- TTO – ‘To Take Out’ packs, produced by a suitably licensed ‘manufacturing’ pharmacy, which are pre-labelled for supply to clients
- Clinic use only – unlabelled packs of drugs, obtained from manufacturers or pharmaceutical wholesalers, that can be administered to or taken by a client on BPAS premises, if the treatment timings allow (NB - Drugs allowed and stocked by BPAS are for Clinic use only if nothing is specified in this list)
- ** - Patient Group Direction (PGD) available but only for use if the specified inclusion criteria are fulfilled and no exclusions exist – Allows for symptomatic relief and essential drug provision without a prescription/Patient Specific Direction (PSD)
- ++ - Protocol available – use is allowed under a BPAS Protocol for non POM drugs without a PGD, Prescription or PSD
- ^^ - Midwives’ Exemption option available
- Surgical procedures – surgical abortion and related pre or post-surgery procedures, that maybe performed under General Anaesthetic (GA), Conscious Sedation (CS) or Local Anaesthetic (LA)
- Medical procedures – chemical abortion and other drug mediated evacuation procedures
- NB - Second Trimester Procedure – Service currently suspended so the preparations used solely for this procedure are shaded out but will be required if the service is reintroduced
- RPOC – Retained Products of Conception that are not evacuated from the uterus and require treatment for removal to prevent necrotic infection
- Miscarriage – management of missed miscarriage where the RPOC require a medical or surgical procedure for removal
- Cervical preparation – a separate, pre-surgical, procedure to reduce the need for and the risks of rigid dilation of the cervix during a surgical procedure
- HIGH RISK REGISTER – Drugs to be included in the BPAS High Risk Drug Register for legal or clinical reasons or both
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Abortion Specific | ||||
| Digoxin Injection 250mg/ml | Surgical procedures | Foeticide | CLINICAL | |
| Potassium Chloride Concentrate 15% | Surgical procedures | Foeticide | CLINICAL | |
| Mifepristone Tablets 200mg with Misoprostol 200micrograms (Including Medabon) |
Medical procedures | Medical abortion as ‘Pills by Post’ | LEGAL | |
| Mifepristone Tablets 200mg (TTOs) | Medical procedures Surgical procedures Post procedure |
Medical abortion Cervical preparation RPOC/Miscarriage |
LEGAL | |
| Mifepristone Tablets 200mg (Clinic use only - unlabelled) (Including Mifegyne) |
Medical procedures Surgical procedures Post procedure |
Medical abortion Cervical preparation RPOC/Miscarriage |
LEGAL | |
| Misoprostol Tablets 200micrograms (TTOs) | Medical procedures Surgical procedures Post procedure |
Medical abortion Cervical preparation RPOC/Miscarriage |
LEGAL | |
| Misoprostol Tablets 200micrograms (Clinic use only - unlabelled) (Including Cytotec) |
Medical procedures Surgical procedures Post procedure |
Medical abortion Cervical preparation RPOC/Miscarriage Haemorrhage |
LEGAL | |
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| General Anaesthetics (GA), Conscious Sedation (CS) Agents and other theatre essentials |
||||
| Alfentanil Hydrochloride Injection 500micrograms/ml (Schedule 2 CD) | Surgical procedures under GA (anaesthetist’s decision) |
Anticipated pain where more beneficial than Fentanyl | CLINICAL | LEGAL |
| Atracurium Besilate Injection 10mg/ml (25mg/2.5ml) | Surgical procedures under GA (anaesthetist’s decision) |
Non-depolarising muscle relaxant (NDMR) |
CLINICAL | |
| Fentanyl Citrate Injection 50micrograms/ml (Schedule 2 CD) | Surgical procedures (GA /CS) (anaesthetist’s or CS trained surgeon’s decision) |
Anticipated pain/additional sedation | CLINICAL | LEGAL |
| Glycopyrronium Bromide 200micrograms/ml (Including Robinul) |
Surgical procedures under GA (anaesthetist’s decision) |
Reduction of secretions | ||
| Midazolam Injection1mg/ml (5ml ampoules containing 5mg/5ml) | Surgical procedures under CS (CS trained surgeon only) |
Conscious Sedation | CLINICAL | LEGAL |
| Propofol Lipuro 1% (10mg/ml) Injection | Surgical procedures under GA (anaesthetist’s decision) |
General Anaesthesia | CLINICAL | |
| Sevoflurane | Surgical procedures under GA (anaesthetist’s decision) |
General Anaesthesia | CLINICAL | |
| Suxamethonium Chloride 50mg/ml (Including Anectine) |
Surgical procedures under GA (anaesthetist’s decision) |
Depolarising muscle relaxant (DMR) | CLINICAL | |
| Thiopental Sodium Powder for Solution for Injection 500mg | Surgical procedures under GA (anaesthetist’s decision) |
General Anaesthesia | CLINICAL | |
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Analgesia | ||||
| Codeine Phosphate Tablets 15mg or 30mg (TTOs and Clinic packs) ** | Medical procedures | Pain | CLINICAL | LEGAL |
| Diclofenac Sodium Suppositories 100mg (Including Voltarol) ** | Surgical procedures | Actual or anticipated pain | ||
| Diclofenac Sodium Tablets 50mg | All procedures | Pain | ||
| Entonox Gas 50:50 ^^ | Second trimester medical procedures |
Actual or anticipated pain | CLINICAL | |
| Ibuprofen Sachets 600 mg (eg Brufen) ** | All procedures | Pain | ||
| Ibuprofen Tablets 400mg ** | All procedures | Pain | ||
| Meptazinol Tablets 200mg (eg Meptid) | Surgical procedures | Pain | ||
| Morphine oral solution 10mg/5ml (eg Oramorph) | Second trimester medical procedures |
Pain | ||
| Paracetamol Caplets 500mg ++ | All procedures | Pain | ||
| Paracetamol Suppositories 500mg ++ | Surgical procedures | Anticipated pain | ||
| Pethidine Hydrochloride Injection 50mg/ml ^^ (Schedule 2 CD) | Second trimester medical procedures |
Pain | CLINICAL | LEGAL |
| Lidocaine and Prilocaine cream (Generic or eg EMLA) | Local anaesthesia | Needle phobia | ||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Antibiotics | ||||
| Amoxicillin Powder for Solution for Injection 1g | Endocarditis risk | Possible/actual infected RPOC (1g IV plus Gentamicin as per NICE) |
||
| Azithromycin Tablets 250mg (TTOs - Extra doses) ** | STI (Confirmed) | Chlamydia (1g orally in clinic then 500mg bd as TTO) |
||
| Azithromycin Tablets 250mg (Clinic Use Only - unlabelled) ** | STI (Confirmed) | Chlamydia (1g orally then 500mg bd as TTO) Gonorrhoea 2nd line (2g orally with 240mg IM Gentamicin) |
||
| Ceftriaxone sodium Powder for Solution for Injection 1g ** | STI (Confirmed) Surgical procedures Suspected/actual infection |
Gonorrhoea (1st line – Single dose of 1g intramuscularly (IM) Potential/actual Post op infection (1st line (1g IM plus Doxy/Met as TTOs) Sepsis (2g IV with IV Gent and Met) |
||
| Doxycycline Hyclate Capsules 100mg (various TTOs) | Surgical procedures STI (Confirmed) Surgical procedures |
Pre-op prophylaxis (400mg) Chlamydia (1st line – 100mg bd for 7 days as TTO) Potential/actual Post op infection (1st line – 100mg bd for 14 days as TTO + Cef/Met) |
CLINICAL | LEGAL |
| Flucloxacillin Capsules 500mg (TTOs) | Post NHS funded vasectomy | Confirmed post op infection (500mg qds – 7 days) |
||
| Gentamicin 40mg/ml (80mg/2ml) ** | Endocarditis risk STI (Confirmed) Suspected/actual infection |
Possible/actual infected RPOC (1.5mg/kg IV plus AmoxicillinNICE) Gonorrhoea (2nd line (240mg IM plus 2g oral Azithromycin) Sepsis (5mg/kg IV with IV Cef and Met) |
||
| Metronidazole 500mg/100ml Infusion Bag | Suspected/actual infection | Sepsis (500mg IV with IV Cef and Gent) |
||
| Metronidazole Tablets 400mg (Clinic packs and TTOs) ** (Post op infection only) | Surgical procedures Surgical procedures |
Pre/Peri-op prophylaxis (400mg 2 hrs prior plus 4 and 8 hrs post as TTO) Potential/actual Post op infection (1st or 2nd line – 400mg bd for 14 days + other) |
||
| Mupirocin Nasal Ointment | Vasectomy | MRSA eradication Vasectomy only - See BPAS policy |
||
| Ofloxacin Tablets 400mg (TTOs) ** | Surgical procedures | Potential/actual Post op infection (2nd line – 400mg bd for 14 days plus Met) |
||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Antidotes and Reversal Agents | ||||
| Flumazenil 0.1mg/ml | Conscious Sedation (CS) CS trained surgeon’s decision |
Benzodiazepine reversal | ||
| Glycopyrronium 500micrograms (0.5mg) with Neostigmine 2.5mg (eg Robinul) | Surgical procedures under GA (anaesthetist’s decision) |
Reversal of NDMR | ||
| Naloxone Injection 400micrograms/ml ++ | GA CS Overdose from non BPAS drug |
Opioid reversal | ||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Antiemetics | ||||
| Cyclizine Lactate Injection 50mg/ml (Including Valoid) ** | All procedures | Actual/potential nausea/emesis See BPAS Flow Chart |
||
| Metoclopramide 10mg/2ml | Surgical procedures | Risk of nausea/emesis/reflux Prescribed in surgical situations |
||
| Ondansetron Orodispersible Melts 8mg (Including Zofran) ** | All procedures | Actual/potential nausea/emesis See BPAS Flow Chart |
||
| Ondansetron Injection 2mg/ml ** | All procedures | Actual/potential nausea/emesis See BPAS Flow Chart |
||
| Prochlorperazine Buccal Tablets 3mg (TTOs) ** | All procedures | Actual/potential nausea/emesis See BPAS Flow Chart Prophylaxis with pre-op Doxycycline |
||
| Prochlorperazine Buccal Tablets 3mg (Clinic stock) ** | All procedures | Actual/potential nausea/emesis See BPAS Flow Chart |
||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Contraception | ||||
| Desogestrel Tablets 75micrograms (Generic or eg Zelletta, Cerelle) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Ethinyloestradiol 2.7mg/Etonogestrel 11.7mg Vaginal Ring (eg SyreniRing) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Ethinyloestradiol 30 micrograms/Desogestrel 150 micrograms (eg Gedarel) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Ethinyloestradiol 30 micrograms/Levonorgestrel 150 micrograms (eg Rigevidon) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Ethinyloestradiol 35 micrograms/Norgestimate 250 micrograms (eg Lizinna, Cilique) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Ethinyloestradiol 35 micrograms/Norethisterone 500 micrograms (Generic or Brevinor) ** |
Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Ethinyloestradiol 500 micrograms/Norelgestromin 6mg Patch (eg Evra) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Ethinyloestradiol/Drospirenone 30micrograms/3mg (eg Yasmin, Lucette etc) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Etonogestrel Implant 68mg (eg Nexplanon or equivalent) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Levonorgestrel 1500micrograms (eg Levonelle or equivalent) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Levonorgestrel IUS 13.5mg (eg Jaydess) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Levonorgestrel IUS 52mg or 20microgram/24 hours (eg Levosert) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Medroxyprogesterone Acetate 104mg Pre-filled syringe (eg Sayana Press) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Medroxyprogesterone Acetate 150mg Pre-filled syringe (eg Depo-Provera) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Norethisterone 350 micrograms Tablets (eg Noriday) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| T-Safe Cu 380 IUD (Clinic Pack) | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Ulipristal acetate Tablets 30mg (Generic or Ella One etc) ** | Discharge after any procedure | Contraception Initiation only - see BPAS Policy |
||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Emergency Situations | ||||
| Adrenaline (Epinephrine) Injection 1:1000 Pre-filled syringe ++ | Emergency | Anaphylaxis | ||
| Adrenaline (Epinephrine) Injection 1:10000 Pre-filled syringe | Emergency | Cardiac resuscitation | ||
| Adenosine 3mg/ml Solution for Injection | Emergency | Cardiac resuscitation Paroxysmal supraventricular tachycardia |
||
| Amiodarone 30mg/ml Pre-filled syringe | Emergency | Cardiac resuscitation Arrhythmias |
||
| Aminophylline 250mg/10ml | Emergency (anaesthetist’s decision) |
Respiratory crises | ||
| Atropine 500microgram/5ml (0.5mg/5ml) Pre-filled syringe | Emergency | Cardiac resuscitation Bradycardia |
||
| Calcium chloride 10% Injection (1000mg/10ml) Pre-filled syringe | Emergency (anaesthetist’s decision) |
Cardiac resuscitation | ||
| Carboprost (as tromethamine) 250micrograms/ml | Emergency | Haemorrhage NB-Limited life when removed from fridge |
||
| Chlorphenamine 10mg/ml injection | Emergency (anaesthetist’s or CS trained surgeon’s decision) |
Suspected allergy or developing Pruritis when IV access in place NB – not for anaphylaxis |
||
| Dantrolene Sodium Powder for Solution for Injection 20mg | Emergency (anaesthetist’s decision) |
Malignant hyperthermia NB- Need 36 packs for average size patient |
||
| Diazepam Rectal Tubes 10mg | Emergency | Status epilepticus | ||
| Doxapram Hydrochloride 20mg/ml Injection | Emergency (anaesthetist’s decision) |
Respiratory crises | ||
| Ephedrine Hydrochloride Injection 30mg/ml Pre-filled syringe | Emergency (anaesthetist’s decision) |
Respiratory crises | ||
| Glucagon 1mg powder and solvent for injection | Emergency | Hypoglycaemia | ||
| Glucose tablets (eg Dextrosol, Lucozade etc) | Emergency | Hypoglycaemia | ||
| Hydrocortisone sodium succinate powder for solution for injection with diluent | Emergency (anaesthetist’s decision) |
Bronchospasm NB – not for anaphylaxis |
||
| Insulin Soluble 100IU/ml (eg Actrapid, Humulin S etc) | Emergency | Hyperglycaemia | ||
| Labetalol Hydrochloride 5mg/ml | Emergency | Acute Hypertension | ||
| Magnesium Sulphate 50% w/v Solution for Injection | Emergency (anaesthetist’s decision) |
Cardiac resuscitation Arrhythmias/pre-eclampsia |
||
| Oxytocin 5IU with Ergometrine 500 micrograms (per ml) ^^ | Emergency | Haemorrhage | ||
| Oxytocin Concentrate for Solution for Infusion 10IU/ml ^^ | Emergency | Haemorrhage | ||
| Oxytocin Concentrate for Solution for Infusion 5IU/ml ^^ | Emergency | Haemorrhage | ||
| Salbutamol Metered Dose Inhaler (MDI) 100micrograms/dose | Emergency | Respiratory crises | ||
| Salbutamol Nebules 2.5mg/2.5ml (1mg/ml) | Emergency | Respiratory crises | ||
| Salbutamol Sulphate Injection 500 micrograms/ml (0.5mg/ml) | Emergency | Respiratory crises | ||
| Tranexamic Acid Solution for Injection 100mg/ml | Emergency | Haemorrhage | ||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Local Anaesthetics | ||||
| Lidocaine Hydrochloride Injection 1% (5ml) ** | Surgical procedures Contraception |
Pain relief Implant insertion |
||
| Lidocaine Hydrochloride Injection 1% (10ml or 20ml - Without preservative) | Surgical procedures | |||
| Lidocaine Hydrochloride Injection 2% (10ml) | Surgical procedures | |||
| Lidocaine Spray 10% (Requires nozzles) ++ | Surgical procedures Contraception |
Dilapan IUD/IUS insertion |
||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Miscellaneous | ||||
| Chlorphenamine Tablets 4mg | All procedures | Allergy | ||
| Diazepam Tablets 5mg | All procedures | Anxiolytic | ||
| Enoxaparin 40mg (or other strengths if unavailable) | All procedures | LMWH for VTE risk See BPAS policy |
CLINICAL | |
| Lubricating Jelly (Tubes) | All procedures | Lubrication for comfort | ||
| Oxygen Gas ++ | All procedures | Hypoxia | ||
| Silver Nitrate Caustic Stick 75% | Surgical procedures | Cautery | ||
| Sodium Bicarbonate Solution for Injection 8.4% (1mmol/ml) | All procedures | Diluent | ||
| Sodium Chloride Solution 0.9% ** | All procedures | Flushing cannulae | ||
| Sodium Chloride Solution for Injection 0.9% | All procedures | Diluent | ||
| Sodium Citrate 0.3M oral solution | Surgical procedures under GA (anaesthetist’s decision) |
Prevention of regurgitation and/or aspiration | ||
| Water for Injection | All procedures | Diluent | ||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| Prophylaxis | ||||
| Anti-D Immunoglobulin 500IU ** | Medical procedures >10 weeks Surgical procedures |
Rh negative women confirmed by a test or as per BPAS Policy | ||
| Drug name – generic (exemplar brand in parentheses) Listed by main classification | Restricted to use in (procedure or unit type) | Used for (clinical situation) | Potential Risks (for HIGH RISK REGISTER) | |
|---|---|---|---|---|
| External | ||||
| Steristrip 6mm X 75mm | Wounds | |||
| Octenisian Antimicrobial Wash Lotion | Antiseptic | |||
| Tisept Sachets | Antiseptic | |||
| Tisept Sachets | Antiseptic | |||
| Travasept Solution | Antiseptic | |||
| Dilapan-S 4mm X 65mm | Appliance | |||
| Lidocaine Spray Nozzles (Single Use) | Appliance | |||