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 Formulary Chapter 6: Endocrine system - Full Chapter
Notes:

This chapter is mostly updated. The section still outstanding is 6.4.1.1 (oestrogens and HRT). 

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06.04.01.01  Expand sub section  Oestrogens and HRT
Elleste Solo®
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First Choice
Green
  • Elleste Solo® 1mg and 2mg tablets
 
Elleste-Duet® tablets (sequential)
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First Choice
Green
 
Evorel Conti® patch
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First Choice
Green
 
Evorel Sequi® patch
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First Choice
Green
 
Evorel®
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First Choice
Green
  • Evorel® patch 
 
Kliofem® tablets
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First Choice
Green
 
Kliovance®
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First Choice
Green
  • Lower dose
 
Oestrogel®
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First Choice
Green
 
Clinorette® tablets
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Second Choice
Green
 
   
Elleste-Duet Conti® tablets
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Second Choice
Green
 
   
Estradot®
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Second Choice
Green
  • Estradot® patch 
 
   
Femoston Conti®
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Second Choice
Green
 
   
Femoston® (sequential)
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Second Choice
Green
 
   
Femseven Conti® patch
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Second Choice
Green
 
   
Femseven Sequi® patch
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Second Choice
Green
  • 2nd line to Evorel Sequi®
 
   
Novofem® tablets
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Second Choice
Green
 
   
Progynova®
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Second Choice
Green
  • Progynova® 1mg and 2mg tablets
 
   
Sandrena® gel
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Second Choice
Green
 
   
Elleste Solo MX® Patch
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Third Choice
Green
  • If a 40mcg or 80mcg strength required
 
   
Estraderm MX® Patch
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Third Choice
Green
 
   
Indivina® tablets
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Third Choice
Green
 
   
Premique® low dose
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Third Choice
Green
 
   
Angeliq®
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Fourth Choice
Green
  • ££££
 
   
Climanor®
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Formulary
Green
 
   
Duavive®
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Formulary
Amber
  • Specialist recommendation
 
   
Estriol® 0.01%
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Formulary
Green
 
   
Gestone® injection
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Formulary
Red
  • Fertility use only
 
   
Lubion® Injection
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Formulary
Red
  • Fertility use only
 
   
Premarin®
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Formulary
Green
 
   
Tibolone (Livial®)
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Formulary
Green
Second line 
   
Zumenon®
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Alternatives
Green
  • Zumenon® 1mg and 2mg tablets
  • Alternative if Elleste Solo® is not available 
 
   
06.04.01.01  Expand sub section  Hormone replacement therapy
06.04.01.01  Expand sub section  Ethinylestradiol
Ethinylestradiol tablets
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Formulary
Red
  • For induction of puberty in female patients who cannot tolerate or are allergic to first-line patches.
  • Red 2 microgram- unlicensed special
  • Amber Specialist recommendation - 10 microgram ££
 
   
06.04.01.01  Expand sub section  Raloxifene
Raloxifene Hydrochloride
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Formulary
Green

In line with NICE

  • Generic 
  • Evirex® £££
  • Evista® £££
  • Ostiral® £££
  • Razylan® £££
 
Link  NICE TA160: quick reference guide on osteoporosis
   
 ....
 Non Formulary Items
Bedol tablets

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Non Formulary
Black
 
Cimagest®

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Non Formulary
Black
  • Discontinued
 
CLimagest®

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Non Formulary
Black
 
Climaval tablets

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Non Formulary
Black

No longer available

 
Climesse® tablets

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Non Formulary
Black
  • Discontinued
 
Cyclo-Progynova

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Non Formulary
Black
 
Femseven® patch

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Non Formulary
Black
 
Hormonin® tablets

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Non Formulary
Black

No longer available 

 
Noristerat injection

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Non Formulary
Black
 
Nuvelle Continous tablets

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Non Formulary
Black
 
Primolut N

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Non Formulary
Black
 
Progynova TS Patch

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Non Formulary
Black
 
Tridestra® tablets

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Non Formulary
Black
 
Trisequens® tablets

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Non Formulary
Black
 
Utrogestan® Vaginal Capsules

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Non Formulary
Black
 
  
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
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
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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