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 Formulary Chapter 6: Endocrine system - Full Chapter
Notes:

 

 

 

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06.01.01.02  Expand sub section  Intermediate- and long-acting insulins
Insulin glargine (Semglee®)
View adult BNF View SPC online View childrens BNF
First Choice
All settings

First line insulin for new patients initiated on insulin glargine 100units/ml and existing patients on Lantus

 
Insulin Detemir
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Formulary
All settings
  • Levemir FlexPen
  • Levemir InnoLet
  • Levemir Penfill
 
 
INSULIN GLARGINE
View adult BNF View SPC online View childrens BNF
Formulary
All settings

 

  • Abasaglar KwikPen
  • Lantus
  • Toujeo
  • Toujeo DoubleStar
 
Link  NICE NG17: Type 1 diabetes in adults: diagnosis and management
Link  For your patients who are currently prescribed Lantus®: A guide on how to use Lantus®.
Link  For your patients with diabetes who are currently prescribed Lantus ®: A step-by-step guide on how to use Lantus® SoloStar.
Link  For your patients with diabetes who are currently prescribed Toujeo® DoubleStar: A guide on how to use Toujeo® DoubleStar.
Link  For your patients with diabetes who are currently prescribed Toujeo® SoloStar: A guide on how to use Toujeo ® SoloStar.
 
Insulin Degludec (Tresiba Flextouch ®)
(200units/ml)
View adult BNF View SPC online View childrens BNF
Formulary

 

  • Tresiba FlexTouch 200units/ml

 Green Type I Diabetes

Amber Recommended Type II Diabetes

 
 
Insulin Degludec (Tresiba®)
View adult BNF View SPC online View childrens BNF
Formulary
Specialist initiation

 

  • Tresiba FlexTouch 100units/ml
  • Tresiba Penfill 100units/ml
 
 
Insulin degludec/liraglutide
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Formulary
Specialist initiation
 
 
Isophane Insulin
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Formulary
All settings

 

  • Humulin I
  • Humulin I KwikPen
  • Insulatard
  • Insulatard InnoLet
  • Insulatard Penfill
  • Insuman Basal
  • Insuman Basal SoloStar

 

 

 
Link  For your patients with diabetes who are currently prescribed Insuman® Basal: A step-by-step guide on how to use Insuman® Basal SoloStar.
 
06.01.01.02  Expand sub section  Biphasic insulins
Biphasic Insulin Aspart
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Formulary
All settings

BRANDS

  • NovoMix 30 FlexPen
  • NovoMix 30 Penfill
 
 
Biphasic Insulin Lispro
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Formulary
All settings

BRANDS

  • Humalog Mix25
  • Humalog Mix25 KwikPen
  • Humalog Mix50
  • Humalog Mix50 KwikPen
 
 
Biphasic Isophane Insulin
View adult BNF View SPC online View childrens BNF
Formulary
All settings

BRANDS

  • Humulin M3
  • Humulin M3 KwikPen
 
 
Biphasic Isophane Insulin (Insuman Comb® )
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Formulary
All settings

Insuman comb 25

Insuman comb 50

 

 

 
 
Insulin Lispro
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Formulary
All settings
  • Admelog
  • Humalog 100units/ml
  • Humalog KwikPen
  • Lyumjev
  • Lyumjev KwikPen
  • Lyumjev Junior KwikPen
 
 
06.01.01.02  Expand sub section  Intermediate Acting Insulin
06.01.01.02  Expand sub section  Long Acting Insulin Analogues
 ....
 Non Formulary Items
Biphasic Isophane Insulin  (Hypurin Porcine 30/70 Mix®)

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Non Formulary
Do not prescribe
Biphasic Isophane Insulin  (Mixtard® 30)

View adult BNF View SPC online View childrens BNF
Non Formulary
Do not prescribe
Insulin degludec with insulin aspart  (DegludecPlus)

View adult BNF View SPC online View childrens BNF
Non Formulary
Insulin glargine 100units/ml  (Abasaglar ®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Do not prescribe

Cost price is more than originator April 2023 DM+d
and DT Abasaglar (£35.28); Lantus (£34.75)

Link  NICE NG17: Type 1 diabetes in adults: diagnosis and management
Insulin Zinc suspension  (Hypurin®Bovine Lente)

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Non Formulary
Do not prescribe

For existing patients only

Discontinued July 2017

Isophane Insulin  (Hypurin Bovine Isophane®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Do not prescribe
Isophane Insulin  (Hypurin Porcine Isophane®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Do not prescribe

For existing patients only

Isophane Insulin  (Pork Insulatard®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Protamine Zinc Insulin  (Hypurin® Bovine Protamine Zinc)

View adult BNF View SPC online View childrens BNF
Non Formulary
Do not prescribe

For existing patients only

Discontinued July 2017

  
Key
Restricted Drug Restricted Drug
Unlicensed Drug Unlicensed
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
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
ICB
ICB
Green Low Carbon

Low carbon footprint

Amber Medium Carbon

Medium carbon footprint

Red High carbon footprint

High carbon footprint

Status Description

All settings

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.  

Specialist only

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.  

Specialist advice

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.   

Specialist initiation

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.  

Shared care agreement

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.  

Do not prescribe

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.  

Self Care

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.   

Green

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  

Amber Initiation

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.  

Amber SC

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.  

Amber Recommended

Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist.  

Red

Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only  

Grey

Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

Black

Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

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