Obstetrics and Gynaecology Specialist formulary list
The following specialist medicines are approved for prescribing by or on the recommendation of a prescribing obstetrics or gynaecology specialist:
| TAF SECTION | MEDICINE | SUMMARY OF RESTRICTED INDICATION | CATEGORY | PROTOCOL |
| 2.2 | Spironolactone | Hirsutism in postmenopausal women (unlicensed: off-label) |
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| 6.1 | Metformin | Polycystic ovary syndrome (unlicensed: off-label) |
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NICE Evidence summary: ESUOM6 Polycystic ovary syndrome: metformin in women not planning pregnancy (unlicensed/off-label medicines) |
| 6.4.1 | Ulipristal acetate 5mg tablets ▼ | Pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age. |
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| Progesterone pessaries | Prevention of recurrent pre-term birth (unlicensed: off-label) |
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Protocol in development | |
| 6.4.2 | Cyproterone acetate | Hirsutism in postmenopausal women (unlicensed: off-label) |
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| Finasteride | Hirsutism in postmenopausal women (unlicensed: off-label) |
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| 6.5.1 | Clomifene | Anovulatory infertility | |
NICE CG156 Fertility: Assessment and treatment for people with fertility problems |
| Choriogonadotrophin alfa (HcG) injection (Ovitrelle®) | Infertility treatment (under specialist supervision – Assisted Conception Unit) |
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| Follitropin alfa pre-filled pen injection (Gonal-F®) | Infertility treatment (under specialist supervision – Assisted Conception Unit) |
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| Menotrophin (human menopausal gonadotrophins) injection (Menopur®) | Infertility treatment (under specialist supervision – Assisted Conception Unit) |
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| 6.7 | Goserelin (Zoladex® 3.6mg implant) |
Endometriosis,
endometrial thinning prior to ablation or resection, uterine fibroids in
conjunction with iron therapy prior to surgery,
pituitary desensitisation before induction of ovulation by gonadotrophins
for in vitro fertilisation (under specialist supervision) Ovarian stromal hyperthecosis (unlicensed: off-label) |
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| Triptorelin (Decapeptyl® SR) 3mg or 11.25mg injection | Alternative to goserelin for endometriosis |
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| Buserelin 150 micrograms/dose nasal spray, injection (Suprecur®) | Infertility treatment (under specialist supervision – Assisted Conception Unit) |
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| Cetrorelix (Cetrotide®) injection | Infertility treatment (under specialist supervision – Assisted Conception Unit) |
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| Cabergoline |
Modify ovarian hyperstimulation during infertility treatment (unlicensed: off-label) Suppression of lactation following stillbirth |
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| 7.1 and 1.9 | Ursodeoxycholic acid | Pruritis of pregnancy due to intrahepatic cholestasis (unlicensed: off-label) |
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Protocol in development |
| 7.1 and 2.4 | Labetalol tablets | Hypertension in pregnancy. 1st line (used in combination with nifedipine if required). |
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NICE CG107Hypertension in pregnancy Protocol in development |
| Labetalol injection |
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| 7.1 and 2.5 | Hydralazine injection | 2nd line hypertension in pregnancy or 1st line when labetalol is contra-indicated |
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Methyldopa | Pregnancy induced hypertension restricted to the Cardiovascular Risk and Obstetric clinics. 3rd line. |
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| 7.1 and 2.6 |
Nifedipine MR
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Hypertension in pregnancy in combination with labetalol (unlicensed: off-label) |
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| 7.1 and 2.11 | Tranexamic Acid Injection |
Post partum haemorrhage Heavy menstrual bleeding |
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Protocol in development |
| 7.1 and 4.6 | Domperidone |
Augmentation of Lactation (unlicensed: off-label) |
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NHS Tayside Guideline Domperidone for the augmentation of lactation and GP letter |
| 7.1 and 6.3 | Betamethasone (as sodium phosphate) injection 4mg/mL | Preterm labour – to reduce the incidence of neonatal respiratory adverse outcomes (unlicensed: off-label) |
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NICE - Preterm labour and birth in development |
| Dexamethasone (as sodium phosphate) injection 4mg/mL |
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| 7.1 and 9.1 | Ferric carboxymaltose (Ferinject®▼) | Treatment of ante-natal anaemia |
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Protocol in development |
| 7.1 and 9.5 | Magnesium Sulfate injection |
Pre-eclampsia Eclampsia Prevention of adverse neurological outcomes in neonates following pre-term birth (unlicensed: off-label) |
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NICE CG107 Hypertension in Pregnancy NHS Tayside Guideline For Management of Severe Preeclampsia/ Eclampsia (for use in Ninewells hospital) |
| 7.1 | Dinoprostone pessaries (Propess®), vaginal gel (Prostin E2®) | Dinoprostone pessaries (Propess®), vaginal gel (Prostin E2®) |
(may be used by community midwives) |
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| Ergometrine injection | Postpartum haemorrhage |
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| Ergometrine with oxytocin (Syntometrine®) injection |
Active management of third stage of labour
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| Oxytocin (Syntocinon®) injection |
Induction or enhancement of labour
Active management of third stage of labour (unlicensed: off-label) |
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| Carboprost Injection | Severe postpartum haemorrhage unresponsive to ergometrine and oxytocin |
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| Atosiban | Inhibition of uncomplicated premature labour between 24 and 33 weeks of gestation. Atosiban may be preferable to a beta2 agonist because it has fewer side-effects. |
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NICE - Preterm labour and birth in development | |
| Terbutaline subcutaneous injection | Hyperstimulation in labour (unlicensed: off-label) |
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| Indometacin tablets and suppositories | Suppression of uterine activity (unlicensed: off-label) |
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Protocol in development | |
| Gemeprost pessaries | Post partum haemorrhage (unlicensed: off-label) |
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| Methotrexate intramuscular injection | Ectopic pregnancy (unlicensed: off-label) |
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NHS Tayside Protocol for medical management of ectopic pregnancy methotrexate (under review) | |
| Mifepristone |
Medical termination of pregnancy Medical management of miscarriage |
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NHS Tayside Protocol for medical management of non continuing pregnancy |
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| Misoprostol |
Induction of medical abortion (unlicensed: off-label) Medical management of miscarriage (unlicensed: off-label) |
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| 7.1 and 10.1.1 | Diclofenac | Post partum analgesia (short term use 3-5 days) |
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| 7.1 and 13.7 |
Imiquimod
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Vulval Intraepithelial Neoplasia (unlicensed: off-label) |
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NHS Tayside Imiquimod letter to GP and PIL (not published) |
| 8.3.4.1 | Tamoxifen | Anovulatory infertility |
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| Letrozole | Anovulatory infertility (unlicensed: off-label) |
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May be prescribed by Hospital Specialists only |
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May be prescribed in General Practice under the direction of a Specialist |
