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
7. Obstetrics, gynaecology and urinary-tract disorders

7.4. Drugs for genito-urinary disorders

7.4.1. Drugs for urinary retention

Preferred List
Preferred List First Line
TAMSULOSIN (modified-release capsules)

Prescribing Notes:

Capsules are the most cost-effective preparation. Tamsulosin MR tablets are non-Formulary

BNF Link

FINASTERIDE (5mg tablets)
Total Formulary
SOLIFENACIN AND TAMSULOSIN (Vesomni) (modified-release tablets)
Specialist and GP
DUTASTERIDE

Restrictions: Restricted to specialist initiation.

Prescribing Notes:

Only suitable for patient with enlargement of the prostate.

BNF Link

ALFUZOSIN

7.4.2. Drugs for urinary frequency, enuresis, and incontinence

Preferred List
TOLTERODINE

Prescribing Notes:

When prescribing antimuscarinics, consideration should be given to other factors which may influence the patient’s condition and response to treatment (e.g. excessive intake of fluid and other lifestyle choices).

BNF Link

SOLIFENACIN

Prescribing Notes:

Most patients will respond adequately to the lower 5mg dose which should be trialled for 6-8 weeks before considering a dose increase. When prescribing antimuscarinics, consideration should be given to other factors which may influence the patient’s condition and response to treatment (e.g. excessive intake of fluid and other lifestyle choices).

BNF Link

OXYBUTYNIN (STANDARD RELEASE TABLETS)

Prescribing Notes:

Oxybutynin should be used with caution in older patients following evidence of potential cognitive impairment. Other oxybutynin preparations are included in the Total Formulary. When prescribing antimuscarinics, consideration should be given to other factors which may influence the patient’s condition and response to treatment (e.g. excessive intake of fluid and other lifestyle choices).

BNF Link

Total Formulary
Specialist and GP
DESMOPRESSIN (NOQDIRNA) (ORAL LYOPHILISATE)

Restrictions:

Desmopressin oral lyophilisate for the symptomatic treatment of nocturia due to idiopathic nocturnal polyuria in adults is restricted to specialist initiation by a consultant gynaecologist/urogynaecologist for use in patients aged 65 years and above (also see prescribing notes below).

Prescribing Notes:

  • A positive diagnosis should be made following analysis of a 3-day volume chart
  • Assessment of efficacy is required every 3 months
  • Monitoring arrangements will be the responsibility of secondary care

BNF Link

Specialist Only
BOTULINUM TOXIN A (BOTOX)

Restrictions: Use for the management of bladder dysfunction (overactive bladder with symptoms of urinary incontinence, urgency and frequency) is restricted to specialist use in adult patients who have failed appropriate oral treatment options. Use in the management of urinary incontinence in adult patients with neurogenic detrusor overactivity due to subcervical spinal cord injury (traumatic or non-traumatic) or multiple sclerosis, who are not adequately managed with anticholinergics is restricted to specialist use.

Prescribing Notes:

Prescribe by brand name.

BNF Link

MIRABEGRON (BETMIGA) (tablets)
TROSPIUM CHLORIDE (REGURIN XL) (capsules)
Specialist and GP
DULOXETINE

Prescribing Notes:

Pelvic floor exercises are considered the first line treatment for stress incontinence in women.

BNF Link

Specialist and GP
OXYBUTYNIN (TRANSDERMAL PATCH)

Prescribing Notes:

Oxybutynin should be used with caution in older patients following evidence of potential cognitive impairment. When prescribing antimuscarinics, consideration should be given to other factors which may influence the patient’s condition and response to treatment (e.g. excessive intake of fluid and other lifestyle choices).

BNF Link

Specialist and GP
OXYBUTYNIN (MR TABLETS)

Prescribing Notes:

Oxybutynin should be used with caution in older patients following evidence of potential cognitive impairment. When prescribing antimuscarinics, consideration should be given to other factors which may influence the patient’s condition and response to treatment (e.g. excessive intake of fluid and other lifestyle choices).

BNF Link

FESOTERODINE FUMARATE

Prescribing Notes: When prescribing antimuscarinics, consideration should be given to other factors which may influence the patient’s condition and response to treatment (e.g. excessive intake of fluid and other lifestyle choices).

BNF Link

7.4.3. Drugs used in urological pain

Total Formulary
Specialist and GP
PENTOSAN POLYSULFATE SODIUM (ELMIRON) (capsules)

Restrictions:

Restricted to specialist intiation for the treatment of bladder pain syndrome characterised by either glomerulations or Hunner's lesions in adults with moderate to severe pain, urgency and frequency of micturition where other treatment options have failed, are not tolerated or are not appropriate. 

BNF Link

Specialist and GP
SODIUM BICARBONATE

Restrictions: Restricted to specialist initiation.

BNF Link

POTASSIUM CITRATE

7.4.4. Bladder instillations and urological surgery

Total Formulary
Specialist and GP
NOXYTHIOLIN

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
GLYCINE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
DIMETHYL SULFOXIDE

Restrictions: Restricted to specialist initiation.

BNF Link

CHLORHEXIDINE

7.4.5. Drugs for erectile dysfunction

Preferred List
SILDENAFIL

Prescribing Notes:

Available for hospital and community prescribing but NHS prescribing by GPs is limited to nationally determined patient groups and schedule 11 restrictions. Please follow Board referral guidance for men suffering erectile dysfunction, including approval for GP prescribing for erectile dysfunction causing severe distress. Consult Summary of Product Characteristics on drug interactions prior to prescribing.

BNF Link

Total Formulary
Specialist and GP
AVIPTADIL WITH PHENTOLAMINE (INVICORP) (intracavernous injection)

Restrictions:

Restricted to specialist initiation for use in patients who have failed on oral therapies (oral phosphodiesterase type-5 inhibitors) and other non-injectable formulations of erectile dysfunction medications.

BNF Link

Specialist and GP
ALPROSTADIL

Restrictions: Restricted to specialist initiation.

BNF Link

VARDENAFIL

Restrictions: Excludes orodispersible tablets.

Prescribing Notes:

Available for hospital and community prescribing but NHS prescribing by GPs is limited to nationally determined patient groups and schedule 11 restrictions. Please follow Board referral guidance for men suffering erectile dysfunction, including approval for GP prescribing for erectile dysfunction causing severe distress. Consult Summary of Product Characteristics on drug interactions prior to prescribing.

BNF Link

TADALAFIL

Restrictions:

Restricted to use for erectile dysfunction or for pulmonary arterial hypertension (see section 2.4.1). Use for benign prostatic hyperplasia is not recommended for use by SMC and is non-Formulary.

Prescribing Notes:

Available for hospital and community prescribing but NHS prescribing by GPs is limited to nationally determined patient groups and schedule 11 restrictions. Please follow Board referral guidance for men suffering erectile dysfunction, including approval for GP prescribing for erectile dysfunction causing severe distress. Consult Summary of Product Characteristics on drug interactions prior to prescribing.

BNF Link