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Birmingham, Sandwell, Solihull and environs APC Formulary
Maintained by Midlands and Lancashire Commissioning Support Unit
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.09  Expand sub section  Antiplatelet drugs
Aspirin (antiplatelet)  (Dispersible)
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Formulary
Green
 
Link  UKMI Q&A: Is there evidence to support the use of EC coated aspirin to reduce GI side effects?
   
Clopidogrel 75mg tablets
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Formulary
Green
 
   
Dipyridamole MR capsules (Persantin® Retard)
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Formulary
Amber
 
   
Dipyridamole tablets
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Formulary
Amber
 
   
Prasugrel (Efient®)
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Formulary
Amber
 
Link  NICE TA317: Prasugrel with percutaneous coronary intervention for treating acute coronary syndromes
   
Ticagrelor (Brilique®)
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Formulary
Amber

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. 

 
Link  NICE TA236: Acute coronary syndromes - ticagrelor
   
Ticagrelor (Brilique®)
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Formulary
Amber

In line with NICE

Use post MI, need for RICaD removed January 2019

 
Link  NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
   
Tirofiban (Aggrastat®)
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Formulary
Red
 
   
 ....
 Non Formulary Items
Abciximab

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Non Formulary
 
Aspirin  (Flamasacard®)

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Non Formulary
 
Aspirin (antiplatelet)  (Angettes® 75)

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Non Formulary
 
Aspirin (antiplatelet)  (Caprin®)

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Non Formulary
 
Aspirin (antiplatelet)  (Nu-Seals® Aspirin)

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Non Formulary
 
Cangrelor

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Non Formulary
 
Clopidogrel  (Grepid®)

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Non Formulary
 
Clopidogrel 300mg  (Plavix®)

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Non Formulary
 
Dipyridamole and Aspirin

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Non Formulary
Black
Discontinued
 
Dipyridamole injection  (Persantin®)

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Non Formulary
 
Eptifibatide  (Integrilin®)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
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.

  

Green

Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications.  

Amber

Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate, or initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.

Some amber medicines require agreement with the local (internal) medicines committee prior to initiation; others may require a framework to support safe transfer and maintenance of care such as a RICaD or ESCA. The Formulary will be annotated to reflect these requirements.   

Red

Medicines for initiation and maintenance prescribing by Specialists only  

Black

Non-formulary medicines- medicines not recommended for routine primary care prescribing.  

Grey

Positive NICE TA and /or awaiting local clarification on place in therapy ; Please contact your Medicines Optimisation team for more information.  

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