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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.01  Positive inotropic drugs
02.01.01  Cardiac glycosides
Digoxin
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Formulary
Green

For heart failure, see The Management of Heart Failure in Primary Care. 

 
Link  UKMI suggested drug monitoring schedule
   
02.01.01  Digoxin-specific antibody
Digoxin specific antibody fragments (Digifab®)
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Formulary
Red
High Cost Medicine

Secondary care use only. 

 
   
02.01.02  Phosphodiesterase type-3 inhibitors
Milrinone (Primacor®)
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Formulary
Red

Secondary care use only. 

 
   
02.02  Diuretics to top
02.02.01  Thiazides and related diuretics
Indapamide
(Standard release)
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First Choice
Green

First choice thiazide for treatment of hypertension.

 
Indapamide MR
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Formulary
Green
 
   
Bendroflumethiazide
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Formulary
Green
 
   
Chlorothiazide 250mg/5ml liquid
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Formulary
Red

Restricted to neonates and paediatric patients with swallowing difficulties.

Available as an unlicensed product.

 
   
Metolazone
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Formulary
Red

For use in secondary care by Cardiology for diuretic resistance and heart failure only.

 
   
02.02.02  Loop diuretics
Furosemide
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First Choice
Green

First choice diuretic for the management of heart failure. See The Management of Heart Failure in Primary Care. 

 
Bumetanide
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Formulary
Green

May be more effective in patients with heart failure who are severely oedematous. See The Management of Heart Failure in Primary Care. 

 
   
02.02.03  Potassium-sparing diuretics and aldosterone antagonists
Amiloride Hydrochloride
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Formulary
Green
 
   
02.02.03  Aldosterone antagonists
Spironolactone
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First Choice
Green

Prescribe generically.

For heart failure, see The Management of Heart Failure in Primary Care. 

 
Eplerenone
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Formulary
Amber Continuation
  • Second line for patients that cannot tolerate spironolactone (APCO November 2013).
  • First line mineralocorticoid receptor antagonist for young (<65) male patients, to reduce the risk of cardiovascular mortality and morbidity in stable patients with left ventricular dysfunction and clinical evidence of heart failure after recent MI (APCO November 2017). 
 
   
02.02.04  Potassium-sparing diuretics with other diuretics to top
Co-amilofruse (Furosemide and amiloride)
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Formulary
Green
 
   
02.02.05  Osmotic diuretics
Mannitol
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Formulary
Red

Secondary care use only. 

 
   
02.02.06  Mercurial diuretics
02.02.07  Carbonic anhydrase inhibitors
02.02.08  Diuretics with potassium
02.03  Anti-arrhythmic drugs to top
02.03.01  Management of arrhythmias
02.03.02  Drugs for arrhythmias
02.03.02  Supraventricular arrhythmias
Adenosine
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Formulary
Red

Secondary care use only. 

 
   
Dronedarone (Multaq®)
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Formulary
Amber Shared Care Protocol

For the treatment and management of non permanent atrial fibrillation in line with Shared Care Protocol and NICE TA197.

APCO January 2011.

 
Link  MHRA: Cardiovascular, hepatic and pulmonary adverse effects - restrictions and monitoring requirements
Link  NICE TA197: Atrial fibrillation - dronedarone
   
02.03.02  Supraventricular and ventricular arrhythmias
Amiodarone Hydrochloride
(Oral)
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Formulary
Amber Shared Care Protocol

In line with Shared Care Protocol.

APCO May 2011.

 
Link  UKMI suggested drug monitoring schedule
   
Amiodarone Hydrochloride
(Injection)
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Formulary
Red
Secondary care use only. 
   
Disopyramide
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Formulary
Amber Continuation

Suitable for continuation in primary care following initiation by a cardiologist.

 
   
Flecainide
(Injection)
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Formulary
Red

Secondary care use only.

 
   
Flecainide
(Oral)
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Formulary
Amber Continuation

Suitable for continuation in primary care following initiation by a cardiologist.

 
   
Propafenone
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Formulary
Amber Continuation

Suitable for continuation in primary care following initiation by a cardiologist.

 
   
Mexiletine
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Unlicensed Drug Unlicensed
Red

Secondary care use only.

For refractory ventricular tachycardia - restricted to EP electro physiological consultants only; and for the treatment of myotonia in patients under the care of Dr. Hilton-Jones.

 
   
02.03.02  Ventricular arrhythmias to top
Lidocaine hydrochloride
(Ventricular arrhythmias)
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Formulary
Red

Secondary care use only. 

 
   
02.04  Beta-adrenoceptor blocking drugs
Bisoprolol
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First Choice
Green

First line for secondary prevention of coronary atery disease (e.g. post STEMI/NSTEMI).

First line choices of beta blockers for heart failure. See The Management of Heart Failure in Primary Care.

 
Carvedilol
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First Choice
Green

First line choices beta blocker for heart failure. See The Management of Heart Failure in Primary Care.

 
Metoprolol Tartrate
(Oral)
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Second Choice
Green

Second line to bisoprolol for secondary prevention of coronary atery disease (e.g. post STEMI/NSTEMI).

 
   
Nebivolol (Nebilet®)
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Third Choice
Brown

3rd line beta blocker option for treating heart failure, after bisoprolol and carvedilol.

APCO May 2019.

 
   
Atenolol
(Oral)
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Formulary
Green
 
   
Atenolol
(Injection)
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Formulary
Red

Specialist prescribing only.

 
   
Esmolol
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Formulary
Red

Specialist prescribing only.

 
   
Labetalol
(Oral)
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Restricted Drug Restricted
Brown

For use in maternity for hypertension.

 
   
Labetalol
(Injection)
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Formulary
Red

Specialist prescribing only.

 
   
Metoprolol Tartrate
(Injection)
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Formulary
Red

Specialist prescribing only.

 
   
Nadolol (Corgard®)
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Formulary
Amber Continuation

For patients with Long QT syndrome. Licensed product now available and also on OUH  formulary.

APCO March 2020.

 
   
Propranolol
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Formulary
Green

To control symptomatic thyrotoxicosis in hyperthyroidism.

See Management Guidelines - Thyroid Diseases.

 
   
Sotalol
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Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
02.05  Drugs affecting the renin-angiotensin system and some other antihypertensive drugs
02.05.01  Vasodilator antihypertensive drugs
Hydralazine
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Formulary
Green

Use in combination with nitrate for the management of heart failure, see The Management of Heart Failure in Primary Care. 

 
   
Iloprost injection
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Formulary
Red
High Cost Medicine

For use by Vascular Surgery for the treatment of limb threatening ischaemia, and by Rheumatology in Raynaud's Syndrome (unlicensed).

 
Link  Commissioning Policy - Pulmonary hypertension in adults
Link  NICE: Review of evidence
   
Macitentan (Opsumit®)
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Formulary
Red
High Cost Medicine
NHS England

For Pulmonary arterial hypertension. Only approved via Specialised centre at Royal Brompton. 

Funded by specialised commissioning - NHS E will not fund at OUH.

APCO May 2018.

 
Link  National Pulmonary Hypertension commissioning policy
   
Minoxidil (Loniten®)
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Formulary

Amber Traffic Light  For continuation in primary care following specialist initiation for hypertension.

Black Traffic Light  For androgenic alopecia. Oral tablets are not licensed for this indication and the solution Regaine® is not available on the NHS (APCO July 2018). 

 
   
Sildenafil (Revatio®)
(Pulmonary hypertension)
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Formulary
Red
High Cost Medicine

Secondary care use only. 

APCO March 2011.

 
Link  National Pulmonary Hypertension commissioning policy
Link  NICE Evidence summary: Pulmonary hypertension in neonates - Sildenafil
   
Sodium nitroprusside
Unlicensed Drug Unlicensed
Red

Secondary care use only. 

 
   
02.05.02  Centrally acting antihypertensive drugs
Clonidine (Catapres®)
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Formulary
Green
 
   
Methyldopa
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Formulary
Green
 
   
02.05.03  Adrenergic neurone blocking drugs to top
02.05.04  Alpha-adrenoceptor blocking drugs
Doxazosin
(Standard-release)
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First Choice
Green
 
Prazosin
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Formulary
Green
 
   
02.05.04  Phaeochromocytoma
Phenoxybenzamine Hydrochloride
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Formulary
Amber Continuation

Suitable for continuation in primary care following initiation by a specialist.

 
   
Phentolamine (Rogitine®, Regitin®)
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Formulary
Red

Specialist prescribing only.

 
   
02.05.05  Drugs affecting the renin-angiotensin system
02.05.05.01  Angiotensin-converting enzyme inhibitors (ACE inhibitors)
Ramipril
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First Choice
Green

First choice ACE inhibitor in management of heart failure. See The Management of Heart Failure in Primary Care.

 
Lisinopril
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Second Choice
Green

For heart failure, see The Management of Heart Failure in Primary Care. 

 
   
Perindopril Erbumine or Tert-butylamine
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Formulary
Green
 
   
Captopril
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Restricted Drug Restricted
Brown

Restricted for paediatric use.

 
   
Enalapril Maleate
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Restricted Drug Restricted
Brown

Restricted to existing patients. Not to be initiated in new patients.

APCO November 2005.

 
   
02.05.05.02  Angiotensin-II receptor antagonists to top
Candesartan
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First Choice
Green

Candesartan is the preferred Angiotensin II receptor antagonist for patients intolerant of ACE inhibitors due to cough.

For heart failure, see The Management of Heart Failure in Primary Care.

 
Losartan
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Second Choice
Green

For patients intolerant of ACE inhibitors due to cough.

 
   
Irbesartan
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Formulary
Green

For patients intolerant of ACE inhibitors due to cough.

 
   
Sacubitril valsartan▼ (Entresto®)
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Formulary
Amber Shared Care Protocol

For the treatment of symptomatic chronic heart failure with reduced ejection fraction in line with Shared Care Protocol.

APCO January 2017.

Report ALL suspected adverse reactions for black triangle drugs to Yellow Card Scheme.

 
Link  NICE TA388: Sacubitril valsartan for heart failure
Link  SMC advice (March 2016)
   
02.05.05.03  Renin inhibitors
02.06  Nitrates, calcium-channel blockers, and potassium-channel activators
02.06  Angina
02.06.01  Nitrates
Glyceryl Trinitrate Sublingual spray
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Formulary
Green
 
   
Glyceryl Trinitrate Sublingual tablets
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Formulary
Green
 
   
Glyceryl Trinitrate Transdermal patch
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Restricted Drug Restricted
Brown

Only for those who cannot have oral therapy.

 
   
Isosorbide Mononitrate
(Standard-release)
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Formulary
Green
 
Link  PrescQIPP: ISMN review
   
Isosorbide Mononitrate MR
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Formulary
Green

Currently the most cost effective 60mg MR tablet is Monomil XL 60mg tablets.

 
   
02.06.02  Calcium-channel blockers to top
Amlodipine
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First Choice
Green

First line calcium-channel blocker for hypertension.

Could be considered for the treatment of co-morbid hypertension / angina in patients with heart failure, see The Management of Heart Failure in Primary Care.

 
Diltiazem Hydrochloride
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Formulary
Green
 
   
Lacidipine
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Formulary
Green
 
   
Lercanidipine
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Formulary
Green
 
   
Nifedipine
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Formulary
Green
 
   
Nimodipine (Nimotop®)
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Formulary
Red

Specialist prescribing only.

 
   
Verapamil Hydrochloride
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Formulary
Green
 
Link  UKMI Q&A: Evidence for verapamil for cluster headache
   
02.06.03  Other anitanginal drugs
Nicorandil
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Formulary
Green
 
Link  MHRA drug safety update Nov 2015 risk of serious skin, mucosal, and eye ulceration, gastrointestinal ulcers which may progress to perforation, haemorrhage, fistula, or absces
   
Ivabradine (Procoralan®)
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Formulary

Amber Traffic Light 

  • Usually specialist prescribing only for arrhythmia but may be appropriate for shared care where an individual patient specific protocol is agreed (APCO January 2008).
  • For patients with chronic heart failure in line with local Amber Continuation Guideline (APCO September 2018). 

Amber Traffic Light As add on therapy for symptomatic treatment of patients with stable angina in line with Shared Care Protocol.


APCO March 2013.

 

 
Link  MHRA: Cardiac side effects of ivabradine - risk minimisation advice
Link  MHRA: Carefully monitor for bradycardia
Link  NICE CG126: Guidance on Stable Angina (2011)
   
Ranolazine (Ranexa®)
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Formulary
Amber Shared Care Protocol

As add on therapy for symptomatic treatment of patients with stable angina in line with Shared Care Protocol.

APCO July 2012.

 
Link  NICE CG126: Guidance on Stable Angina (2011)
   
Perhexiline Maleate 100mg Tablets
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Unlicensed Drug Unlicensed
Red

For the treatment of hypertrophic cardiomyopathy and heart failure in patients who still have symptoms despite maximal dose with standard therapy.

APCO November 2013.

 
   
02.06.04  Peripheral vasodilators and related drugs
Naftidrofuryl Oxalate
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Formulary
Amber Continuation

For the treatment of intermittent claudication as per NICE TA223.

APCO July 2011.

 
Link  NICE CG147: Lower limb peripheral arterial disease management
Link  NICE TA223: Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease
   
Pentoxifylline (Trental®)
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Formulary

Amber Traffic Light  For the management of osteoradionecrosis in line with Shared Care Protocol.

APCO November 2012.

Amber Traffic Light  For the treatment of venous leg ulcers in line with Shared Care Protocol.

APCO November 2013.

Red Traffic Light  For gastric/liver indications.

APCO January 2014.

Black Traffic Light  For the treatment of intermittent claudication in people with peripheral arterial disease as per NICE TA223.

APCO July 2011.

 
Link  NICE TA223: Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease
   
02.06.04  Other preparations used in peripheral vascular disease
02.07  Sympathomimetics
02.07.01  Inotropic sympathomimetics to top
Dobutamine
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Formulary
Red

Specialist prescribing only.

 
   
Dopamine Hydrochloride
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Formulary
Red

Specialist prescribing only.

 
   
Dopexamine (Dopacard®)
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Formulary
Red

Specialist prescribing only.

 

 
   
Isoprenaline
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Unlicensed Drug Unlicensed
Red

Specialist prescribing only.

Available from ‘special-order’ manufacturers or specialist importing companies.

 

 
   
02.07.02  Vasoconstrictor sympathomimetics
Ephedrine
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Formulary
Red

Specialist prescribing only.

 
   
Metaraminol
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Formulary
Red

Specialist prescribing only.

 
   
Midodrine (Bramox®)
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation, in line with local amber continuation guideline.

Licensed product is now available. Limited evidence of effectiveness of midodrine and need for ongoing monitoring by the GP.

APCO July 2017.

 
Link  NICE Evidence Summary: Orthostatic hypotension - midodrine
   
Noradrenaline / Norepinephrine
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Formulary
Red

Specialist prescribing only.

 

 
   
Phenylephrine
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Formulary
Red

Specialist prescribing only.

 
   
02.07.03  Cardiopulmonary resuscitation
Adrenaline / Epinephrine 1 in 10,000 (dilute)
(CPR)
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Formulary
Green
 
   
02.08  Anticoagulants and protamine
Idarucizumab (Praxbind®)
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Formulary
Red

For the reversal of the anticoagulant effect of dabigatran.

APCO March 2016.

 
   
02.08.01  Parenteral anticoagulants
Argatroban (Exembol®)
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Formulary
Red

Secondary care use only. 

 
   
02.08.01  Heparin to top
Heparin
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Formulary
Red

Secondary care use only. 

 
   
02.08.01  Low molecular weight heparins
Dalteparin (Fragmin®)
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Formulary

In line with Dalteparin Guideline and Shared Care Protocol for Primary Care:

Amber Traffic Light  For sub-therapeutic INRs, DVT in patients with cancer, IV drug users & first doses in high risk of VTE in pregnancy.

Red Traffic Light  For perioperative anticoagulation, extended thromboprophylaxis & post-partum, trauma and intermediate risk of VTE in pregnancy.

Brown Traffic Light  For DVT & long haul flight prophylaxis.

APCO September 2016.

Brown Traffic Light For DVT (out of hours), in line with DVT service specification. Prescribe one off initial dose only if presentation of DVT outside of DVT clinic hours.

APCO September 2018.

Red Traffic Light For venous thromboprophylaxis for lower limb immobilisation. 

APCO July 2017.

NB. More information can be found on the OUHFT Anticoagulation & Thrombosis page.

 
   
Tinzaparin (Innohep®)
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Formulary

Black Traffic Light  For Oxfordshire patients. Dalteparin is LMWH of choice in Oxfordshire.

APCO September 2008.

Amber Traffic Light For South East locality patients referred by Royal Berkshire Hospital Foundation Trust ONLY. In line with Royal Berkshire Hospital Foundation Trust Shared Care Protocol.

APCO January 2014.

 
   
02.08.01  Heparinoids
Danaparoid (Orgaran®)
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Formulary
Red

Secondary care use only. 

 
   
02.08.01  Hirudins
Bivalirudin (Angiox®)
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Formulary
Red

For the treatment of ST-segment-elevation myocardial infarction as per NICE TA230.

 
Link  MHRA Drug Safety Update: Risks associated with incorrect dose
Link  NICE TA230 : Bivalirudin for the treatment of STEMI, 2011
   
02.08.01  Heparin flushes
Heparin
(Flush)
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Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
Link  UKMI Q&A: Heparin vs saline flushes for maintenance of patency in intravascular catheters & cannulae
   
02.08.01  Epoprostenol to top
Epoprostenol (Flolan®)
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Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
Link  MHRA: Incompatibilities between Veletri and some administration devices
   
02.08.01  Fondaparinux
Fondaparinux (Arixtra®)
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Formulary
Red

Secondary care use only. 

 
   
02.08.02  Oral anticoagulants
Acenocoumarol (Sinthrome®)
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Formulary
Green

NB. More information can be found on the OUHFT Anticoagulation & Thrombosis page.

 
   
Apixaban (Eliquis®)
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Formulary

Green Traffic Light  For preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation. See Primary Care Prescriber Decision Support for DOACs in Atrial Fibrillation.

APCO January 2017.

Amber Traffic Light  For treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism. See Guidelines for DOACs for Treatment and Secondary Prevention of VTE.

APCO May 2015.

Brown Traffic Light For DVT (out of hours), in line with DVT service specification. Prescribe one off initial dose only if presentation of DVT outside of DVT clinic hours.

See Guidelines for DOACs for Treatment and Secondary Prevention of VTE.

APCO September 2018.

Red Traffic Light  For preventing VTE after total hip or knee replacement in adults in line with NICE TA245.

APCO March 2012.

NB. More information can be found on the OUHFT Anticoagulation & Thrombosis page.

 
Link  Apixaban - Manufacturer patient alert card
Link  Prescribing Points: Anticoagulation Special Edition
Link  NICE TA245: Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults
Link  NICE TA275: Apixaban for AF
Link  NICE TA341: Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
   
CoaguChek Testing Strips
(INR self-testing)
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Restricted Drug Restricted
Brown

Restricted to patients who meet the following criteria:

  • To be on long-term oral anticoagulation.
  • To have sufficient eye sight to enable them to use the coagulometer.
  • To be sufficiently dextrous to carry out self-testing. (Training may be considered for patient carers or next of kin who meet the eye sight and dexterity criteria.)
  • To have GP support for the prescribing of strips.
  • To already be dosed by the Oxfordshire Anticoagulation Service (JR, Churchill or Horton hospitals).
  • To be able to afford the coagulometer (about £500 for the CoaguCheks and approximately £20 for enough quality control solutions for approximately one year, not including the training programme).

The patient would have to receive suitable training to carry out self-testing and this would normally be provided by the hospital anticoagulation service if self-testing is agreed appropriate.

 

APCO September 2018. 

 
   
Dabigatran (Pradaxa®)
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Formulary

Green Traffic Light  For preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation. See Primary Care Prescriber Decision Support for DOACs in Atrial Fibrillation.

APCO January 2017.

Amber Traffic Light  For treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism. See Guidelines for DOACs for Treatment and Secondary Prevention of VTE.

APCO May 2015.

Red Traffic Light  For preventing VTE after total hip or knee replacement in adults in line with NICE TA157. 

APCO November 2008.

NB. More information can be found on the OUHFT Anticoagulation & Thrombosis page.

 
Link  Dabigatran - Manufacturer patient alert card
Link  Prescribing Points: Anticoagulation Special Edition
Link  MHRA: Dabigatran - risk of serious haemorrhage
Link  MHRA: Dabigatran contraindicated in patients with prosthetic heart valve(s) requiring anti-coagulant treatment
Link  NICE TA157: Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults
Link  NICE TA249: Dabigatran for Stroke prevention in AF
Link  NICE TA327: Dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
   
Edoxaban (Lixiana®)
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Formulary

Green Traffic Light  For preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation. See Primary Care Prescriber Decision Support for DOACs in Atrial Fibrillation.

APCO January 2017.

Amber Traffic Light  For treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism. See Guidelines for DOACs for Treatment and Secondary Prevention of VTE.

APCO January 2017.

NB. More information can be found on the OUHFT Anticoagulation & Thrombosis page.

 
Link  Prescribing Points: Anticoagulation Special Edition
Link  NICE TA354: Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism
Link  NICE TA355:Edoxaban for preventing stroke/systemic embolism in non‑valvular atrial fibrillation
Link  Risk minimisation resources
   
Phenindione
View adult BNF View SPC online View childrens BNF
Formulary
Green

NB. More information can be found on the OUHFT Anticoagulation & Thrombosis page.

 
   
Rivaroxaban (Xarelto®)
View adult BNF View SPC online View childrens BNF
Formulary

Green Traffic Light  For preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation. See Primary Care Prescriber Decision Support for DOACs in Atrial Fibrillation.

APCO January 2017.

Amber Traffic Light 

APCO May 2015.

Brown Traffic Light 

  • For DVT (out of hours), in line with DVT service specification. Prescribe one off initial dose only if presentation of DVT outside of DVT clinic hours. See Guidelines for DOACs for Treatment and Secondary Prevention of VTE (APCO September 2018).
  • For superficial thrombophlebitis, second line to dalteparin in patients at intermediate risk (APCO January 2019).

Red Traffic Light Specialist use only for preventing atherothrombotic events in people with coronary or peripheral artery disease as per NICE TA607.

APCO January 2020.

 
Link  Rivaroxaban - Manufacturer patient alert card
Link  Prescribing Points: Anticoagulation Special Edition
Link  MHRA Drug Safety Update: Rivaroxaban (Xarelto▼) after transcatheter aortic valve replacement: increase in all-cause mortality, thromboembolic and bleeding events in a clinical trial
Link  NICE TA256: Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation
Link  NICE TA287: Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism
Link  NICE TA335: Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome
Link  NICE TA607: Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease
   
Warfarin
View adult BNF View SPC online View childrens BNF
Formulary
Amber Shared Care Protocol

To be initiated in primary care for atrial fibrillation in line with Shared Care Protocol.

APCO March 2017.

NB. More information can be found on the OUHFT Anticoagulation & Thrombosis page.

 
Link  NPSA warfarin booklet
Link  Oral anticoagulant therapy patient booklets in different languages
Link  Prescribing Points: Anticoagulation Special Edition
Link  UKMI Q&A: IM injections in warfarin patients
Link  UKMI Q&A: Warfarin and PPI interaction
   
02.08.03  Protamine sulphate
Protamine Sulphate
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only. 

 
   
02.09  Antiplatelet drugs
Abciximab
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only. 

 
   
Aspirin dispersible tablets
(Antiplatelet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  Aspirin’s effect on reducing cancer risk
Link  UKMI Q&A Lack of evidence to support EC aspirin to reduce GI side-effects
Link  UKMI Q&A: Can a person with low dose aspirin take gingko?
   
Cangrelor (Kengrexal® )
View adult BNF View SPC online View childrens BNF
Formulary
NHS England

Red Traffic Light Specialist prescribing only for Percutaneous Coronary Intervention (PCI). Funded by specialised commissioning. 

APCO September 2019.

Black Traffic Light For reducing atherothrombotic events in people undergoing percutaneous coronary intervention or awaiting surgery requiring interruption of anti‑platelet therapy as per NICE TA351 (terminated appraisal).

APCO September 2015.

 

 
Link  NICE TA351: Reducing Artherothrombotic Events
   
Clopidogrel
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation for prevention of occlusive vascular events as per NICE TA210.

APCO January 2011.

 
Link  MHRA: Risk of aquired haemophilia
Link  NICE Evidence summary: Clopidogrel for transient ischaemic attack
Link  NICT TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Dipyridamole MR
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation for prevention of occlusive vascular events as per NICE TA210.

APCO January 2011.

 
   
Prasugrel (Efient®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation with percutaneous coronary intervention for treating acute coronary syndromes as per NICE TA317.

NB. Treatment for up to 12 months is recommended unless stopping prasugrel is clinically indicated.

APCO May 2010.

 
Link  MHRA: increased risk of bleeding—information on timing of loading dose
Link  MHRA: Rare but serious hypersensitivity reactions with prasugrel.
Link  NICE TA317 (replaces TA182): Acute coronary syndrome - prasugrel
   
Ticagrelor (Brilique®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation
  • Suitable for continuation in primary care following specialist initiation for acute coronary syndromes as per NICE TA236, see Prescribing guidance in primary care (APCO November 2012). 
  • Suitable for continuation in primary care following specialist recommendation for preventing atherothrombotic events after myocardial infarction as per NICE TA420 see Ticagrelor Amber Continuation Guideline (APCO January 2017).
 
Link  NICE TA236: Ticagrelor for the treatment of acute coronary syndromes
Link  NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
   
02.10  Stable angina, acute coronary syndromes, and fibrinolysis to top
02.10.01  Management of stable angina and acute coronary syndromes
02.10.02  Fibrinolytic drugs
Alteplase (Actilyse Cathflo®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
Alteplase (Actilyse®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
Link  NICE TA264: Ischaemic stroke (acute) - alteplase
   
Streptokinase
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
Urokinase
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
02.11  Antifibrinolytic drugs and haemostatics
Tranexamic Acid
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line for heavy menstrual bleeding, in line with OCCG guidelines on Heavy Menstrual Bleeding - Care Pathway and Referral Criteria

 
Link  NICE Evidence summary: Tranexamic acid for significant haemorrhage following trauma
Link  CKS Review of Evidence: Drugs to treat menorrhagia
Link  Medicines for Children leaflet: Tranexamic acid for heavy bleeding during periods
Link  Medicines for Children leaflet: Tranexamic acid for the treatment or prevention of bleeding
   
Antihaemophilic Factor/von Willebrand Factor Complex (Voncento®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Funded by specialised commissioning.

 
   
02.11  Blood-related products
Antithrombin III (Kybemin®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
Emicizumab
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only (haemophilia).

APCO September 2018.

 

 
   
Factor IX Fraction, Dried
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
Factor VIIa (Recombinant) (Novo 7®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
Factor VIII Fraction, Dried
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
Factor VIII Inhibitor Bypassing Fraction (FEIBA)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
Factor XIII Fraction, Dried
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
Human fibrinogen & thrombin (Raplixa® )
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

Funded by specialised commissioning.

 
   
Protein C Concentrate (Ceprotin®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
   
Prothrombin Complex Concentrate  (Octaplex®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Specialist prescribing only.

Funded by specialised commissioning.

 
Link  Manufacturers data sheet (SPC)
   
02.12  Lipid-regulating drugs to top
Alirocumab (Praluent®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

For primary hypercholesterolaemia and mixed lipidaemia as per NICE TA393.

APCO July 2016.

 
Link  NICE TA393: Alirocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
   
Evolocumab (Repatha® )
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

For treating primary hypercholesterolaemia and mixed dyslipidaemia as per NICE TA394.

APCO July 2016.

 
Link  NICE TA394: Evolocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
   
02.12  Bile acid sequestrants
Colestyramine
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

See Lipid Modification Guidance. A bile acid sequestrant may be used for particular patients groups after secondary care advice oxon.diabetes_lipidsadvice@nhs.net.

 
   
Colestipol (Colestid®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

See Lipid Modification Guidance. A bile acid sequestrant may be used for particular patients groups after secondary care advice oxon.diabetes_lipidsadvice@nhs.net.

 
   
Colesevelam (Cholestagel®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Please note - due to a current manufacturing issue with colestyramine it has been agreed that clinicians can prescribe colesevelam on a temporary basis without having to seek prior approval via the OUH. Please ensure this is added to the Acute medication only to ensure it is switched back as soon as the stock issue is resolved

24th May 2019

Suitable for prescribing in primary care following recommendation from gastroenterology only (for bile acid malabsorption in patients with a true intolerance to colestyramine and colestipol). Gastroenterology will have to obtain ‘Prior Approval’ from the Medicines Optimisation team.

GPs will be notified by Medicines Optimisation team if approved for use in individual patients.

APCO September 2016.

 
Link  NICE Evidence Summary: Colesevelam for bile acid malabsorption
   
02.12  Ezetimibe
Ezetimibe (Ezetrol®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

For treating primary heterozygous-familial and non-familial hypercholesterolaemia as per NICE TA385.

Decision to start ezetimibe should be made in conjunction with specialist advice oxon.diabetes_lipidsadvice@nhs.net.

See Lipid Modification Guidance.

APCO July 2016.

 
Link  NICE TA385: Ezetimibe for treating primary heterozygous-familial and non-familial hypercholesterolaemia
   
02.12  Fibrates
Bezafibrate
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Decision to start a fibrate should be made in conjunction with specialist advice oxon.diabetes_lipidsadvice@nhs.net.

See Lipid Modification Guidance.

 
   
Fenofibrate
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Decision to start a fibrate should be made in conjunction with specialist advice oxon.diabetes_lipidsadvice@nhs.net.

See Lipid Modification Guidance.

 
   
02.12  Statins
Atorvastatin
View adult BNF View SPC online View childrens BNF
First Choice
Green

Atorvastatin is the first line statin, usually at 20 mg for primary prevention and 40-80 mg for secondary prevention.

See Lipid Modification Guidance.

APCO September 2015.

 
Simvastatin
View adult BNF View SPC online View childrens BNF
Second Choice
Green

For lipid modification, see Lipid Modification Guidance.

NB. Simvastatin 80 mg is not recommended - MHRA warning.

APCO September 2015.

 
Link  MHRA: Interaction and dosing recommendations
Link  MHRA: Simvastatin - dose limitations with concomitant amlodipine or diltiazem
   
Pravastatin
View adult BNF View SPC online View childrens BNF
Third Choice
Green

Pravastatin, up to 40mg, is a third line alternative for primary prevention in patients who cannot take simvastatin or atorvastatin due to interactions.

See Lipid Modification Guidance.

APCO September 2015.

 
   
Rosuvastatin
View adult BNF View SPC online View childrens BNF
Third Choice
Green

Rosuvastatin is a third line option for secondary prevention in patients who cannot take simvastatin or atorvastatin due to interactions.

See Lipid Modification Guidance.

APCO September 2015.

 
Link  Rosuvastatin PrescQIPP review
   
02.12  Nicotinic acid group to top
02.12  Omega-3 fatty acid compounds
02.12  PCSK9 inhibitors
02.12  Other lipid modifying agents
02.13  Local sclerosants
Sodium Tetradecyl Sulphate (Fibro-Vein®)
Formulary
Red

Secondary care use only. Sclerotherapy of reticular veins and spider veins in legs and varicose veins.

 
   
 ....
 Non Formulary Items
Acebutolol  (Sectral®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Acipimox  (Olbetam®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Not recommended in line with Lipid Modification Guidance.

 
Aliskiren  (Rasilez®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Not recommended for use due to lack of comparative clinical and cost effectiveness data and local guidance.

Link  MHRA: Aliskiren (Rasilez▼): risk of cardiovascular and renal adverse reactions—new contraindications and warnings
 
Ambrisentan

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

This drug is commissioned by NHS England for pulmonary arterial hypertension as per policy: NHSE A11/P/b.

The OUHFT is not a designated centre.

Link  National Pulmonary Hypertension commissioning policy
 
Amlodipine and Valsartan  (Exforge®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aprotinin  (Trasylol®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aspirin enteric-coated
(Antiplatelet)

View adult BNF View SPC online View childrens BNF
Non Formulary

Please consider aspirin dispersible tablets:

  • Aspirin causes GI irritation by systemic effect.
  • There is no evidence that EC coating of low dose aspirin reduced GI side effects.
  • EC preparations are more expensive than plain tablets.

 
Atenolol and Co-amilozide  (Kalten®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Atenolol and Nifedipine  (Beta-Adalat®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Atenolol and Nifedipine  (Tenif®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Atorvastatin and Ezetimibe  (Atozet®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Azilsartan  (Edarbi®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

No evidence to support place in therapy over other cost-effective alternatives.

APCO September 2012.

 
Bosentan  (Tracleer®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

This drug is commissioned by NHS England for digital ulcers and pulmonary arterial hypertension as per policy:


The OUHFT is not a designated centre.

 
Burinex K®

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Captopril and Hydrochlorothiazide  (Capozide®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Captopril and Hydrochlorothiazide  (Co-zidocapt®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Catridecacog  (NovoThirteen®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Celiprolol Hydrochloride

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Centyl K®

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Chlortalidone

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  UKMI Q&A: Where can chlortalidone tablets be obtained from?
 
Cilazapril  (Vascace®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Discontinued in 2014.

 
Cilostazol  (Pletal®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

For the treatment of intermittent claudication in people with peripheral arterial disease as per NICE TA223.

APCO July 2011.

Link  MHRA: Cilostazol (Pletal) - Risks of cardiovascular and bleeding events
Link  NICE TA223: Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease
 
Ciprofibrate

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Co-amilozide  (Amiloride and hydrochlorothiazide)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Co-flumactone  (Hydroflumethiazide and spironolactone )

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Co-tenidone (Atenolol and Chlortalidone)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Co-triamterzide  (Triamterene and hydrochlorothiazide)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cozaar- Comp®
(Losartan & hydrochlorothiazide)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cyclopenthiazide  (Navidrex®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Digitoxin

View adult BNF View childrens BNF
Non Formulary
 
Dipyridamole and Aspirin  (Asasantin Retard®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Diumide-K Continus®

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Doxazosin MR

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Modified release preparation is Non-Formulary. Please use the standard-release preparation.

NB: there is no need for a modified-release preparation as standard-release doxazosin is once daily.

APCO September 2009.

 
Enalapril and Hydrochlorothiazide  (Innozide®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Enoxaparin  (Clexane®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Dalteparin is LMWH of choice in line with the OUHFT.

APCO September 2008.

 
Enoximone  (Perfan®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Eprosartan  (Teveten®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Eptifibatide  (Integrilin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Etamsylate  (Dicynene®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Tablets discontinued in the UK in 2012. UnlicensedUnlicensed tablets (more expensive) are available through IDIS. IV discontinued Nov 2002.

 
Ethanolamine Oleate

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Factor IX, recombinant  (Rixubis®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Felodipine

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fluvastatin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fosinopril Sodium  (Staril®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fresh Frozen Plasma

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Gemifibrozil

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Guanethidine Monosulphate  (Ismelin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Iloprost nebules  (Vantavis®)

View adult BNF View SPC online View childrens BNF
Non Formulary

For pulmonary arterial hypertension.

Funded by specialised commissioning.

 
Imidapril  (Tanatril®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Indoramin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Inositol Nicotinate  (Hexopal®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

For the treatment of intermittent claudication in people with peripheral arterial disease as per NICE TA223.

APCO July 2011.

Link  NICE TA223: Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease
 
Isosorbide Dinitrate
(Parenteral preparations)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Isosorbide Dinitrate tablets

View adult BNF View SPC online View childrens BNF
Non Formulary

Isosorbide dinitrate is a pro-drug of isosorbide mononitrate, consider prescribing isosorbide mononitrate.

 
Isradipine  (Prescal®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lasikal®

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lepirudin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lisinopril and Hydrochlorothiazide  (Carace® Plus)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lisinopril and Hydrochlorothiazide  (Lisicostad®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lisinopril and Hydrochlorothiazide  (Zestoretic®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lomitapide  (Lojuxta®▼)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

Not routinely commissioned by NHS England for homozygous familial hypercholesterolaemia.

APCO May 2014.

 
Moexipril  (Perdix®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Moxisylyte  (Opilon®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Moxonidine

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Neo-NaClex-K®

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nicardipine

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nicotinic Acid  (Solgar Niacin®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Not recommended in line with Lipid Modification Guidance.

 
Nisoldipine  (Syscor® MR)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Octocog alfa sucrose plasma protein-free  (Iblias®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Olmesartan  (Sevikar®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Omega-3-Acid Ethyl Esters  (Omacor®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Recommendation from NHSE as part of Items which should not routinely be prescribed in primary care: Guidance for CCGs.

See Lipid Modification Guidance.

NB. Omacor contains soya oil. If you are allergic to peanut or soya, do not use this medicinal product.

APCO March 2018.

Link  NICE therapeutic topic: Omega-3 fatty acid supplements
Link  NICE: schizophrenia - omega-3 fatty acid medicines
Link  PrescQIPP: Omega 3 fatty acids review
 
Oxerutins  (Paroven®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oxprenolol Hydrochloride

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oxprenolol Hydrochloride and Cyclopenthiazide  (Trasidrex®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Perindopril Arginine  (Coversyl® Arginine )

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Use equivalent dose of perindopril erbumine (also known as tert-butylamine).

Where:
5mg perindopril arginine ≡ 4mg perindopril erbumine

Recommendation from NHSE as part of Items which should not routinely be prescribed in primary care: Guidance for CCGs.

APCO January 2018.

 
Perindopril Arginine and Indapamide  (Coversyl® Arginine Plus)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Use equivalent dose of perindopril erbumine (also known as tert-butylamine).

Where:
5mg perindopril arginine ≡ 4mg perindopril erbumine

In line with Medicines Management and Therapeutics Committee decision.

APCO July 2009.

 
Pindolol

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Pindolol  (Visken®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Pindolol and Clopamide  (Viskaldix®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Procainamide

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Quinapril  (Accupro®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Quinapril and Hydrochlorothiazide

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ramipril and Felodipine  (Triapin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Reteplase  (Rapilysin®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Discontinued.

 
Riociguat  (Adempas®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Sevikar HCT®

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Sildenafil
(Digital ulcers)

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Non Formulary

This drug is commissioned by NHS England for digital ulcers as per policy NHSE A13/P/b. The OUHFT is not a designated centre.

Link  NHSE Clinical Commissioning Policy: Treatment of Digital Ulceration in Systemic Sclerosis
Link  NICE Evidence summary: Sildenafil for digital ulcers
 
Simoctocog alfa  (Nuwiq)
(®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Simvastatin and Ezetimibe  (Inegy®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Simvastatin and Fenofibrate  (Cholib®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Sitaxentan Sodium  (Thelin®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Sitaxentan has been withdrawn from the market because the benefit of treatment does not outweigh the risk of severe hepatotoxicity.

 
Spironolactone and furosemide  (Lasilactone®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Tadalafil  (Adcirca®)
(Pulmonary hypertension)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Telmisartan

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Tenecteplase  (Metalyse®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Terazosin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Timolol

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Timolol Maleate and Bendroflumethiazide  (Prestim®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Timolol Maleate and Co-amilozide  (Moducren®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Tirofiban  (Aggrastat®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Tolazoline

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Torasemide

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Trandolapril  (Gopten®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Trandolapril and Verapamil  (Tarka®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Triamterene  (Dytac®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Triamterene and chlortalidone  (Kalspare®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Triamterene and furosemide  (Frusene®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Triamterene and hydrochlorothiazide  (Dyazide®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Valsartan

View adult BNF View SPC online View childrens BNF
Non Formulary

Several suppliers are experiencing intermittent supply issues with valsartan products.

 
Vorapaxar  (Zontivity®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Xipamide  (Diurexan®)

View adult BNF View SPC online View childrens BNF
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
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
SMC
Scottish Medicines Consortium
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

Red

Red: Medicines which should only be prescribed in secondary care by a specialist.  

Amber Continuation

Amber Continuation: Medicines which should be initiated or recommended by a specialist for continuation in primary care. The specialist must notify the GP that the prescribing responsibility has been transferred.   

Amber Shared Care Protocol

Amber Shared Care Protocol: Medicines which are appropriate to be initiated and stabilised by a specialist, once stabilised the medicine may be appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement. The shared care protocol must be approved by the Area Prescribing Committee Oxfordshire (APCO).   

Green

Green: Medicines which are suitable for initiation and ongoing prescribing within primary care.   

Brown

Brown: Medicines which should only be prescribed in restricted circumstances.  

Black

Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.  

OCCG Green

not used  

netFormulary