netFormulary Oxfordshire Clinical Commissioning Group NHS
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 Formulary Chapter 6: Endocrine system - Full Chapter
06.01  Drugs used in diabetes
06.01.01  Insulins
06.01.01.01  Short-acting insulins
Insulin (Actrapid®)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Insulin (Humulin® S)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 Diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Green Traffic Light  First line insulins for Type 2 Diabetes in line with Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Insulin (Insuman® Infusat)
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Formulary
Amber Continuation

For use in external portable insulin pumps.

Suitable for prescribing in primary care following recommendation from diabetes specialist only.

 
   
Insulin (Insuman® Rapid)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 Diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Green Traffic Light  First line insulins for Type 2 Diabetes in line with Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Insulin 500units/mL (Humulin R®)
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Formulary
Amber Continuation

Suitable for prescribing in primary care following recommendation from diabetes specialist only.

Imported from United States.

 
   
Insulin Aspart (Fiasp®)
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Formulary
Amber Continuation

Fiasp can be initiated in patients following diabetes specialist (CDS and OUH) recommendation and maintenance of register ONLY IF both the following criteria fulfilled:

  • Patient is currently on a rapid acting insulin analogue (ie Novorapid, Humalog, Apidra)
  • Presence of a mismatch between insulin rise and post prandial glucose rise.

Fiasp® should NOT be used as the first line prandial insulin for any patient with diabetes. 

APCO May 2017. 

 
   
Insulin Aspart (NovoRapid®)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Insulin bovine (Hypurin® Bovine Neutral)
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Restricted Drug Restricted
Brown

Consider asking for specialist review-unusual regime to use.

 
   
Insulin Glulisine (Apidra®)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Insulin Lispro (Humalog®)
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Formulary

Biosimilar Insulin Lispro Sanofi is first line choice for NEW patients if insulin lispro is indicated. Existing patients should not be switched unless in line with an agreed protocol. All prescriptions should be written by brand name.

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Insulin Lispro Sanofi
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Formulary

Biosimilar Insulin Lispro Sanofi is first line choice for NEW patients if insulin lispro is indicated. Existing patients should not be switched unless in line with an agreed protocol. All prescriptions should be written by brand name.

Green Traffic Light Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

APCO January 2019.

 
   
Insulin porcine (Hypurin® Porcine Neutral)
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Restricted Drug Restricted
Brown

Consider asking for specialist review-unusual regime to use.

 
   
06.01.01.02  Intermediate- and long-acting insulins
Insulin degludec (Tresiba®)
(100 units/ml)
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Formulary
Amber Continuation

Treatment should only be initiated on recommendation from the diabetes specialist team (OCDEM or Community Diabetes Service). Degludec can be considered for type 1 or 2 patients who are having more than 2 hypoglycaemic events per week, or have had more than 1 diabetic ketoacidosis episode in the past 12 months, or require a more flexible dosing interval.

All patients MUST be entered into the national degludec audit. Degludec is available as 100units/ml and 200units/ml, please follow MHRA guidance when prescribing.

APCO January 2017.

 
Link  MHRA: Insulin degludec (Tresiba▼) - available in additional higher strength
   
Insulin degludec (Tresiba®)
(200 units/ml)
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Formulary
Amber Continuation

Treatment should only be initiated on recommendation from the diabetes specialist team (OCDEM or Community Diabetes Service). Degludec can be considered for type 1 or 2 patients who are having more than 2 hypoglycaemic events per week, or have had more than 1 diabetic ketoacidosis episode in the past 12 months, or require a more flexible dosing interval, or who are on a total long acting insulin dose of more than 80 units per day.

All patients MUST be entered into the national degludec audit. Degludec is available as 100units/ml and 200units/ml, please follow MHRA guidance when prescribing.

APCO January 2017.

 
Link  MHRA: Insulin degludec (Tresiba▼) - available in additional higher strength
   
Insulin degludec and liraglutide (Xultophy®)
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Formulary
Amber Continuation

Initiation by diabetes consultant only with criteria in GLP-1 receptor agonist guidelines.

Also see prescribing information on Xultophy®.

APCO May 2017.

 
   
Insulin Detemir (Levemir®)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Insulin Glargine (Lantus®)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Insulin Glargine (Toujeo®)
(300 units/ml)
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Formulary
Amber Continuation

On recommendation of the diabetes specialist team (OCDEM or Community Diabetes Service) for patients who are already on optimised complex regime, who have already tried other insulins (including degludec if patient meets criteria) and on a total long acting insulin dose of more than 80 units per day (or lower if they have very limited injections sites or require 3rd party administration).

APCO January 2017.

 
Link  UKMI Briefing: Product safety assessment report
   
Insulin Glargine biosimilar
(Abasaglar®)
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Formulary

Note that biosimilar 'Abasaglar' is first line choice for NEW patients if glargine is indicated. Existing patients should not be switched.

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

APCO January 2016.

 
Link  UKMI Briefing: Product safety assessment report
   
Insulin Zinc suspension (Hypurin®Bovine Lente)
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Restricted Drug Restricted
Brown

Consider asking for specialist review-unusual regime to use.

 
   
Isophane Insulin (Humulin® I)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Green Traffic Light  First line insulins for Type 2 Diabetes in line with Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Isophane Insulin (Hypurin® Bovine Isophane)
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Restricted Drug Restricted
Brown

Consider asking for specialist review-unusual regime to use.

 
   
Isophane Insulin (Hypurin® Porcine Isophane)
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Restricted Drug Restricted
Brown

Consider asking for specialist review-unusual regime to use.

 
   
Isophane Insulin (Insulatard®)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Isophane Insulin (Insuman® Basal)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes should have access to specialist Type 1 Diabetes services in line with national guidance. Type 1 Diabetes is a different disease to Type 2 Diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Green Traffic Light  First line insulins for Type 2 Diabetes in line with Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Protamine Zinc Insulin (Hypurin® Bovine Protamine Zinc)
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Restricted Drug Restricted
Brown

Consider asking for specialist review-unusual regime to use.

 
   
06.01.01.02  Biphasic insulins to top
Biphasic Insulin Aspart (NovoMix® 30)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes are more likely to achieve tight glucose control with a combination of basal and bolus insulin rather than mixed insulin.  Mixed insulin should be reserved for patients who cannot tolerate multiple injections or in whom a trial of multiple injections has resulted in significant hypoglycaemia.

Patients with type 1 diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Biphasic Insulin Lispro (Humalog® Mix25)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes are more likely to achieve tight glucose control with a combination of basal and bolus insulin rather than mixed insulin.  Mixed insulin should be reserved for patients who cannot tolerate multiple injections or in whom a trial of multiple injections has resulted in significant hypoglycaemia.

Patients with type 1 diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Biphasic Insulin Lispro (Humalog® Mix50)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes are more likely to achieve tight glucose control with a combination of basal and bolus insulin rather than mixed insulin.  Mixed insulin should be reserved for patients who cannot tolerate multiple injections or in whom a trial of multiple injections has resulted in significant hypoglycaemia.

Patients with type 1 diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Biphasic Isophane Insulin (Humulin® M3)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes are more likely to achieve tight glucose control with a combination of basal and bolus insulin rather than mixed insulin.  Mixed insulin should be reserved for patients who cannot tolerate multiple injections or in whom a trial of multiple injections has resulted in significant hypoglycaemia.

Patients with type 1 diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Green Traffic Light  First line insulins for Type 2 Diabetes in line with Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Biphasic Isophane Insulin (Hypurin® Porcine 30/70 Mix)
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Restricted Drug Restricted
Brown

Consider asking for specialist review-unusual regime to use.

 
   
Biphasic Isophane Insulin (Insuman® Comb 15)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes are more likely to achieve tight glucose control with a combination of basal and bolus insulin rather than mixed insulin.  Mixed insulin should be reserved for patients who cannot tolerate multiple injections or in whom a trial of multiple injections has resulted in significant hypoglycaemia.

Patients with type 1 diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Biphasic Isophane Insulin (Insuman® Comb 25)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes are more likely to achieve tight glucose control with a combination of basal and bolus insulin rather than mixed insulin.  Mixed insulin should be reserved for patients who cannot tolerate multiple injections or in whom a trial of multiple injections has resulted in significant hypoglycaemia.

Patients with type 1 diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Green Traffic Light  First line insulins for Type 2 Diabetes in line with Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
Biphasic Isophane Insulin (Insuman® Comb 50)
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Formulary

Green Traffic Light  Patients with Type 1 Diabetes are more likely to achieve tight glucose control with a combination of basal and bolus insulin rather than mixed insulin.  Mixed insulin should be reserved for patients who cannot tolerate multiple injections or in whom a trial of multiple injections has resulted in significant hypoglycaemia.

Patients with type 1 diabetes should have access to specialist type 1 diabetes services in line with national guidance. Type 1 diabetes is a different disease to type 2 diabetes with different treatment pathways. Please consider accessing specialist diabetes care for all your patients with Type 1 Diabetes.

Restricted Item Brown Traffic Light  Should not usually be used first line in Type 2 Diabetes. See Insulin Initiation and Adjustment in Type 2 Diabetes Primary Care Guidelines.

 
   
06.01.01.03  Hypodermic equipment
BD Viva
(Needles for insulin pens)
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First Choice
Green

BD Viva is first-line choice for insulin pen needles.

APCO November 2018.

 
Neon Verifine Safety
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

First line insulin safety needle available as most cost-effective. Will replace BD Autoshield Duo as first line

APCO July 2019.

 
BD Autoshield needles
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Restricted Drug Restricted

Brown Traffic Light Restricted for use by school staff for small number of primary school age children requiring insulin injections given by school staff and equipment supplied by GP (as per LEA agreement).

APCO September 2018. 

Black Traffic Light No GP prescribing, to be supplied by Oxford Health.

APCO November 2014.

 
   
GlucoRx FinePoint
(Needles for insulin pens)
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Formulary
Green

BD Viva is first-line choice for insulin pen needles.

APCO November 2018.

 
   
Injection Devices (Autopen®)
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Formulary
Green
 
   
Injection Devices (ClikSTAR®)
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Formulary
Green
 
   
Injection Devices (HumaPen®)
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Formulary
Green
 
   
Injection Devices (JuniorSTAR®)
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Formulary
Green
 
   
Injection Devices (NovoPen®)
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Formulary
Green
 
   
Microdot Droplet
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
Mylife Clickfine
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
NovoTwist
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
Omnican Fine
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
PROFine
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
TriCare
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
Unifine Pentips
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
BD Micro-Fine
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
HaemoFine
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
IME-FINE
(Needles for insulin pens)
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Restricted Drug Restricted
Brown

BD Viva and GlucoRx FinePoint are first-line choices for insulin pen needles.

APCO November 2016.

 
   
06.01.02  Antidiabetic drugs
06.01.02.01  Sulphonyureas
Gliclazide
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First Choice
Green

Gliclazide is first line sulfonylurea.

APCO September 2016.

 
Glibenclamide
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Restricted Drug Restricted
Brown

Unusual regime to use, review patient. Gliclazide is first line sulfonylurea.

APCO September 2016.

 
   
Glimepiride
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Restricted Drug Restricted
Brown

Unusual regime to use, review patient. Gliclazide is first line sulfonylurea.

APCO September 2016.

 
   
Glipizide
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Restricted Drug Restricted
Brown

Unusual regime to use, review patient. Gliclazide is first line sulfonylurea.

APCO September 2016.

 
   
Tolbutamide
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Restricted Drug Restricted
Brown

Unusual regime to use, review patient. Gliclazide is first line sulfonylurea.

APCO September 2016.

 
   
06.01.02.02  Biguanides
Metformin Hydrochloride
(Standard release)
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First Choice
Green

APCO September 2016.

 
Metformin Hydrochloride
(Modified-release)
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Restricted Drug Restricted
Brown

For primary care only if GI intolerance to standard release formulation.

APCO September 2016.

 
   
Metformin Hydrochloride
(Liquid)
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Restricted Drug Restricted
Brown

Only for patients with swallowing difficulties.

Drug tariff special.

APCO September 2016.

 
   
06.01.02.03  Other antidiabetic drugs to top
06.01.02.03  Alpha glucosidase inhibitors
Acarbose (Glucobay®)
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Formulary
Green

APCO September 2016.

 
   
06.01.02.03  DPP4 inhibitors (gliptins)
Alogliptin (Vipidia▼®)
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First Choice
Green

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
Alogliptin and Metformin (Vipdomet®)
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Formulary
Green

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Alogliptin and Pioglitazone (Incresync®)
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Formulary
Green

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Linagliptin (Trajenta®)
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Restricted Drug Restricted
Brown

For use in patients with renal impairment. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Linagliptin and Metformin (Jentadueto®)
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Restricted Drug Restricted
Brown

For use in patients with renal impairment. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Saxagliptin (Onglyza®)
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Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
Link  Serious hypersensitivity reactions & acute pancreatitis - Dear HCP Letter
   
Saxagliptin and metformin (Komboglyze®)
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Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Sitagliptin (Januvia®)
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Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Sitagliptin and Metformin (Janumet®)
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Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Vildagliptin (Galvus®)
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Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
06.01.02.03  GLP1 agonists
Liraglutide 1.2mg (Victoza®)
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Restricted Drug Restricted
Brown

First line option in line with updated GLP-1 receptor agonist guidelines.

See patient agreement form.

APCO September 2019.

 
Link  NICE TA203: Diabetes (type 2) - liraglutide
   
Liraglutide 1.8mg (Victoza®)
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Restricted Drug Restricted
Brown

GP can titrate to 1.8mg if partial response. If no response consider one of the more cost effective options

See GLP-1 receptor agonist guidelines and patient agreement form.

APCO September 2019.

 
   
Dulaglutide (Trulicity®)
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Restricted Drug Restricted
Brown

First line option in line with updated GLP-1 receptor agonist guidelines (previously for those who would gain benefit from once weekly and can’t have semaglutide).

See patient agreement form.

APCO September 2019.

 
Link  NICE Evidence Summary: Dulaglutide for Type 2 diabetes
   
Exenatide (Byetta▼®)
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Restricted Drug Restricted
Brown

Existing patients only (unless high CV risk) in line with updated GLP-1 receptor agonist guidelines

See patient agreement form.

APCO September 2019.

 
Link  MRHA: Risk of severe pancreatitis and renal failure with Exenatide
   
Exenatide prolonged release (Bydureon▼®)
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Restricted Drug Restricted
Brown

Restricted to existing patients only.

Prescribe semaglutide as first line prolonged release glucagon–like peptide (GLP-1) receptor agonist treatment in line with GLP-1 receptor agonist guidelines. Existing patients who meet NICE criteria for continuation can continue with treatment.

Not included in the GLP-1 receptor agonist guidelinesSee patient agreement form.

APCO September 2019.

 
Link  MHRA: Risk of severe pancreatitis and renal failure with Exenatide
Link  NICE TA248: MR exenatide
   
Lixisenatide (Lyxumia▼®)
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Restricted Drug Restricted
Brown

Restricted Item 

Existing patients only (unless high CV risk) in line with updated GLP1 guidelines.

See patient agreement form.

APCO September 2019.

 
   
Semaglutide (Ozempic®)
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Restricted Drug Restricted
Brown

First line option in line with updated GLP1 guidelines (previously for those who would gain benefit from once weekly). If eye disease present, see flowchart. 

See patient agreement form.

APCO September 2019.

 

 
   
06.01.02.03  Meglitinides
Nateglinide (Starlix®)
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Restricted Drug Restricted
Brown

For use in specific circumstances only. Consider conversation with specialist before initiation.

APCO September 2016.

 
   
Repaglinide
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Restricted Drug Restricted
Brown

For use in specific circumstances only. Consider conversation with specialist before initiation.

APCO September 2016.

 
   
06.01.02.03  SGL2 inhibitors to top
Dapagliflozin (Forxiga▼®)
View adult BNF View SPC online View childrens BNF
First Choice

Green 1st line SGLT2i option for type 2 diabetes (empagliflozin also first line).

Dapagliflozin has shown CV outcome benefit in primary prevention; empagliflozin, in secondary prevention.

See SGLT2i checklist, patient information leaflet on DKA risk, and OCCG letter to clinicians.

APCO May 2019.

Amber Traffic Light In combination with insulin for treating type 1 diabetes as per NICE TA597. 

APCO November 2019.

 
Empagliflozin (Jardiance▼®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

1st line SGLT2i option for type 2 diabetes (dapagliflozin also first line)

Dapagliflozin has shown CV outcome benefit in primary prevention; empagliflozin, in secondary prevention

See SGLT2i checklistpatient information leaflet on DKA risk and OCCG letter to clinicians.

APCO November 2018.

 
Canagliflozin (Invokana▼®)
View adult BNF View SPC online View childrens BNF
Second Choice
Brown

Second line option SGLT2i - consider discussion with specialist team.

See SGLT2i checklist, patient information leaflet on DKA risk and OCCG letter to clinicians.

APCO November 2018.

 
Link  NICE TA315: Canagliflozin for type 2 diabetes
Link  NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
Link  MHRA Safety Update: SGLT2 inhibitors - updated advice on the risk of diabetic ketoacidosis
Link  MHRA: Risk of Lower Limb Amputation
Link  MHRA: SGLT2 inhibitors - updated advice on increased risk of lower-limb amputation (mainly toes)
   
Empagliflozin and Metformin (Synjardy®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

1st line SGLT2i option for type 2 diabetes (dapagliflozin also first line)

Dapagliflozin has shown CV outcome benefit in primary prevention; empagliflozin, in secondary prevention

See SGLT2i checklistpatient information leaflet on DKA risk and OCCG letter to clinicians.

APCO November 2018.

 
Link  MHRA Safety Update: SGLT2 inhibitors - updated advice on the risk of diabetic ketoacidosis
   
Ertugliflozin (Steglatro®)
View adult BNF View SPC online View childrens BNF
Formulary
Brown

Second SGLT2i option as monotherapy or with metformin for treating type 2 diabetes, in line with NICE TA 572.

To review the formulary position when cardiovascular outcome data is available. See SGLT2i checklist, patient information leaflet on DKA risk and OCCG letter to clinicians

APCO May 2019.

 
Link  NICE TA572: Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes
   
Canagliflozin and Metformin (Vokanamet®)
View adult BNF View SPC online View childrens BNF
Formulary
Brown

Second line option SGLT2i - consider discussion with specialist team.

See SGLT2i checklist, patient information leaflet on DKA risk and OCCG letter to clinicians.

APCO November 2018.

 
Link  MHRA Safety Update: SGLT2 inhibitors - updated advice on the risk of diabetic ketoacidosis
Link  MHRA: SGLT2 inhibitors - updated advice on increased risk of lower-limb amputation (mainly toes)
   
Dapagliflozin and Metformin (Xigduo®)
View adult BNF View SPC online View childrens BNF
Formulary
Brown

1st line SGLT2i option for type 2 diabetes (empagliflozin also first line).

Dapagliflozin has shown CV outcome benefit in primary prevention; empagliflozin, in secondary prevention.

See SGLT2i checklist, patient information leaflet on DKA risk, and OCCG letter to clinicians.

APCO May 2019.

 
Link  MHRA Safety Update: SGLT2 inhibitors - updated advice on the risk of diabetic ketoacidosis
   
06.01.02.03  Thiazolidinediones
Pioglitazone
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Formulary

Green Traffic Light  For Type 2 Diabetes Mellitus.

APCO September 2016.

Red Traffic Light  Advanced liver fibrosis associated with non-alcoholic fatty liver disease (NAFLD) as per NICE NG49.

APCO July 2016.

 
Link  NICE NG49: Non-alcoholic fatty liver disease (NAFLD): assessment and management
Link  MHRA: Risk of bladder cancer with pioglitazone
Link  MHRA: Risk of cardiac failure when pioglitazone combined with insulin
   
Pioglitazone and Metfomin (Competact®)
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Formulary
Green

APCO September 2016.

 
   
06.01.03  Diabetic ketoacidosis
06.01.04  Treatment of hypoglycaemia
06.01.04  Chronic hypoglycaemia
06.01.05  Treatment of diabetic nephropathy and neuropathy to top
06.01.06  Diagnostic and monitoring agents for diabetes mellitus
06.01.06  Blood glucose monitoring
FreeStyle Libre®
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Formulary
Amber Continuation

Prescribers in primary care are requested to only prescribe Freestyle Libre® sensors on an NHS prescription, in line with OCCG policy, following receipt of an NHS diabetes specialist clinic request accompanied by a completed patient/carer agreement form. Prescribing should only be undertaken for 6 months unless the clinic confirms continuation for individual patients.

NB. Ensure patient agreement form is completed jointly by patient and NHS diabetes specialist:

APCO January 2018.

 
   
Blood glucose test strip (Accu-Chek® Active)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Accu-Chek® Performa )
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Advocate® Redi-Code+)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (AutoSense®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Betachek Visual®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (CareSens® Pro)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Contour®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Contour® TS)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Dario® Lite)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Element®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Finetest Lite®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Glucoflex-R®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoLab®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoMen® Areo Sensor)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Glucomen® GM)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoNavii® Glucose)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoRx Go®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoRx Nexus®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoRx Q®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Formerly GlucoRx Original Strips. 

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 

 
   
Blood glucose test strip (GlucoRx® HCT )
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoZen.auto®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GluNEO®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (i-Health®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Microdot®+)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Mylife Pura®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Mylife Unio®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Omnitest® 3)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Omnitest® 5)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (One Touch Select® Plus)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (One Touch Ultra®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Palmdoc®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Palmdoc® iCare Advanced)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (SD Codefree®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (SuperCheck Plus®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (SuperCheck2®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (SURESIGN Resure®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (TEE2®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (TRUEyou®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (VivaChek Ino®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (WaveSense JAZZ®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (WaveSense JAZZ® Duo)
View adult BNF View SPC online View childrens BNF
Formulary
Green

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Accu-Chek® Aviva)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Accu-Chek® Mobile)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Betachek C50®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Betachek G5®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (BGStar®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Breeze 2®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (CareSens® N)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Compact 3®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Contour® Next)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Dario®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (eBchek®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (FineTouch®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (FreeStyle Lite®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (FreeStyle Optium®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (FreeStyle®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoDock® Glucose)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoMen® LX Sensor)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoMen® Visio Sensor)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (IME-DC®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (MediSense® SoftSense)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (MediTouch 2®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (MediTouch®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Mendor Discreet®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (MODZ®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (MyGlucoHealth®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (On-Call Advanced®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (One Touch® Verio)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (One Touch® Vita)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Palmdoc® iCare Advanced Solo)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (Sensorcard®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (TRUEresult®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (TrueTrack® System)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
Blood glucose test strip (GlucoMen® Sensor)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

First line test strip is Finetest Lite. Other blood glucose meters with strips costing <£6 for 50 can also be considered first line.

Clinicians are encouraged to use cost-effective options unless there is a clear need to use other meters. See guidance on Choosing a Blood Glucose Monitoring Meter and Guideline for Blood Glucose Monitoring

APCO May 2019.

 
   
06.01.06  Urinalysis
Test Strips (GlucoMen areo Ketone Sensors®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

The Glucomen Areo 2k Meter is favoured at OCDEM and the Community Diabetes Service. Other cost-effective options are GlucoRx HCT Ketone Strips and KetoSens Ketone Strips.

See Ketone Testing And Sick Day Rules Guideline and ketone meter comparison table in Prescribing Point May 2017

APCO March 2017.

 
Test Strips (GlucoRx HCT Ketone Test Strips®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

The Glucomen Areo 2k Meter is favoured at OCDEM and the Community Diabetes Service. Other cost-effective options are GlucoRx HCT Ketone Strips and KetoSens Ketone Strips.

See Ketone Testing And Sick Day Rules Guideline and ketone meter comparison table in Prescribing Point May 2017

APCO March 2017.

 
Test Strips (KetoSens®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

The Glucomen Areo 2k Meter is favoured at OCDEM and the Community Diabetes Service. Other cost-effective options are GlucoRx HCT Ketone Strips and KetoSens Ketone Strips.

See Ketone Testing And Sick Day Rules Guideline and ketone meter comparison table in Prescribing Point May 2017

APCO March 2017.

 
Protein (Medi-Test® Protein 2)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Protein test strips (Albustix®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Test Strips (Diastix®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Test Strips (FreeStyle Optium ß-Ketone Test Strips®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

The Glucomen Areo 2k Meter is favoured at OCDEM and the Community Diabetes Service. Other cost-effective options are GlucoRx HCT Ketone Strips and KetoSens Ketone Strips.

See Ketone Testing And Sick Day Rules Guideline and ketone meter comparison table in Prescribing Point May 2017

APCO March 2017.

 
   
Test Strips (GlucoMen LX Ketone Test Strips®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

The Glucomen Areo 2k Meter is favoured at OCDEM and the Community Diabetes Service. Other cost-effective options are GlucoRx HCT Ketone Strips and KetoSens Ketone Strips.

See Ketone Testing And Sick Day Rules Guideline and ketone meter comparison table in Prescribing Point May 2017

APCO March 2017.

 
   
06.01.06  Oral glucose tolerance test
Polycal® Liquid
View adult BNF View SPC online View childrens BNF
Formulary
Green

The Oral Glucose Tolerance Test (OGTT) requires 75g of anhydrous glucose which is equivalent to 113 mL of Polycal Liquid. Dilute the Polycal liquid with extra fluid to a total volume of 200-300mL. See BNF for information.

 
   
06.02  Thyroid and Antithyroid drugs to top
06.02.01  Thyroid hormones
Levothyroxine
(Thyroxine)
View adult BNF View SPC online View childrens BNF
First Choice
Green

For treatment of primary hypothyroidism, see Management Guidelines - Thyroid Diseases.

 
Liothyronine
(Triiodothyronine)
View adult BNF View SPC online View childrens BNF
Formulary

Amber Traffic Light  Hypothyroidism for:

  • Patients currently receiving liothyronine monotherapy
  • Levothyroxine + liothyronine combination therapy for new patients with hypothyroidism
  • Patients currently receiving liothyronine and levothyroxine combination therapy

OCCG current local guidance has now been updated to be in line with the recently published RMOC guidance (June 2019). Shared care protocol is still in discussion with endocrinology.

Red Traffic Light Secondary care use only:

  • Liothyronine monotherapy: Oncology for Thyroid and parathyroid disease.

  • Liothyronine monotherapy or combination therapy for resistant depression.

APCO November 2019.

 
Link  British Thyroid Association-Frequently Asked Questions for GP’s
Link  British Thyroid Association-Frequently Asked Questions for patients
Link  British Thyroid Association-Information for Endocrinologists
Link  PrescQIPP: Switching liothyronine to levothyroxine
   
06.02.02  Antithyroid drugs
Carbimazole
View adult BNF View SPC online View childrens BNF
First Choice
Green

First line treatment for hyperthyroidism. See Management Guidelines - Thyroid Disease. 

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

Second line for hyperthyroidsm if Carbimazole cannot be tolerated. See Management Guidelines - Thyroid Diseases. 

 
Link  UKMI suggested drug monitoring schedule
   
Iodine and Iodide
(Aqueous iodine oral solution)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
Potassium Iodide 60mg capsules
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
06.03  Corticosteroids
06.03.01  Replacement therapy
Fludrocortisone
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
Link  NICE Evidence Summary - Postural hypotension
   
06.03.02  Glucocorticoid therapy to top
Betamethasone (Betnesol®)
(tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Dexamethasone
(Tablets/ Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Hydrocortisone
(tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Hydrocortisone sodium phosphate (Efcortesol®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Available as a ready to use solution, so may be more suitable for GP emergency bags than Solu-Cortef®.

 
   
Hydrocortisone sodium succinate (Solu-Cortef®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Available as a powder to be mixed with water for injection before use.

 
   
Prednisolone
(Replacement)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  UKMI: Prednisolone - Use plain, Not EC Tablets
Link  UKMI: Prednisolone - Use plain, Not Soluble Tablets
   
Betamethasone (Betnesol®)
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

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

Suitable for continuation in primary care following specialist initiation.

 
Link  NICE CG186: Multiple Sclerosis; management in primary and secondary care.
Link  Cochrane: Oral versus Intravenous Steroids for Treatment of Relapses in Multiple Sclerosis
   
06.04  Sex hormones
06.04.01  Female sex hormones and their modulators
06.04.01.01  Oestrogens and HRT
Combined continuous HRT patch (Evorel® Conti)
View adult BNF View SPC online View childrens BNF
First Choice
Green

First line transdermal option for combined continuous HRT treatment, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
Combined continuous HRT tablet (Kliovance®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

First line oral combined continuous HRT treatment, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
Combined cyclical HRT patch (Evorel® Sequi)
View adult BNF View SPC online View childrens BNF
First Choice
Green

First line transdermal sequential/ cyclical combined HRT option, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
Combined cyclical HRT tablet (Elleste-Duet®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

First line treatment option for sequential/ cyclical combined HRT treatment, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
Oestrogen only HRT patch (Evorel®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

First line transdermal option for oestrogen only HRT, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
Oestrogen only HRT tablet (Elleste-Solo®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

First line oral treatment for oestrogen only HRT, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
Oestrogens only HRT gel (Sandrena®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

Suitable if patient preference, skin allergy to patches or side effects, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
Combined cyclical HRT patch (FemSeven® Sequi)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

Alternative option if skin allergy or poor absorption with Evorel® Sequi, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
   
Combined cyclical HRT tablet (Femoston®, Prempak-C®)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

In line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

NB. Prempak-C has been discontinued.

 
   
Continuous combined HRT patch (FemSeven® Conti)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

Alternative option if skin allergy or poor absorption with Evorel®, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
   
Continuous combined HRT tablet (Indivina®,Angeliq®, Femoston® Conti, Premique® low dose)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

In line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

NB. Stock supply issues with Premique® Low Dose 0.3mg/1.5mg have been resolved. Premique® 0.625mg/5mg have been discontinued.

 
   
Oestrogens only HRT patch (Elleste-Solo® MX)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

Alternative option if skin allergy /poor absorption with Evorel, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
   
Oestrogens only HRT patch (Estradot®)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

Smaller sized patches consider for higher doses and petite women, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
   
Oestrogens only HRT tablet (Premarin®)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

Consider if previously well on conjugated equine oestrogen, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
   
Tibolone (Livial®)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

Consider if low libido, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
Link  MHRA: Information on breast cancer risks
   
06.04.01.01  Hormone replacement therapy
Bazedoxifene & conjugated oestrogens (Duavive®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation if intolerant to progestogens, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO November 2017.

 
   
06.04.01.01  Ethinylestradiol to top
06.04.01.01  Raloxifene
Raloxifene Hydrochloride (Evista®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

For the secondary prevention of osteoporotic fragility fractures in postmenopausal women as per NICE TA161:

  • In whom alendronate and either risedronate or editronate are contra-indicated or not tolerated and
  • Who also have a combination of T-score, age and number of independent clinical risk factors for fracture.


Raloxifene is not recommended as a treatment option in postmenopausal women for primary prevention of osteoporotic fractures.

 
Link  NICE TA160: Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women
Link  NICE TA161: Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women
   
06.04.01.01  Oestrogen only tablets
06.04.01.01  Oestrogens and progestogen sequential combined therapy
06.04.01.01  Continuous combined therapy
06.04.01.01  Gonadomimetic to top
06.04.01.01  Selective oestrogen modulator
06.04.01.02  Progestogens
Medroxyprogesterone Acetate (Provera®)
(HRT)
View adult BNF View SPC online View childrens BNF
Formulary
Green

As adjunctive progestogen in HRT treatment, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
   
Micronised Progesterone (Utrogestan®)
(Oral capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Green

As adjunctive progestogen in HRT treatment, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

 
   
Norethisterone (Utovlan®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Progesterone 400mg  (Cyclogest®)
(Pessary)
View adult BNF View SPC online View childrens BNF
Formulary

Amber Traffic Light  Suitable for continuation in primary care following specialist initiation, for prevention of pre-term labour.

Initiated by pre-term labour clinic at 12 weeks and continued by GP until 34 weeks gestation. 

 APCO May 2018. 

Black Traffic Light  Not recommended for fertility treatment. GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.
For use by Oxford Fertility Unit only.

 
   
06.04.02  Male sex hormones and antagonists
Mesterolone (Pro-Viron®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
Testosterone 2% gel (Tostran®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Shared Care Protocol

For testosterone replacement therapy in line with Shared Care Protocol.

APCO October 2014.

 
   
Testosterone 50mg/5g gel (Testim®)
View adult BNF View SPC online View childrens BNF
Formulary

NB. NOW DISCONTINUED, there may be some supply available.

Amber Traffic Light  For testosterone replacement therapy in line with Shared Care Protocol.

APCO October 2014.

Amber Traffic Light  To be initiated by menopause clinic for low libido in menopause / post-menopause when there is no improvement in symptoms on HRT alone. Use in line with Oxfordshire HRT formulary and treatment guidance. 

APCO November 2017.

 
   
Testosterone 50mg/5g gel (Testogel®)
View adult BNF View SPC online View childrens BNF
Formulary

Amber Traffic Light  For testosterone replacement therapy in line with Shared Care Protocol.

APCO October 2014.

Amber Traffic Light  To be initiated by menopause clinic for low libido in menopause / post-menopause when there is no improvement in symptoms on HRT alone. Use in line with Oxfordshire HRT formulary and treatment guidance. 

APCO November 2017.

 
   
Testosterone Undecanoate (Nebido®)
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Shared Care Protocol

For testosterone replacement therapy in line with Shared Care Protocol.

APCO October 2014.

 
   
06.04.02  Anti-androgens
Cyproterone Acetate
(Male hypersexuality)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
Finasteride
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  NICE CG97 Lower urinary tract symptoms in men: quick reference guide
Link  MHRA: Finasteride - rare reports of depression and suicidal thoughts
   
06.04.03  Anabolic steroids to top
06.04.04  Gender dysphoria
06.05  Hypothalamic and pituitary hormones and anti-oestrogens
06.05.01  Hypothalamic and anterior pituitary hormones and anti-oestrogens
06.05.01  Anti-oestrogens
Clomifene Citrate (Clomid®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

For anovulatory infertility and should only be prescribed by the treating consultant, in line with Clinical Commissioning Policy 11H.

GPs should not prescribe any fertility drugs.

 
   
06.05.01  Anterior pituitary hormones to top
Somatropin (Omnitrope®, Genotropin®)
View adult BNF View SPC online View childrens BNF
First Choice
Amber Shared Care Protocol
High Cost Medicine

First choice products for new patients who are eligible for treatment with growth hormone (in accordance with NICE guidance), in line with NHS South Central Guidance to Support Cost-effective Choice of Growth Hormone (Somatropin) Products.

For adult Shared Care Protocol, see here

For paediatric Shared Care Protocol, see here

(Other brands in the paediatric Shared Care Protocol include Humatrope®, Norditropin®, Nutropin®).

 
Somatropin (Saizen®)
View adult BNF View SPC online View childrens BNF
Second Choice
Amber Shared Care Protocol
High Cost Medicine

Reserved for those who have proven adherence problems,

in line with NHS South Central Guidance to Support Cost-effective Choice of Growth Hormone (Somatropin) Products.

For adult Shared Care Protocol, see here

For paediatric Shared Care Protocol, see here

(Other brands in the paediatric Shared Care Protocol include Humatrope®, Norditropin®, Nutropin®).

 
Link  NICE TA188: Somatropin for growth failure in children
Link  NICE TA64: Growth hormone deficiency (adults)
   
Somatropin  (Zomacton®)
View adult BNF View SPC online View childrens BNF
Second Choice
Amber Shared Care Protocol
High Cost Medicine

A needle free option reserved for those with needle phobia, in line with NHS South Central Guidance to Support Cost-effective Choice of Growth Hormone (Somatropin) Products.

For adult Shared Care Protocol, see here

For paediatric Shared Care Protocol, see here

 

(Other brands in the paediatric Shared Care Protocol include Humatrope®, Norditropin®, Nutropin®).

 
Link  NICE TA188: Somatropin for growth failure in children
Link  NICE TA64: Growth hormone deficiency (adults)
   
Choriogonadotropin Alfa (Ovitrelle®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only for treatment of male infertility.

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

APCO November 2018.

 
   
Menotrophin
(Human Menopausal Gonadotrophins)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only.

To induce ovulation in women who have not successfully recruited a follicle using other ovulation induction methods, and in male subfertility, to treat hypogonadotrophic hypogonadism to stimulate spermatogenesis.

APCO September 2018.

 
   
Tetracosactide (Synacthen®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only. 

 
   
06.05.01  Hypothalmic hormones
Gonadorelin
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
Protirelin (TRH)
View adult BNF View SPC online View childrens BNF
Unlicensed Drug Unlicensed
Red

Specialist prescribing only.

 
   
06.05.02  Posterior pituitary hormones and antagonists
Tolvaptan (Jinarc®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

For autosomal dominant polycystic kidney disease.

APCO May 2016.

 
Link  NICE TA358: Autosomal dominant polycystic kidney disease - tolvaptan
   
06.05.02  Posterior pituitary hormones
Desmopressin
View adult BNF View SPC online View childrens BNF
Formulary

Amber Traffic Light  For diabetes insipidus. 

Green Traffic Light  For nocturnal enuresis (oral preparation).

 
Link  NICE Evidence Summary: Desmopressin for nocturia in men
Link  Patient Safety Alert: Omission of desmopressin can be fatal
Link  Medicines for Children leaflet: Desmopressin for bedwetting
   
Desmopressin (Octim®)
(Nasal spray)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only for nocturnal enuresis.

APCO September 2005.

 
   
Terlipressin (Glypressin®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
Vasopressin (Pitressin®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
06.05.02  Antidiuretic hormone antagonists
06.06  Drugs affecting bone metabolism to top
06.06  Osteoporosis
06.06.01  Calcitonin and parathyroid hormone
Teriparatide (Forsteo®)
View adult BNF View SPC online View childrens BNF
Formulary
High Cost Medicine

Amber Traffic Light  For the secondary prevention of osteoporotic fragility fractures in postmenopausal women in line with Shared Care Protocol and Osteoporosis - Guidance for Fracture Risk Assessment and Prevention in Primary Care.

APCO May 2018.

Red Traffic Light For osteoporosis in Men. Funded by specialised commissioning.

APCO July 2019.

Black Traffic Light  Not recommended for:

  • Secondary prevention of osteoporotic fragility fractures in men in line with NICE TA 161 (APCO November 2012).
  • Non-union fractures in line with Clinical Commissioning Policy 252
 
   
06.06.02  Bisphosphonates and other drugs affecting bone metabolism
06.06.02  Bisphosphonates
Alendronic Acid 70mg tablets
View adult BNF View SPC online View childrens BNF
First Choice
Green

First line treatment for osteoporosis, see Guidance for Fracture Risk Assessment and Prevention in Primary Care.

APCO May 2018.

 
Risedronate Sodium 35mg tablets
View adult BNF View SPC online View childrens BNF
Second Choice
Green

For patients who cannot tolerate alendronic acid, as per Guidance for Fracture Risk Assessment and Prevention in Primary Care

APCO May 2018.

 
   
Sodium Clodronate
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation for breast cancer or myeloma patients with hypercalcaemia associated with skeletal metasteses.

APCO November 2006.

 
   
Ibandronic Acid
(50mg tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation:

 
Link  NICE Evidence Summary: Early breast cancer (preventing recurrence and improving survival): adjuvant bisphosphonates
   
Ibandronic Acid
(150mg tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Alternative option if Alendronate or Risedronate is not suitable, as per Guidance for Fracture Risk Assessment and Prevention in Primary Care.

APCO May 2018.

 
Link  NICE TA464: Bisphosphonates for treating osteoporosis
   
Ibandronic Acid 3mg injection (Bonviva®)
(Osteoporosis )
View adult BNF View SPC online View childrens BNF
Formulary
Red

For treating osteoporosis in line with Guidance for fracture risk assessment and prevention in primary care, as per NICE TA464.

APCO May 2018.

 
Link  NICE TA464: Bisphosphonates for treating osteoporosis
Link  MHRA: Osteonecrosis of the jaw - risk minimisation
   
Pamidronate Disodium
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  MHRA: Osteonecrosis of the jaw - risk minimisation
   
Zoledronic Acid 4mg (Zometa®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

For hypercalcaemia and skeletal events linked with malignancy.

See Guidelines for adjuvant biphosphonate treatment for post-menopausal women with early breast cancer (APCO November 2017). 

 
Link  MHRA: Osteonecrosis of the jaw - risk minimisation
Link  Osteonecrosis of the jaw patient reminder cards
   
Zoledronic Acid 5mg (Aclasta®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing for:

  • Treating osteoporosis as per NICE TA464 (APCO November 2017).
  • Steroid induced osteoporosis (third-line), if not tolerating risedronate 35mg. (APCO March 2010).
  • TPN induced osteoporosis (unlicensedunlicensed) (APCO June 2007).
  • Prevention and treatment of steroid induced osteoporosis and secondary prevention in men (APCO July 2017). 
 
Link  NICE TA464: Bisphosphonates for treating osteoporosis
Link  MHRA: Osteonecrosis of the jaw - risk minimisation
Link  Osteonecrosis of the jaw patient reminder cards
   
06.06.02  Denosumab to top
Denosumab (Prolia®)
(Osteoporosis)
View adult BNF View SPC online View childrens BNF
Formulary

Brown Traffic Light  Third line treatment for primary and secondary prevention of osteoporotic fractures in line with Denosumab for Osteoporosis in Primary Care Guidelines.

APCO May 2018. 

Black Traffic Light  For treatment of bone loss associated with hormone ablation in men with prostate cancer at increased risk of fractures. NB. This is under review.

APCO September 2010. 

 
Link  NICE CG175: https://www.nice.org.uk/guidance/CG175
Link  NICE TA204: Osteoporotic fractures - denosumab
Link  MHRA Safety Update: Osteonecrosis of the external auditory canal (June 17)
Link  MHRA: Osteonecrosis of the jaw - risk minimisation (July 2015)
Link  MHRA: Risk of osteonecrosis of the jaw and hypocalcaemia (September 14)
Link  MHRA Safety Update: Atypical femoral fracture with long-term use (Febuary 13)
Link  MHRA Safety Update: Hypocalcaemia - monitoring recommended (October 12)
   
Denosumab (XGEVA®)
(Metastases)
View adult BNF View SPC online View childrens BNF
Formulary

Red Traffic Light Secondary care use only

  • For the prevention of skeletal-related events in adults with bone metastases from solid tumours as per NICE TA265 (APCO November 2012).
  • For tumor induced hypercalcemia. Agreed at MMTC Oct 2019. (APCO November 2019).

Black Traffic Light  Not recommended for

  • preventing complications that result from prostate cancer spreading to the bone as per NICE TA265 (APCO November 2012).
  • preventing skeletal-related events in multiple myeloma as per NICE TA549 (APCO January 2019).
 
Link  NICE TA265: Bone metastases from solid tumours - denosumab: guidance
Link  MHRA Safety Update: Osteonecrosis of the external auditory canal (June 17)
Link  NICE TA549: Denosumab for preventing skeletal-related events in multiple myeloma (terminated appraisal)
Link  MHRA: Osteonecrosis of the jaw - risk minimisation (July 2015)
Link  MHRA: Risk of osteonecrosis of the jaw and hypocalcaemia (September 14)
   
06.06.02  Strontium renelate
06.07  Other endocrine drugs
06.07.01  Bromocriptine and other dopaminergic drugs
Bromocriptine
(Hyperprolactinaemia)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
Cabergoline
(Hyperprolactinaemia)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
06.07.02  Drugs affecting gonadotrophins
Danazol (Danol®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Following recommendation from a specialist.

 
   
06.07.02  Gonadorelin analogues to top
Triptorelin
(Central Precocious Puberty)
View adult BNF View SPC online View childrens BNF
First Choice
Amber Shared Care Protocol

Initiation by Paediatric Endocrinologist only for Central Precocious Puberty (CPP) in line with Shared Care Protocol.

APCO May 2011.

 
06.07.02  Breast pain (mastalgia)
06.07.03  Metyrapone
Metyrapone (Metopirone®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Specialist prescribing only.

 
   
06.07.04  Somatomedins
 ....
 Non Formulary Items
Albiglutide  (Eperzan®)

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

Not included in GLP-1 receptor agonist guidelines.

APCO January 2019.

 
Alendronic Acid with Colecalciferol  (Fosavance®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Armour thyroid®

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

Use of unlicensed thyroid extracts (e.g. Armour thyroid, ERFA Thyroid), plus compounded thyroid hormones, iodine containing preparations, dietary supplementation are not recommended. 

APCO November 2019.

Link   UKMI Q&A: What clinical evidence is there for “Armour thyroid” or desiccated thyroid extract?
 
Biosimilar Insulin Glargine  (Semglee®)

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

Concern that now three different glargine products available but not interchangeable. Still considerable generic prescribing that needs to be reviewed. To be reconsidered in 3-6 months once more work on generic prescribing has been done.

APCO July 2019.

 
Buserelin
(Central Precocious Puberty)

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

Not recommended in line with Central Precocious Puberty (CPP) Shared Care Protocol.

NB. Triptorelin is the only licensed gonadotrophin releasing hormone analogue for CPP.

APCO May 2011.

 
Calcitonin (salmon)
(Injection)

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

For the secondary prevention of osteoporotic fragility fractures in men.

APCO November 2012.

Link  EMA recommendation limiting long term use of calcitonin
Link  Restrictions on use of calcitonin
 
Cetrorelix  (Cetrotide®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

For use by Oxford Fertility Unit only. 

 
Chorionic Gonadotrophin  (Choragon®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Chorionic Gonadotrophin  (Pregnyl®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Corifollitropin Alfa  (Elonva®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Cortisone Acetate
(Cortisone)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dapagliflozin and Saxagliptin  (Qtern®)

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

Not recommended for use as not in line with NICE guidance. 

APCO May 2017. 

 
Deflazacort  (Calcort®)

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

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

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dutasteride  (Avodart®)

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

Please use finasteride.

No evidence of advantage over finasteride or that patients failing on finasteride will benefit from dutasteride.

APCO September 2011.

 
Erfa Thyroid®

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

Use of unlicensed thyroid extracts (e.g. Armour thyroid, ERFA Thyroid), plus compounded thyroid hormones, iodine containing preparations, dietary supplementation are not recommended. 

APCO November 2019.

 
Ethinylestradiol

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Follitropin Alfa  (Gonal-F®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Follitropin Alfa and Beta  (Puregon®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Follitropin Alfa biosimilar  (Bemfola®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Follitropin delta  (Rekovelle®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ganorelix  (Orgalutran®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Gestrinone  (Dimetriose®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Gliclazide  (Diamicron® MR)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
No clear evidence for using the MR formulation over the immediate release preparation.

 

APCO September 2011.
 
Glucagon  (GlucaGen® HypoKit)

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

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Goserelin
(Central Precocious Puberty)

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

Not recommended in line with Central Precocious Puberty (CPP) Shared Care Protocol.

NB. Triptorelin is the only licensed gonadotrophin releasing hormone analogue for CPP.

APCO May 2011.

 
Human Menopausal Gonadotrophins  (Menogon®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Hydrocortisone acetate  (Hydrocortisab®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Hydrocortisone MR  (Plenadren®)

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

No evidence of improved compliance.

APCO January 2013.

 
Ibandronic Acid IV infusion  (Bondronat®)

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

Not included in guideline.

APCO September 2014.

Link  MHRA: Osteonecrosis of the jaw - risk minimisation
Link  NICE TA464: Bisphosphonates for treating osteoporosis
 
Insulin 100units/mL  (Humulin® R)

View adult BNF View SPC online View childrens BNF
Non Formulary

Imported from United States. Humulin® S is the equivalent licensed preparation in the UK.

 
Ketoconazole  (Ketoconazole HRA)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
KEYA(r) Smart
(Blood glucose and Ketone test strip)

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

Specialists have not advised on appropriate patient group requiring combined strip. 

May be reviewed at a future meeting.

APCO November 2017.

 
Leuprorelin
(Central Precocious Puberty)

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

Not recommended in line with Central Precocious Puberty (CPP) Shared Care Protocol.

NB. Triptorelin is the only licensed gonadotrophin releasing hormone analogue for CPP.

APCO May 2011.

 
Lucozade®

View adult BNF View SPC online View childrens BNF
Non Formulary

Not NHS Not suitable for prescribing as not in the Drug Tariff. 

Lucozade® have reduced the glucose content in their drinks by almost 50% (from 17g of carbohydrate to 8.9g).

Patients should be advised to check the label of any product purchased to ensure that they are aware of the correct quantity to consume. 

 
Lutropin Alfa  (Luveris®)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Mecasermin  (Increlex®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
Link  Commissioning Policy - Mecasermin in Growth Failure
 
Medroxyprogesterone Acetate  (Climanor®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Micronised Progesterone  (Utrogestan®)
(Vaginal capsule)

View adult BNF View SPC online View childrens BNF
Non Formulary

GPs should not prescribe any fertility drugs as per Clinical Commissioning Policy 11G.

 
Nafarelin
(Non-malignant indications)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nandrolone  (Deca-Durabolin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nature Thyroid®

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

Use of unlicensed thyroid extracts (e.g. Armour thyroid, ERFA Thyroid), plus compounded thyroid hormones, iodine containing preparations, dietary supplementation are not recommended. 

APCO November 2019.

 
Oestrogen only HRT gel  (Oestrogel)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogen only HRT implant  (Estradiol)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Climagest®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Climaval®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Climesse®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Cyclo-Progynova®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Elleste-Duet Conti®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Estracombi®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Estraderm MX®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Estraderm TTS®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Estradiol®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Femapak®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Fematrix®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (FemSeven®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (FemTab®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (FemTab® Sequi)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Harmogen®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Hormonin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Menorin® 50)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Novofem®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Nuvelle®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Ovestin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Progynova®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Progynova® TS)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Tridestra®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Trisequens®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oestrogens for HRT  (Zumenon®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oral glucose tolerance test.  (Rapilose® OGTT)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Parathyroid Hormone  (Preotact®)

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

For the secondary prevention of osteoporotic fragility fractures in men as per NICE TA 161.

APCO November 2012.

 
Pasireotide

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Pegvisomant  (Somavert®)

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

Considered low priority for prescribing at Priorities Forum.

APCO September 2005.

 
Polycal® Powder

View adult BNF View SPC online View childrens BNF
Non Formulary

For OGTT see polycal liquid (above).

 
Prednisolone enteric-coated
(Replacement)

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

Lack of substantial evidence that they confer any GI benefits.

APCO January 2011.

Link  UKMI: Prednisolone - Use plain, Not EC Tablets
 
Prednisone MR
(Lodotra)

View adult BNF View SPC online View childrens BNF
Non Formulary