| Formulary Chapter 2: Cardiovascular system - Full Chapter
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| Chapter Links... |
 NICE CG107: Hypertension in pregnancy: diagnosis and management |
| NICE CG108: Chronic heart failure in adults: management |
| NICE CG126: Stable angina: management |
| NICE CG127: Hypertension in adults: diagnosis and management |
| NICE CG180: Atrial fibrillation: management |
| NICE CG68: Stroke and transient ischaemic attack in over 16s: diagnosis and initial management |
| NICE NG185; Acute coronary syndromes |
| Details... |
| 02.12 |
Lipid-regulating drugs |
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Alirocumab (Praluent®)
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Formulary
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In line with NICE.
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NICE TA393: Alirocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
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Bempedoic acid
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Formulary
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Evolocumab (Repatha®)
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Formulary
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In line with NICE.
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NICE TA394: Evolocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
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Inclisiran (Leqvio® )
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Formulary
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Inclisiran is covered by NICE TA 733.
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Inclisiran dosing and administration guide
 BCWB ICS CVD CLN Position Statement: Inclisiran (Leqvio). Approved 09/02/2022
Medicines Optimisation Pack for INCLISIRAN
Letter to accompany Inclisiran Medicines Optimisation pack October 2021
NICE TA733: Inclisiran for treating primary hypercholesterolaemia or mixed dyslipidaemia
Procurement guide Inclisiran
RCGP- BMA (December 2021): Information on the proposals for the prescription of inclisiran in primary care settings
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Volanesorsen
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Formulary
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| 02.12 |
Bile acid sequestrants |
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Colesevelam (Cholestagel®)
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Formulary
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Colestipol (Colestid®)
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Formulary
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Colestyramine
(Sachets)
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Formulary
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| 02.12 |
Ezetimibe |
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Ezetimibe (Ezetrol®)
(Tablets)
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Formulary
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In line with NICE.
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NICE TA385: Ezetimibe for treating primary heterozygous-familial and non-familial hypercholesterolaemia
NICE TA694: Bempedoic acid with ezetimibe for treating primary hypercholesterolaemia or mixed dyslipidaemia
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| 02.12 |
Fibrates |
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Bezafibrate
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Formulary
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Immediate release formulation
Modified release formulation
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Fenofibrate
(Tablets, Capsules)
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Formulary
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| 02.12 |
Statins |
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Atorvastatin
(Tablets)
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Formulary
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CG181: Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease
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Pravastatin
(Tablets)
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Formulary
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CG181: Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease
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Rosuvastatin
(Tablets)
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Formulary
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Restricted to patients unable to tolerate other low cost generic statins.
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CG181: Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease
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Simvastatin
(Tablets)
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Formulary
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CG181:Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease
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| 02.12 |
Nicotinic acid group |
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| 02.12 |
Omega-3 fatty acid compounds |
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Icosapent ethyl
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Formulary
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NICE TA805 :Icosapent ethyl with statin therapy for reducing the risk of cardiovascular events in people with raised triglycerides
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| 02.12 |
PCSK9 inhibitors |
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| 02.12 |
Other lipid modifying agents |
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Bempedoic acid with ezetimibe (Nustendi®)
(Tablets)
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Formulary
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In line with NICE
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NICE TA694: Bempedoic acid with ezetimibe for treating primary hypercholesterolaemia or mixed dyslipidaemia
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| .... |
| Non Formulary Items |
Acipimox
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Non Formulary
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Acipimox (Olbetam®)
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Non Formulary
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Ciprofibrate
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Non Formulary
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Colestyramine (Questran®, Questran® Light)
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Non Formulary
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Fluvastatin
(Capsules)
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Non Formulary
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CG181: Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease
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Fluvastatin (Lescol® XL)
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Non Formulary
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Fluvastatin m/r
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Non Formulary
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Gemfibrozil
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Non Formulary
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Gemifibrozil
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Non Formulary
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Gemifibrozil (Lopid®)
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Non Formulary
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Lomitapide (Lojuxta®)
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Non Formulary
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Nicotinic Acid
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Non Formulary
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Nicotinic acid/ laropiprant (Tredaptive ®)
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Non Formulary
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Omega-3-Acid Ethyl Esters (Omacor®)
(Capsules)
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Non Formulary
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Patient Information: Changes to omega-3 fatty acids prescribing
UKMI Q&A: Review of evidence dor dyslexia
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Omega-3-Marine Triglycerides (Maxepa)
(Capsules)
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Non Formulary
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Patient Information: Changes to omega-3 fatty acids prescribing
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Pravastatin Sodium (Lipostat®)
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Non Formulary
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Simvastatin (Zocor®)
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Non Formulary
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Simvastatin and Ezetimibe (Inegy®)
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Non Formulary
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Simvastatin with fenofibrate
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Non Formulary
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Key |
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Restricted Drug |
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Unlicensed |
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
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Cytotoxic Drug |
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Controlled Drug |
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High Cost Medicine |
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Cancer Drugs Fund |
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NHS England |
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Homecare |
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ICB |
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Low carbon footprint |
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Medium carbon footprint |
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High carbon footprint |
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| Status |
Description |
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All Settings
Suitable for initiation, ongoing prescribing, and discontinuation in both primary and secondary care settings. They are generally familiar, frequently used therapies that can be started within their licensed indications without specialist oversight. |
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Specialist only
Designated for initiation, ongoing prescribing, monitoring, exclusively by a specialists either in a hospital or as part of a specialist service (to note this could be in a non-hospital setting). Primary care should neither start nor continue these treatments except as part of a specialist service. A specialist could be either a medical or non-medical prescriber. |
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Specialist advice
Prescribers in primary care should seek advice and a recommendation from a specialists prior to initiating a medicine. Once agreed with a specialist, medicines can be initiated, prescribed and monitored in primary care without a formal shared-care agreement. |
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Specialist initiation
Medicines in this category require a specialist to start therapy, titrate dosage, and assess initial efficacy or tolerability. Once stabilised, prescribing responsibility may transfer to primary care without the need for a formal shared-care agreement. |
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Shared care agreement
Prescribing responsibility can be shared across health settings and between specialists and GPs only when formal shared care arrangement has been made. For example, there may be extensive and complex monitoring requirements or significant safety concerns (note would need a national policy on this to define the criteria for requiring a formal SCA), this will be produced once nationally. |
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Do not prescribe
Not approved for routine prescribing in primary or secondary care. For example, because they are agents classified in the BNF as “not NHS” or “Drugs of Low Clinical Value”, or they are products on NICE’s “do not do” list or NHS England’s “should not routinely prescribe” list. |
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Self Care
Not for routine prescribed in primary or secondary care unless as part of care for a long term condition. Instead, patients should be encouraged to self care with support from community pharmacy. |
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Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications |
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Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
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Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist. |
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Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only |
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Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
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