netFormulary Oxfordshire Clinical Commissioning Group NHS
Formulary  
 Search
 Formulary Chapter 6: Endocrine system - Full Chapter
06.01.02.03  Expand sub section  Other antidiabetic drugs
06.01.02.03  Expand sub section  Alpha glucosidase inhibitors
Acarbose (Glucobay®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

APCO September 2016.

 
   
06.01.02.03  Expand sub section  DPP4 inhibitors (gliptins)
Alogliptin (Vipidia▼®)
View adult BNF View SPC online View childrens BNF
First Choice
Green

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
Alogliptin and Metformin (Vipdomet®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Alogliptin and Pioglitazone (Incresync®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Linagliptin (Trajenta®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

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

APCO November 2018. 

 
   
Linagliptin and Metformin (Jentadueto®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

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

APCO November 2018. 

 
   
Saxagliptin (Onglyza®)
View adult BNF View SPC online View childrens BNF
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®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Sitagliptin (Januvia®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Sitagliptin and Metformin (Janumet®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
Vildagliptin (Galvus®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

Alogliptin is first choice DPP4i. See OCCG DPP4i switch protocol

APCO November 2018. 

 
   
06.01.02.03  Expand sub section  GLP1 agonists
Liraglutide 1.2mg (Victoza®)
View adult BNF View SPC online View childrens BNF
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®)
View adult BNF View SPC online View childrens BNF
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®)
View adult BNF View SPC online View childrens BNF
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▼®)
View adult BNF View SPC online View childrens BNF
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▼®)
View adult BNF View SPC online View childrens BNF
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 guidelines. See patient agreement form.

APCO September 2019.

 
Link  MHRA: Risk of severe pancreatitis and renal failure with Exenatide
Link  NICE TA248: MR exenatide
   
Lixisenatide (Lyxumia▼®)
View adult BNF View SPC online View childrens BNF
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®)
View adult BNF View SPC online View childrens BNF
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  Expand sub section  Meglitinides to top
Nateglinide (Starlix®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

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

APCO September 2016.

 
   
Repaglinide
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Brown

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

APCO September 2016.

 
   
06.01.02.03  Expand sub section  SGL2 inhibitors
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
   
Sotagliflozin
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Use with insulin for treating type 1 diabetes as per NICE TA622. Drug is not available yet in the UK - once available this will be discussed again at APCO. 

APCO March 2020.

 
Link  NICE TA622: Sotagliflozin with insulin for treating type 1 diabetes
   
06.01.02.03  Expand sub section  Thiazolidinediones
Pioglitazone
View adult BNF View SPC online View childrens BNF
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®)
View adult BNF View SPC online View childrens BNF
Formulary
Green

APCO September 2016.

 
   
 ....
 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.

 
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. 

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

Traffic Light Status Information

Status Description

Red

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

Amber Continuation

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

Amber Shared Care Protocol

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

Green

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

Brown

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

Black

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

OCCG Green

not used  

netFormulary