|Therapeutic Area||Formulary Choices||Cost for 28|
(unless otherwise stated)
|Rationale for decision / comments|
|12.2 Drugs acting on the nose|
|Nasal Allergy||Symptoms of nasal allergy are usually controlled with nasal corticosteroids and / or oral antihistamines|
|Beclometasone - suitable for self-care|
Fluticasone nasal spray is available as self care from pharmacies as Pirinase
|50mcg/spray: £1.93 (200 dose unit)||Beclometasone nasal sprays are available OTC, unbranded versions at less than NHS prescription charge.
Do Not prescribe Beconase Hayfever or Beconase 180 dose preparations as these are significantly more expensive.
Patients can buy fluticasone nasal spray OTC
as Rhinocort Aqua®
|64mcg/spray: £3.49 (120 dose unit)|
|27.5mcg/spray: £6.44 |
(120 dose unit)
|Note: Fluticasone propionate nasal sprays are non-formulary.
All patients currently prescribed Fluticasone propionate should be switched to Fluticasone furoate nasal spray Avamys® as significantly more cost-effective.
If necessary to use fluticasone propionate prescribe as brand Nasofan®.
|Mometasone||50mcg/spray: £2.31 (140 dose unit)|
|Triamcinolone||55mcg/spray: £7.39 (120dose unit)|
|Dymista® (Fluticasone propionate/azelastine hydrochlor) is non formulary|
|Anticholinergics||Ipratropium||21mcg/spray: £6.54 |
(180 dose unit)
|Use Ipratropium only if rhinorhoea is main problem.|
|Decolonisation of nasal MRSA||Mupirocin||Nasal ointment 2%: £4.24 (3g)||For use in decolonisation of nasal MRSA, standard regime is tds nasal application for 5 days. Where there is clinical infection, nasal decolonisation treatment should be undertaken in addition to any systemic treatment given|
(Neomycin 0.5% /
|Nasal cream £2.24 (15g)||Please refer to CCG Management of Infection Guidance MRSA decolonisation policy guide is page 17