Clinical Guidelines
The following guidelines have been approved by the Nottinghamshire Area Prescribing Committee and the relevant secondary care trust(s) Drugs and Therapeutics Committee(s) (D&TCs).
They have been developed in association with the relevant clinicians in primary, secondary and tertiary care (where applicable).
Please click here if you would like the NAPC to consider any clinical guidelines you are developing.
Allergy | Anticoagulants | Cardiovascular | Continence and Stoma | Dependence | Dermatology | Diabetes | Endocrine | Eye |
Gastroenterology | High-Cost Drugs | Mental Health Resources |Neurology | Nutrition including Oral Nutritional Supplements |
Obstetrics and Gynaecology | Pain | Palliative Care | Prescribing and Prescription Governance | Renal | RespiratoryTransgender | Urology | Woundcare | Miscellaneous |
- Allergic Rhinoconjunctivitis Primary Care Pathway (previously Allergic Rhinitis) (198 kb) Review date: March 2025
- Cows Milk Allergy - Quick Reference Guide (307 kb) Review date: May 2025
- Cows Milk Allergy Guidelines (434 kb) Review date: May 2025
- Urticaria & Angioedema Primary Care Pathway (366 kb) Review date: January 2026
Anticoagulants
- Anticoagulants in AF (770 kb) Review date: November 2025
- Direct Oral Anticoagulants for DVT and PE (prescribing information) (372 kb) Review date: October 2024
- DOAC Position Statement (117 kb) Review date: October 2023
- Enoxaparin information sheet (220 kb) Review date: Jan 2024
Cardiovascular
- Blood Pressure and Heart Rate Monitoring in Children (886 kb) Review date: September 2023
- Heart failure traffic light treatment guidelines (1227 kb) Review date: May 2023
- Hyperlipidaemia Guidelines - Summary of National Guidance for Lipid Management for Primary and Secondary Prevention of CVD (351 kb) Review date: Nov 2023
- Hyperlipidaemia management - Statin Intolerance Pathway (338 kb) Review date: Jan 2023
- Hypertriglyceridaemia guidelines (191 kb) Review date: August 2024
- Inclisiran Prescribing Information Sheet (168 kb) Review date: Jan 2026
- Midodrine Monitoring Guidance (256 kb) Review date: July 2025
Continence and Stoma
- Continence Formulary - Primary Care (1147 kb) Review date: See individual sections - earliest is March 2023
- Stoma Ancillaries Items formulary (192 kb) Review date: July 2025
Dependence
- Alcohol Dependence Guidelines (primary care) (713 kb) Review date: July 2025
- Naltrexone information sheet (194 kb) Review date: July 2025
- Smoking Cessation - Position Statement (44 kb) Review date: May 24.
Dermatology
- Barrier Preparations Formulary (596 kb) Review date: June 2024
- Emollient Formulary (212 kb) Review date: May 2024
- Psoriasis (Adults & Children) (255 kb) Review date: July 2023
- Solar keratosis - primary care pathway (207 kb) Review date: Nov 2025
- Topical Tacrolimus for Facial Vitiligo (84 kb) Review date: January 2026
Diabetes
- Blood Glucose and ketone testing - frequency and eligibility (223 kb) Review date: Jan 2025
- Blood glucose testing meters formulary - Nottingham & Nottinghamshire ICB (409 kb) Review date: Jan 2026
- Diabetes - type 2 treatment algorithm (573 kb) Review date: Nov 2025
- Freestyle Libre and Dexcom One prescribing criteria (196 kb) Review date: December 2025
- Continuous Glucose Monitoring devices Holding statement (195 kb)
Endocrine
- Cinacalcet prescribing information sheet (278 kb) Review date: May 2023
- Liothyronine for hypothyroidism position statement (68 kb) Review date: March 2026
- Steroid Card Patient Letter (23 kb)
- Steroid Emergency Card and Steroid Treatment Card - guidance on use (251 kb) Review date: Dec 2024
- Testosterone Information Sheet (605 kb) Review date: Sept 2023
Eye
- Ciclosporin eye drops information sheet (143 kb) Review date: March 2025
- Eye Lubricant formulary (188 kb) Review date: October 2025
- Eye Lubricant prescribing advice (150 kb) Review date: October 2024
Gastroenterology
- Inflammatory Bowel Disease shared care protocols
- Inflammatory Bowel Disease patient information leaflets
- Aminosalicylates in Inflammatory Bowel Disease in Adults - information sheet (155 kb) Review date: July 2025
- Anaemia in IBD pathway (349 kb) Review date: Aug 2024
- Anaemia in IBD- Ferric Maltol Treatment Algorithm (148 kb) Review date: Aug 2024
- Bariatric Surgery - Monitoring and Medication Post Surgery (271 kb) Review date: September 2025
- Constipation - links to national guidelines (94 kb) Review date: April 2024
- Gastroprotection (with PPI) for patients on NSAID or antiplatelet (240 kb) Review date: July 2025
- Linaclotide Prescribing Information Sheet (109 kb) Review date: Dec 2024
- Omeprazole liquid for children - review algorithm (256 kb) Review date: December 2024
- Prucalopride prescribing information sheet (413 kb) Review date: June 2024
High Cost Drugs
- High Cost Drugs - Ankylosing Spondylitis treatment algorithm (130 kb) Review date: March 2025
- High Cost Drugs - Atopic Dermatitis treatment algorithm (92 kb) Review date: March 2025
- High Cost Drugs - Crohns Disease treatment algorithm (39 kb) Review date: July 2025
- High Cost Drugs - Psoriasis treatment algorithm (81 kb) Review date: March 2025
- High Cost Drugs - Psoriatic Arthritis treatment algorithm (85 kb) Review date: March 2025
- High Cost Drugs - Rheumatoid Arthritis treatment algorithm (47 kb) Review date: March 2025
- High Cost Drugs - Ulcerative Colitis treatment algorithm (32 kb) Review date: July 2025
- Biosimilar Position Statement (136 kb)
Mental Health Resources
- ADHD adults shared care protocols
- ADHD adults patient information
- ADHD children and young people shared care protocols
- ADHD children and young people patient information
- Valproate for patients of child-bearing potential shared care protocol
- Agomelatine prescribing information sheet (157 kb) Review date: August 2024
- Antidepressants in Primary Care - Prescribing, Stopping & Swapping (472 kb) Review date: September 2025
- Antipsychotics - clozapine information sheet (745 kb) Review date: June 2024
- Antipsychotics - Prescribing Guideline (517 kb) Review date: June 2024
- Benzodiazepines and Z-hypnotics: Guidance on Prescribing and Deprescribing (590 kb) Review date: August 2024
- Clonidine for Tic Disorders in Children and Young People (181 kb) Review date: March 2025
- Dementia - donepezil information sheet (Amber 2) (350 kb) Review date: July 2023
- Dementia - galantamine information sheet (Amber 2) (732 kb) Review date: July 2023
- Dementia - managing behaviour and psychological problems (308 kb) Review date: October 2024
- Dementia - memantine information sheet (Amber 2) (197 kb) Review date: July 2023
- Dementia - rivastigmine information sheet (Amber 2) (358 kb) Review date: July 2023
- Lamotrigine Bipolar Disorder (639 kb) Review date: November 2023
- Lithium Prescribing Guideline (Amber 2) (355 kb) Review date: October 2024
- Vortioxetine Information Sheet (138 kb) Review date: January 2026
Neurology
- Buccal Midazolam Guideline for patients under paediatric care (234 kb) Review date: May 2026
- Melatonin and use in sleep problems in children (1009 kb) Review date: August 2023
- Monoamine-oxidase-B Inhibitors in Patients with Off Periods Without Dyskinesia (102 kb) Review date: December 2024
- Narcolepsy- Methylphenidate Information sheet (109 kb) Review date: January 2023
- Narcolepsy- Modafinil Information sheet (89 kb) Review date: January 2023
- Narcolepsy-Dexamfetamine Information sheet (111 kb) Review date: January 2023
- Parkinsons disease - cabergoline information sheet (Amber 2) (548 kb) Review date: April 2024
- Parkinsons disease - pramipexole information sheet (Amber 2) (551 kb) Review date: April 2024
- Parkinsons disease - ropinirole information sheet (Amber 2) (543 kb) Review date: April 2024
- Parkinsons disease - rotigotine information sheet (Amber 2) (543 kb) Review date: April 2024
- Restless legs treatment algorithm (196 kb) Review date: March 2026
Nutrition including Oral Nutritional Supplements
- Gluten Free foods in Nottingham and Nottinghamshire Position Statement (131 kb) Review date: May 2023
- Infant feeds premature infants (803 kb) Review date: Nov 2023
- Lactose intolerance - guideline (607 kb) Review date: Aug 2024
- Lactose intolerance - patient information leaflet for secondary intolerance (615 kb) Review date: August 2024
- Oral Nutritional Supplements (ONS) in Adults - care home request form (800 kb)
- Oral Nutritional Supplements (ONS) in Adults - Food First Leaflet (379 kb)
- Oral Nutritional Supplements (ONS) in Adults - full guideline (1218 kb) Review date: Sept 2023
- Oral Nutritional Supplements (ONS) in Adults - quick reference guide (671 kb) Review date: Sept 2023
- Vitamin B12 treatment guideline (192 kb) Review date: September 23
- Vitamin D guideline for Adults (764 kb) Review date: February 2024
- Vitamin D guideline for Children (434 kb) Review date: February 2024
Obstetrics and Gynaecology
- Domperidone for lactation stimulation - prescribing information (176 kb) Review date: May 2025
- Domperidone for lactation stimulation - standard letter (25 kb) Review date: May 2025
- HRT Formulary Choices Summary (317 kb) Review date: June 2024
- Hypothyroidism in Pregnancy Primary Care Guidance (209 kb) Review date: May 2024
- Nausea and Vomiting in Pregnancy (136 kb) Review date: May 2023
- Testosterone for postmenopausal women- Prescribing information sheet (108 kb) Review date: May 2025
Pain
- Overarching Pain Guidelines - Management of Chronic Pain in Adult Patients (1067 kb) Review date: September 2025
- Cluster Headaches - Home Oxygen Pathway (219 kb) Review date: July 2025
- Headache in adults guideline (370 kb) Review date: April 2026
- Neuropathic Pain Guideline (438 kb) Review date: September 2024
- Opioid Deprescribing for Persistent Non-Cancer Pain (256 kb) Review date: April 2026
- Opioids for Non-Cancer Pain (157 kb) Review date: June 2024
Palliative Care
- Heart Failure - Palliative Care Guidance (637 kb) Review date: March 2024
- End of Life guidance (597 kb) Review date: May 2025
- Palliative Care Pocketbook (468 kb) Review date: Dec 2022
Prescribing and Prescription Governance
- Emergency Supply and Retrospective Prescribing ICB Position Statement (181 kb)
- Inappropriate request - template letter (24 kb) Review date: Nov 2025
- Limited Clinical Value Medicines and Appliances (previously called Low Priority List) (294 kb) Review date: Nov 2023
- Out of Area Prescribing Requests (117 kb) Review date: July 2025
- Unlicensed "Specials" - alternatives and options for prescribing (315 kb) Review date: Sep 2023
- Policy for the prescribing and supply of unlicensed and off-label medication (242 kb) Review date: April 2026
Renal
- Renal function calculation and drug dosing/monitoring (622 kb) Review date: May 2024
- Sick Day Rules Guidance (165 kb) Review date: Nov 2025
- Sick Day Rules Patient Leaflet - to be printed and filled in for the patient to keep (184 kb) Review date: Nov 2025
Respiratory
- Asthma in adults (330 kb) Review date: February 2025
- Asthma in children and young people (260 kb) Review date: March 2025
- Asthma self management plan (236 kb) Review date: June 25
- Bronchiectasis self management plan (228 kb) Review date: June 25
- Colistimethate for non CF bronchiectasis - information sheet (Amber 2) (616 kb) Review date: March 2023
- COPD emergency supply medicines – prescribing information (239 kb) Review date: Mar 2026
- COPD guideline (1384 kb) Review date: April 2024
- COPD self management plan (193 kb) Review date: June 25
- Guidance on (S)MART [(Single-inhaler) Maintenance and Reliever Therapy] in asthma (244 kb) Review date: April 26
Transgender
- Transgender collaborative care protocol
- Feminising Hormone Treatment for Adults
- Masculinising Hormone Treatment for Adults
- Transgender & Non-Binary Adults - Prescribing & Monitoring Responsibilities in Primary Care (268 kb) Review date: May 2024
Urology
- Desmopressin (Noqdirna) Prescribing Information Sheet (237 kb) Review date: September 2025
- Male LUTS clinical guideline (222 kb) Review date: May 2025
- Overactive bladder - clinical guidance (206 kb) Review date: Jan 2026
Woundcare
- Woundcare Formulary CityCare (241 kb) Review date: Jan 2022
- Woundcare formulary - County (1625 kb)
Miscellaneous
- Falls - Medicines and Falls Chart (medicines that may increase risk of falls) (642 kb) Review date: January 2026
- Fludrocortisone for Orthostatic Hypotension (773 kb) Review date: April 2024
- Gonadorelin analogues for prostate and breast cancer - position statement (220 kb) Review date: May 2023
- Gynaecomastia Guidelines (188 kb) Review date: March 2026
- Osteoporosis guideline (613 kb) Review date: July 2022
- Biosimilar FAQ's (164 kb) Review date: May 2026