Highland Out of Hours (OOH) Formulary

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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
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 
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

 
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.
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  
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 

20mg capsule x 7 20mg capsule x 28

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
Revaxsis Injection
Anti-D (Rho) Immunoglobulin Injection
Tetanus immunoglobulin injection
Infections
Drug classification Drug Form, Strength, Pack size Directions
 Penicillins Amoxicillin Capsules 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 100mL Take ...... mL THREE times a day for ...... days. Discard remainder.
  Benzylpenicillin 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 Tablets 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. 

  Flucloxacillin Capsules 250mg x 28, 500mg x 28 Take ...... tablet(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.
  Phenoxy-methlpenicillin Tablets 250mg x 28 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 250mg capsules x 28 Take ONE capsule FOUR times daily for ...... days. Discard remainder.
  Cefotaxime Injection 1g, 2g For 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.
  Ceftriaoxone Injection 1g For use in meningococcal meningitis and known penicillin allergy
Tetracyclines Doxycycline 
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 disease Pre-pack: take ONE capsule twice daily for ...... days.
Macrolides Clarithromycin Tablets 250mg x 14 Take ...... tablet(s) TWICE a day for ...... days.
    Oral suspension 125mg/5mL x 100mL Take ...... mL TWICE a day for ...... days.
  Erythromycin 
(ethylsuccinate)
Tablets 250mg x 28 Take ...... tablets(s) FOUR times a day for ...... day(s).
    Oral suspension 125mg/5mL x 100mL, 250mg/5mL Take ...... mL FOUR times a day for ...... days. Discard remainder.
Quinolones Ciprofloxacin 250mg tablets x 20 Take TWO tablets TWICE a day for ...... days
Other antibiotics Trimethoprim 200mg tablets x 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 400mg tablets x 14 Take ONE tablet TWICE a day for ..... days.
    400mg tablets x 21 Take ONE tablet THREE times a day for ..... days (used for dental, dirty skin infections or bites with a penicillin allergy)
  Nitrofurantoin M/R capsules 100mg x 6 Urinary tract infection: Take ONE capsule TWICE a day for THREE days.
    M/R capsules 100mg x 14 Take ONE capsule TWICE a day for ...... days.
  Chloramphenicol Injection 1 gram For 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
Antifungals Nystatin Oral suspension 100,000 units/1mL x 30mL Oral candidiasis
Antiviral drugs Aciclovir Tablets 800mg x 35 Take ONE tablet FIVE times a day for ...... days
Malignant Disease and Immunosuppression

Nil relevant specifically to OOH

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
Diprobase Cream 50g
Hydrocortisone Cream 1% 30g
Others
Drug Form, Strength, Pack size
HIV PEP  Starter pack
Activated charcoal (Charcodote®) Oral suspension 1g/5mL 250mL