The 18 items on NHS England's prescribing 'blacklist'

Guidance from NHS England and NHS Clinical Commissioners recommends that the following 18 items are no longer prescribed on the NHS in primary care.

CCGs have been advised that prescribers in primary care should no longer initiate these treatments for any new patients and be supported in deprescribing these treatments where appropriate.

  • Co-proxamol
  • Dosulepin*
  • Prolonged-release doxazosin (also known as doxazosin modified release)
  • Immediate release fentanyl* - this does not apply to patients undergoing palliative care treatment and where the recommendation to use this treatment has been made by a multidisciplinary team and/or other healthcare professional with a specialism in palliative care.
  • Glucosamine and chondroitin
  • Herbal treatments
  • Homeopathy
  • Lidocaine plasters* - this does not apply to patients with neuropathic pain who have been treated in line with NICE guidance but are still experiencing neuropathic pain associated with previous herpes zoster infection (post-herpetic neuralgia). 
  • Liothyronine (including Armour Thyroid and liothyronine combination products) - precsribing committees may decide exceptions may be made for patients who have an on-going need for liothyronine as confirmed by a consultant NHS endocrinologist.
  • Lutein and antioxidants
  • Omega-3 fatty acid compounds
  • Oxycodone and naloxone combination product*
  • Paracetamol and tramadol combination product
  • Perindopril arginine
  • Rubefacients (excluding topical NSAIDs)
  • Once-daily tadalafil
  • Travel vaccines (vaccines administered exclusively for the purposes of travel) - cholera, diphtheria/tetanus/polio, hepatitis A, typhoid should still be issued on the NHS.
  • Trimipramine

Read the full guidance here

*The guidance says that if, in exceptional circumstances, there is a clinical need for this to be prescribed in primary care, this should be undertaken in a cooperation arrangement with a multi-disciplinary team.

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