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 Formulary Chapter 24: Pharmacy First - Full Chapter
Notes:

By promoting “Pharmacy First” together we can change patient behaviour to use the pharmacy first and not go to the GP for the treatment of minor self-limiting conditions (NHS England Guidance).

Eligibility criteria:

  • Use when purchasing an OTC medicine would be an issue and non-supply would generate an unnecessary GP appointment.
  • If the patient pays for their prescription they will pay the OTC cost of any medicines supplied.
  • If people are willing to pay for a medicine then they should be encouraged to do so.
  • Medication supplied will be free of charge ONLY if exempt from prescription charges.
  • The service is available to Isle of Wight residents and UK visitors to the island
  • The patient does not always need to be present in the pharmacy e.g. children or elderly

The extended range of minor ailments that can be treated by the community pharmacy staff under Pharmacy First;

  • Allergies / Hayfever
  • Cold sores / Impetigo
  • Conjunctivitis
  • Coughs / colds and sore throats
  • Contact Dermatitis
  • Earwax
  • Fungal Skin Infections
  • Headlice / Scabies / Worms
  • Haemorrhoids
  • Hyperhydrosis (excessive sweating)
  • Insect bites and stings
  • Indigestion / Constipation / Diarrhoea
  • Mouth ulcers
  • Headache / Migraine
  • Minor burns and scalds
  • Musculoskeletal pain & soft tissue injury (aches and pains)
  • Paediatric fever / teething / nappy rash
  • Vaginal thrush
  • Warts / verrucae
 Details...
24.01  Expand sub section  Pharmacy First
Aciclovir 5% cream (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 2g Tube for the treatment of cold sores

 
Link  Patient Information Leaflet
Anusol Plus® HC ointment (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 15g for the treatment of the swelling, itch and irritation of internal and external piles (Haemorrhoids) and anal itching

 
Link  Patient Information Leaflet
Anusol Plus® HC suppositories (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 12 for the treatment of the swelling, itch and irritation of internal piles (Haemorrhoids) and anal itching

 
Link  Patient Information Leaflet
Anusol® Cream or ointment (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 25g for the treatment of the swelling, itch and irritation of internal and external piles (Haemorrhoids) as well as other minor ano-rectal conditions such as anal itching.

 
Link  Patient Information Leaflet
Anusol® suppositories (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 12 pack for the treatment of internal piles (Haemorrhoids)

 
Link  Patient Information Leaflet
Beclomethasone nasal spray 50mcg/spray (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 200 dose for the treatment of allergic rhinitis including hayfever such as sneezing and a runny, itchy or blocked up nose

 
Link  Patient Information Leaflet
Benzoyl Peroxide 5% Gel (Pharmacy First)
(Acnecide®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30g for the treatment of acne of the face, neck or back

 
Link  Patient Information Leaflet
Benzydamine 0.15% mouthwash (Pharmacy First)
(Difflam®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 200ml for the treatment of mouth ulcers, sore throat, discomfort associated with dentures or dental work

 
Link  Patient Information Leaflet
Benzydamine 0.15% spray (Pharmacy First)
(Difflam®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30ml for the treatment of mouth ulcers, teething, sore throat, sore tongue or gums, discomfort associated with dentures or dental work

 
Link  Patient Information Leaflet
Buccastem 3mg Tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 8 tablet pack for the treatment of migraine related nausea (feeling sick) and vomiting (being sick)

 
Link  Patient Information Leaflet
Buscopan IBS Relief® tablets 10mg tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 20 tablet pack to relieve the abdominal cramps which cause pain and discomfort associated with Irritable Bowel Syndrome (IBS)

 
Link  Patient Information Leaflet
Cetirizine 10mg tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30 tablet pack

In adults and children aged 6 years and above;

  • for the relief of symptoms of hay fever (seasonal allergic rhinitis) and allergies such as dust or pet allergies (perennial allergic rhinitis), such as sneezing, itchy, runny and blocked nose, itchy, red and watery eyes.
  • for the relief of swelling, redness and itchiness of the skin (symptoms of chronic idiopathic urticaria, which is also known as chronic nettle rash).
 
Link  Patient Information Leaflet
Cetirizine 1mg/ml solution (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 200ml

to relieve the symptoms of hayfever (seasonal rhinitis) in adults and children over the age of 2 years, which include:

  • sneezing
  • irritated, runny or blocked nose
  • itchy, red and watering eyes

It is used to relieve the symptoms of other allergies in adults and older children (over the age of 6 years), including:

  • runny and itchy nose (non-seasonal rhinitis) • pet or house mite allergies
  • skin allergies such as rash, itching and urticaria (hives)
 
Link  Patient Information Leaflet
Chloramphenicol 0.5% eye drops (Pharmacy First)
(Optrex®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 10ml

for use in children aged 2 years and over, in adults and the elderly for treatment of bacterial infections that affect the front surfaces of the eye.

 
Link  Patient Information Leaflet
Chloramphenicol 1% eye ointment (Pharmacy First)
(Optrex®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 4g

for use in children aged 2 years and over, in adults and the elderly for treatment of bacterial infections that affect the front surfaces of the eye.

 
Link  Patient Information Leaflet
Chlorhexidine Gluconate 0.2% mouthwash (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 300ml for the treatment of;

  • Oral hygiene and plaque inhibition
  • Oral candidiasis
  • Gingivitis
  • Management of mouth aphthous ulcers
 
Chlorphenamine 2mg/5ml liquid (sugar free) (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 150ml

to treat the itchiness, redness, swelling, tenderness and irritation that can be caused by;

  • hayfever and other allergies e.g. pet, house dust mite and mould spore allergies
  • nettle rash and hives
  • skin allergies and dermatitis
  • prickly heat and heat rash
  • reactions to food, food additives or medicines
  • insect bites and stings
  • the itchy rash of chickenpox.
 
Link  Patient Information Leaflet
Chlorphenamine 4mg tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 28 tablet pack

to treat the itchiness, redness, swelling, tenderness and irritation that can be caused by;

  • hayfever and other allergies e.g. pet, house dust mite and mould spore allergies
  • nettle rash and hives
  • skin allergies and dermatitis
  • prickly heat and heat rash
  • reactions to food, food additives or medicines
  • insect bites and stings
  • the itchy rash of chickenpox.
 
Link  Patient Information Leaflet
Choline salicylate 8.7% (Pharmacy First)
(Bonjela Adult®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 15g

for treatment of;

  • pain and discomfort of common mouth ulcers and cold sores.
  • aid healing of sore spots and ulcers due to dentures and braces. 

in adults and children over the age of 16.

 
Link  Patient Information Leaflet
Clotrimazole 1% cream (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 20g

for the treatment of fungal skin infections such as ringworm, athlete’s foot, fungal nappy rash and fungal sweat rash. It is also used to relieve irritation of the vulva (external thrush) or the end of the penis, which may be associated with thrush.

 

 
Link  Patient Information Leaflet
Clotrimazole 10% vaginal cream (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x pack for the treatment of vaginal thrush

 
Link  Patient Information Leaflet
Clotrimazole 2% cream (Pharmacy First)
(Canestan Thrush®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 20g

to treat irritation of the vulva (vulvitis) which is caused by vaginal thrush (candidiasis).

 

 
Link  Patient Information Leaflet
Clotrimazole 500mg pessary (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x pack

for the treatment of vaginal thrush

 
Link  Patient Information Leaflet
Clotrimazole HC 1% cream (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 15g

for the treatment of athlete’s foot and fungal sweat rash when there are additional symptoms of inflammation (such as swelling, redness and itching).

 

 
Link  Patient Information Leaflet
Dentinox® Teething Gel (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 10g

for pain relief and discomfort associated with teething, in children from 5 months of age, when other non-medicinal methods such as massaging of the gums or use of teething rings do not provide necessary relief.

 

 
Link  Patient Information Leaflet
Dimeticone 4% lotion (Pharmacy First)
(Hedrin®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 50ml (one application)

for the treatment of headlice in adults and children over 6 months of age.

 
Link  Patient Information Leaflet
Docusate sodium 100mg capsules (Pharmacy First)
(Dulcoease®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30 capsule pack

for the treatment of constipation

 
Link  Patient Information Leaflet
Epimax® Cream (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 100g

for the treatment of eczema, psoriasis or other dry skin conditions

 
Fluconazole 150mg capsule (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 tablet pack

to treat vaginal thrush (in women) and associated candidal balanitis (in men).

 
Link  Patient Information Leaflet
Hydrocortisone 1% cream (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 15g

for treatment to reduce inflammation in a variety of inflammatory skin conditions, such as:

  • mild to moderate eczema
  • dermatitis caused by irritants or allergens
  • insect bite reactions
 
Link  Patient Information Leaflet
Hydrocortisone 2.5mg mucoadhesive buccal tabs (Pharmacy First)
(formerly Corlan®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 20 tablet pack

for the treatment of mouth ulcers

 
Link  Patient Information Leaflet
Hyoscine Butylbromide 10mg tablets (Pharmacy First)
(Buscopan®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 20 tablet pack

to treat the abdominal cramps which cause pain and discomfort associated with Irritable Bowel Syndrome (IBS).

 
Link  Patient Information Leaflet
Ibuprofen 100mg/5ml suspension (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 100ml

for relief in children (from 3 months to 12 years) of mild to moderate muscular pain, headache, earache, sore throat, dental pain and backache. This medicine can also be used in minor injuries such as sprains and strains. It also reduces temperature in fever (e.g.post-immunisation fever), as well as other symptoms of cold and influenza.

 
Link  Patient Information Leaflet
Ibuprofen 200mg tablets (Formulary First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 24 tablet pack for the treatment of pain and inflammation

 
Link  Patient Information Leaflet
Ibuprofen 400mg tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 24 tablet pack for the treatment of pain and inflammation

 
Link  Patient Information Leaflet
Ibuprofen 5% gel (Pharmacy First)
(Recommend Fenbid® 100g)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 100g to treat painful joints and muscles

 
Link  Patient Information Leaflet
Ispaghula husk 3.5g sachets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30 sachet pack for the treatment of constipation

 
Link  Patient Information Leaflet
Lactulose solution (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 500ml for the treatment of constipation

 
Link  Patient Information Leaflet
Linicin® lotion with comb pack (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1x100ml, 2 applications = family pack for the treatment of head lice

 
Link  Patient Information Leaflet
Loperamide 2mg capsules (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 6 capsule pack for the treatment of diarrhoea.

 
Link  Patient Information Leaflet
Loratadine 10mg tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30 tablet pack for the treatment of allergy

 
Link  Patient Information Leaflet
Loratadine 5mg/5ml syrup (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 100ml pack for the treatment of allergy

 
Link  Patient Information Leaflet
Macrogol sachets (Pharmacy First)
(Cosmocol®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 20 sachet pack for the treatment of long term constipation and faecal impaction

 
Link  Patient Information Leaflet
Mebendazole 100mg tablet (Pharmacy First)
(Ovex®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 1 tablet pack for the treatment of threadworm infections of the gut

 
Link  Patient Information Leaflet
Mebendazole 100mg/5ml oral suspension (Pharmacy First)
(Ovex®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30ml for the treatment of threadworm infections of the gut

 
Link  Patient Information Leaflet
Melolin® dressing 5cmx5cm plus tape 1.25cm (Pharmacy First)
(Micropore®)
View adult BNF View SPC online View childrens BNF
Formulary

Up to 3 x 5cm x 5cm

 
Metanium® nappy rash ointment (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30g

 
Link  Patient Information Leaflet
Miconazole 2% cream (Pharmacy First)
(Daktarin®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30g for the treatment of fungal and associated bacterial infections of the skin and nails.

 
Link  Patient Information Leaflet
Miconazole oral gel 20mg/g (Pharmacy First)
(Daktarin®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 15g to treat superficial fungal infections of the mouth and throat.

 
Link  Patient Information Leaflet
Migraleve Duo® Tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 24 tablet pack for the short term treatment of acute moderate pain which is not relieved by paracetamol, ibuprofen or aspirin alone such as migraine attacks, including the symptoms of migraine headache, nausea and vomiting

 
Link  Patient Information Leaflet
Nit detection plastic comb (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary  
Oral re-hydration therapy sachets (Pharmacy First)
(ORS®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 12 sachet pack to replace lost salts and fluids, in order to prevent dehydration with short term (acute) diarrhoea.

 
Paracetamol 120mg/5ml suspension (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 100ml to relieve pain and reduce high temperatures. Paracetamol Suspension can be used in babies and children for the treatment of mild or moderate pain and feverishness associated with teething, toothache, headache, colds and flu. It can also be used in babies who develop fever after vaccination.

 
Link  Patient Information Leaflet
Paracetamol 250mg/5ml suspension (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 100ml for relieving pain and reduce high temperatures. Paracetamol Oral Suspension can be used in children and adults for the treatment of mild or moderate pain and feverishness associated with teething, toothache, headache, colds and flu. It is suitable for adults who have difficulty swallowing tablets.

 

 
Link  Patient Information Leaflet
Paracetamol 500mg tablets (Formulary First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 32 tablet pack for the relief of pain and temperature relief of fever. 

 
Link  Patient Information Leaflet
Peptac® suspension (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 500ml for the treatment of heartburn and indigestion

 
Permethrin Cream 5% (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 30g to treat infestations of scabies and crab lice on the body

 
Link  Patient Information Leaflet
Salactac® Gel 8g (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 8g pack for the treatment for warts, verrucas, corns and calluses.

 

 
Link  Patient Information Leaflet
Saline nasal drops (NaCl) (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 10ml to help wash away built up mucus

 
Senna tablets 7.5mg tablets (Pharmacy First)
(Senokot®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 20 tablet pack for the treatment of short term occasional constipation

 
Link  Patient Information Leaflet
Sodium bicarbonate 5% ear drops (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 10ml to soften dried or hardened ear wax

 
Sodium cromoglicate 2% eye drops (Pharmacy First)
(Opticrom®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 5ml for the relief and treatment of eye allergies

 
Link  Patient Information Leaflet
Soluble Aspirin 300mg tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 32 tablet pack for the treatment of pain and swelling and the reduction of high temperatures

 
Link  Patient Information Leaflet
Soluble Paracetamol 500mg tablets (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 24 tablet pack for the relief of pain and temperature relief of fever. 

 
Link  Patient Information Leaflet
Sumatriptan 50mg (Pharmacy First)
(Migraitan®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 2 tablet pack for the relief of acute migraine

 
Terbinafine 1% cream (Pharmacy First)
(Lamisil AT®)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 15g for the treatment of athletes foot

 
Link  Patient Information Leaflet
Zeroderm® Cream (Pharmacy First)
View adult BNF View SPC online View childrens BNF
Formulary

1 x 125g to moisturise and soften dry skin

 
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Drugs that may be initiated, stabilised and maintained by primary, secondary or tertiary care Secondary and tertiary care prescribing may be continued by primary care. [this does not indicate first/second line choice]  

Green Hospital

Items used by the Hospital but would not normally be continued into primary care. Primary care prescribers can change to GREEN first or second.   

Green plus

Initiation of drugs by primary care following written advice from secondary/ tertiary care advice.  

Yellow

Drugs that may be continued in primary care following initiation and stabilisation in secondary/tertiary care  

Amber

Items requiring a shared care agreement. These items should be initiated and stabilised by secondary or tertiary care. The GP should only be asked to take over prescribing through a formal shared care agreement. Secondary care will be expected to continue prescribing until the agreement is made.  

Red

Hospital/ Trust ONLY. These are items the secondary and tertiary care are responsible for prescribing and will need to continue to prescribe for long term maintenance. These items will NOT be prescribed in primary care. But primary care should be informed the patient is receiving these items. This will include NHSE funded items requiring repatriation.  

GP - Black

Items covered by NHSE ‘Should not prescribe in primary care list’ – See CCG policy on Drugs of limited clinical value  

GP - Grey

Grey List: Items covered by NHSE ‘Should not prescribe in primary care list’ that are not to be routinely prescribed but may be suitable in a defined population – See CCG policy on Drugs of limited clinical value  

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