netFormulary Sheffield Teaching Hospitals NHS
NHS Foundation Trust  
 Formulary Chapter 18: STHFT Antidotes - Full Chapter
18  Expand sub section  Poisoning
18  Expand sub section  Body Temperature
18  Expand sub section  Nerve agents
18  Expand sub section  Pesticides
18  Expand sub section  Snake bites and animal stings to top
Antivenoms for non-indigenous venomous animals
Indication: Significant evenomation
Kept in Pharmacy: No
Kept in A&E: No
Further information: DoH stock held at Royal Liverpool Hospital and Guys and St Thomas’ Foundation Trust. All cases must be discussed with UK NPIS first (0844 892 0111) as clinical authorisation is required and they will only be issued on a named patient basis. See Toxbase monograph
Please see ViperTab entry for antivenom for European Adder 
Viper Antivenom, European (ViperaTAB)
Formulary injection
Indication: European adder (vipera berus)
Kept in Pharmacy: Yes
Kept in A&E: Yes
Further information: Unlicensed in the UK. Stored in the fridge. See Midlands Medicines rarely used drugs list for advice on where to obtain further supplies out of hours
18  Expand sub section  Convulsion
18  Expand sub section  Removal and Elimination
18  Expand sub section  Removal from the Gastro-intestinal tract
18  Expand sub section  Prevention of absorption
18  Expand sub section  Active elimination techniques to top
18  Expand sub section  Specific Drugs
18  Expand sub section  Alcohol
18  Expand sub section  Analgesics (non-opioid)
18  Expand sub section  Analgesics (opioid)
18  Expand sub section  Antidepressants to top
18  Expand sub section  Antimalarials
18  Expand sub section  Beta Blockers
18  Expand sub section  Calcium-channel blockers
18  Expand sub section  Hypnotics and anxiolytics
18  Expand sub section  IronSalts to top
18  Expand sub section  Lithium
18  Expand sub section  Phenothiazines and related drugs
18  Expand sub section  Stimulants
18  Expand sub section  Theophylline
18  Expand sub section  Other poisons to top
18  Expand sub section  Cyanides
18  Expand sub section  Ethylene glycol and methanol
18  Expand sub section  Heavy Metals
18  Expand sub section  Noxious gases
18  Expand sub section  CS Spray to top
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
Track Changes
Display tracking information
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Link to adult BNF
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Link to SPCs
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHS England

Traffic Light Status Information

Status Description


Definition Certain drugs that are initiated by a specialist but are suitable for GPs to continue ongoing prescribing. The specialist should provide the GP with necessary information and support in order for treatment to be managed safely in primary care. Shared care protocols (SCP) or prescribing guidelines may be available. 1. Requiring specialist assessment to enable patient selection. 2. Requiring a period of monitoring by a specialist. 3. The initial prescription should normally be issued by the specialist unless the agreed SCP states otherwise.  


Definition A drug which should not be initiated in Sheffield unless exceptional circumstances apply to the individual concerned and an Individual Funding Request (IFR) has been agreed by NHS Sheffield. The drug should not be withdrawn from patients already established on treatment but other treatment options should be considered at routine review. Criteria 1. There is a clear Yorkshire and Humber Specialised Commissioning Group decision to not routinely fund usage of the drug. 2. There is a NICE recommendation that the drug should not be prescribed on the NHS for the condition specified. 3. A drug requiring specific commissioning arrangements to be clarified and put in place before prescribing can take place.  


Drugs for which GPs should take full responsibility for initiating and ongoing prescribing.   


Definition Prescribing and ongoing supply is normally undertaken by a consultant or other physician within a secondary care service. In some exceptional circumstances and following discussion between primary and secondary care, GPs may consider it to be in the patient’s best interest for drugs in the Red section of the traffic light scheme to be prescribed in primary care. Red traffic light drugs meet one or more of the following criteria: 1. Require specialist assessment to enable patient selection, initiation, ongoing treatment and monitoring of efficacy, toxicity or adverse effects. 2. Specifically designated as “hospital only “either by product licence or by DH 3. Hospital initiated clinical trial materials used in accordance with the trial protocol 4. Not listed in the current BNF or BNF (C). 5. Being used to treat a condition that is not suitable for primary care prescribing because of disease specific requirements, complexity or defined commissioning arrangements.