licensed product
  •  ....