NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

NRT - Formulary Choices

Key messages

  • Prescribers should familiarise themselves with the GGC Formulary advice for nicotine replacement therapy (NRT) preparations:
  • Nicotinell® products (24-hour patches, lozenges or gum) are the nicotine replacement treatments of choice in GGC.
  • If dual nicotine replacement is appropriate then a second product should be added to Nicotinell® patches.
  • If a mini lozenge is required, the first choice is Niquitin Mini®
  • Redness and itching in the early stages of patch use is common. This is generally a localised reaction which should wear off and is not necessarily a reaction to the adhesive. It is worth persisting and altering the position of the patch before considering an alternative formulation.

The requirement to prescribe outwith the above range of Formulary products should be rare. In the last 12 months, in GGC Acute, 28% of NRT by volume (and 45% of cost) has been for non-Formulary items. Nicquitin® clear patches are the most frequently requested non-Formulary product, these should be replaced with Nicotinell® patches. (See above regarding localised reactions).  Nicorette® inhalator does not have an equivalent product on Formulary but is rarely the only formulation that is suitable.

Selecting a preferred product is associated with cost efficiency and therefore use of non-Formulary products is strongly discouraged; a non-formularly product prescribed in Acute is unlikely to be available on prescription after discharge from hospital. In exceptional circumstances, and on discussion with Clinical Pharmacists / Smoking Cessation Advisors, non-Formulary products may be used for individual patients.  Refer to the memos for Pharmacy and Nursing staff in Acute care for further information on the supply of NRT.

There's lots of support available for people who want to stop smoking in hospital and in the community: see Quit Your Way.

 

 

Published 29/08/19. Medicines Update blogs are correct at the time of publication.