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, renal and urinary-tract disorders

7.2. Treatment of vaginal and vulval conditions

7.2.1. Preparations for vaginal and vulval changes

Preferred List
ESTRADIOL (VAGINAL TABLETS)
ESTRIOL (INTRAVAGINAL CREAM (0.1%))

Prescribing Notes:

The cream contains 1mg estriol in 1g of cream (0.1%)

BNF Link

Total Formulary
ESTRIOL (INTRAVAGINAL CREAM (0.01%))

Prescribing Notes:

The estriol concentration of estriol intravaginal cream is 0.01%. This preparation contains arachis (peanut) oil and is not suitable for patient with peanut allergy. This preparation also damages latex condoms.  

BNF Link

OESTROGEN (ESTRING) (VAGINAL RING)
Specialist and GP
OSPEMIFENE (SENSHIO) (tablets)

Restrictions:

Treatment of moderate to severe symptomatic vulvar and vaginal atrophy (VVA) in post-menopausal women who are not candidates for local vaginal oestrogen therapy is restricted to intitiation by, or on advice of, a specialist.

BNF Link

7.2.2. Vaginal and vulval infections

Preferred List
CLOTRIMAZOLE (PESSARY)

Prescribing Notes:

One pessary contains 500mg of clotrimazole.

BNF Link

CLOTRIMAZOLE (CREAM)

Prescribing Notes:

the clotrimazole content is 1%.

BNF Link

Total Formulary
DEQUALINIUM CHLORIDE (FLUOMIZIN) (vaginal tablets)

Restrictions:

The treatment of bacterial vaginosis is restricted to use in patients for whom the initial treatment is not effective or well tolerated.

BNF Link

METRONIDAZOLE (VAGINAL GEL)

Restrictions:

Metronidazole gel is restricted to patients unable to tolerate or comply with oral metronidazole therapy.

Prescribing Notes:

Strength: 0.75%

BNF Link

MICONAZOLE
NYSTATIN
POVIDONE-IODINE

7.2.3. Preparations for uterine fibroids

Total Formulary
Specialist and GP
RELUGOLIX, ESTRADIOL AND NORETHISTERONE (RYEQO) (tablets)

Restrictions:

Restricted to specialist initiation for use in patients who have failed or are unsuitable for conventional therapies (first line treatments), such as tranexamic acid, hormonal contraceptives and intrauterine delivery systems.

BNF Link

Specialist and GP
ULIPRISTAL ACETATE (ESMYA) (tablets)

Restrictions:

The treatment of moderate to severe symptoms of uterine fibroids in adult women is restricted to the following MHRA advice:

  • intermittent treatment of moderate to severe symptoms of uterine fibroids in women of reproductive age who are not eligible for surgery or where surgery has failed
  • treatment is to be initiated and supervised by a physician experienced in the diagnosis and treatment of uterine fibroids

Please refer to MHRA information prior to initiation.

BNF Link