For treatment of symptoms of oral mucositis and oesophageal lesions when recommended by cancer care specialist only Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for CCGs All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical

A short course of soluble betamethasone (one 500microgram tablet to be dissolved in 10-20mls water and rinsed around the mouth up to four times per day - not to be swallowed) may be prescribed for patients with severe recurrent aphthous ulcers that have not responded to first line options. Acne Acne is a common skin condition that affects most people at some point. It causes spots, oily skin and sometimes skin that’s hot or painful to touch. Acne most commonly develops on the face. For patients undergoing bone marrow transplant treatment and haematology patients on multiple drug regimens that include high dose methotrexate Note: Lozenges and sprays have not been considered for formulary inclusion. The BNF states: ‘There is no convincing evidence that antiseptic lozenges and sprays have a beneficial action and they sometimes irritate and cause sore tongue and sore lips. Some of these preparations also contain local anaesthetics, which relieve pain but may cause sensitisation.’ Using a humidifier once or twice a day, especially in your sleeping area at night, can help a lot. Cool or warm mist both work; use what you prefer. There are different kinds of humidifiers, including small, personal models, some with face masks and others that just direct steam in the air near you.RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment. The slow dissolving pastilles contain malic acid (0.8%), a recognised sialogogue and fruit flavours which stimulate natural saliva production in the same way as food. The pastilles are sugar-free and containcalcium lactate and sodium phosphate for active remineralisation of the teeth and which act as buffers to the acidity of the product. Salivix Spray is used for the relief of dry mouth in those aged 6 years of age and over, including the elderly, when saliva production is weakened but potentially functioning salivary gland tissue is still the mouth. Why choose Salivix Spray? The oral spray contains xylitol and fluoride, which protects against tooth decay, whilst the peppermint flavour promotes fresh breath. How does it work?

See SPS link below to understand safety risks associated with betamethasone soluble tablets used as mouthwash (off-label use). GWH only: Restricted for use in patients undergoing autologous stem cell transplant only. Consultant haematologist prescription only. Salivix pastilles are tutti-frutti flavoured and stimulate natural saliva production. The product can be used for stimulation of saliva production in patients suffering from dry mouth when saliva secretion is impaired and potentially functioning gland tissue is still present.Acid Reflux Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). If it keeps happening, it’s called gastro-oesophageal reflux disease (GORD). Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.