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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.09  Expand sub section  Antiplatelet drugs
Abciximab
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Red

Secondary care use only. 

 
   
Aspirin dispersible tablets
(Antiplatelet)
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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® )
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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
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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
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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®)
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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®)
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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
   
 ....
 Non Formulary Items
Aspirin enteric-coated
(Antiplatelet)

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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.

 
Dipyridamole and Aspirin  (Asasantin Retard®)

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Non Formulary
 
Eptifibatide  (Integrilin®)

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Non Formulary
 
Tirofiban  (Aggrastat®)

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Non Formulary
 
Vorapaxar  (Zontivity®)

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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
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  

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