Nutrition and blood

9.1.1.1 Oral iron

First line: ferrous sulphate, ferrous fumarate

Second line option: ferrous gluconate

For maternity use: Pregaday®

9.1.1.2 Parenteral iron - choice according to local specialist policy

Options: Iron dextran (Cosmofer®), iron sucrose (Venofer®), iron isomaltoside 1000 (Monofer®), ferric carboxymaltose (Ferinject®)

9.1.2 Drugs used in megalobalstic anaemias

First line: folic acid, hydroxycobalamin

9.1.3 Drugs used in hypoplastic, haemolytic and renal anaemias

For hospital initiation as first line therapy in essential thrombocythaemia: hydroxycarbamide

shared care guideline for hydroxycarbamide

For hospital use only: epoetin beta (NeoRecormon®), methoxy polyethylene glycol-epoetin beta (Mircera®), desferrioxamine.

9.1.4 Drugs used in platelet disorders

For hospital initiation as second line therapy in essential thrombocythaemia: anagrelide

shared care guideline for anagrelide

9.1.6 Drugs used in neutropenia

For hospital use only: lenogastrim

9.2.1.1 Oral potassium

First line: potassium chloride effervescent tablets (Sando-K®)
Second line: potassium chloride M/R tablets (Slow-K®), potassium chloride syrup (Kay-Cee-L®)

For paediatric use: potassium chloride syrup (Kay-Cee-L®)

For management of hyperkalaemia: calcium polystyrene sulphonate (Calcium Resonium®)

9.2.1.2 Oral sodium and water

First line: sodium chloride M/R tablets

For oral rehydration therapy: rehydration sachets

9.2.1.3 Oral bicarbonate

First line: sodium bicarbonate capsules

9.2.2.1 Electrolytes and water

Ready to use solution should be used where possible

For hospital use: Compound sodium chloride IV infusion BPC (Ringer's solution®), Compound sodium lactate IV infusion BP (Hartmann's solution), Glucose 5%.10%,20% and 50% IV infusions, Sodium bicarbonate 1.26% IV infusion, Sodium chloride 0.45% and glucose 2.5% IV infusion, Sodium chloride0.45%, 0.9% and 1.8% IV infusion, Sodium chloride 0.18% and glucose 4% IV infusion.

9.2.2.2 Plasma substitutes

All colloids including Gelofusine® are non-formulary at RBCH and PGH outside of registered clinical trials.

DCH: Gelaspan

9.3 Intravenous nutrition

For hospital use: OliClinomel N4®, OliClinomel N6®, Vitrimix KV®
Supplementary preparations for hospital use: Additrace®, Addiphos®, Solivito®, Vitlipid®, Decan®, Cernevit®

9.5.1.1 Calcium supplements

First line: calcium carbonate (Adcal®)
Second line: calcium lactate

For paediatrics: Calcium Sandoz liquid®

For hospital initiation: Sandocal®

For hospital use only: calcium gluconate injection

9.5.1.2 Hypercalcaemia and hypercalciuria

For hospital use for renal patients: calcitonin, cinacalcet (in accordance with NICE TA 117)

Cinacalcet - for hospital initiation for primary hyperparathyroidism (RBCH NHS FT only)

shared care guideline for cinacalcet

9.5.1.3 Magnesium

For hospital use only: magnesium sulfate, magnesium citrate, magnesium glycerophosphate

9.5.2.1 Phosphate supplements

First line: Phosphate-Sandoz®

For hospital use only: phosphate polyfusor

9.5.2.2 Phosphate binding agents

For hospital initiation: aluminum hydroxide (Alu-Cap®), calcium acetate (Phosex®), calcium carbonate
For hospital initiation for renal patients: lanthanum, sevelamer

9.6.2 Vitamin B group

First line: vitamin B Co strong, pyridoxine tablets, thiamine

For hospital use only: Pabrinex® IM/IV high potency injection

9.6.3 Vitamin C

First line: ascorbic acid

9.6.4 Vitamin D

Vitamin D management

oral ergocalciferol preparations

First line: Adcal-D3®
Alternative preparations are available subject to patient preference

For hospital initiation: alfacalcidol, calcitriol

For hospital use only: ergocalciferol injection

9.6.5 Vitamin E

First line: alpha tocopheryl

9.6.6 Vitamin K

First line: phytomenadione

Menadiol for malabsorption syndrome

9.6.7 Multivitamin preparations

First line: multivitamins
For paediatrics: Abidec^®

Ketovite

For nutrition team only: Sanatogen Gold

Guidance on vitamin supplementation in pregnancy, breastfeeding and children under 5

Pan-Dorset Formulary