| Formulary Chapter 2: Cardiovascular system - Full Chapter
|
| Chapter Links... |
 BSSE APC Primary Care Clinical Pathway for Arial Fibrillation Detection and Management (Nov 19) |
 UKMI NICE Bites: Secondary prevention - A summary of prescribing recommendations from NICE guidance (CG172, 2013) |
| Details... |
| 02.01 |
Positive inotropic drugs |
|
|
| 02.01.01 |
Cardiac glycosides |
|
|
Digoxin Tablets
|
First Choice
|
Use only if still symptomatic despite optimal treatment of HF with atrial fibrillation.
Take extra caution in the elderly who may be more susceptible to digitalis toxicity.
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|
|
Digoxin Elixir
|
Formulary
|
Use only if still symptomatic despite optimal treatment of HF with atrial fibrillation.
Take extra caution in the elderly who may be more susceptible to digitalis toxicity.
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Digoxin Injection
|
Formulary
|
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| 02.01.01 |
Digoxin-specific antibody |
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Digoxin specific antibody fragments (Digifab®)
((antidote))
|
Formulary
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| 02.01.02 |
Phosphodiesterase type-3 inhibitors |
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Enoximone (Perfan®)
|
Formulary
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| 02.02 |
Diuretics |
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| 02.02.01 |
Thiazides and related diuretics |
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Chlortalidone Tablets
|
Formulary
|
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Indapamide
|
Formulary
|
Use 2.5mg tablets only
|
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Metolazone
|
Formulary
|
Specialist recommendation (unlicensed)
Use with local trust approval.
Available from "special-order" manufacturers or specialist-importing companies.
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Bendroflumethiazide
|
Formulary
|
2.5mg dose (higher doses are not indicated in hypertension)
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Bumetanide
|
Formulary
|
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Furosemide
|
Formulary
|
Tablets
Oral solution
Injection
|
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| 02.02.03 |
Potassium-sparing diuretics and aldosterone antagonists |
|
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Amiloride Hydrochloride
|
Formulary
|
Tablets
Oral solution
|
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| 02.02.03 |
Aldosterone antagonists |
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Spironolactone tablets
|
Formulary
|
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Eplerenone tablets
|
Formulary
|
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NICE CG108: Chronic heart failure
|
| 02.02.04 |
Potassium-sparing diuretics with other diuretics |
|
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Co-amilofruse (furosemide and amiloride)
|
Formulary
|
Combination products should be avoided, unless compliance is an issue.
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| 02.02.05 |
Osmotic diuretics |
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Mannitol infusion
|
Formulary
|
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| 02.02.06 |
Mercurial diuretics |
|
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| 02.02.07 |
Carbonic anhydrase inhibitors |
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Acetazolamide
|
Formulary
|
Itracranial hypertension
|
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| 02.02.08 |
Diuretics with potassium |
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| 02.03 |
Anti-arrhythmic drugs |
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| 02.03.01 |
Management of arrhythmias |
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| 02.03.02 |
Drugs for arrhythmias |
|
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| 02.03.02 |
Supraventricular arrhythmias |
|
|
Adenosine injection
|
Formulary
|
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Dronedarone tablets (Multaq®)
|
Formulary
|
To be used in line with NICE guidance
|
Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
NICE TA197: Atrial fibrillation - dronedarone
|
| 02.03.02 |
Supraventricular and ventricular arrhythmias |
|
|
Amiodarone injection
|
Formulary
|
|
Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
|
Amiodarone tablets
|
Formulary
|
|
Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
|
Disopyramide capsules
|
Formulary
|
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Disopyramide injection
|
Formulary
|
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Flecainide injection
|
Formulary
|
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Flecainide tablets
|
Formulary
|
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Propafenone hydrochloride
|
Formulary
|
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|
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| 02.03.02 |
Ventricular arrhythmias |
|
|
Mexiletine hydrochloride
|
Formulary
|
 unlicensed
Use with local trust approval.
Available from "special-order" manufacturers or specialist importing companies.
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Lidocaine hydrochloride
|
Formulary
|
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| 02.04 |
Beta-adrenoceptor blocking drugs |
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|
Atenolol
|
Formulary
|
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Bisoprolol
|
Formulary
|
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Carvedilol
|
Formulary
|
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Esmolol injection
|
Formulary
|
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|
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Labetalol injection
|
Formulary
|
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|
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Labetalol tablets
|
 Restricted
|
Specific indication- Pregnancy
|
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Metoprolol tartrate
|
Formulary
|
Tablets
Modified Release tablets
|
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Metoprolol tartrate injection
|
Formulary
|
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Propranolol
|
Formulary
|
Tablets
Modified Release capsules
|
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Sotalol
|
Formulary
|
Anti Arrhythmic
|
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| 02.05 |
Drugs affecting the renin-angiotensin system and some other antihypertensive drugs |
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| 02.05.01 |
Vasodilator antihypertensive drugs |
|
|
Hydralazine tablets
|
Formulary
|
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Minoxidil tablets (Loniten®)
|
Formulary
|
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Bosentan (Tracleer®)
|
Formulary
|
NHS England commissioned
|
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Iloprost nebules (Vantavis®)
|
Formulary
|
NHS England commissioned
|
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Macitentan (Opsumit® )
|
Formulary
|
NHS England commissioned
|
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Metirosine
|
Formulary
|
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|
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Sildenafil (Revatio®)
|
Formulary
|
NHS England commissioned
|
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Sodium nitroprusside
|
Formulary
|
Injection (Secondary Care only)
|
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| 02.05.02 |
Centrally acting antihypertensive drugs |
|
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Clonidine Hydrochloride tablets (Catapres®)
|
Formulary
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Methyldopa tablets
|
Formulary
|
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Moxonidine tablets
|
Formulary
|
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| 02.05.03 |
Adrenergic neurone blocking drugs |
|
|
| 02.05.04 |
Alpha-adrenoceptor blocking drugs |
|
|
Doxazosin tablets
|
Formulary
|
Plain tablets
 Modified release tablets are non- formulary
|
Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
Patient Information Leaflet
UKMI Q&A: Switching from modified release doxazosin to standard release doxazosin in patients with hypertension
|
| 02.05.04 |
Phaeochromocytoma |
|
|
Phenoxybenzamine Hydrochloride capsules
|
Formulary
|
Check availibility
|
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| 02.05.05 |
Drugs affecting the renin-angiotensin system |
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Sacubitril valsartan (Entresto ®![]())
|
Formulary
|
- In line with NICE
- transfer to Primary care at 3 months following initiation by Heart Failure specialist supported by a RICaD. Click here to access RICaD
|
NICE TA388: Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction (April 2016)
|
| 02.05.05.01 |
Angiotensin-converting enzyme inhibitors (ACE inhibitors) |
|
|
Lisinopril tablets
|
Formulary
|
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Perindopril erbumine tablets
|
Formulary
|
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Ramipril capsules
|
Formulary
|
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Captopril tablets
|
Formulary
|
For existing patients only
|
|
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Enalapril tablets
|
Formulary
|
For existing patients only.
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| 02.05.05.02 |
Angiotensin-II receptor antagonists |
|
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Candesartan cilexetil tablets
|
Formulary
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Irbesartan tablets
|
Formulary
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Losartan tablets
|
Formulary
|
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Valsartan capsules
|
Formulary
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| 02.05.05.03 |
Renin inhibitors |
|
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Aliskiren (Rasilez®)
|
Formulary
|
For existing patients only
|
Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
NHS Clinical Commissioners Items which should not routinely be prescribed in primary care:
|
| 02.06 |
Nitrates, calcium-channel blockers, and potassium-channel activators |
|
|
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| 02.06.01 |
Nitrates |
|
|
Glyceryl Trinitrate Injection
|
Formulary
|
Secondary Care use only
|
|
|
Glyceryl Trinitrate MR Bucaal Tabletsq
|
Formulary
|
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|
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Glyceryl Trinitrate patches
|
Formulary
|
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Glyceryl Trinitrate SL spray and SL tablets
|
Formulary
|
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|
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Isosorbide Dinatrate
(Oral)
|
Formulary
|
|
|
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Isosorbide Mononitrate
|
Formulary
|
Tablets
|
|
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Isosorbide Mononitrate MR
|
Formulary
|
APC preferred brands:-
Chemydur XL tablets
Monomil XL tablets
|
|
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| 02.06.02 |
Calcium-channel blockers |
|
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Amlodipine
|
First Choice
|
|
|
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Diltiazem
|
Formulary
|
60mg tablets - FIRST LINE. For administration three times a day. No requirement for brand name prescribing.
Modified- release formulations should be prescribed by brand name.
Brand rationalisation- APC preferred brands:(in alphabetical order, does not suggest order of preference)
Adizem SR capsules and tablets
Adizem XL capsules
Angitil SR capsules
Angitil XL capsules
Tildiem LA capsules
Tildiem Retard tablets
|
|
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Felodipine
|
Formulary
|
Brand rationalisation - APC preferred brands:-
Cardioplen XL
Felotens XL
|
|
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Nifedipine
|
Formulary
|
Standard release capsules
and
Modified Release preparations: Brand rationalisation- APC preferred brands:-
Adipine MR tablets
Adipine XL tablets
Coracten SR capsules
Coracten XL capsules
|
|
|
Nimodipine (Nimotop®)
|
Formulary
|
|
|
|
Verapamil
|
Formulary
|
Standard release tablets
and
Modified release formulations: Brand rationalisation - APC preferred brand:
Securon SR tablets
|
UKMI Q&A: Evidence for verapamil for cluster headache
|
|
|
| 02.06.03 |
Other anitanginal drugs |
|
|
Ivabradine tablets
|
Formulary
|
Supported by a RICaD, see link below.
|
NICE CG126: Management of Stable Angina
NICE TA267: Chronic heart failure - ivabradine
RICaD: Ivabradine in chronic heart failure / chronic stable angina.
|
Nicorandil tablets
|
Formulary
|
Specialist initiation
|
|
|
Ranolazine (Ranexa®)
|
Formulary
|
Supported by RICaD, see link below.
|
NICE CG126: Management of Stable Angina
RICaD: Ranolazine in chronic stable angina.
|
Perhexiline tablets
|
Formulary
|
|
|
|
| 02.06.04 |
Peripheral vasodilators and related drugs |
|
|
Naftidrofuryl Oxalate capsules
|
Formulary
|
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|
|
| 02.06.04 |
Other preparations used in peripheral vascular disease |
|
|
| 02.07 |
Sympathomimetics |
|
|
| 02.07.01 |
Inotropic sympathomimetics |
|
|
Dobutamine
|
Formulary
|
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|
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Dopamine
|
Formulary
|
|
|
|
Isoprenaline
|
Formulary
|
|
|
|
| 02.07.02 |
Vasoconstrictor sympathomimetics |
|
|
Ephedrine
|
Formulary
|
|
|
|
Metaraminol
|
Formulary
|
|
|
|
Midodrine (Bramox®)
|
Formulary
|
- Transfer to Primary Care supported by an ESCA.
- Click here for ESCA
|
|
|
Noradrenaline / Norepinephrine
|
Formulary
|
|
|
|
Phenylephrine
|
Formulary
|
|
|
|
| 02.07.03 |
Cardiopulmonary resuscitation |
|
|
| 02.08 |
Anticoagulants and protamine |
|
|
| 02.08.01 |
Parenteral anticoagulants |
|
|
|
|
Heparin sodium injection
|
Formulary
|
|
|
|
| 02.08.01 |
Low molecular weight heparins |
|
|
Enoxaparin
|
Formulary
|
Single use in suspected DVT
For all other indications.
The APC's view is that on clinical grounds, the status for certain indications approved by APC should be amber, supported by an ESCA.
HOWEVER, until the commissioning arrangements have been agreed to allow safe transfer of patient care, the status will remain RED.(ESCAs to be developed).
|
|
|
Tinzaparin
|
Formulary
|
For single dose in suspected DVT.
For all other indications.
The APC's view is that on clinical grounds, the status for certain indications approved by APC should be amber, supported by an ESCA.
HOWEVER, until the commissioning arrangements have been agreed to allow safe transfer of patient care, the status will remain RED.(ESCAs to be developed).
|
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|
|
Danaparoid (Orgaran®)
|
Formulary
|
|
|
|
|
|
Bivalirudin (Angiox®)
|
Formulary
|
|
NICE CG94: Unstable angina and NSTEMI
|
| 02.08.01 |
Heparin flushes |
|
|
TauroLock (TauroLock HEP 500 ®)
|
Formulary
|
|
|
|
|
|
Epoprostenol (Flolan®)
|
Formulary
|
|
|
|
|
|
Fondaparinux (Arixtra®)
|
Restricted
|
Hospital only
|
|
|
| 02.08.02 |
Oral anticoagulants |
|
|
Warfarin tablets
|
Formulary
|
Anticoagulants can only be initiated or recommended by clinicians/practitioners who have the necessary skills and experience in line with Local commissioning arrangements.
|
 UKMI Q&A: IM injections in warfarin patients
UKMI Q&A: Is there an interaction between warfarin and proton pump inhibitors
|
Acenocoumarol (Sinthrome®)
|
Formulary
|
|
|
|
Apixaban
(2.5mg tabs: £57.00/60 5mg tabs: £53.20/56)
|
Formulary
|
 Following diagnosis of AF- use in line with NICE. Initiation/ recommendation by a clinician who routinely initiates anticoagulants.
BSSE APC Primary Care Clinical Pathway for Arial Fibrillation Detection and Management
Use following Hip and Knee surgery- full course of treatment supplied on discharge.
For the treatment and secondary prevention of DVT and/or PE - use in line with NICE. Initiation/ recommendation by a clinician who routinely initiates anticoagulants. Where this is not the patient's GP, transfer to GP should be with the support of RICaD.
RICaD: Apixaban in DVT/ PE
|
NICE TA245: Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults
NICE TA275: Stroke and systemic embolism (prevention, non-valvular atrial fibrillation) - apixaban
NICE TA341: Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
|
Edoxaban
(15mg tabs: £17.50 /10; 30mg tabs: £49.00/28; 60mg tabs: £49.00/28)
|
Formulary
|
Following diagnosis of AF- use in line with NICE. Initiation/ recommendation by a clinician who routinely initiates anticoagulants.
BSSE APC Primary Care Clinical Pathway for Arial Fibrillation Detection and Management
For treating and for preventing recurrent DVT and PE- use in line with NICE. Initiation/ recommendation by a clinician who routinely initiates anticoagulants. Where this is not the patient's GP, transfer to GP should be with the support of RICaD
RICaD: Edoxaban in DVT/PE
|
TA354: Edoxaban for treating and preventing DVT and/or PE
TA355: Edoxaban for preventing stroke and systemic embolism in people with atrial fibrillation
|
Rivaroxaban
(2.5mg tabs:£50.40/56; 10mg tabs:£54/30; 15mg tabs:£50.40/28; 20mg tabs:£50.40/28)
|
Formulary
|
Following diagnosis of AF- use in line with NICE. Initiation/ recommendation by a clinician who routinely initiates anticoagulants.
BSSE APC Primary Care Clinical Pathway for Arial Fibrillation Detection and Management
For the treatment and secondary prevention of DVT and/or PE - use in line with NICE. Initiation/ recommendation by a clinician who routinely initiates anticoagulants. Where this is not the patient's GP, transfer to GP should be with the support of RICaD.
RICaD: Rivaroxaban in DVT /PE
For preventing adverse outcomes after acute management of ACS use in line with NICE TA335. Initiation/ recommendation by a clinician who routinely initiates anticoagulants. Where this is not the patient's GP, transfer to GP should be with the support of RICaD.
RICaD: Rivaroxaban post ACS
For preventing atherothrombotic events in people with coronary or peripheral artery disease use in line with NICE TA607
Use following Hip and Knee surgery- full course of treatment supplied on discharge.
|
NICE TA256: Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation
NICE TA261: Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism
NICE TA287: Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism
NICE TA335: Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome (Mar 2015)
NICE TA607: Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease
|
Dabigatran
(£51.00/ 60 capsules (all strengths))
|
Formulary
|
Following diagnosis of AF- use in line with NICE. Initiation/ recommendation by a clinician who routinely initiates anticoagulants.
BSSE APC Primary Care Clinical Pathway for Arial Fibrillation Detection and Management
Use following Hip and Knee surgery- full course of treatment supplied on discharge.
For the treatment and secondary prevention of DVT and/or PE - use in line with NICE. Initiation/ recommendation by a clinician who routinely initiates anticoagulants. Where this is not the patient's GP, transfer to GP should be with the support of RICaD.
RICaD: Dabigatran in DVT / PE
|
NICE TA157: Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults
NICE TA249: Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation
NICE TA327: Dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
|
Phenindione tablets
|
Formulary
|
|
|
|
| 02.08.02 |
Stroke prevention in AF |
|
|
| 02.08.02 |
Atrial Fibrillation |
|
|
|
|
| 02.08.02 |
VTE prophylaxis in hip/knee surgery |
|
|
|
|
| 02.08.03 |
Protamine sulphate |
|
|
Protamine Sulphate
|
Formulary
|
|
|
|
| 02.09 |
Antiplatelet drugs |
|
|
Aspirin (antiplatelet) (Dispersible)
|
Formulary
|
|
UKMI Q&A: Is there evidence to support the use of EC coated aspirin to reduce GI side effects?
|
Clopidogrel 75mg tablets
|
Formulary
|
|
|
|
Dipyridamole MR capsules (Persantin® Retard)
|
Formulary
|
|
|
|
Dipyridamole tablets
|
Formulary
|
|
|
|
Prasugrel (Efient®)
|
Formulary
|
|
NICE TA317: Prasugrel with percutaneous coronary intervention for treating acute coronary syndromes
|
Ticagrelor (Brilique®)
|
Formulary
|
Use in ACS,
The need for a RICaD has been removed (February 2018) following discussion at the APC. Rationale: clinicians are familiar with this drug for this indication.
|
NICE TA236: Acute coronary syndromes - ticagrelor
|
Ticagrelor (Brilique®)
|
Formulary
|
In line with NICE
Use post MI, need for RICaD removed January 2019
|
NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
|
Tirofiban (Aggrastat®)
|
Formulary
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 02.10 |
Stable angina, acute coronary syndromes, and fibrinolysis |
|
|
|
|
| 02.10.01 |
Management of stable angina and acute coronary syndromes |
|
|
| 02.10.02 |
Fibrinolytic drugs |
|
|
Alteplase
|
Restricted
|
Hospital only drug
|
NICE TA264: Ischaemic stroke (acute) - alteplase
|
Reteplase
|
Restricted
|
Hospital only
|
|
|
Streptokinase
|
Restricted
|
Hospital only
|
|
|
Tenecteplase
|
Restricted
|
Hospital only
|
|
|
Urokinase
|
Restricted
|
Hospital only
|
|
|
|
|
|
|
| 02.11 |
Antifibrinolytic drugs and haemostatics |
|
|
Etamsylate (Dicynene®)
|
Formulary
|
|
|
|
Evicel (®)
|
Formulary
|
|
|
|
Tisseel
|
Formulary
|
|
|
|
Tranexamic Acid 5% mouthwash
|
Formulary
|
Palliative use only
|
|
|
Tranexamic Acid 500mg tablets
|
Formulary
|
|
|
|
Tranexamic Acid Injection
|
Formulary
|
Injection (Secondary Care only)
|
|
|
| 02.11 |
Blood-related products |
|
|
Factor VIIa (Recombinant) (Eptacog alfa)
|
Formulary
|
|
|
|
Fresh Frozen Plasma
|
Formulary
|
|
|
|
Prothrombin complex injection
|
Formulary
|
|
|
|
| 02.12 |
Lipid-regulating drugs |
|
|
|
|
|
|
|
|
|
|
|
|
Atorvastatin tablets
|
Formulary
|
|
|
|
Fluvastatin capsules
|
Formulary
|
|
|
|
Pravastatin tablets
|
Formulary
|
|
|
|
Rosuvastatin tablets
|
Formulary
|
|
|
|
Simvastatin tablets
|
Formulary
|
|
|
|
| 02.12 |
Bile acid sequestrants |
|
|
Colestyramine sachets
|
Formulary
|
Jaundice and Primary Biliary Cholangitis (PBC)
|
|
|
|
|
Ezetimibe (Ezetrol®)
|
Formulary
|
in line with NICE
|
NICE TA385: Hypercholesterolaemia - ezetimibe
|
| 02.12 |
Fibrates |
|
|
Bezafibrate
|
Formulary
|
immediate release formulation
modified release formulation
|
|
|
Fenofibrate
|
Formulary
|
tablets
capsules
|
|
|
| 02.12 |
Nicotinic acid group |
|
|
| 02.12 |
Omega-3 fatty acid compounds |
|
|
|
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Alirocumab (Praluent®)
|
Formulary
|
To be used in line with NICE TA393
|
NICE TA393: Alirocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
|
Evolocumab (Repatha®)
|
Formulary
|
To be used in line with NICE TA 394
|
NICE TA394: Evolocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
|
| 02.12 |
Other lipid modifying agents |
|
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| 02.13 |
Local sclerosants |
|
|
Sodium Tetradecyl Sulphate (Fibro-Vein®)
|
Formulary
|
|
|
|
| .... |
| Non Formulary Items |
Abciximab
|
Non Formulary
|
|
|
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Acebutolol
|
Non Formulary
|
|
|
|
Acipimox (Olbetam®)
|
Non Formulary
|
|
|
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Adrenaline / Epinephrine
|
Non Formulary
|
|
|
|
Antithrombin III (Kybemin®)
|
Non Formulary
|
|
|
|
Aprotinin (Trasylol®)
|
Non Formulary
|
|
|
|
Argatroban (Exembol®)
|
Non Formulary
|
|
|
|
Aspirin (Flamasacard®)
|
Non Formulary
|
|
|
|
Aspirin (antiplatelet) (Angettes® 75)
|
Non Formulary
|
|
|
|
Aspirin (antiplatelet) (Caprin®)
|
Non Formulary
|
|
|
|
Aspirin (antiplatelet) (Nu-Seals® Aspirin)
|
Non Formulary
|
|
|
|
Atenolol and Co-amilozide (Kalten®)
|
Non Formulary
|
|
|
|
Atenolol and Nifedipine
|
Non Formulary
|
|
|
|
Azilsartan
|
Non Formulary
|
|
|
|
Bemiparin
|
Non Formulary
|
|
|
|
Cangrelor
|
Non Formulary
|
|
|
|
Canusal®
|
Non Formulary
|
|
|
|
Captopril and Hydrochlorothiazide (Capozide®)
|
Non Formulary
|
|
|
|
Captopril and Hydrochlorothiazide (Co-zidocapt®)
|
Non Formulary
|
|
|
|
Celiprolol Hydrochloride
|
Non Formulary
|
|
|
|
Cilostazol (Pletal®)
|
Non Formulary
|
|
|
|
Ciprofibrate
|
Non Formulary
|
|
|
|
Clopidogrel (Grepid®)
|
Non Formulary
|
|
|
|
Clopidogrel 300mg (Plavix®)
|
Non Formulary
|
|
|
|
Colesevelam (Cholestagel®)
|
Non Formulary
|
|
|
|
Colestipol (Colestid®)
|
Non Formulary
|
|
|
|
Colestyramine (Questran®)
|
Non Formulary
|
|
|
|
Colestyramine (Questran® Light)
|
Non Formulary
|
|
|
|
Co-tenidone (atenolol and chlortalidone)
|
Non Formulary
|
|
|
|
Dalteparin
|
Non Formulary
|
|
|
|
Dipyridamole and Aspirin
|
Non Formulary
|
Discontinued |
|
|
Dipyridamole injection (Persantin®)
|
Non Formulary
|
|
|
|
Dopamine Hydrochloride (Select-A-jet® Dopamine)
|
Non Formulary
|
|
|
|
Dopexamine
|
Non Formulary
|
|
|
|
Dopexamine (Dopacard®)
|
Non Formulary
|
|
|
|
Drotrecogin Alfa (Activated) (Xigris®)
|
Non Formulary
|
|
|
|
Enalapril and Hydrochlorothiazide (Innozide®)
|
Non Formulary
|
|
|
|
Eprosartan (Teveten®)
|
Non Formulary
|
|
|
|
Eptifibatide (Integrilin®)
|
Non Formulary
|
|
|
|
Ethanolamine Oleate
|
Non Formulary
|
|
|
|
Factor IX Fraction, Dried
|
Non Formulary
|
|
|
|
Factor VIII Fraction, Dried
|
Non Formulary
|
|
|
|
Factor VIII Inhibitor Bypassing Fraction
|
Non Formulary
|
|
|
|
Factor XIII Fraction, Dried
|
Non Formulary
|
|
|
|
Fluvastatin M/R (Lescol® XL)
|
Non Formulary
|
|
|
|
Fosinopril
|
Non Formulary
|
|
|
|
Gemifibrozil
|
Non Formulary
|
|
|
|
Gemifibrozil (Lopid®)
|
Non Formulary
|
|
|
|
Guanethidine Monosulphate
|
Non Formulary
|
|
|
|
Heparin
|
Non Formulary
|
|
|
|
Hepsal®
|
Non Formulary
|
|
|
|
Hydralazine (Apresoline®)
|
Non Formulary
|
|
|
|
Iloprost injection
|
Non Formulary
|
|
|
|
Indapamide (Natrilix-SR®)
|
Non Formulary
|
|
|
|
Indoramin (Doralese®)
|
Non Formulary
|
|
|
|
Inositol Nicotinate (Hexopal®)
|
Non Formulary
|
|
|
|
Isradipine (Prescal®)
|
Non Formulary
|
|
|
|
Lepirudin
|
Non Formulary
|
|
|
|
Lercanidipine
|
Non Formulary
|
|
|
|
Lisinopril and Hydrochlorothiazide (Carace® Plus)
|
Non Formulary
|
|
|
|
Lisinopril and Hydrochlorothiazide (Lisicostad®)
|
Non Formulary
|
|
|
|
Lisinopril and Hydrochlorothiazide (Zestoretic®)
|
Non Formulary
|
|
|
|
Lomitapide (Lojuxta®▼)
|
Non Formulary
|
|
|
|
Mexiletine 167mg hard capsules (Namuscla®)
|
Non Formulary
|
£££
Namuscla® brand of mexiletine is not licensed for treatment of ventricular arrhythmia
|
|
|
Moexipril (Perdix®)
|
Non Formulary
|
|
|
|
Moracizine
|
Non Formulary
|
|
|
|
Moxisylyte (Opilon®)
|
Non Formulary
|
|
|
|
Nadolol (Corgard®)
|
Non Formulary
|
|
|
|
Naftidrofuryl Oxalate (Praxilene®)
|
Non Formulary
|
|
|
|
Nebivolol (Nebilet®)
|
Non Formulary
|
|
|
|
Nicotinic Acid
|
Non Formulary
|
|
|
|
Nicotinic acid/ laropiprant (Tredaptive ®)
|
Non Formulary
|
|
|
|
Omega-3-Acid Ethyl Esters (Omacor®)
|
Non Formulary
|
|
Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
Patient Information Leaflet
UKMI Q&A: Review of evidence for dyslexia
|
Omega-3-Marine Triglycerides (Maxepa®)
|
Non Formulary
|
|
Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
Patient Information Leaflet
|
Oxerutins (Paroven®)
|
Non Formulary
|
|
|
|
Oxprenolol Hydrochloride
|
Non Formulary
|
|
|
|
Oxprenolol Hydrochloride and Cyclopenthiazide (Trasidrex®)
|
Non Formulary
|
|
|
|
Pentoxifylline (Trental®)
|
Non Formulary
|
|
|
|
Perindopril Arginine (Coversyl® Arginine)
|
Non Formulary
|
|
Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
Patient Information Leaflet
|
Phentolamine
|
Non Formulary
|
|
|
|
Pindolol
|
Non Formulary
|
|
|
|
Pindolol and Clopamide (Viskaldix®)
|
Non Formulary
|
|
|
|
Pravastatin Sodium (Lipostat®)
|
Non Formulary
|
|
|
|
Prazosin
|
Non Formulary
|
|
|
|
Procainamide
|
Non Formulary
|
|
|
|
Protein C Concentrate (Ceprotin®)
|
Non Formulary
|
|
|
|
Quinapril and Hydrochlorothiazide
|
Non Formulary
|
|
|
|
Ramipril and Felodipine (Triapin®)
|
Non Formulary
|
|
|
|
Sevikar HCT®
|
Non Formulary
|
|
|
|
Simvastatin (Zocor®)
|
Non Formulary
|
|
|
|
Simvastatin and Ezetimibe (Inegy®)
|
Non Formulary
|
|
|
|
Sitaxentan Sodium (Thelin®)
|
Non Formulary
|
|
|
|
Telmisartan
|
Non Formulary
|
|
|
|
Terazosin
|
Non Formulary
|
|
|
|
Timolol
|
Non Formulary
|
|
|
|
Timolol Maleate and Bendroflumethiazide (Prestim®)
|
Non Formulary
|
|
|
|
Tolazoline
|
Non Formulary
|
|
|
|
Torasemide
|
Non Formulary
|
|
|
|
Trandolapril (Gopten®)
|
Non Formulary
|
|
|
|
Trandolapril and Verapamil (Tarka®)
|
Non Formulary
|
|
|
|
Tranexamic Acid (Cyklokapron®)
|
Non Formulary
|
|
|
|
| |
Key |
|
|
|
|
Cytotoxic Drug
|
|
|
Controlled Drug
|
|
High Cost Medicine
|
|
Cancer Drugs Fund
|
|
NHS England |
|
Homecare |
|
CCG |
|
Traffic Light Status Information
| Status |
Description |
|
Prescribing in children
The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.
The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
|
|
Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians. |
|
Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
|
Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist. |
|
Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
|
Medicines for initiation and maintenance prescribing by Specialists only. |
|
Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
|
Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
|
The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest. |
|
|
|
