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 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
06.01.02.03  Expand sub section  DPP4 inhibitors (gliptins)
06.01.02.03  Expand sub section  GLP1 agonists
06.01.02.03  Expand sub section  Meglitinides to top
06.01.02.03  Expand sub section  SGL2 inhibitors
Dapagliflozin (Forxiga▼®)
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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▼®)
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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▼®)
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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®)
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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®)
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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®)
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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®)
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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
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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
 ....
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  

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