APPENDICES TO PART FOUR

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Annexe 41-1Annexe 41-2Annexe 41-3Annexe 41-4Annexe statuts typesAnnexe à l'article D4322-4

Article Annexe 41-4

French Public Health CodeIn force
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Updated 30 Oct 2023

LIST OF MEDICINAL PRODUCTS AND MEDICAL DEVICES REFERRED TO IN ARTICLES D. 4151-31 TO D. 4151-34

Table I


LIST OF THERAPEUTIC CLASSES OR MEDICINAL PRODUCTS AUTHORISED TO MIDWIVES FOR THEIR PROFESSIONAL USE

OR FOR PRESCRIBING TO WOMEN


I. - Initial prescription
1° Local gastric antacids and gastrointestinal dressings.

2° Gastric antisecretory agents:

- H2 antihistamines, preferably ranitidine or famotidine;

- proton pump inhibitors, preferably omeprazole.


3° Local antiseptics.

4° Local anaesthetics:

- medicines containing lidocaine;

- creams or patches containing a combination of lidocaine and prilocaine.


5° Anti-infectives:

- Oral antibiotics, in accordance with the recommendations established by the French National Authority for Health and learned societies, in the first-line curative treatment of:

a) asymptomatic bacteriuria in pregnant women,

b) simple cystitis, with no risk factor for complications.

- Local or oral anti-infectives for the first-line curative treatment of vaginosis or vaginitis, in accordance with the recommendations established by the French National Authority for Health and learned societies;

- Oral or parenteral antibiotics for the prevention of maternal-foetal infections in pregnant women, in accordance with the recommendations established by the French National Authority for Health and learned societies;

- Antivirals for the prevention of recurrences of genital herpes and in cases of primary infection;

- Local antifungals used in the treatment of vulvovaginitis;

- Oral or parenteral antibiotics used in the treatment of sexually transmitted infections caused by Chlamydiae trachomatis and Neisseria gonorrhoeae, in accordance with the recommendations of the French National Authority for Health;

- Local or oral anti-infectives used in the curative treatment of lower genital infections caused by Trichomonas vaginalis.


6° Antispasmodics.

7. Antiemetics.

8° Analgesics:

- paracetamol;

- tramadol;

- nefopam;

- combination of paracetamol and codeine;

- combination of paracetamol and tramadol;

- nalbuphine, prescribed in a hospital setting as a second-line treatment for the latency phase. Do not exceed 20 mg without the advice of a doctor;

- combination of paracetamol and opium powder solely for pain management in the context of termination of pregnancy by medication (IVG).


9° Non-steroidal anti-inflammatory drugs (NSAIDs) only for the management of post-partum pain, in the context of abortion or in the context of primary dysmenorrhoea, excluding specialities specifically indicated for the symptomatic management of rheumatic conditions.

10° Contraceptives in all their forms and routes of administration.

11° Homeopathic medicines.

12° Laxatives.

13° Oral vitamins and minerals.

14° Folic acid in doses recommended for the primary prevention of embryonic anomalies of neural tube closure.

15° Medicines with trophic and protective activitý taken locally.

16° Proctology drugs: local topicals with or without corticoids and with or without anaesthetics.

17° Infusion solutions:

- glucose solutions of any concentration;

- 0.9% isotonic sodium chloride solutions;

- 10% calcium gluconate solutions;

- Ringer's solutions.


18° Oxytocics and analogues.

19° Oxygen.

20° Medication to block lactation.

21° Equimolecular mixture of oxygen and nitrous oxide, exclusively in hospitals and subject to appropriate training.

22° Anti-D immunoglobulins.

23° Nicotine replacement products.

24° Anti-progestational drugs and prostaglandins required for the voluntary interruption of pregnancy by medication.

II. - In renewal of prescription made by a doctor
1° Nifedipine in accordance with pre-established protocols in force.

III. - In an emergency, pending the intervention of a doctor
1° Injectable ephedrine up to a maximum of one 30 mg ampoule per patient.

2° Adrenaline injectable subcutaneously in cases of anaphylaxis.

3° Nitrate derivatives, according to pre-established protocols in force.

Table II


LIST OF THERAPEUTIC CLASSES OR MEDICINAL PRODUCTS AUTHORISED TO MIDWIVES FOR THEIR PROFESSIONAL USE

OR FOR PRESCRIBING TO NEW-BORN BABIES


I. - Initial prescription
1° Local antiseptics.

2° Local anaesthetics:

- creams or patches containing a combination of lidocaine and prilocaine.


3° Analgesics:

- oral or rectal paracetamol.


4° Local antifungals.

5° Antiseptic, antibacterial and antiviral eye drops without anaesthetics, corticoids or vasoconstrictors.

6° Oxygen.

7° Oral vitamins and mineral salts:

- injectable form is authorised for vitamin K1.


8° Topicals with trophic and protective activity;

9° Solutions for infusion:

- glucose solutions (of any concentration);

- 0.9% isotonic sodium chloride solution;

- 10% calcium gluconate solution.


10° Gastrointestinal dressings.

11° Nirsévimab.

12° Specific anti-HBs immunoglobulins in association with the hepatitis B vaccine in newborns of mothers carrying the HBs antigen.


II. - In an emergency and while waiting for the doctor
1° Injectable or intratracheal adrenaline for resuscitation of the newborn.

2° Naloxone in dilutable ampoules allowing titration and a dose defined according to the weight of the newborn and without benzyl alcohol.

Table III


LIST OF THERAPEUTIC CLASSES OR MEDICINAL PRODUCTS AUTHORISED TO MIDWIVES FOR THEIR PROFESSIONAL USE

OR THEIR PRESCRIPTION TO MALE PARTNERS OF THEIR PATIENTS


I. - Initial prescription
1° Oral or parenteral antibiotics for the treatment of asymptomatic sexually transmitted infections caused by Chlamydiae trachomatis and Neisseria gonorrhoeae, in accordance with the recommendations of the French National Authority for Health.

2° Oral anti-infectives for the curative treatment of asymptomatic Trichomonas vaginalis infections in the partners of women infected with this germ.

Table IV


LIST OF MEDICINAL PRODUCTS CLASSIFIED AS NARCOTICS AUTHORISED TO MIDWIVES FOR THEIR PROFESSIONAL USE

OR THEIR PRESCRIPTION


1° Morphine hydrochloride, injectable ampoules containing 10 mg, up to a limit of two ampoules per patient.

Table V


LIST OF MEDICINAL PRODUCTS AUTHORISED FOR MIDWIVES TO PRESCRIBE TO MEMBERS OF A CHILD'S FAMILY

OR A PREGNANT WOMAN'S FAMILY.


1° Nicotine replacement products.

Table VI


LIST OF MEDICAL DEVICES THAT MIDWIVES MAY PRESCRIBE

1° Standard pregnancy belt.

2° Elastic orthosis to support the lower limbs.

3° Perineal cutaneous probe or electrode.

4° Neuromuscular electrostimulator for perineal re-education.

5° Breast pump.

7° Diaphragm.

8° Cervical cap.

9° Compresses, cotton, crepe strips, tubular support net, adhesive sutures and plasters.

10° Intra-uterine devices.

11° Condoms.

12° Blood glucose self-monitoring devices: blood glucose meter, blood glucose test strips, lancing device, lancets.

13° Pessaries.

Mariela Petrova

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Mariela Petrova

Mariela Petrova

Avocate au Barreau de Paris

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15+ Years In Corporate Practice

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