- A joint National Patient Safety Alert has been issued by NHS Improvement and NHS England national patient safety team, Royal College of General Practitioners, Royal College of Physicians and Society for Endocrinology, regarding the introduction of a new Steroid Emergency Card to support the early recognition and treatment of adrenal crisis in adults.
- The alert asks providers to ensure all eligible patients are issued with a Steroid Emergency Card; and to put processes in place to check if a patient has a Steroid Emergency Card ahead of any emergency treatment, elective surgery, or other invasive procedures.
For topical corticosteroids see NHS Somerset Formulary Inflammatory skin conditions.
For parenteral corticosteroids see NHS Somerset Formulary Arthritis.
For nasal corticosteroids see NHS Somerset Formulary Nose.
For inhaled corticosteroids see NHS Somerset Formulary Inhaled corticosteroids and spacers.
Using oral or parenteral corticosteroids during breastfeeding (SPS July 2023)
| Therapeutic Area | Formulary Choices | Cost for 28 (unless otherwise stated) | Rationale for decision / comments |
|---|---|---|---|
| Glucocorticoid therapy | Prednisolone | 1mg tablets: £0.76 5mg tablets: £0.85 | Can be crushed. Prescribing should be in multiple of 5mg for safety reasons. Prednisolone 25mg is non formulary. Prescribers are advised to use plain prednisolone. Enteric coated prednisolone has slower onset of action, less consistent blood levels and no proven evidence of GI protective effect. Recommended as a much cheaper (35%) alternative to soluble prednisolone. |
| as Prednisolone Dompe® | 1mg/ml oral solution £11.41 (2 x 5ml single dose units) | The package contains a measuring spoon dosing 3.75 ml, 2.5 ml and 1.25 ml corresponding to partial doses. | |
| Hydrocortisone | 10mg tablets: £2.63 (30) 20mg tablets: £2.60 (30) | Hydrocortisone oral solution 5mg/5ml is available via specials see link for NHS Somerset Specials guidance |