| Formulary Chapter 6: Endocrine system - Full Chapter
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| Chapter Links... |
 NICE Guidance on prescribing |
| NICE NG28: Type 2 diabetes in adults: management |
| DVLA guidance |
| Details... |
| 06.04.01 |
Female sex hormones and their modulators |
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| 06.04.01.01 |
Oestrogens and HRT |
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Evorel Conti®
(Patch)
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First Choice
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Evorel Sequi®
(Patch)
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First Choice
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Evorel®
(Patch)
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First Choice
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Femseven Conti®
(Patch)
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Second Choice
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Femseven Sequi®
(Patch)
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Second Choice
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2nd line to Evorel Sequi®
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COMBINED CYCLICAL HRT
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Formulary
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BRANDS
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Elleste Solo
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Formulary
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Elleste-Duet Conti®
(Tablets)
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Formulary
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Clinorette®
(Tablets)
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Formulary
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Estraderm MX®
(Patches)
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Formulary
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Estradot®
(Patches)
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Formulary
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Estriol® 0.01%
(Cream)
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Formulary
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Femseven ®
(Patch)
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Formulary
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Kliofem®
(Tablets)
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Formulary
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Kliovance®
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Formulary
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Lubion®
(Injection)
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Formulary
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Fertility use only
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Novofem®
(Tablets)
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Formulary
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Ovestin ®
(Cream)
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Formulary
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Premarin®
(Tablets)
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Formulary
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Premique® low dose
(Tablets)
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Formulary
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Tridestra®
(Tablets)
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Formulary
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Zumenon®
(Tablets)
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Formulary
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Indivina®
(Tablets)
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Formulary
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Premique® modified release
(Tablets)
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Formulary
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Progynova®
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Formulary
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Progynova® 1mg and 2mg tablets
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Climanor®
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Formulary
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| 06.04.01.01 |
Hormone replacement therapy |
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| 06.04.01.01 |
Ethinylestradiol |
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Ethinylestradiol
(Tablets)
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Formulary
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| 06.04.01.01 |
Raloxifene |
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Raloxifene
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Formulary
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NICE TA 160 Raloxifene for the primary prevention of osteoporotic fragility fractures in postmenopausal women
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| 06.04.01.01 |
Oestrogen only tablets |
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| 06.04.01.01 |
Oestrogens and progestogen sequential combined therapy |
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| 06.04.01.01 |
Continuous combined therapy |
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| 06.04.01.01 |
Gonadomimetic |
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| 06.04.01.01 |
Selective oestrogen modulator |
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| 06.04.01.02 |
Progestogens |
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Medroxyprogesterone Acetate (Climanor®)
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Formulary
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Medroxyprogesterone Acetate (Depo -Provera®)
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Formulary
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Medroxyprogesterone Acetate (Provera®)
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Formulary
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Medroxyprogesterone Acetate (Sayana press®)
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Formulary
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Suitable for self injection in patients who have had appropriate tranining
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Progesterone
(Pessary)
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Formulary
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BRANDS
- Cyclogest pessary
- Lutigest pessary
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Progesterone (micronised) (Utrogestan ®)
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Formulary
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| Non Formulary Items |
Bazedoxifene/Conjugated Oestrogens (Duavive®)
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Non Formulary
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BMS- guidance on HRT prescribing
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Climagest
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Non Formulary
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Climaval®
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Non Formulary
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Cyclo-Progynova®
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Non Formulary
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Dienogest
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Non Formulary
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BRANDS
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Dydrogesterone (Duphaston®)
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Non Formulary
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Dysrogesterone (Duphaston® HRT)
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Non Formulary
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Estradiol with progesterone continuous tablets for HRT (Angeliq®)
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Non Formulary
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Hormonin®
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Non Formulary
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Norethisterone (Micronor®HRT)
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Non Formulary
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Nuvelle Continous tablets
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Non Formulary
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Primolut N®
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Non Formulary
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Progesterone Injection (Gestone®)
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Non Formulary
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Ulipristal acetate (Esmya®)
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Non Formulary
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MHRA March 2020 Esmya (ulipristal acetate): suspension of the licence due to risk of serious liver injury
July 2018 - Traffic light status amended to RED in light of EMA update
Esmya: new measures to minimise risk of rare but serious liver injury
The only indication approved for use by the APC is
pre-operative treatment of moderate to severe symptoms of uterine fibroids (1 course). |
EMA June 2018: Esmya: new measures to minimise risk of rare but serious liver injury
MHRA February 2018: Esmya (ulipristal acetate) for uterine fibroids: do not initiate or re-start treatment; monitor liver function in current and recent users
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Utrogestan® Vaginal Capsules
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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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