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 classification Drug Form, Strength, Pack size Directions
Anxiety & agitation Diazepam Tablets 2mg x 2
Take ONE tablet TWICE daily
Tablets 5mg x 2 Take 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

 
Propranolol Tablets 10mg x 28  
Haloperidol Tablets 500 micrograms x 28
Tablets 5mg x 28
Injection 1mg/1mL
Injection 5mg/5mL
 
Extrapyramidal dysfunction (EPS) Procyclidine Tablets 5mg x 28 
Injection 10mg/2mL
 
Nausea & vomiting Cyclizine Injection 50mg/1mL  
Prochlorperazine Tablets 5mg x 28
 
Buccal tablets (Buccastem®) 3mg x 10 Take ONE or TWO tablets TWICE daily. Place between upper lip and gum and allow to dissolve.
Injection 12·5mg/1mL  
Levomepromazine Injection 25mg/mL  
Domperidone Tablets 10mg x 30  
Metoclopramide Tablets 10mg x 14
Take ONE tablet THREE times daily
Injection 10mg/1mL  
Hyoscine Hydrobromide tablets 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.
Analgesia Paracetamol Tablets 500mg x 16 Take TWO tablets every FOUR to SIX hours if required for relief of pain.
Oral suspension 120mg/5mL x 100mL Take ...... mL every FOUR to SIX hours when required.
Oral suspension 250mg/5mL x 100mL Take ...... 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 phosphate Tablets 30mg x 28  
Co-codamol Tablets 30/500mg x 10 Take TWO tablets every FOUR to SIX hours if required for relief of PAIN
Dihydrocodeine Tablets 30mg x 10 Take ONE tablet every FOUR hours when required for PAIN
TramadolCD Tablets 50mg x100  
Morphine Oral solution (Oramorph®) 10mg/5mL x 100mL
 
MorphineCD Injection 10mg/1mL  
DiamorphineCD Injection 5mg
Injection 10mg
 
Migraine Propranolol Tablets 10mg x 28  
Sumatriptan Tablets 50mg x 6 Take 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  
Rizatriptan Orodispersible tablets 10mg  
Status epilepticus MidazolamCD 
(Epistatus®
Oromucosal solution 50mg/5mL  Unlicensed
Lorazepam Injection 4mg/1mL  
Diazepam Enema 5mg x 5, 10mg x 5  

Ear, Nose and Oropharynx

Drug Form, Strength, Pack size Direction
Naseptin (chlorhexidine 0·1%, neomycin 0·5%) Cream 15g For 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%) Spray Otitis externa

Endocrine

Drug classification Drug Form, Strength, Pack size Directions
Insulin Actrapid Injection 100 units/mL x 10mL  
Hypoglycaemic agents Glucose Oral gel 40%
Injection 20%
 
Glucagon    
Steroids Prednisolone Tablets 5mg x 28
Soluble tablets 5mg x 28  
Take ...... tablets ONCE daily in the morning for ...... days. Discard remainder.
Hydrocortisone Injection 100mg/1mL  
Dexamethasone

Tablets 2mg x 50

 
Haemostatic Tranexamic Acid Tablets 500mg x 60 Menorrhagia

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 classification Drug  Form, Strength, Pack size Directions
Antacids Compound Aliginate (Peptac) oral suspension 500mL Take .....mL as required for heartburn.
Give patient a 5mL spoon. 
Antispasmodics and drugs altering gut motility Mebeverine  135mg tablet x 100  
Metoclopramide  10mg tablet  x 14 Take ONE tablet THREE times daily
Hyoscine Butylbromide injection 20mg/1mL   The oral formulation of hyoscine butylbromide is poorly absorbed and therefore not recommended.
Domperidone  10mg tablet x 30 Take ONE tablet THREE times daily when required for nausea.
Proton pump inhibitors Omeprazole   Take ONE capsule in the morning.
Acute diarrhoea Oral rehydration salts  powder sachet    
Loperamide  2mg capsule x 20 Take TWO capsules to start with, then ONE capsule after each loose bowel motion. Do not take more than 8 in 24 hours.
Laxatives Macrogol oral powder, compound (Laxido) ‘3350’ oral powder sachet 13·125 grams/sachet  
Senna/sennosides 7.5mg tablet  
Bisacodyl 5mg suppository x 5
10mg suppository x 5 
 
Glycerol Adult 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

Drug Form, Strength, Pack size
Revaxis Injection
Anti-D (Rho) Immunoglobulin Injection
Tetanus immunoglobulin injection

Infections

Drug classification Drug, common indication and duration Form, Strength, Pack size Directions
 Penicillins

Amoxicillin

Respiratory tract infections (LRTI, CAP , acute bronchitis, infective exacerbation of COPD) 5 days
Acute otitis media 5 days
Acute rhinosinusitis 5 days
Pericoronitis 3 days
Dental abscess 5 days

Capsules 250mg x 15 (children only)
Capsules 500mg x 9 and 15
Take ONE capsule THREE times a day for ...... days. Discard remainder.
Oral suspension 125mg/5mL x 100mL, 250mg/5mL x 100mL Take ...... mL THREE times a day for ...... days. Discard remainder.

Benzylpenicillin

Suspected meningitis, stat dose

Injection 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-amoxiclav

Infective exacerbation of COPD (severe) 5 days (with amoxicillin)
Bite wounds – prophylaxis 3 days, treatment 5 days
Upper UTI (ONLY if sensitivity known, not for empiric use due to increased resistance rates) 7 days

Tablets 250mg/125mg x 21 (children only)
500/125mg x 15 and 21

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

Oral suspension 125/31mg per 5mL x 100mL
250/62.5mg per 5mL x 100mL

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

Flucloxacillin

Skin and soft tissue infection 5 days
Breast abscess 7 to 10 days
Mastitis 10 to 14 days

Capsules 250mg x 28 (children only)
500mg x 20
Take ...... capsule(s) FOUR times a day for ...... days. Discard remainder.
Oral suspension 125mg/5mL x 100mL, 250mg/5mL x 100mL Take ...... mL FOUR times a day for ...... days. Discard remainder.

Phenoxymethylpenicillin

Sore throat 5 days
Recurrent known strep throat 10 days
Acute rhinosinusitis 5 days
Dental abscess up to 5 days

Tablets 250mg x 20  Take ...... 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.
Cephalosporins

Cefalexin

Lower UTI 3 days in women, 7 days in men
Upper UTI 7 days (dose 1 gram three times a day)

 

Capsules 500mg x 9
Capsules 500mg x 21

Take ...... capsule(s) ...... times a day for ...... days.

Oral suspension
125mg/5mL x 100mL
 250mg/5mL x 100mL

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

Cefotaxime

Meningitis, stat dose

Injection 1g, 2g For intramuscular/ intravenous/ intraosseous use in meningitis or sepsis
Adult: 2 gram.
Neonate and child up to 11 years: 50mg/kg
Child age 12 to 17 years: 1 gram
Check brand for reconstitution information.
Administer intravenously/ IO over 3 to 5 minutes.
Can be given intramuscularly at same dilution using WFI or lidocaine 1%.
Doses over 1g must be administered to separate sites.

Ceftriaxone

Meningitis, stat dose

Injection 1g, 2g For intramuscular/ intravenous/ intraosseous use in meningitis or sepsis
Adult and child over 9 years: 2 gram
Child Up to 1 month: 250mg
2 to 11 months: 500mg
1 to 4 years: 1 gram
5 to 8 years: 1.5 grams
10mL WFI per 1g vial or 20ml WFI per 2g vial. Administer intravenously/ IO over 3 to 5 minutes.
For intramuscular injection, check brand for reconstitution information, can use WFI or lidocaine 1% at same dilution Doses over 1g must be administered to separate sites.
Tetracyclines

Doxycycline 

Acute rhinosinusitis 5 days
Acute exacerbation of COPD 5 days
Acute cough/bronchitis/LRTI 5 days
Cellulitis 5 days then review (may need 7 days)
Bite wounds (in combination with metronidazole) 3 days (prophylaxis), 5 days (treatment)
Hospital/Healthcare acquired pneumonia up to 8 days

Capsules 100mg x 8 Take TWO capsules on the first day then take ONE capsule DAILY for ...... days.
Capsules 100mg x 14 Take ONE capsule twice daily for ...... days.
Macrolides

Clarithromycin

Sore throat, acute exacerbation of COPD 5 days
Acute otitis media 5 days

Tablets 500mg x 10 Take ...... tablet(s) TWICE a day for ...... days.
Oral suspension 125mg/5mL x 100mL Take ...... mL TWICE a day for ...... days.
Quinolones

Ciprofloxacin

Upper UTI only if sensitivity known 7 days

Tablets 250mg x 14

Take TWO tablets TWICE a day for ...... days

Tablets 500mg x 14

Take ONE tablet TWICE a day for ...... days

Other antibiotics

Trimethoprim

Lower UTI in women 3 days
Lower UTI in men 7 days

Tablets 200mg x 6 and 14 Take ONE tablet TWICE a day for ...... day(s).
Oral suspension 50mg/5mL x 100mL Take ...... mL ...... a day for  ...... days. Discard remainder.

Metronidazole

Dental infections 3 days
Dental abscess 3 days then review, may need 5 days
Added in dirty or penetrating wound 5 days

Tablets 400mg x 21 Take ONE tablet THREE times a day for ..... days

Nitrofurantoin

Lower UTI in women 3 days
Lower UTI in men 7 days

M/R capsules 100mg x 6 Take ONE capsule TWICE a day for THREE days.
M/R capsules 100mg x 14 Take ONE capsule TWICE a day for ...... days.

Co-trimoxazole

Upper urinary tract infection 7 days
Hospital or healthcare-acquired pneumonia up to 8 days
CrCl 30ml or less – reduce dose to 480mg twice daily

Tablets 80mg/400mg x 28
Tablets 160g/800mg x 10

Take …… tablet TWICE a day for …… days
Antifungals

Nystatin

Oral candidiasis 7 days

Oral suspension 100,000 units/1mL x 30mL Rinse 1ml around the mouth before swallowing FOUR times a day
Antiviral drugs

Aciclovir

Herpes simplex
Varicella zoster

Tablets 200mg x 25
Tablets 800mg x 35

Take ONE tablet FIVE times a day for ...... days

Oseltamivir

Influenza treatment twice daily for 5 days
Influenza prophylaxis once daily for 10 days

Capsules 75mg x 10
Capsules 45mg x 10
Capsules 30mg x 10
All packs: Take ONE capsule … times a day for …. days

Malignant Disease and Immunosuppression

Drug Form, Strength, Pack size Directions
Ondansetron Oral lyophilisates 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.

Musculoskeletal

Drug Form, Strength, Pack size Directions
Ibuprofen Tablets 200mg x 24 Take ...... 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  
Naproxen Tablets 250mg x 14 take TWO tablets initially, then ONE tablet every EIGHT hours as required
Diclofenac

Injection 75mg/3mL

 

Nutrition and Blood

Drug Form, Strength, Pack size Directions
Phytomenadione Injection 10mg/1mL  
Dioralyte Oral rehydration sachets x 6 To 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 chloride Injection 0.9%  

Obstetrics, Gynaecology and Urinary-Tract Disorders

Drug Form, Strength, Pack size
Clotrimazole Pessary 500mg
Cream 1%
Syntometrine (ergometrine /oxytocin)  500micrograms /5 units per 1mL injection
Levonorgestrel Tablet 1·5mg x 1
Ulipristal (EllaOne®) Tablet 30mg x 1
Catheter Patency Solution (Solution G) For crystalline dissolution
Diclofenac Suppositories 50mg x 10

 

Respiratory

Drug classification Drug Form, Strength, Pack size Directions
Respiratory - general Salbutamol Aerosol 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
 
Budesonide Nebuliser liquid 1mg/2mL x 20 units  
Ipratropium bromide Nebuliser solution 250 micrograms/1mL x20 units
500 micrograms/2mL x 20 units
 
Magnesium sulfate Injection 50% 1 x 10mL  
Volumatic®    
Aerochamber® Plus standard, child, infant  
Antihistamines and allergic emergencies Cetirizine Tablet 10mg x 10 Take ONE tablet daily or HALF a tablet TWICE daily if you feel dizzy or drowsy.
Loratadine Tablet 10mg x 28  
Chlorphenamine Tablet 4mg x 14 Take ONE tablet every FOUR to SIX hours as required. Maximum of ...... tablets in 24 hours.
Oral solution 2mg/5mL x 150mL Take ...... mL every FOUR to SIX hours as required. Maximum of ...... mL in 24 hours.
Injection 10mg/1mL  
Oxygen   both cylinders and oxygen concentrators should be available locally
Dexamethasone Tablet 2mg x 50
Oral solution 2mg/5mL x 150mL
Injection 4mg/1mL
 
Prednisolone Tablet 5mg x 28
Soluble tablet 5mg x 30
Take ..... tablets ONCE daily in the morning for ...... days. Discard remainder.

Skin

Drug Form, Strength, Pack size Directions
Diprobase Cream 50g  
Hydrocortisone Cream 1% 30g  
Clotrimazole Cream 1% Paediatric ballinitis, elderly patients with fungal rash

Others

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

Editorial Information

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Document Id: AF012