Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
1. Gastro-intestinal system

1.9. Drugs affecting intestinal secretions

1.9.1. Drugs affecting biliary composition and flow

Preferred List
Specialist and GP
URSODEOXYCHOLIC ACID

Restrictions: For the dissolution of cholesterol gallstones in the gall bladder and for the treatment of primary billiary cirrhosis (PBC), provided there is no decompensated hepatic cirrhosis. It is restricted to specialist initiation.

BNF Link

Total Formulary
Specialist and GP
OBETICHOLIC ACID (tablets)

Restrictions:

Restricted to specialist initiation for primary biliary cholangitis (primary biliary cirrhosis) in patients for whom alternative treatment options are not tolerated or where there has been an inadequate response. Alternative treatments include the off-label use of bezafibrate in combination with ursodeoxycholic acid.

BNF Link

1.9.2. Bile acid sequestrants

Preferred List
COLESTYRAMINE (SACHETS)

1.9.3. Aprotinin

1.9.4. Pancreatin

There is great variation in patient response to these products. Fat malabsorption has the most bearing on the clinical picture. Theoretically, 60,000 BPU of lipase should enable a completely achylic patient to digest the fat in a normal meal; the quantity of protease and amylase that comes from this dose of lipase is more than sufficient to digest the protein and carbohydrate. For details of the CSM warning for use in children, refer to the BNF or BNF for Children.
Preferred List
PANCREATIN (CREON)

Prescribing Notes:

There is great variation in patient response to these products. Fat malabsorption has the most bearing on the clinical picture. Theoretically, 60,000 BPU of lipase should enable a completely achylic patient to digest the fat in a normal meal; the quantity of protease and amylase that comes from this dose of lipase is more than sufficient to digest the protein and carbohydrate. For details of the CSM warning for use in children, refer to the BNF or BNF for Children.

BNF Link

Total Formulary
Specialist and GP
PANCREASE HL

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
NUTRIZYM 22

Restrictions: Restricted to specialist initiation.

BNF Link

PANCREX
NUTRIZYM
CREON MICRO

Restrictions: Restricted to use in young cystic fibrosis sufferers who are unable to swallow capsules.

BNF Link