GP Out of Hours Formulary: Highland HSCP (Formularies)

This is intended to be an addendum to the full Highland Formulary. It contains drugs that should be directly available to a practitioner in the out of hours period to provide medical care to patients. Where patient packs are listed the full pack should be given to the patient complete with the patient information leaflet.

For full information on prescribing see BNF or BNF for Children, and the Highland Formulary for additional advice on using these drugs.

Anaesthesia

Drug Form, Strength, Pack size Directions
Lidocaine Injection 1%
Injection 2%
 
Lidocaine with adrenaline Injection 1%
Injection 2%
 
Ametop (tetracaine) 4% gel  
Emla (lidocaine 2·5% with prilocaine 2·5%) Cream  
Flumazenil Injection 500 micrograms/5mL  
Naloxone Injection 400 micrograms/1mL
(Minijet®) 400 micrograms/1mL 
 
LAT (lidocaine 4%, adrenaline 0·1%, tetracaine 0·5%) Gel 3mL (unlicensed) Paediatric wounds

Cardiovascular

Drug classification Drug Form, Strength, Pack size Directions
Cardiovascular - general Furosemide tablets 40mg x 28
oral solution 50mg/5mL x 150mL
injection 20mg/2mL
 
Adenosine injection 6mg/2mL  
Amiodarone injection, prefilled syringe 300mg/10mL  
Propranolol tablets 10mg x 28  
Bisoprolol tablets 1·25mg x 28  
Labetalol tablets 100mg x 56 Take one twice daily
Glyceryl trinitrate  Aerosol spray 400microgram per dose, 200 dose unit  
CPR drugs Adrenaline/epinephrine 1 in 10,000 (1mg/10mL) (Minijet®)
1 in 1,000 (1mg/1mL) vial
1 in 1,000 (5mg/5mL) vial
 
Amiodarone injection Prefilled syringe 300mg/10mL (Minijet®)  
Atropine injection  1mg/10mL (Minijet®)
600 microgram/1mL vial 
 
Anticoagulants, antiplatelets & fibrinolytics Heparin sodium Injection 5000 units/5mL  
Enoxaparin injection Pre-filled syringe 100mg/1mL  
Rivaroxaban Tablets 15mg x 2  
Aspirin  Dispersible tablets 75mg x 28, 300mg x 28  
Clopidogrel Tablets 75mg x 28  
Tenecteplase Injection 50mg (10 000 units)/50mL  
Tranexamic acid Tablets 500mg x 60
Injection 500mg/5mL
1 gram to be given over 10 minutes for prevention and treatment of significant haemorrhage following trauma

Central Nervous System

Drug classificationDrugForm, Strength, Pack sizeDirections
Anxiety & agitationDiazepamTablets 2mg x 2
Take ONE tablet TWICE daily
Tablets 5mg x 2Take ONE tablet TWICE daily
Tablets 5mg x 14
take ONE tablet THREE times daily
Injection (emulsion) 10mg/2mL
Lorazepam

Tablets 1mg x 2

Take HALF to ONE tablet when required for agitation

Tablets 1mg x 28

PropranololTablets 10mg x 28
HaloperidolTablets 500 micrograms x 28
Tablets 5mg x 28
Injection 1mg/1mL
Injection 5mg/5mL
Extrapyramidal dysfunction (EPS)ProcyclidineTablets 5mg x 28 
Injection 10mg/2mL
Nausea & vomitingCyclizineInjection 50mg/1mL
ProchlorperazineTablets 5mg x 28
Buccal tablets (Buccastem®) 3mg x 10Take ONE or TWO tablets TWICE daily. Place between upper lip and gum and allow to dissolve.
Injection 12·5mg/1mL
LevomepromazineInjection 25mg/mL
DomperidoneTablets 10mg x 30
MetoclopramideTablets 10mg x 14
Take ONE tablet THREE times daily
Injection 10mg/1mL
Hyoscine Hydrobromidetablets 300 micrograms x 30
Dexamethasone

Tablet 2mg x 50
Oral solution 2mg/5mL x 150mL
Injection 4mg/1mL

Ondansetron

Oral lyophilisate 8mg x 10

Moderately emetogenic chemotherapy or radiotherapy: Place ONE tablet on the tongue and allow to disperse up to every 12 hours for up to 5 days.
AnalgesiaParacetamolTablets 500mg x 16Take TWO tablets every FOUR to SIX hours if required for relief of pain.
Oral suspension 120mg/5mL x 100mLTake ...... mL every FOUR to SIX hours when required.
Oral suspension 250mg/5mL x 100mLTake ...... mL every FOUR to SIX hours when required.
Suppositories 120mg x 10, 240mg x 10, 500mg x 10
Solution for intravenous infusion 1gram/100mL For use in mild to moderate pain
Codeine phosphateTablets 30mg x 28
Co-codamolTablets 30/500mg x 10Take TWO tablets every FOUR to SIX hours if required for relief of PAIN
DihydrocodeineTablets 30mg x 10Take ONE tablet every FOUR hours when required for PAIN
TramadolCDTablets 50mg x100
MorphineOral solution (Oramorph®) 10mg/5mL x 100mL
MorphineCDInjection 10mg/1mL
DiamorphineCDInjection 5mg
Injection 10mg
MigrainePropranololTablets 10mg x 28
SumatriptanTablets 50mg x 6Take ONE or TWO tablets. The dose may be repeated after at least TWO hours if migraine recurs
Injection, pre-filled syringe 6mg/0·5mL x 2 with autoinjector
RizatriptanOrodispersible tablets 10mg
Status epilepticusMidazolamCD 
(Epistatus®
Oromucosal solution 50mg/5mL Unlicensed
LorazepamInjection 4mg/1mL
DiazepamEnema 5mg x 5, 10mg x 5

Ear, Nose and Oropharynx

DrugForm, Strength, Pack sizeDirection
Naseptin (chlorhexidine 0·1%, neomycin 0·5%)Cream 15gFor eradication of nasal carriage of staphylococci, apply to nostrils 4 times daily for 10 days. Naseptin® is also used for the treatment of epistaxis and following minor procedures.
Otomize (dexamethasone 0.1%, neomycin 3250 units/mL, glacial acetic acid 2%)SprayOtitis externa

Endocrine

Drug classificationDrugForm, Strength, Pack sizeDirections
InsulinActrapidInjection 100 units/mL x 10mL
Hypoglycaemic agentsGlucoseOral gel 40%
Injection 20%
Glucagon
SteroidsPrednisoloneTablets 5mg x 28
Soluble tablets 5mg x 28  
Take ...... tablets ONCE daily in the morning for ...... days. Discard remainder.
HydrocortisoneInjection 100mg/1mL
Dexamethasone

Tablets 2mg x 50

HaemostaticTranexamic AcidTablets 500mg x 60Menorrhagia

Eye

Drug Form, Strength, Pack size Directions
Chloramphenicol eye ointment 1% 4g Apply to ...... eye(s) FOUR times a day for ...... days
eye drops 0·5% 10mL Put ONE drop FOUR times a day in ...... eye(s) for ONE week
Prednisolone (Pred Forte) Eye drops 1% 5mL  Only to be started in patients with previous confirmed diagnosis or after discussion with consultant ophthalmologist. Urgent review must be arranged – see ophthalmology out of hours guidelines for referral pathways.
Fusidic acid Eye drops 1%  
Ganciclovir Eye gel 0·15% Apply ONE drop of gel in each infected eye FIVE times daily until healed, then THREE times daily for 7 days
Tropicamide Preservative-free eye drops 1% 0·5mL x 20 units  
Cyclopentolate Eye drops 1% 5mL  
Diclofenac Preservative-free eye drops 0·1% 0·3mL x 5 units Put ONE drop into ....... eye(s) THREE times a day for ONE day, then TWICE daily thereafter
Proxymetacaine Preservative-free eye drops 1% 0·5mL x 20 units   
Fluorescein Sodium Preservative-free eye drops 2% 0·5mL x 20 units  
Tetracaine hydrochloride Minims 1% eye drops 0.5mL unit dose

Put ONE drop onto .......... eye(s) as required for surface anaesthesia.

Gastro-intestinal

Drug classificationDrug Form, Strength, Pack sizeDirections
AntacidsCompound Aliginate (Peptac) oral suspension500mLTake .....mL as required for heartburn.
Give patient a 5mL spoon. 
Antispasmodics and drugs altering gut motilityMebeverine 135mg tablet x 100
Metoclopramide 10mg tablet  x 14Take ONE tablet THREE times daily
Hyoscine Butylbromide injection 20mg/1mLThe oral formulation of hyoscine butylbromide is poorly absorbed and therefore not recommended.
Domperidone 10mg tablet x 30Take ONE tablet THREE times daily when required for nausea.
Proton pump inhibitorsOmeprazoleTake ONE capsule in the morning.
Acute diarrhoeaOral rehydration salts  powder sachet
Loperamide 2mg capsule x 20Take TWO capsules to start with, then ONE capsule after each loose bowel motion. Do not take more than 8 in 24 hours.
LaxativesMacrogol oral powder, compound (Laxido) ‘3350’ oral powder sachet13·125 grams/sachet
Senna/sennosides7.5mg tablet
Bisacodyl5mg suppository x 5
10mg suppository x 5 
GlycerolAdult 4g suppository x 12
Child 2g suppository x 12
Infant 1g suppository x 12
Phosphates (rectal)enema with standard rectal tube
Sodium citrate (rectal)enema with nozzle

Immunological products and vaccines

DrugForm, Strength, Pack size
RevaxisInjection
Anti-D (Rho) ImmunoglobulinInjection
Tetanus immunoglobulininjection

Infections

Drug classificationDrugForm, Strength, Pack sizeDirections
 PenicillinsAmoxicillinCapsules 250mg x 21
Capsules 500mg x 21
Take ONE capsule THREE times a day for ...... days. Discard remainder.
Oral suspension 125mg/5mL x 100mL, 250mg/5mL x 100mLTake ...... mL THREE times a day for ...... days. Discard remainder.
Capsules 500mg x 21Acute exacerbation of COPD: 500mg three times a day PLUS co-amoxiclav 625mg three times a day for 5 days.
BenzylpenicillinInjection 600mg, 1·2g

Adult: 1·2g, 4mL WFI or saline per 600mg vial; administer 1·2g over 4 minutes. Use 2mL for intramuscular injection.
Children: under 1 year 300mg
1 to 9 years: 600mg
Over 10 yrs: 1·2g

3·6mL WFI per 600mg vial gives 150mg/mL solution. Administer over 2 to 4 minutes intravenously/IO.

Co-amoxiclavTablets 250mg/125mg x 21, 500.125mg x 21

Take ONE tablet THREE times a day for ..... days. Discard remainder. 

Oral suspension 125/31mg per 5mL x 100mL

Take ..... mL THREE times a day for ..... days. Discard remainder. 

Tablet 500mg/125mg x 21

Animal/human bite, or Upper UTI or UTI in catheterised patient: 625mg three times a day for 7 days

Acute exacerbation of COPD: 625mg three times a day for 4 days PLUS amoxicillin 500mg three times a day for 5 days.
FlucloxacillinCapsules 250mg x 28, 500mg x 28Take ...... tablet(s) FOUR times a day for ...... days. Discard remainder.
Oral suspension 125mg/5mL x 100mL, 250mg/5mL x 100mLTake ...... mL FOUR times a day for ...... days. Discard remainder.
PhenoxymethlpenicillinTablets 250mg x 28Take ...... tablet(s) FOUR times a day for ...... days. Discard remainder.
Oral solution 125mg/5mL x 100mL,
250mg/5mL x 100mL
Take ...... mL FOUR times a day for ...... days. Discard remainder.
CephalosporinsCefalexinCapsules 250mg x 28Take ONE capsule FOUR times daily for ...... days. Discard remainder.
Capsules 500mg x 28

Penicillin allergic UTI: 500mg three times a day for 3 days (women) / 7 days (men).

CefotaximeInjection 1g, 2gFor intramuscular/intravenous use in sepsis
Adult: 1gram (regardless of weight) 2mL WFI per 500mg vial or 4mL WFI per 1g vial. Administer intravenously over 3 to 5 minutes. Can be given intramuscularly at same dilution.
Neonate: 50mg/kg/day in 4 doses
Child: 100mg/kg/day in 4 doses
Add 1·8 mL water to 500mg vial, 3·6mL WFI to 1g vial = 250mg/mL solution. Administer intravenously/ IO over 3 to 5 minutes. Can be given intramuscularly at same dilution.
CeftriaxoneInjection 1gFor use in meningococcal meningitis and known penicillin allergy.
TetracyclinesDoxycycline 
Capsules 100mg x 8
For lower respiratory-tract infections.Take TWO capsules on the first day then take ONE capsule DAILY for ...... days.
For cellulitis and Lyme diseasePre-pack: take ONE capsule twice daily for ...... days.
MacrolidesClarithromycinTablets 250mg x 14Take ...... tablet(s) TWICE a day for ...... days.
Oral suspension 125mg/5mL x 100mLTake ...... mL TWICE a day for ...... days.
Erythromycin 
(ethylsuccinate)
Tablets 250mg x 28Take ...... tablets(s) FOUR times a day for ...... day(s).
Oral suspension 125mg/5mL x 100mL, 250mg/5mLTake ...... mL FOUR times a day for ...... days. Discard remainder.
QuinolonesCiprofloxacin250mg tablets x 20Take TWO tablets TWICE a day for ...... days
Tablet 750mg x 20

Upper UTI and UTI in catheterised patient: 750mg twice a day for 7 days

LevofloxacinTablet 500mg x 20CAP CURB 2 or higher for patients who are penicillin allergic: 500mg twice daily for 7 days
Other antibioticsTrimethoprimTablet 200mg x 14Take ONE tablet TWICE a day for ...... day(s).
Oral suspension 50mg/5mL x 100mLTake ...... mL ...... a day for  ...... days. Discard remainder.
Metronidazole400mg tablets x 14Take ONE tablet TWICE a day for ..... days.
400mg tablets x 21Take ONE tablet THREE times a day for ..... days (used for dental, dirty skin infections or bites with a penicillin allergy)
NitrofurantoinM/R capsules 100mg x 6Urinary tract infection: Take ONE capsule TWICE a day for THREE days.
M/R capsules 100mg x 14Take ONE capsule TWICE a day for ...... days.
ChloramphenicolInjection 1 gramFor intravenous use in meningitis or sepsis of unknown origin.
For use in patients with confirmed anaphylaxis to penicillin as use of cephalosporin is not advised in these patients.
Adult: 25mg/kg
Children: 12·5mg/kg
Co-trimoxazoleTablets 160mg/800mg x 28For nursing home residents or following recent hospital admission (not for CAP) 960mg twice daily (reduce dose to 480mg twice daily in renal impairment CrCl 30ml/min or less)
ClindamycinCapsules 150mg x 100 + 150mg x 24Mastitis in penicillin allergic patient: 450mg 4 x daily for 10 days 
AntifungalsNystatinOral suspension 100,000 units/1mL x 30mLOral candidiasis.
Antiviral drugsAciclovirTablets 800mg x 35Take ONE tablet FIVE times a day for ...... days
OseltamivirCapsules 75mg x 10Influenza prophylaxis: 75mg once daily for 10 days.
Influenza treatment 75mg twice daily for 5 days.

Malignant Disease and Immunosuppression

DrugForm, Strength, Pack sizeDirections
OndansetronOral lyophilisates 8mg x 10Moderately emetogenic chemotherapy or radiotherapy: Place ONE tablet on the tongue and allow to disperse up to every 12 hours for up to 5 days.

Musculoskeletal

DrugForm, Strength, Pack sizeDirections
IbuprofenTablets 200mg x 24Take ...... tablet(s) every SIX to EIGHT hours
Oral suspension 100mg/5mL x 100mL...... mL to be taken THREE, to FOUR times daily
Gel 5% x 100g
NaproxenTablets 250mg x 14take TWO tablets initially, then ONE tablet every EIGHT hours as required
Diclofenac

Injection 75mg/3mL

Nutrition and Blood

DrugForm, Strength, Pack sizeDirections
PhytomenadioneInjection 10mg/1mL
DioralyteOral rehydration sachets x 6To be taken when required for diarrhoea as directed by your doctor. Dissolve or mix with water before taking as directed on the patient information leaflet.
Water for injections
Sodium chlorideInjection 0.9%

Obstetrics, Gynaecology and Urinary-Tract Disorders

DrugForm, Strength, Pack size
ClotrimazolePessary 500mg
Cream 1%
Syntometrine (ergometrine /oxytocin) 500micrograms /5 units per 1mL injection
LevonorgestrelTablet 1·5mg x 1
Ulipristal (EllaOne®)Tablet 30mg x 1
Catheter Patency Solution (Solution G) For crystalline dissolution
DiclofenacSuppositories 50mg x 10

Respiratory

Drug classificationDrugForm, Strength, Pack sizeDirections
Respiratory - generalSalbutamolAerosol inhalation 100 micrograms/metered inhalation 1 x 200 dose unit
Nebuliser solution 2·5mg/2·5mL x 20 units, 5mg/5mL x 20 units
Oral solution 2mg/5mL x 150mL
BudesonideNebuliser liquid 1mg/2mL x 20 units
Ipratropium bromideNebuliser solution 250 micrograms/1mL x20 units
500 micrograms/2mL x 20 units
Magnesium sulfateInjection 50% 1 x 10mL
Volumatic®
Aerochamber® Plusstandard, child, infant
Antihistamines and allergic emergenciesCetirizineTablet 10mg x 10Take ONE tablet daily or HALF a tablet TWICE daily if you feel dizzy or drowsy.
LoratadineTablet 10mg x 28
ChlorphenamineTablet 4mg x 14Take ONE tablet every FOUR to SIX hours as required. Maximum of ...... tablets in 24 hours.
Oral solution 2mg/5mL x 150mLTake ...... mL every FOUR to SIX hours as required. Maximum of ...... mL in 24 hours.
Injection 10mg/1mL
Oxygenboth cylinders and oxygen concentrators should be available locally
DexamethasoneTablet 2mg x 50
Oral solution 2mg/5mL x 150mL
Injection 4mg/1mL
PrednisoloneTablet 5mg x 28
Soluble tablet 5mg x 30
Take ..... tablets ONCE daily in the morning for ...... days. Discard remainder.

Skin

DrugForm, Strength, Pack sizeDirections
DiprobaseCream 50g
HydrocortisoneCream 1% 30g
ClotrimazoleCream 1%Paediatric ballinitis, elderly patients with fungal rash

Others

DrugForm, Strength, Pack size
HIV PEP Starter pack
Activated charcoal (Charcodote®)Oral suspension 1g/5mL 250mL