Miscellaneous
Formulary
Version 7
April 2014
Contents:
Continence supplies
Stoma accessories
Skin care products
Bowel care products
Page 2
Page 7
Page 9
Page 11
1
Continence
Appliance
Product details
Gauge/
CH size
Cost per pack
Usual
quantity
Comments
One every
12 weeks
 Packaged in single units.
 Prescribe two initially and from then on
only one to be prescribed at a time.
 If catheter life is less than four weeks,
i.e. requiring recurrent re-catherisation,
consider a medium term catheter and
refer to your local continence service
for advice.
1.Long-term catheters
Bard Biocath Aquamatic
Hydrogel Coated
Bard Biocath Hydrogel
Coated Latex
Bard Silicone Elastomer
Coated Latex
Bard All Silicone
Coloplast All Silicone
Male 10ml prefilled
Female 10ml prefilled
Paediatric 5ml
12-22
12-22
8-10
£8.36 /catheter
£8.40 /catheter
£8.23 /catheter
Male 10ml prefilled
Female 10ml prefilled
Male 10ml
Female 10ml
Paediatric 5ml
12-22
12-22
12-22
12-16
8-10
£9.65 /catheter
£9.65 /catheter
£9.22 /catheter
£8.84 /catheter
£9.20 /catheter
12-22
£3.01 /catheter
12-22
12-16
8-10
£2.63 /catheter
£3.93 /catheter
£7.28 /catheter
8-22
£30.52 (pack of 25)
Female
8-14
£30.52 (pack of 25)
Paediatric
8-10
£30.52 (pack of 25)
Male
Female
Paediatric
Male
Male
8-24
8-18
6-10
8
10-14
£32.09 (pack of 25)
£39.30 (pack of 25)
£39.30 (pack of 25)
£41.45 (pack of 30)
£41.45 (pack of 30)
2. Short to medium-term catheters
Bard PTFE Coated Latex
Standard 10ml
prefilled
Male 10ml
Female 10ml
Paediatric 5ml
1 every
month
Packaged in single units.
Prescribe two initially and from then on
only one to be prescribed at a time
Review before each prescription
Approx. 4
Packs per
month if
using
regularly 3
– 4 times/
day
 Single use
 Dependent on frequency of use.
3. Intermittent cathethers for intermittent selfcatherisation
Single-use pre-lubricated intermittent catheters
Conveen Easicath
Male
Astra Tech LoFric
Coloplast Speedicath
2
Appliance
Product details
Male
Female
Female
Female
Female
Paediatric
Paediatric
Speedicath 30cm
Tiemann
Gauge/
CH size
16-18
6
8
10-14
16
6
8-10
8-12
10-14
Cost per pack
Usual
quantity
Comments
£43.41 (pack of 30)
£44.95 (pack of 30)
£44.89 (pack of 30)
£47.26 (pack of 30)
£43.41 (pack of 30)
£43.41 (pack of 30)
£43.41 (pack of 30)
£43.41 (pack of 30)
£43.41 (pack of 30)
4. Catheter maintenance solutions
Solution G
Uro-Tainer Twin (Suby G)
2 x 30ml sachets
£4.72
OptiFlow G (Suby G)
50ml sachet
£3.50
Uriflex G
Solution R
Uro-Tainer Twin Sol R
100ml sachet
£3.45
2 x 30ml sachets
£4.72
Optiflo R
50ml
£3.50
Uriflex R
100ml sachet
£3.45
Sodium Chloride 0.9%
Optiflo S
50ml
£3.30
Uro-Tainer NaCI 0.9%
50ml sachet
£3.45
Uriflex S
100ml sachet
£3.45
 Regular bladder irrigation interrupts
the closed drainage system and
should only be undertaken if the risk
of obstruction is greater than the risk
of infection associated with
interrupting the closed system (Epic
guidelines 2000).
 All patients who require the
intervention using a catheter patency
solution must have a care plan.
 If the urinary pH is raised, Citric Acid
3.23% (solution G) is usually the
preferred solution.
 Citric Acid 6% (Solution R or
equivalent) should only be used under
specific circumstances and in
discussion with a specialist.
6. Catheter valves
Bard Flip-Flo catheter valve
Coloplast catheter valve
£12.89 (pack of 5)
£25.89 (pack of 10)
4 valves
per month
Valves should be changed every 7 days
£28.33 (pack of 10)
£28.08 (pack of 10)
Approx. 1
box every
Changed every 5-7 days
7. Sterile leg bags
Bard Uriplan
Direct Inlet
30cm tube
350ml
350ml
3
Appliance
Coloplast Aquadry
Coloplast Simpla Trident T1
Coloplast Simpla Trident T2
Product details
Gauge/
CH size
Cost per pack
Usual
quantity
Comments
Direct Inlet
10cm tube
30cm tube
Direct inlet
10cm tube
30cm tube
38cm adjustable
Short tube
Long tube adjustable
Short tube
Long tube adjustable
Short tube
Long tube adjustable
Short tube
Long tube
Short tube
Long tube
Short tube
Long tube adjustable
Short tube
Short tube
Long tube
Short tube
Long tube
500ml
500ml
500ml
750ml
750ml
750ml
750ml
350ml
350ml
500ml
500ml
750ml
750ml
350ml
500ml
500ml
750ml
750ml
750ml
350ml
500ml
500ml
750ml
750ml
£28.55
£28.66 (pack of 10)
£28.66 (pack of 10)
£28.75 (pack of 10)
£28.75 (pack of 10)
£28.75 (pack of 10)
£28.75 (pack of 10)
£25.43
£25.43
£25.43
£25.43
£25.43
£25.43
£29.24 (pack of 10)
£29.46 (pack of 10)
£29.60 (pack of 10)
£29.60 (pack of 10)
£29.60 (pack of 10)
£29.26 (pack of 10)
£29.58 (pack of 10)
£29.90 (pack of 10)
£29.90 (pack of 10)
£30.05 (pack of 10)
£30.05 (pack of 10)
other
month
B1000
1000ml
£10.62 /bag
1 – 2 bags
per month
Lasts up to 28 days
90cm tube
Standard Size
connector
2 litre
2 litre
£2.55 (pack of 10)
£2.83 (pack of 10)
3 x 10 bag
packs
/month
Non-drainable bags are single use
8. Belly bag®
B1000
9. Night drainage bags
Bard Uriplan
Simpla Continence Care
(Is this Simpla 2 litre S2
Urine drainage bag with
non-return valve with
4
Appliance
Product details
Gauge/
CH size
Cost per pack
Usual
quantity
Comments
standard size connector?)
10. Incontinence sheaths
a) Non-latex sheaths with self-adhesive liner
Rochester Medical Ltd Clear
Small
Advantage Silicone Sheath
Medium
Standard
Large
Extra Large
Coloplast Conveen Security
Extra Small
+ Sheath with anti-kink
Small
design
Medium
Large
Extra Large
Coloplast Conveen Security
Extra Small
+ self sealing Urisheath with
Small
anti-kink design
Medium
Large
Extra Large
b) Latex Sheaths with self-adhesive liner
Rochester Medical Ltd
Small
Freedom Sheath
Medium
Standard
Large
Extra Large
Rochester Medical Ltd
Small
Freedom Plus SheathMedium
shorter length
Standard
Large
Extra Large
Conveen Sheath with antiVery Small
kink design
Small
Medium
Large
23mm
28mm
31mm
35mm
40mm
£50.02 (pack of 30)
£50.02 (pack of 30)
£50.02 (pack of 30)
£50.02 (pack of 30)
£50.02 (pack of 30)
£51.64 (pack of 30)
£51.64 (pack of 30)
£51.64 (pack of 30)
£51.64 (pack of 30)
£51.64 (pack of 30)
£51.10 (pack of 30)
£51.10 (pack of 30)
£51.10 (pack of 30)
£51.10 (pack of 30)
£51.10 (pack of 30)
1 box
(may not
be
required
every
month)
Each sheath may be left in place for 1 to
3 days between changes
23mm
28mm
31mm
35mm
40mm
23mm
28mm
31mm
35mm
40mm
£50.27 (pack of 30)
£50.27 (pack of 30)
£50.27 (pack of 30)
£50.27 (pack of 30)
£50.27 (pack of 30)
£50.27 (pack of 30)
£50.27 (pack of 30)
£50.27 (pack of 30)
£50.27 (pack of 30)
£50.27 (pack of 30)
£49.80
£49.80
£49.80
£49.80
1 box
(may not
be
required
every
month)
Each sheath may be left in place for 1 to
3 days between changes
5
Appliance
Conveen self-sealing
Urisheath
Product details
Gauge/
CH size
Extra Large
Extra small
Small
Medium
Large
Extra Large
Cost per pack
Usual
quantity
Comments
£49.80
£51.13 (pack of 30)
£51.13 (pack of 30)
£51.13 (pack of 30)
£51.13 (pack of 30)
£51.13 (pack of 30)
11. Non sterile leg bags (for use with sheaths only)
Coloplast Ltd Conveen
Security
50cm tube
50cm tube
50cm tube
350ml
500ml
750ml
£24.66 (pack of 10)
£24.66 (pack of 10)
£24.66 (pack of 10)
Small
Medium
Large
Small
Standard
Medium
Large
24-39cm
36-55cm
40-70cm
24-33cm
34-39cm
40-46 cm
47-64cm
£8.00 (pack of 4)
£8.00 (pack of 4)
£8.00 (pack of 4)
£8.26 (pack of 4)
£8.26 (pack of 4)
£8.26 (pack of 4)
£8.26 (pack of 4)
12. Accessories
Leg bag holders
Bard Ltd Urisleeve
Coloplast Aquasleeve
G-strap
Simpla G-Strap
Bard Confasure Catheter
Retaining Strap
Adult
Abdominal
Small
Adult
Abdominal
£14.04 (pack of 5)
£15.49 (pack of 5)
£14.27 (pack of 5)
£14.27 (pack of 5)
£14.84 (pack of 5)
6
Approx. 1
box every
other
month
Can be left in place for 5-7 days
Stoma accessories
Product
1.
£19.40
30
30
£19.50
£23.19
60
50
100
30
25
25
£3.68
£3.56
£7.94
£2.08
£2.39
£2.39
150
50
£46.31
£30.01
30
30
20
£11.80
£12.79
£12.71
30
£49.69
10
30
30
10
£17.34
£55.36
£56.43
£21.86
30
£55.42
Moudable washers
Salts SecuPlast Mouldable Seals
Standard
Hollister Adapt Barrier Rings 48mm
Pelican Cohesive Slims Small 48mm
Pelican Cohesive Seals Small 48mm
Hollister Adapt Barrier Rings 98mm
6.
30
Flange extenders
Salts SecuPlast Hydro
Salts SecuPlast Hydro Aloe
Coloplast Brava Elastic Tape
5.
£6.62
Discharge solidifying agents
Opus AbsorbaGel
Opus Deogel
4.
28ml
Skin fillers
Hollister Adapt Paste 60g
Dansac Soft Paste
Pelican Paste
Convatec Orabase paste s103
Convatec Orahesive Powder
OstoMart OstoSEAL Protective Powder
3.
Price
Usual quantity
Comments
Barrier films
3m Health Care Cavilon No Sting Barrier
Film Pump Spray
Medicareplus Medi Derma-S Non Sting
Medical Barrier Film Wipes
C D Medical Ltd Clinifilm Wipes
3m Health Care Cavilon No Sting Barrier
Film Stoma Wipe
2.
Pack size
Stoma collars
Salts Dermacol Stoma Collar 35mm
7
Follow directions of
stoma nurse
Films/wipes used with
each bag/flange change
for selected patients
only i.e. diabetics,
palliative patients and
difficult stomas
Product
Salts Dermacol Stoma Collar 38mm
Salts Dermacol Stoma Collar 29mm
Salts Dermacol Stoma Collar 32mm
Salts Dermacol Stoma Collar 26mm
7.
Pack size
30
30
30
30
Price
Usual quantity
Comments
£55.42
£55.42
£55.42
£55.42
Adhesive Removers (Sprays/Wipes)
Peel-Easy Spray
CliniMed Essentials Appeel No Sting
Medical Adhesive Remover Aerosol
Spray
Pelican Release Non-Sting Adhesive
Remover Aerosol Spray
OstoMart OstoCLEAR Adhesive
Remover Sachets
Peel-Easy No Sting Wipes
50ml
50ml
£7.10
£9.10
50ml
£9.24
30
£8.97
30
£11.66
1 -3 cans per month
(depending on
frequency of bag
changes)
Used each time stoma
bag is changed
Stoma support garments and clothing - Please check with stoma nurse specialist that it is recommended for that patient
Deodourants, cleansers and soaps are not clinically necessary and prescribing of these products will not be supported in Suffolk.

The formulary should be sufficient to cover 80% of patients needs. In exceptional circumstances other products may be
prescribed in discussion with a stoma care nurse.
Contacts:
Debbie Cooper, community stoma nurse, 07855 773682 or 01473 242168
Sarah Skingley, community stoma nurse, 07855 773681
8
Skincare
Product
1.
Container size
Price
Comments
Soap substitutes
Emulsifying ointment (OTC)
QV® Gentle Wash (OTC)
Dermol® 500 lotion (OTC)
2.
Zeroderm® ointment (OTC)
White soft paraffin 50% / liquid paraffin
50% ointment (OTC)
QV® intensive ointment (OTC)
Ultrabase® cream (OTC)
Zerobase® (OTC)
QV Cream® (OTC)
Doublebase® gel (OTC)
Dermol® cream (OTC)
Aveeno® lotion (OTC)
3. Emollients with urea
Balneum Cream (OTC)
Balneum Plus Cream (OTC)
Calmurid® cream (OTC)
500g
250ml
500ml pump
500ml
£2.12
£3.14
£5.24
£6.04
125g
500g
500g
£2.41
£4.10
£2.21
450g
50g
500g pump
500g pump
100g
500g
1.05kg pump
100g
500g pump
100g
500g pump
500ml
£5.65
£1.40
£4.80
£1.04
£5.26
£2.04
£5.86
£11.94
£2.65
£5.83
£2.86
£6.63
£6.66
50g
500g
100g
500g
100g
500g
£2.85
£9.97
£3.29
£14.99
£9.27
£35.70
9
Only if infection present or is a frequent complication
Only if infection present or is a frequent complication
Restricted to paediatric use; ACBS borderline
substance
Usually only on advice from secondary care
Usually only on advice from secondary care
Product
Container size
Price
Comments
4. Emollient bath and shower preparations
There is a lack of good evidence to support the prescribing of these items. These should only be prescribed at the request of secondary care in
exceptional circumstances. Patients should be encouraged to wash with soap substitutes. Soap substitutes available OTC include ZeroAQS®,
Oilatum® soap bar, QV® gentle wash.
5. Barrier preparations
Conotrane cream (OTC)
Sudocrem (OTC)
Cavilon No Sting Barrier Film (OTC)
6. Skin cleanser
Proshield Foam Spray cleanser
7. Pressure sore prevention
Aderma Pads
Kerrapro
100g
500g
60g
125g
250g
400g
1ml foam applicators
3ml foam applicators
28ml pump spray
£0.88
£3.51
£1.25
£1.84
£3.09
£4.34
£4.96 (pack of 5)
£7.96 (pack of 5)
£6.65
235ml
£6.45
10x10x0.3
10x10x1.2
20x20x0.3
20x20x1.2
30x5x0.3
50x2.5x0.3
Heel Standard
Heel Extra Large
Sacrum/Ankle Wrap
50x2.5x0.3cm
30X5X0.3CM
10X10X1.2CM
10X10X0.3CM
Heel x 2
Sacrum/Ankle
3.66
7.22
17.04
20.36
4.68
5.68
12.49
13.66
16.11
£5.20
£6.25
£12.50
£4.15
£14.66
£16.50
10
Only where the patient has a wound
NB.
Cavilon Durable Barrier Cream is non- formulary and
should not be prescribed.
Bowelcare
Product
Size/strength
Pack size
Price
1. Anal Plugs
Conoplast Ltd Peristeen
Small
Large
20
20
3.5g
30
£44.93
£44.00
2. Laxatives
Ispaghula husk sachet (Ispagel) (sugar and
gluten free)
Bisacodyl gastro-resistant tablets
Senna Tablets
Docusate sodium capsules
Macrogol (Laxido)
Lactulose
Glycerol suppositories
Docusate enema
Phosphate enema
Micralex enema
Sodium Picosulfate
Condanthramer capsules 25mg/200mg
Condanthramer suspension
25mg/200ml/5ml
5mg
7.5mg
100mg
60
30
20
15ml
128ml (standard tube)
1
128ml (long tube)
1
100ml
60
300ml
11
£3.43
£10.11
£2.09
Comments
Process for Reviewing Formulary Product
12