The decisions made at the Greater Manchester Medicines Management Group (GMMMG) and Clinical Effectiveness and Governance Committee (CEG) at their meetings in September, October, and November 2025 have now been reviewed by GM Executive and can be found at https://gmmmg.nhs.uk/meetings/decision-summaries/.
Updates to formulary
- Budesonide rectal foam and enema – green (specialist advice)
- Ciclosporin 0.9mg/mL eye drops – green (specialist initiation)
- Cyanocobalamin 1mg tablets – green for specified indications
- Cyanocobalamin 50 microgram tablets – green and grey, only for medically diagnosed deficiency
- Cyanocobalamin 100 microgram and 500 microgram tablets – Do Not Prescribe
- Hydrocortisone 0.5% cream – Do Not Prescribe
- Calcium acetate tablets – green (specialist initiation)
- Dienogest tablets for endometriosis – green (specialist advice)
- Empagliflozin and canagliflozin amended to second line options, with ertugliflozin third line
- Sumatriptan / naproxen tablets – Do Not Prescribe
- Somapacitan for growth hormone deficiency – red
- Spesolimab for generalised pustular psoriasis – red
- Efgartigimod for myasthenia gravis – Do Not Prescribe
- Marstacimab for haemophilia – red
- Sparsentan for IgA nephropathy – red
- Ivermectin 3mg tablets – not recommended
- Dust mite extract – green (specialist intitiation)
- Nemolizumab for atopic dermatitis – red
- Mirikizumab for Crohn’s disease – red
- Discontinued medicines removed from formulary
- Epilim Chronosphere granules – 750mg and 1000mg
- Osvaren tablets
- Levemir pre-filled pens and cartridges
- Diazepam 2mg/5mL oral solution
- Humulin I, Humulin M3, Humulin S, Humalog Mix25
- Otomize ear spray (replaced with generic)
- Sodium fusidate oral formulations
- Hypurin Porcine insulin vials
- Vanzacaftor / tezacaftor / deutivacaftor for cystic fibrosis – red
Available at https://www.greatermanchesterformulary.nhs.uk/. Links to NICE guidance and MHRA safety advice added as appropriate. For full details of formulary and RAG updates, see the decision summaries available at https://gmmmg.nhs.uk/meetings/decision-summaries/.
Pathways and guidelines
The following are available at https://gmmmg.nhs.uk/guidance/clinical-guidance-and-pathways/.
- Promazine position statement and patient information leaflet – https://gmmmg.nhs.uk/guidance/medicine-and-device-recommendations/
- Seven minute briefings – https://gmmmg.nhs.uk/guidance/seven-minute-briefings/
- Use of medicines in pregnancy
- Learning from opioid related deaths in Greater Manchester
- Updated CMDU pathway – https://gmmmg.nhs.uk/guidance/clinical-guidance-and-pathways/antimicrobial-guidance-and-resources/
- Dienogest information for primary care prescribers – https://gmmmg.nhs.uk/guidance/information-leaflets-for-primary-care/
- Position statement on the use of generic levetiracetam – https://gmmmg.nhs.uk/guidance/medicine-and-device-recommendations/
- GMMMG formulary application and change form – https://gmmmg.nhs.uk/joint-formulary/submissions/
For full details of new and updated pathways, see the decision summaries available at https://gmmmg.nhs.uk/meetings/decision-summaries/.
Colleagues are asked disseminate for implementation within your organisations.
All approved CRG and GMMMG meeting minutes can be found at: https://gmmmg.nhs.uk/meetings/clinical-reference-group/ and https://gmmmg.nhs.uk/meetings/gmmmg-meetings/.